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Value based health care

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https://www.readbyqxmd.com/read/28749065/concise-review-the-high-cost-of-high-tech-medicine-planning-ahead-for-market-access
#1
REVIEW
Dawn Driscoll, Stephanie Farnia, Panos Kefalas, Richard T Maziarz
Cellular therapies and other regenerative medicines are emerging as potentially transformative additions to modern medicine, but likely at a staggering financial cost. Public health care systems' budgets are already strained by growing and aging populations, and many private insurer's budgets are equally stretched. The current systems that most payers employ to manage their cash flow are not structured to absorb a sudden onslaught of very expensive prescriptions for a large portion of their covered population...
August 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28748535/financial-incentives-and-physician-practice-participation-in-medicare-s-value-based-reforms
#2
Adam M Markovitz, Patricia P Ramsay, Stephen M Shortell, Andrew M Ryan
OBJECTIVES: To evaluate whether greater experience and success with performance incentives among physician practices are related to increased participation in Medicare's voluntary value-based payment reforms. DATA SOURCES/STUDY SETTING: Publicly available data from Medicare's Physician Compare (n = 1,278; January 2012 to November 2013) and nationally representative physician practice data from the National Survey of Physician Organizations 3 (NSPO3; n = 907,538; 2013)...
July 26, 2017: Health Services Research
https://www.readbyqxmd.com/read/28746136/using-organizational-philosophy-to-create-a-self-sustaining-compensation-plan-without-harming-academic-missions
#3
Robert Leverence, Richard Nuttall, Rachel Palmer, Mark Segal, Alicia Wood, Fay Yancey, Jonathon Shuster, Mark Brantly, Robert Hromas
PROBLEM: Academic physician reimbursement has moved to productivity-based compensation plans. To be sustainable, such plans must be self-funding. Additionally, unless research and education are appropriately valued, faculty involved in these efforts will become disillusioned, yet revenue generation in these activities is less robust than for clinical care activities. APPROACH: Faculty at the Department of Medicine, University of Florida Health, elected a committee of junior and senior faculty and division chiefs to restructure the compensation plan in fiscal year (FY) 2011...
August 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28746023/the-patient-centered-medical-home-as-a-community-based-strategy
#4
Berkeley A Franz, John W Murphy
Increasing attention has been devoted to the important role that primary care will play in improving population health. One innovation, the patient-centered medical home (PCMH), aims to unite a variety of professionals with patients in the prevention and treatment of illness. Although patient perspectives are critical to this model, this article questions whether the PCMH in practice is truly community-based. That is, do physicians, planners, and other health care professionals take seriously the value of integrating local knowledge into medical care? The argument presented is that community-based philosophy contains a foundational principle that the perspectives of health care practitioners and community members must be integrated...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28745788/the-application-value-of-continuous-nursing-for-home-oxygen-therapy-of-patients-in-the-stable-phase-of-chronic-obstructive-pulmonary-disease
#5
Y-L Yu, X-S Zheng, X-X Han, M-J Sun
OBJECTIVE: To analyze the application value of continuous nursing in improving the effects of home oxygen therapy for patients in the stable phase of chronic obstructive pulmonary disease (COPD). PATIENTS AND METHODS: Patients in the stable phase of COPD (n=106) were selected and divided into the control group and observation group based on parity digit of their admission number. There were 53 cases in each group. The patients in the control group received COPD health education at discharge, while the observation group received continuous nursing...
July 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28745094/nich-at-its-best-for-diabetes-at-its-worst-texting-teens-and-their-caregivers-for-better-outcomes
#6
David V Wagner, Samantha A Barry, Maggie Stoeckel, Lena Teplitsky, Michael A Harris
BACKGROUND: There is growing evidence for the feasibility of text-based interventions for pediatric patients with type 1 diabetes (T1D). However, less is known regarding whether the use of personalized text messages with high-risk youth and their caregivers is associated with improvements in youth health. This study examines the use of diabetes-specific texts and associated health outcomes for participants of the Novel Interventions in Children's Healthcare (NICH) program. METHODS: Text messages sent to youth with T1D and their caregivers during NICH intervention were coded regarding diabetes relevance and adherence-related content...
May 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28744736/management-of-bone-health-in-postmenopausal-women-on-aromatase-inhibitors-ais-a-single-health-care-system-experience
#7
Douglas Tremblay, Vaibhav Patel, Kenneth M Fifer, Jessica Caro, Olivia Kolodka, John Mandelli, Charles L Shapiro
INTRODUCTION: Aromatase inhibitors (AIs) are the preferred therapy for postmenopausal women with early-stage estrogen receptor-positive breast cancers. However, their use causes bone loss and increased risks of osteoporosis and fractures. METHODS: This is a retrospective review of all postmenopausal women with breast cancer diagnosed and treated with AI between 2010 and 2015. Of the 564 women identified, 319 were eligible. RESULTS: The median age at AI initiation was 65 years (range 51-85 years), and the median duration of AI therapy was 28 months (1-72 months)...
July 26, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28742377/reducing-delay-in-diagnosis-multistage-recommendation-tracking
#8
Ben Wandtke, Sarah Gallagher
OBJECTIVE: The purpose of this study was to determine whether a multistage tracking system could improve communication between health care providers, reducing the risk of delay in diagnosis related to inconsistent communication and tracking of radiology follow-up recommendations. MATERIALS AND METHODS: Unconditional recommendations for imaging follow-up of all diagnostic imaging modalities excluding mammography (n = 589) were entered into a database and tracked through a multistage tracking system for 13 months...
July 25, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28740443/approaches-to-teach-evidence-based-practice-among-health-professionals-an-overview-of-the-existing-evidence
#9
REVIEW
Athina E Patelarou, Konstantinos G Kyriakoulis, Aliki A Stamou, Aggelos Laliotis, Dimitra Sifaki-Pistolla, Michail Matalliotakis, Emmanuel Prokopakis, Evridiki Patelarou
Health care professionals' adoption of evidence-based practice (EBP) remains limited, although most health care professionals are familiar with EBP and believe in its value. This systematic review aimed to bring together the best methods used to teach EBP to health professionals. The authors conducted a systematic search for the period 2005-2015 (an update of the search took place in October 2016) using PubMed interface (Medline). MeSH terms as well as free-text keywords were used. Studies were analyzed and evaluated by title and abstract...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28738397/effects-of-self-management-education-through-telephone-follow-up-in-diabetic-patients
#10
Mahmood Namjoo Nasab, Abbas Ghavam, Abbas Yazdanpanah, Fereidoun Jahangir, Nasrin Shokrpour
It is expected that the number of people living with diabetes rise especially in low- and middle-income countries. In Iran, more than four million adults have diabetes mellitus, and self-management education is essential for effective diabetes self-care. This study aimed to investigate the effect of self-management education with telephone follow-up in diabetic patients of rural areas of Fars province in Lamerd city, Iran. In this experimental study, 64 participants were randomly assigned to intervention and control groups (32 patients for each group)...
July 2017: Health Care Manager
https://www.readbyqxmd.com/read/28737972/identifying-health-information-technology-needs-of-oncologists-to-facilitate-the-adoption-of-genomic-medicine-recommendations-from-the-2016-american-society-of-clinical-oncology-omics-and-precision-oncology-workshop
#11
Kevin S Hughes, Edward P Ambinder, Gregory P Hess, Peter Paul Yu, Elmer V Bernstam, Mark J Routbort, Jean Rene Clemenceau, John T Hamm, Phillip G Febbo, Susan M Domchek, James L Chen, Jeremy L Warner
At the ASCO Data Standards and Interoperability Summit held in May 2016, it was unanimously decided that four areas of current oncology clinical practice have serious, unmet health information technology needs. The following areas of need were identified: 1) omics and precision oncology, 2) advancing interoperability, 3) patient engagement, and 4) value-based oncology. To begin to address these issues, ASCO convened two complementary workshops: the Omics and Precision Oncology Workshop in October 2016 and the Advancing Interoperability Workshop in December 2016...
July 24, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28733299/robot-assisted-surgery-in-a-broader-healthcare-perspective-a-difference-in-difference-based-cost-analysis-of-a-national-prostatectomy-cohort
#12
Vibe Bolvig Hyldgård, Karin Rosenkilde Laursen, Johan Poulsen, Rikke Søgaard
OBJECTIVE: To estimate costs attributable to robot-assisted laparoscopic prostatectomy (RALP) as compared with open prostatectomy (OP) and laparoscopic prostatectomies (LP) in a National Health Service perspective. PATIENTS AND METHODS: Register-based cohort study of 4309 consecutive patients who underwent prostatectomy from 2006 to 2013 (2241 RALP, 1818 OP and 250 LP). Patients were followed from 12 months before to 12 months after prostatectomy with respect to service use in primary care (general practitioners, therapists, specialists etc) and hospitals (inpatient and outpatient activity related to prostatectomy and comorbidity)...
July 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28732739/environmental-scan-of-infection-prevention-and-control-practices-for-containment-of-hospital-acquired-infectious-disease-outbreaks-in-acute-care-hospital-settings-across-canada
#13
Wrechelle Ocampo, Rose Geransar, Nancy Clayden, Jessica Jones, Jill de Grood, Mark Joffe, Geoffrey Taylor, Bayan Missaghi, Craig Pearce, William Ghali, John Conly
BACKGROUND: Ward closure is a method of controlling hospital-acquired infectious diseases outbreaks and is often coupled with other practices. However, the value and efficacy of ward closures remains uncertain. PURPOSE: To understand the current practices and perceptions with respect to ward closure for hospital-acquired infectious disease outbreaks in acute care hospital settings across Canada. METHODS: A Web-based environmental scan survey was developed by a team of infection prevention and control (IPC) experts and distributed to 235 IPC professionals at acute care sites across Canada...
July 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28732477/a-web-based-clinical-decision-tool-to-support-treatment-decision-making-in-psychiatry-a-pilot-focus-group-study-with-clinicians-patients-and-carers
#14
Catherine Henshall, Lisa Marzano, Katharine Smith, Mary-Jane Attenburrow, Stephen Puntis, Jakov Zlodre, Kathleen Kelly, Matthew R Broome, Susan Shaw, Alvaro Barrera, Andrew Molodynski, Alastair Reid, John R Geddes, Andrea Cipriani
BACKGROUND: Treatment decision tools have been developed in many fields of medicine, including psychiatry, however benefits for patients have not been sustained once the support is withdrawn. We have developed a web-based computerised clinical decision support tool (CDST), which can provide patients and clinicians with continuous, up-to-date, personalised information about the efficacy and tolerability of competing interventions. To test the feasibility and acceptability of the CDST we conducted a focus group study, aimed to explore the views of clinicians, patients and carers...
July 21, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28731893/validity-of-administrative-data-in-identifying-cancer-related-events-in-adolescents-and-young-adults-a-population-based-study-using-the-impact-cohort
#15
Sumit Gupta, Paul C Nathan, Nancy N Baxter, Cindy Lau, Corinne Daly, Jason D Pole
BACKGROUND: Despite the importance of estimating population level cancer outcomes, most registries do not collect critical events such as relapse. Attempts to use health administrative data to identify these events have focused on older adults and have been mostly unsuccessful. We developed and tested administrative data-based algorithms in a population-based cohort of adolescents and young adults with cancer. METHODS: We identified all Ontario adolescents and young adults 15-21 years old diagnosed with leukemia, lymphoma, sarcoma, or testicular cancer between 1992-2012...
July 20, 2017: Medical Care
https://www.readbyqxmd.com/read/28731547/does-hospital-ownership-influence-hospital-referral-region-health-rankings-in-the-united-states
#16
Hanadi Hamadi, Emma Apatu, Aaron Spaulding
Extensive evidence demonstrates that a hospital's organizational ownership structure impacts its overall performance, but little is known concerning the influence of hospital structure on the health of its community. This paper explores the association between US hospital referral region (HRR) health rankings and hospital ownership and performance. Data from the 2016 Commonwealth Fund Scorecard on Local Health System Performance, the American Hospital Association dataset, and the Hospital Value-Based Purchasing dataset are utilized to conduct a cross-sectional analysis of 36 quality measures across 306 HRRs...
July 21, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28729309/the-role-of-a-decision-support-smartphone-application-in-enhancing-community-health-volunteers-effectiveness-to-improve-maternal-and-newborn-outcomes-in-nairobi-kenya-quasi-experimental-research-protocol
#17
Pauline Bakibinga, Eva Kamande, Milka Omuya, Abdhalah K Ziraba, Catherine Kyobutungi
INTRODUCTION: Improving maternal and newborn survival remains major aspirations for many countries in the Global South. Slum settlements, a result of rapid urbanisation in many developing countries including Kenya, exhibit high levels of maternal and neonatal mortality. There are limited referral mechanisms for sick neonates and their mothers from the community to healthcare facilities with ability to provide adequate care. In this study, we specifically plan to develop and assess the added value of having community health volunteers (CHVs) use smartphones to identify and track mothers and children in a bid to reduce pregnancy-related complications and newborn deaths in the urban slums of Kamukunji subcounty in Nairobi, Kenya...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28728533/lifestyle-inequalities-explaining-socioeconomic-differences-in-preventive-practices-of-clinically-overweight-women-after-menopause
#18
Mélisa Audet, Alex Dumas, Rachelle Binette, Isabelle J Dionne
Excess weight and menopause are two major factors increasing aging women's vulnerability to chronic diseases. However, social position and socioeconomic status have also been identified as major determinants influencing both health behaviors and the development of such diseases. This study focuses on the socioeconomic variations of behavioral risk factors of chronic diseases in aging women. By drawing on Bourdieu's sociocultural theory of practice, 40 semistructured interviews were conducted to investigate preventive health practices of clinically overweight, postmenopausal women from contrasting socioeconomic classes living in Canada...
August 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28728524/what-s-at-stake-in-u-s-health-reform-a-guide-to-the-affordable-care-act-and-value-based-care
#19
Betty A Rambur
The U.S. presidential election of 2016 accentuated the divided perspectives on the Patient Protection and Affordable Care Act of 2010, commonly known as Obamacare. The perspectives included a pledge from then candidate Donald J. Trump to "repeal and replace on day one"; Republican congressional leaders' more temperate suggestions in the first weeks of the Trump administration to "repair" the Affordable Care Act (ACA); and President Trump's February 5, 2017 statement-16 days after inauguration-that a Republican replacement for the ACA may not be ready until late 2017 or 2018...
January 1, 2017: Policy, Politics & Nursing Practice
https://www.readbyqxmd.com/read/28727944/computer-based-case-simulations-for-assessment-in-health-care-a-literature-review-of-validity-evidence
#20
Robyn C Ward, Timothy J Muckle, Michael J Kremer, Mary Anne Krogh
Simulation for education and training in health-care professions has been widely applied. However, its value as an assessment tool for competence is not fully known. Logistical barriers of simulation-based assessments have led some health-care organizations to utilize computer-based case simulations (CCSs) for assessment. This article provides a review of the literature on the identification of psychometrically sound, CCS instruments designed to measure decision-making competence in health-care professionals...
January 1, 2017: Evaluation & the Health Professions
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