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https://www.readbyqxmd.com/read/29148323/impact-of-postdischarge-follow-up-care-on-medicare-expenditures-does-rural-make-a-difference
#1
Matthew Toth, Mark Holmes, Mark Toles, Courtney Van Houtven, Morris Weinberger, Pam Silberman
Reducing postdischarge Medicare expenditures is a key focus for hospitals. Early follow-up care is an important piece of this focus, but it is unclear whether there are rural-urban differences in the impact of follow-up care on Medicare expenditures. To assess this difference, we use the Medicare Current Beneficiary Survey, Cost and Use Files, 2000-2010. We conduct a retrospective analysis of 30-day postdischarge Medicare expenditures using two-stage residual inclusion with a quantile regression, where the receipt of 7-day follow-up care was the main independent variable...
January 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29143480/telephone-discharge-support-for-frail-vulnerable-older-people-discharged-from-hospital-impact-on-readmission-rates-participant-and-general-practitioner-feedback
#2
Claire P Heppenstall, Hugh C Hanger, Timothy J Wilkinson, Michelle Dhanak
OBJECTIVE: To assess the use and acceptability to older participants and general practitioners (GPs) of telephone support postdischarge to reduce readmissions. METHODS: A prospective cohort study of older people after discharge from a specialist geriatric unit, and comparison with a previous cohort. Telephone follow-up calls were made fortnightly for three months. Structured questionnaires were used to obtain feedback from participants and GPs. RESULTS: Readmission rates were high, 40%, despite the intervention...
November 15, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/29133331/malnutrition-and-its-association-with-readmission-and-death-within-7-days-and-8-180-days-postdischarge-in-older-patients-a-prospective-observational-study
#3
Yogesh Sharma, Michelle Miller, Billingsley Kaambwa, Rashmi Shahi, Paul Hakendorf, Chris Horwood, Campbell Thompson
OBJECTIVE: The relationship between admission nutritional status and clinical outcomes following hospital discharge is not well established. This study investigated whether older patients' nutritional status at admission predicts unplanned readmission or death in the very early or late periods following hospital discharge. DESIGN, SETTING AND PARTICIPANTS: The study prospectively recruited 297 patients ≥60 years old who were presenting to the General Medicine Department of a tertiary care hospital in Australia...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29131450/potential-for-health-care-cost-savings-with-preoperative-gastrostomy-tube-placement-in-the-head-and-neck-cancer-population
#4
Ashley C Mays, Harrison G Bartels, Paul R Wistermayer, Matt L Rohlfing, Christopher M Gentile, Ralph D'Agostino, Joshua D Waltonen
BACKGROUND: The purpose of this study was to examine the cost differences between preoperative and postoperative placement of gastrostomy tubes (G-tubes) in patients with head and neck cancer. METHODS: We conducted a retrospective chart review of patients with aerodigestive tract cancers from 2010 to 2015. Data included inpatient and postdischarge costs, demographics, tumor characteristics, surgical treatment, length of stay (LOS), time spent in the intensive care unit (ICU), and readmissions...
November 13, 2017: Head & Neck
https://www.readbyqxmd.com/read/29130267/long-term-impact-of-a-postdischarge-community-health-worker-intervention-on-health-care-costs-in-a-safety-net-system
#5
Alison A Galbraith, David J Meyers, Dennis Ross-Degnan, Marguerite E Burns, Catherine E Vialle-Valentin, Marc R Larochelle, Sharon Touw, Fang Zhang, Meredith Rosenthal, Richard B Balaban
OBJECTIVE: Patient navigators (PNs) may represent a cost-effective strategy to improve transitional care and reduce hospital readmissions. We evaluated the impact of a PN intervention on health system costs in the 180 days after discharge for high-risk patients in a safety-net system. DATA SOURCE/SETTING: Primary and secondary data from an academic safety-net health system. STUDY DESIGN: We compared per-patient utilization and costs, overall and by age, for high-risk, medical service patients randomized to the PN intervention relative to usual care between October 2011 and April 2013...
December 2017: Health Services Research
https://www.readbyqxmd.com/read/29129345/defining-value-based-care-in-cardiac-and-vascular-anesthesiology-the-past-present-and-future-of-perioperative-cardiovascular-care
#6
REVIEW
Lavinia M Kolarczyk, Harendra Arora, Michael W Manning, David A Zvara, Robert S Isaak
Health care reimbursement models are transitioning from volume-based to value-based models. Value-based models focus on patient outcomes both during the hospital admission and postdischarge. These models place emphasis on cost, quality of care, and coordination of multidisciplinary services. Perioperative physicians are challenged to evaluate traditional practices to ensure coordinated, cost-effective, and evidence-based care. With the Centers for Medicare and Medicaid Services planned introduction of bundled payments for coronary artery bypass graft surgery, cardiovascular anesthesiologists are financially responsible for postdischarge outcomes...
September 28, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29126971/prevalence-and-postdischarge-incidence-of-malignancies-in-patients-with-acute-coronary-syndrome
#7
Alberto Cordero, Ramón López-Palop, Pilar Carrillo, Julio Núñez, Araceli Frutos, Vicente Bertomeu-González, Fernando Yépez, Nina Alcantara, Francisco Ribes, Mària Juskova, Vicente Bertomeu-Martínez
INTRODUCTION AND OBJECTIVES: Malignancies are the second cause of death in developed countries after cardiovascular disease and both share common risk factors. METHODS: This prospective study assessed the prevalence and postdischarge incidence of malignancies in all consecutive patients admitted for an acute coronary syndrome. RESULTS: A total of 1819 patients were included. On admission, the prevalence of malignancies was 3.4%, and 41.9% of the patients were considered disease-free; of the 1731 discharged patients, the incidence was 3...
November 7, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29117055/improving-patient-experience-through-nursing-satisfaction
#8
Amanda McNicholas, Abby McCall, Alanna Werner, Ronda Wounderly, Erin Marinchak, Pamela Jones
Patient experience is a vital component of quality health care. In our institution we sought to improve both nursing satisfaction and collaboration, in conjunction with improving patient experience, predicting the two are directly proportional. We hypothesized that a more satisfied nursing team would result in an overall improvement in patient experience. To explore this hypothesis, we implemented multiple process changes to create an advanced practitioner-directed floor (APDF) on our 28-bed trauma, medical-surgical unit...
November 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29117051/analysis-of-patient-follow-up-at-a-level-i-trauma-center-in-ohio
#9
Brian Fletcher, Tami Meyers, Michelle Guilliams, Teresa Poliseno, Josh Burton, Michael Lieber, Ed Buggie, M Shay OʼMara
Trauma patients report being unprepared for hospital discharge. The purpose of this study was to identify follow-up compliance rates at our trauma clinic and identify factors associated with trauma patients' adherence to follow-up appointment. We recruited patients 15 years and older who were discharged from the trauma service between December 2014 and August 2015. Demographic information and injury-related variables were obtained from the trauma registry for patients who attended their follow-up and those who did not attend...
November 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29115709/safety-of-discharge-for-children-with-cancer-and-febrile-neutropenia-off-antibiotics-using-absolute-neutrophil-count-threshold-values-as-a-surrogate-marker-for-adequate-bone-marrow-recovery
#10
Matthew E Campbell, Debra L Friedman, Daniel E Dulek, Zhiguo Zhao, Yi Huang, Adam J Esbenshade
BACKGROUND: Febrile neutropenia (F&N) is common among pediatric oncology patients. However, there is a lack of clarity regarding parameters whereby such patients have demonstrated adequate bone marrow recovery for hospital discharge and empiric antibiotic discontinuation. PROCEDURE: A retrospective review was performed for 350 episodes of F&N occurring at a single institution between 2007 and 2012 in pediatric oncology patients who were afebrile for 24 hr and had no bacterial source identified...
November 8, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29114003/pediatric-patient-centered-transitions-from-hospital-to-home-improving-the-discharge-medication-process
#11
Leah A Mallory, Noah P Diminick, Jonathan P Bourque, Meredith R Bryden, Jessica L Miller, Nancy M Nystrom, Melanie R Lord, Lorraine L McElwain
OBJECTIVES: Medications prescribed at hospital discharge can lead to patient harm if there are access barriers or misunderstanding of instructions. Filling prescriptions before discharge can decrease these risks. We aimed to increase the percentage of patients leaving the hospital with new discharge medications in hand to 70% by 18 months. METHODS: We used sequential plan-do-study-act cycles from January 2015 to September 2016. We used statistical process control charts to track process measures, new medications filled before discharge, and rates of bedside delivery with pharmacist teaching to the inpatient pediatric unit...
November 7, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29112546/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-surgery-in-the-obese-patient
#12
Linas Venclauskas, Almantas Maleckas, Juan I Arcelus
: A systematic literature search was performed and patients were selected as obese patients undergoing bariatric surgery or obese patients undergoing nonbariatric surgical procedures. In addition, patients were stratified according to low risk of venous thromboembolism and high risk of venous thromboembolism (age >55 years, BMI >55 kg m, history of venous thromboembolism, venous disease, sleep apnoea, hypercoagulability or pulmonary hypertension). Prophylaxis of venous thromboembolism was analysed depending on the type of modality: compression devices of the lower extremities (including intermittent pneumatic compression and graduated compression stockings), pharmacological prophylaxis or inferior vena cava filters...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29103665/lipid-management-after-first-diagnosis-of-coronary-artery-disease-contemporary-results-from-an-observational-cohort-study
#13
Christoph Waldeyer, Moritz Seiffert, Nils Staebe, Julian Braetz, Rebecca Kohsiack, Francisco Ojeda, Niklas Schofer, Mahir Karakas, Tanja Zeller, Christoph Sinning, Benedikt Schrage, Dirk Westermann, Karsten Sydow, Stefan Blankenberg, Fabian J Brunner, Renate B Schnabel
PURPOSE: Although the efficacy of lipid-lowering medication (LLM) in patients with coronary artery disease (CAD) is well established, the majority of patients fail to achieve their LDL-C goals. The evidence for measurement of LDL-C to achieve these goals is limited. The goal of the present study, therefore, was to analyze ambulatory LLM management in relation to performance of LDL-C measurements and achieved LDL-C levels after the initial diagnosis of CAD. METHODS: The study followed up a subcohort of 200 patients with newly diagnosed CAD of the INTERCATH trial, an observational study including patients undergoing coronary angiography...
November 2, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/29102205/a-multi-institutional-cohort-study-confirming-the-risks-of-clostridium-difficile-infection-associated-with-prolonged-antibiotic-prophylaxis
#14
Katherine A Kirkwood, Brian C Gulack, Alexander Iribarne, Michael E Bowdish, Giampaolo Greco, Mary Lou Mayer, Karen O'Sullivan, Annetine C Gelijns, Nishit Fumakia, Ravi K Ghanta, Jesse M Raiten, Anuradha Lala, Joseph S Ladowski, Eugene H Blackstone, Michael K Parides, Alan J Moskowitz, Keith A Horvath
OBJECTIVES: The incidence and severity of Clostridium difficile infection (CDI) have increased rapidly over the past 2 decades, particularly in elderly patients with multiple comorbidities. This study sought to characterize the incidence and risks of these infections in cardiac surgery patients. METHODS: A total of 5158 patients at 10 Cardiothoracic Surgical Trials Network sites in the US and Canada participated in a prospective study of major infections after cardiac surgery...
September 28, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29101296/stopping-antithrombotic-therapy-after-acute-upper-gastrointestinal-bleeding-is-associated-with-reduced-survival
#15
Keith Siau, Jack L Hannah, James Hodson, Monika Widlak, Neeraj Bhala, Tariq H Iqbal
INTRODUCTION: Antithrombotic drugs are often stopped following acute upper gastrointestinal bleeding (AUGIB) and frequently not restarted. The practice of antithrombotic discontinuation on discharge and its impact on outcomes are unclear. OBJECTIVE: To assess whether restarting antithrombotic therapy, prior to hospital discharge for AUGIB, affected clinical outcomes. DESIGN: Retrospective cohort study. SETTING: University hospital between May 2013 and November 2014, with median follow-up of 259 days...
November 3, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/29100592/peri-operative-emergency-department-utilization-in-inpatient-and-outpatient-medicare-laparoscopic-cholecystectomy
#16
Susan M Nedza, Donald E Fry, Michael Pine, Agnes M Reband, Pan Chen, Gregory Pine
BACKGROUND: Preoperative emergency department (ED) visits may reflect the patient's biliary disease, or may signal unstable comorbid conditions that have relevance following inpatient laparoscopic cholecystectomy (ILC) and outpatient laparoscopic cholecystectomy (OLC) in Medicare patients. METHODS: We used the Medicare inpatient and outpatient Limited Datasets to identify elective laparoscopic cholecystectomy patients from 2011 to 2014. ED visits for 30-days before the surgical event were identified and correlated with the probability of patients returning to the ED in the 30-days following the procedure...
October 24, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29100572/emergency-department-postdischarge-phone-calls-lessons-learned
#17
Ines Luciani-Mcgillivray
No abstract text is available yet for this article.
November 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29097058/the-quality-of-discharge-care-planning-in-acute-stroke-care-influencing-factors-and-association-with-postdischarge-outcomes
#18
Nadine E Andrew, Doreen Busingye, Natasha A Lannin, Monique F Kilkenny, Dominique A Cadilhac
BACKGROUND: Comprehensive discharge planning is important for successful transitions from hospital to home after stroke. The aim of this study was to describe the quality of discharge planning received by patients discharged home from acute care, identify factors associated with a positive discharge experience, and assess the influence of discharge quality on outcomes. METHOD: Patients discharged to the community and registered in the Australian Stroke Clinical Registry in 2014 were invited to participate...
October 30, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29095189/venous-thromboembolism-after-surgical-treatment-of-breast-cancer
#19
Arash Momeni, Justin P Fox
BACKGROUND: Venous thromboembolism (VTE) remains a serious complication after the surgical treatment of breast cancer. Contemporary guidelines limit VTE chemoprophylaxis to the period of hospitalization. We conducted this study to evaluate the frequency of postdischarge VTE among surgically treated breast cancer patients and identify patient level factors associated with postdischarge VTE. METHODS: Using Arkansas, Florida, Nebraska, and New York state inpatient databases, we conducted a retrospective cohort study of adult women who underwent surgical treatment for breast cancer between October 1, 2008, and September 30, 2013...
October 31, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29094371/the-impact-of-postdischarge-surveillance-on-surgical-site-infection-diagnosis
#20
Danielle N Garcia Stickney, Kelley M Thieman Mankin
OBJECTIVE: To evaluate the impact of postdischarge surveillance on surgical site infection (SSI) diagnosis. STUDY DESIGN: Prospective enrollment with retrospective case review SAMPLE POPULATION: Dogs and cats (n = 1271) undergoing surgery April 2012-November 2013. METHODS: The medical record of each animal was reviewed and a 30-day follow-up questionnaire was sent to each pet owner. A standardized definition of SSI was used to identify all animals with SSI...
November 2, 2017: Veterinary Surgery: VS
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