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https://www.readbyqxmd.com/read/28930900/retrospective-evaluation-of-the-impact-of-a-geriatric-trauma-institute-on-fragility-hip-fracture-patient-outcomes
#1
Elizabeth D Katrancha, Jami Zipf, Nancy Abrahams, Richard Schroeder
BACKGROUND: Fragility hip fractures occur in the older than 65-year population at an alarming rate. It is estimated that 260,000 hip fractures occur annually. Patient outcomes following hip fractures are devastating. One of every 5 patients dies within 1 year of injury, and 1 of 3 remains in a nursing home for years after the injury. Published literature recommends an interdisciplinary approach to caring for hip-fractured patients and expediting surgery to improve outcomes. PURPOSE: The purpose of this study was to retrospectively evaluate the impact of the Geriatric Trauma Institute (GTI) on fragility hip fracture patient outcomes...
September 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28922266/time-to-asthma-related-readmission-in-children-admitted-to-the-icu-for-asthma
#2
Sze Man Tse, Christian Samson
OBJECTIVES: To compare the time to asthma-related readmissions between children with a previous ICU hospitalization for asthma and those with a non-ICU hospitalization and to explore predictors of time to readmission in children admitted to the ICU. DESIGN: Retrospective cohort study using a pan-Canadian administrative inpatient database from April 1, 2008, to March 31, 2014. SETTING: All adult and pediatric Canadian hospitals. SUBJECTS: Children 2-17 years old with a hospitalization for asthma...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28914276/appropriate-reconciliation-of-cardiovascular-medications-after-elective-surgery-and-postdischarge-acute-hospital-and-ambulatory-visits
#3
Jonathan S Lee, Ralph Gonzales, Eric Vittinghoff, Kitty K Corbett, Kirsten E Fleischmann, Neil Sehgal, Andrew D Auerbach
OBJECTIVE: To describe appropriate discharge reconciliation of cardiovascular medications and assess associations with postdischarge healthcare utilization in surgical patients. DESIGN: Retrospective cohort study from January 2007 to December 2011. SETTING: An academic medical center. PATIENTS: Seven hundred and fifty-two adults undergoing elective noncardiac surgery and taking antiplatelet agents, beta-blockers, renin-angiotensin system inhibitors, or statin lipid-lowering agents before surgery...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28906495/effects-of-a-transition-home-program-on-preterm-infant-emergency-room-visits-within-90-days-of-discharge
#4
B Vohr, E McGowan, L Keszler, M O'Donnell, K Hawes, R Tucker
OBJECTIVE: To evaluate effects of a transition home program (THP) and risk factors on emergency room (ER) use within 90 days of discharge for preterm (PT) infants <37 weeks gestation. STUDY DESIGN: This is a prospective 3-year cohort study of 804 mothers and 954 PT infants. Mothers received enhanced neonatal intensive care unit transition support services until 90 days postdischarge. Regression models were run to identify the effects of THP implementation year and risk factors on ER visits...
September 14, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28899986/perioperative-spending-on-spinal-fusion-for-scoliosis-for-children-with-medical-complexity
#5
Jay G Berry, Michael Glotzbecker, Jonathan Rodean, Izabela Leahy, Joanne Cox, Sara J Singer, Margaret O'Neill, Matt Hall, Lynne Ferrari
BACKGROUND: Global payment is used with surgeries to optimize health, lower costs, and improve quality. We assessed perioperative spending on spinal fusion for scoliosis to inform how this might apply to children. METHODS: Retrospective analysis of 1249 children using Medicaid and aged ≥5 years with a complex chronic condition undergoing spinal fusion in 2013 from 12 states. From perioperative health services measured 6 months before and 3 months after spinal fusion, we simulated a spending reallocation with increased preoperative care and decreased hospital care...
September 12, 2017: Pediatrics
https://www.readbyqxmd.com/read/28886338/hospitalizations-for-ambulatory-care-sensitive-conditions-and-unplanned-readmissions-among-medicare-beneficiaries-with-alzheimer-s-disease
#6
Pei-Jung Lin, Yue Zhong, Howard M Fillit, Joshua T Cohen, Peter J Neumann
INTRODUCTION: Medicare beneficiaries with Alzheimer's disease and related dementias (ADRDs) may have more potentially avoidable hospitalizations and readmissions than people without dementia. These hospitalizations may be indicative of access barriers, problems in continuity of care, inefficient resource use, and poor patient outcomes. METHODS: We examined national frequency and costs of ambulatory care sensitive condition hospitalizations and unplanned, all-cause, and condition-specific 30-day readmissions in >2...
September 5, 2017: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
https://www.readbyqxmd.com/read/28885763/the-maastricht-frailty-screening-tool-for-hospitalised-patients-mfst-hp-to-identify-non-frail-patients
#7
Ron M J Warnier, Erik van Rossum, Sander M J van Kuijk, Wubbo J Mulder, Jos M G A Schols, Gertrudis I J M Kempen
BACKGROUND: The Maastricht frailty screening tool for hospitalised patients (MFST-HP) is a frailty screening tool that is fully integrated in the nursing assessment at admission. This study aims to determine the predictive value of the MFST-HP for the health outcomes length of hospital stay, discharge destination, readmission and mortality. METHODS: Data of 2691 hospitalised patients (70+), admitted between 01-01-2013 and 31-12-2013, were included in the study. The predictive value of the MFST-HP was analysed by means of receiver operating characteristics curves...
September 8, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28871024/telemedicine-guided-education-on-secondary-stroke-and-fall-prevention-following-inpatient-rehabilitation-for-texas-patients-with-stroke-and-their-caregivers-a-feasibility-pilot-study
#8
Mansi M Jhaveri, Ruby Benjamin-Garner, Nahid Rianon, Mark Sherer, Gerard Francisco, Farhaan Vahidy, Kayta Kobayashi, Mary Gaber, Paige Shoemake, Kim Vu, Alyssa Trevino, James Grotta, Sean Savitz
INTRODUCTION: The aftermath of stroke leaves many consequences including cognitive deficits and falls due to imbalance. Stroke survivors and families struggle to navigate the complex healthcare system with little assistance posthospital discharge, often leading to early hospital readmission and worse stroke outcomes. Telemedicine Guided Education on Secondary Stroke and Fall Prevention Following Inpatient Rehabilitation feasibility study examines whether stroke survivors and their caregivers find value in telerehabilitation (TR) home visits that provide individualised care and education by a multidisciplinary team after discharge from inpatient rehabilitation...
September 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28869115/wound-discharge-after-pharmacological-thromboprophylaxis-in-lower-limb-arthroplasty
#9
Christopher W Jones, S Spasojevic, G Goh, Z Joseph, D J Wood, Piers J Yates
BACKGROUND: The benefits vs risk of pharmacological prophylaxis for thromboembolic disease in orthopedic patients remain controversial. Pharmacological thromboprophylaxis regimes are commonly used in this patient group. Few studies specifically examine wound complications attributable to this therapy. In this prospective trial, we investigated the effect of various regimens on postoperative wounds. METHODS: A prospective, observational, multicenter study involving patients undergoing elective hip or knee arthroplasty was undertaken...
August 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28862964/hospital-practice-of-direct-home-discharge-and-30-day-readmission-after-transcatheter-aortic-valve-replacement-in-the-society-of-thoracic-surgeons-american-college-of-cardiology-transcatheter-valve-therapy-sts-acc-tvt-registry
#10
John A Dodson, Mathew R Williams, David J Cohen, Pratik Manandhar, Sreekanth Vemulapalli, Caroline Blaum, Hua Zhong, John S Rumsfeld, Judith S Hochman
BACKGROUND: Nearly 17% of patients are readmitted within 30 days of discharge after transcatheter aortic valve replacement. Selected patients are discharged to skilled nursing facilities, yet the association between a hospital's practice to discharge home versus to skilled nursing facilities, and readmission remains unclear. METHODS AND RESULTS: The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy (STS/ACC TVT) Registry was used to evaluate readmissions among patients undergoing transcatheter aortic valve replacement (2011-2015)...
August 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28859584/impact-of-physician-follow-up-care-on-psychiatric-readmission-rates-in-a-population-based-sample-of-patients-with-schizophrenia
#11
Paul Kurdyak, Simone Natalie Vigod, Alice Newman, Vasily Giannakeas, Benoit H Mulsant, Therese Stukel
OBJECTIVE: The study evaluated the association between physician follow-up within 30 days after hospital discharge and psychiatric readmission within the subsequent 180 days. METHODS: Among inpatients with schizophrenia who were discharged between 2007 and 2012 in Ontario (N=19,132), those who had a 30-day follow-up visit with a primary care physician (PCP) only, a psychiatrist only, or both were compared with a no-follow-up group. The primary outcome was psychiatric readmission in the subsequent 180 days...
September 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28859364/impact-of-supplemental-home-enteral-feeding-postesophagectomy-on-nutrition-body-composition-quality-of-life-and-patient-satisfaction
#12
C L Donohoe, L A Healy, M Fanning, S L Doyle, A Mc Hugh, J Moore, N Ravi, J V Reynolds
The aim of this prospective cohort study is to analyze the impact of supplemental home enteral nutrition (HEN) post-esophageal cancer surgery on nutritional parameters, quality of life (QL), and patient satisfaction. A systematic review reported that over 60% of patients lose >10% of both body weight and BMI by 6 months after esophagectomy. Enteral feeding (EF) is increasingly a modern standard postoperatively; however, the impact of extended HEN postdischarge has not been systematically studied. One hundred forty-nine consecutive patients [mean age 62 ± 9, 80% male,76% adenocarcinoma, 66% on multimodal protocols, and 69% with BMI ≥ 25 kg/m2] were studied...
September 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28858554/office-based-anesthesia-safety-and-outcomes-in-pediatric-dental-patients
#13
Allison L Spera, Mark A Saxen, Juan F Yepes, James E Jones, Brian J Sanders
The number of children with caries requiring general anesthesia to achieve comprehensive dental care and the demand for dentist anesthesiologists to provide ambulatory anesthesia for these patients is increasing. No current published studies examine the safety and outcomes of ambulatory anesthesia performed by dentist anesthesiologists for dental procedures in pediatric patients, and there is no national requirement for reporting outcomes of these procedures. In 2010, the Society for Ambulatory Anesthesia Clinical Outcomes Registry was developed...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28853623/predischarge-predictors-of-readmissions-and-postdischarge-complications-in-robot-assisted-radical-prostatectomy
#14
Leilei Xia, Benjamin L Taylor, Jose E Pulido, Phillip Mucksavage, David I Lee, Thomas J Guzzo
BACKGROUND AND OBJECTIVE: Robot-assisted radical prostatectomy (RARP) has become the preferred surgical treatment for localized prostate cancer in the United States. Little is reported about the association between predischarge outcomes and postdischarge outcomes following RARP. The objective of this study was to explore the predischarge predictors of readmissions and postdischarge complications in RARP. MATERIALS AND METHODS: The National Surgery Quality Improvement Program (NSQIP) database was used to identify prostate cancer patients who underwent elective RARP from 2012 to 2014...
August 30, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28852672/bundle-in-the-bronx-impact-of-a-transition-of-care-outpatient-parenteral-antibiotic-therapy-bundle-on-all-cause-30-day-hospital-readmissions
#15
Theresa Madaline, Priya Nori, Wenzhu Mowrey, Elisabeth Zukowski, Shruti Gohil, Uzma Sarwar, Gregory Weston, Riganni Urrely, Matthew Palombelli, Vinnie Frank Pierino, Vanessa Parsons, Amy Ehrlich, Belinda Ostrowsky, Marilou Corpuz, Liise-Anne Pirofski
BACKGROUND: A streamlined transition from inpatient to outpatient care can decrease 30-day readmissions. Outpatient parenteral antibiotic therapy (OPAT) programs have not reduced readmissions; an OPAT bundle has been suggested to improve outcomes. We implemented a transition-of-care (TOC) OPAT bundle and assessed the effects on all-cause, 30-day hospital readmission. METHODS: Retrospectively, patients receiving postdischarge intravenous antibiotics were evaluated before and after implementation of a TOC-OPAT program in Bronx, New York, between July, 2015 and February, 2016...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28837458/early-lessons-on-bundled-payment-at-an-academic-medical-center
#16
Lindsay E Jubelt, Keith S Goldfeld, Saul B Blecker, Wei-Yi Chung, John A Bendo, Joseph A Bosco, Thomas J Errico, Anthony K Frempong-Boadu, Richard Iorio, James D Slover, Leora I Horwitz
INTRODUCTION: Orthopaedic care is shifting to alternative payment models. We examined whether New York University Langone Medical Center achieved savings under the Centers for Medicare and Medicaid Services Bundled Payments for Care Improvement initiative. METHODS: This study was a difference-in-differences study of Medicare fee-for-service patients hospitalized from April 2011 to June 2012 and October 2013 to December 2014 for lower extremity joint arthroplasty, cardiac valve procedures, or spine surgery (intervention groups), or for congestive heart failure, major bowel procedures, medical peripheral vascular disorders, medical noninfectious orthopaedic care, or stroke (control group)...
September 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28837451/within-hospital-variation-in-30-day-adverse-events-implications-for-measuring-quality
#17
Robert E Burke, Thomas Glorioso, Anna K Barón, Peter J Kaboli, P Michael Ho
Novel measures of hospital quality are needed. Because quality improvement efforts seek to reduce variability in processes and outcomes, hospitals with higher variability in adverse events may be delivering poorer quality care. We sought to evaluate whether within-hospital variability in adverse events after a procedure might function as a quality metric that is correlated with facility-level mortality rates. We analyzed all percutaneous coronary interventions (PCIs) performed in the Veterans Health Administration (VHA) system from 2007 to 2013 to evaluate the correlation between within-hospital variability in 30-day postdischarge adverse events (readmission, emergency department visit, and repeat revascularization), and facility-level mortality rates, after adjustment for patient demographics, comorbidities, PCI indication, and PCI urgency...
August 21, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28832865/drivers-of-payment-variation-in-90-day-coronary-artery-bypass-grafting-episodes
#18
Vinay Guduguntla, John D Syrjamaki, Chad Ellimoottil, David C Miller, Richard L Prager, Edward C Norton, Patricia Theurer, Donald S Likosky, James M Dupree
Importance: Coronary artery bypass grafting (CABG) is scheduled to become a mandatory Medicare bundled payment program in January 2018. A contemporary understanding of 90-day CABG episode payments and their drivers is necessary to inform health policy, hospital strategy, and clinical quality improvement activities. Furthermore, insight into current CABG payments and their variation is important for understanding the potential effects of bundled payment models in cardiac care. Objective: To examine CABG payment variation and its drivers...
August 23, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28811042/understanding-readmissions-in-children-undergoing-surgery-a-pediatric-nsqip-analysis
#19
Afif N Kulaylat, Dorothy V Rocourt, Anthony Y Tsai, Kathryn L Martin, Brett W Engbrecht, Mary C Santos, Robert E Cilley, Christopher S Hollenbeak, Peter W Dillon
BACKGROUND: Readmission is increasingly being utilized as an important clinical outcome and measure of hospital quality. Our aim was to delineate rates, risk factors, and reasons for unplanned readmission in pediatric surgery. MATERIALS AND METHODS: Retrospective review of pediatric patients (n=130,274) undergoing surgery (2013-2014) at hospitals enrolled in the Pediatric National Surgical Quality Improvement Program (NSQIP-P) was performed. Logistic regression was used to model factors associated with unplanned 30-day readmission...
July 31, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28803034/variations-in-the-costs-of-radical-cystectomy-for-bladder-cancer-in-the-usa
#20
Jeffrey J Leow, Alexander P Cole, Thomas Seisen, Joaquim Bellmunt, Matthew Mossanen, Mani Menon, Mark A Preston, Toni K Choueiri, Adam S Kibel, Benjamin I Chung, Maxine Sun, Steven L Chang, Quoc-Dien Trinh
BACKGROUND: Radical cystectomy (RC) for muscle-invasive bladder cancer (BCa) has potential for serious complications, prolonged length of stay and readmissions-all of which may increase costs. Although variations in outcomes are well described, less is known about determinants driving variation in costs. OBJECTIVE: To assess surgeon- and hospital-level variations in costs and predictors of high- and low-cost RC. DESIGN, SETTING, AND PARTICIPANTS: Cohort study of 23 173 patients who underwent RC for BCa in 208 hospitals in the USA from 2003 to 2015 in the Premier Healthcare Database...
August 9, 2017: European Urology
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