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Value-based healthcare

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https://www.readbyqxmd.com/read/28918407/burden-of-non-adherence-to-latent-tuberculosis-infection-drug-therapy-and-the-potential-cost-effectiveness-of-adherence-interventions-in-canada-a-simulation-study
#1
Anik R Patel, Jonathon R Campbell, Mohsen Sadatsafavi, Fawziah Marra, James C Johnston, Kirsten Smillie, Richard T Lester
OBJECTIVE: Pharmaceutical treatment of latent tuberculosis infection (LTBI) reduces the risk of progression to active tuberculosis (TB); however, poor adherence tempers the protective effect. We aimed to estimate the health burden of non-adherence, the maximum allowable cost of hypothetical new adherence interventions to be cost-effective and the potential value of existing adherence interventions for patients with low-risk LTBI in Canada. DESIGN: A microsimulation model of LTBI progression over 25 years...
September 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28916490/decision-making-about-healthcare-related-tests-and-diagnostic-strategies-a-systematic-review-shows-limitations-in-most-tools-designed-to-assess-quality-and-develop-recommendations
#2
Reem A Mustafa, Wojtek Wiercioch, Maicon Falavigna, Yuan Zhang, Liudmila Ivanova, Ingrid Arevalo-Rodriguez, Adrienne Cheung, Barbara Prediger, Matthew Ventresca, Jan Brozek, Nancy Santesso, Patrick Bossuyt, Amit X Garg, Nancy Lloyd, Monika Lelgemann, Diedrich Bühler, Holger J Schünemann
OBJECTIVES: To identify and describe critical appraisal tools designed for assessing the quality of evidence (QoE) and/or strength of recommendations (SoR) related to healthcare related tests and diagnostic strategies (HCTDS). STUDY DESIGN: and Settings: We conducted a systematic review to identify tools applied in guidelines, methodological articles, and systematic reviews to assess HCTDS. RESULTS: We screened 5534 titles and abstracts, 1004 full text articles, and abstracted data from 330 references...
September 12, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28914125/mobilizing-cross-sector-community-partnerships-to-address-the-needs-of-criminal-justice-involved-older-adults-a-framework-for-action
#3
Lia Metzger, Cyrus Ahalt, Margot Kushel, Alissa Riker, Brie Williams
Purpose The rapidly increasing number of older adults cycling through local criminal justice systems (jails, probation, and parole) suggests a need for greater collaboration among a diverse group of local stakeholders including professionals from healthcare delivery, public health, and criminal justice and directly affected individuals, their families, and advocates. The purpose of this paper is to develop a framework that local communities can use to understand and begin to address the needs of criminal justice-involved older adults...
September 11, 2017: International Journal of Prisoner Health
https://www.readbyqxmd.com/read/28914122/improving-health-in-prisons-from-evidence-to-policy-to-implementation-experiences-from-the-uk
#4
Jane Leaman, Anna Amelia Richards, Lynn Emslie, Eamonn Joseph O'Moore
Purpose The purpose of this paper is to understand the components of a high-quality prison healthcare system and the impact, ten-years on, of the transfer of accountability in England, from a justice ministry to a health ministry. Design/methodology/approach A rapid the evidence review was undertaken, which included a review of 82 papers and qualitative interviews with key informants. The concepts and themes identified were summarised and analysed through a framework analysis, designed to improve population outcomes and address health inequalities...
September 11, 2017: International Journal of Prisoner Health
https://www.readbyqxmd.com/read/28914121/evidence-based-recommendations-to-improve-reproductive-healthcare-for-incarcerated-women
#5
Andrea Knittel, Angeline Ti, Sarah Schear, Megan Comfort
Purpose The purpose of this paper is to describe standards for evidence-based reproductive healthcare for incarcerated women. Design/methodology/approach The literature on reproductive healthcare in the US criminal justice system and recommendations from professional organizations were reviewed and critical areas of concern were identified. Within these areas, studies and expert opinion were synthesized and policy recommendations were formulated through an iterative process of group discussion and document revision...
September 11, 2017: International Journal of Prisoner Health
https://www.readbyqxmd.com/read/28914118/universal-opt-out-screening-for-hepatitis-c-virus-hcv-within-correctional-facilities-is-an-effective-intervention-to-improve-public-health
#6
Meghan D Morris, Brandon Brown, Scott A Allen
Purpose Worldwide efforts to identify individuals infected with the hepatitis C virus (HCV) focus almost exclusively on community healthcare systems, thereby failing to reach high-risk populations and those with poor access to primary care. In the USA, community-based HCV testing policies and guidelines overlook correctional facilities, where HCV rates are believed to be as high as 40 percent. This is a missed opportunity: more than ten million Americans move through correctional facilities each year. Herein, the purpose of this paper is to examine HCV testing practices in the US correctional system, California and describe how universal opt-out HCV testing could expand early HCV detection, improve public health in correctional facilities and communities, and prove cost-effective over time...
September 11, 2017: International Journal of Prisoner Health
https://www.readbyqxmd.com/read/28911323/exploring-how-different-modes-of-governance-act-across-health-system-levels-to-influence-primary-healthcare-facility-managers-use-of-information-in-decision-making-experience-from-cape-town-south-africa
#7
Vera Scott, Lucy Gilson
BACKGROUND: Governance, which includes decision-making at all levels of the health system, and information have been identified as key, interacting levers of health system strengthening. However there is an extensive literature detailing the challenges of supporting health managers to use formal information from health information systems (HISs) in their decision-making. While health information needs differ across levels of the health system there has been surprisingly little empirical work considering what information is actually used by primary healthcare facility managers in managing, and making decisions about, service delivery...
September 15, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28906237/exploring-context-and-the-factors-shaping-team-based-primary-healthcare-policies-in-three-canadian-provinces-a-comparative-analysis
#8
Renée Misfeldt, Esther Suter, Sara Mallinson, Omenaa Boakye, Sabrina Wong, Louise Nasmith
This paper discusses findings from a high-level scan of the contextual factors and actors that influenced policies on team-based primary healthcare in three Canadian provinces: British Columbia, Alberta and Saskatchewan. The team searched diverse sources (e.g., news reports, press releases, discussion papers) for contextual information relevant to primary healthcare teams. We also conducted qualitative interviews with key health system informants from the three provinces. Data from documents and interviews were analyzed qualitatively using thematic analysis...
August 2017: Healthcare Policy, Politiques de Santé
https://www.readbyqxmd.com/read/28902122/on-p-values-and-effect-modification
#9
Martin Mayer
AIM: A crucial element of evidence-based healthcare is the sound understanding and use of statistics. As part of instilling sound statistical knowledge and practice, it seems useful to highlight instances of unsound statistical reasoning or practice, not merely in captious or vitriolic spirit, but rather, to use such error as a springboard for edification by giving tangibility to the concepts at hand and highlighting the importance of avoiding such error. This article aims to provide an instructive overview of two key statistical concepts: effect modification and P values...
September 8, 2017: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/28901341/-healthcare-services-citizen-s-right-and-healthcare-systems-safeguard-considerations-rising-from-the-charlie-gard-story
#10
Giuseppe R Gristina
The story of Charlie Gard, an 11-month-old boy suffering from a rare inherited mitochondrial disease called 'infantile encephalomyopathic mitochondrial DNA depletion syndrome' and kept alive thanks to life supports, rises some issues regarding the provision of healthcare. Is there a right of an individual person to buy any healthcare benefits only because he has enough money to do so? If the answer is 'yes', in light of the distributive justice principle how do governments balance this right with the obligation to regulate health care systems ensuring that all treatments are useful and affordable for everybody? Many considerations of the best interest of patients can be found in this debate, but we cannot ignore neither the value of the scientific method as the cornerstone of the medical profession nor a commitment to support the moral integrity of clinical practice by refusing to provide treatments that do not meet a reasonable threshold of scientific justification evidence-based...
September 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28900493/a-multi-center-prospective-study-to-validate-an-algorithm-using-urine-and-plasma-biomarkers-for-predicting-gleason-%C3%A2-3-4-prostate-cancer-on-biopsy
#11
Maher Albitar, Wanlong Ma, Lars Lund, Babak Shahbaba, Edward Uchio, Soren Feddersen, Donald Moylan, Kirk Wojno, Neal Shore
Background: Unnecessary biopsies and overdiagnosis of prostate cancer (PCa) remain a serious healthcare problem. We have previously shown that urine- and plasma-based prostate-specific biomarkers when combined can predict high grade prostate cancer (PCa). To further validate this test, we performed a prospective multicenter study recruiting patients from community-based practices. Patients and Methods: Urine and plasma samples from 2528 men were tested prospectively. Results were correlated with biopsy findings, if a biopsy was performed as deemed necessary by the practicing urologist...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28898574/integrating-kidney-transplantation-into-value-based-care-for-people-with-renal-failure
#12
Benjamin E Hippen, Franklin W Maddux
Healthcare reimbursement is increasingly tied to value instead of volume, with special attention paid to resource-intensive populations such as patients with renal disease. To this end, Medicare has sponsored pilot projects to encourage providers to develop care coordination and population health management strategies to provide quality care while reducing resource utilization. In this Personal Viewpoint essay, we argue in favor of expanding one such pilot project-the Comprehensive ESRD Care (CEC) initiative-to include patients with advanced chronic kidney disease and kidney transplant recipients...
September 12, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28898341/-shared-decision-making-in-patients-with-diabetes-mellitus
#13
Valentina Serrano, Laura Larrea-Mantilla, René Rodríguez-Gutiérrez, Gabriela Spencer-Bonilla, Germán Málaga, Ian Hargraves, Víctor M Montori
Patients with diabetes mellitus often have several medical problems and carry a burden imposed by their illness and treatment. Health care often ignores the values, preferences and context of patients, leading to treatments that do not fit into patients’ overwhelmed lives. Shared Decision Making (SDM) emerges as a way to answer the question: “What’s best for the patient?”. SDM promotes an empathic conversation between patients and clinicians that integrates the best evidence available with their values, preferences and context...
May 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28894546/nurses-perception-of-the-strategies-to-gaining-professional-power-a-qualitative-study
#14
Rana Rezai Sepasi, Fariba Borhani, Abbas Abbaszadeh
BACKGROUND: Power in nursing is a broad concept that has a determining effect on the achievement of professional goals. Gaining power is essential for promoting the roles of nurses, improving their professional image and the consistent improvement of healthcare systems. OBJECTIVES: This study was conducted to identify and clarify strategies for gaining power in the nursing profession through the experiences of Iranian nurses. METHODS: The present qualitative grounded theory study was conducted on fifteen participants selected through purposive sampling...
July 2017: Electronic Physician
https://www.readbyqxmd.com/read/28893767/gps-perceptions-of-resilience-training-a-qualitative-study
#15
Anna Cheshire, John Hughes, George Lewith, Maria Panagioti, David Peters, Chantal Simon, Damien Ridge
BACKGROUND: GPs are reporting increasing levels of burnout, stress, and job dissatisfaction, and there is a looming GP shortage. Promoting resilience is a key strategy for enhancing the sustainability of the healthcare workforce and improving patient care. AIM: To explore GPs' perspectives on the content, context, and acceptability of resilience training programmes in general practice, in order to build more effective GP resilience programmes. DESIGN AND SETTING: This was a qualitative study of the perspectives of GPs currently practising in England...
September 11, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28891284/a-highly-stretchable-nanofiber-based-electronic-skin-with-pressure-strain-and-flexion-sensitive-properties-for-health-and-motion-monitoring
#16
Kun Qi, Jianxin He, Hongbo Wang, Yuman Zhou, Xiaolu You, Nan Nan, Weili Shao, Lidan Wang, Bin Ding, Shizhong Cui
The development of flexible and stretchable electronic skins that can mimic the complex characteristics of natural skin is of great value for applications in human motion detection, healthcare, speech recognition, and robotics. In this work, we propose an efficient and low-cost fabrication strategy to construct a highly sensitive and stretchable electronic skin that enables the detection of dynamic and static pressure, strain, and flexion based on an elastic graphene oxide(GO) doped polyurethane (PU) nanofiber membrane with an ultrathin conductive poly(3,4-ethylenedioxythiophene) (PEDOT) coating layer...
September 11, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28891171/innovation-in-health-service-management-adoption-of-project-management-offices-to-support-major-health-care-transformation
#17
Mélanie Lavoie-Tremblay, Monique Aubry, Guylaine Cyr, Marie-Claire Richer, Jean-François Fortin-Verreault, Claude Fortin, Caroline Marchionni
AIM: To explore the characteristics that influence project management offices acceptance and adoption in healthcare sector. BACKGROUND: The creation of project management offices has been suggested as a promising avenue to promote successful organisational change and facilitate evidence-based practice. However, little is known about the characteristics that promote their initial adoption and acceptance in health care sector. This knowledge is important in the context where many organisations are considering implementing project management offices with nurse managers as leaders...
September 10, 2017: Journal of Nursing Management
https://www.readbyqxmd.com/read/28889817/a-systematic-approach-for-assessing-in-the-absence-of-full-evidence-whether-multicomponent-interventions-can-be-more-cost-effective-than-single-component-interventions
#18
Janne C Mewes, Lotte M G Steuten, Maarten J IJzerman, Wim H van Harten
OBJECTIVES: Multicomponent interventions (MCIs), consisting of at least two interventions, are common in rehabilitation and other healthcare fields. When the effectiveness of the MCI versus that of its single interventions is comparable or unknown, evidence of their expected incremental cost-effectiveness can be helpful in deciding which intervention to recommend. As such evidence often is unavailable this study proposes an approach to estimate what is more cost-effective; the MCI or the single intervention(s)...
September 11, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/28888565/the-use-of-echocardiography-for-pediatric-patients-presenting-with-syncope
#19
Jonathan H Pelletier, Sarah Blanchard, Reid C Chamberlain, Christoph P Hornik, Michael J Campbell, Kevin D Hill
OBJECTIVES: To assess the frequency, yield, and cost of echocardiograms meeting "rarely appropriate" criteria. STUDY DESIGN: Retrospective, single-center study of pediatric patients presenting with syncope. Patients were categorized according to the appropriate use criteria and based upon location of care (emergency department only, primary care setting only, or referred to a pediatric cardiologist). Multivariable regression was used to determine factors associated with performance of a "rarely appropriate" echocardiogram...
September 6, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28887347/pharmacists-supporting-population-health-in-patient-centered-medical-homes
#20
Antoinette B Coe, Hae Mi Choe
PURPOSE: The integral role of pharmacists in supporting population health initiatives in the patient-centered medical home (PCMH) model of care is described. SUMMARY: Population health initiatives focus on the health outcomes of a group of patients; in the PCMH model, such groups of patients, known as panels, may be defined as patients assigned to a care team or provider. The basic characteristics of the PCMH model include physician-led, team-based practice; coordinated and integrated care within the PCMH and in the patient's community; provision of safe, evidence-based, high-quality care; incorporation of health information technology and continuous quality improvement strategies into panel identification, documentation, and care processes; improved access to care (e...
September 15, 2017: American Journal of Health-system Pharmacy: AJHP
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