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https://www.readbyqxmd.com/read/28742770/role-of-the-perioperative-surgical-home-in-optimizing-the-perioperative-use-of-opioids
#1
Thomas R Vetter, Zeev N Kain
Several federal agencies have recently noted that the United States is in the midst of an unprecedented "opioid epidemic," with an increasing number of opioid-related overdoses and deaths. Providers currently face 3 population-level, public health challenges in providing optimal perioperative pain care: (1) the continued lack of overall improvement in the excessive incidence of inadequately treated postoperative pain, (2) minimizing or preventing postoperative opioid-related side effects, and (3) addressing current opioid prescribing patterns, and the accompanying problematic surge in prescription opioid diversion, misuse, abuse, addiction, and overdose...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742756/cost-effectiveness-of-mindfulness-based-stress-reduction-vs-cognitive-behavioral-therapy-or-usual-care-among-adults-with-chronic-low-back-pain
#2
Patricia M Herman, Melissa L Anderson, Karen J Sherman, Benjamin H Balderson, Judith A Turner, Daniel C Cherkin
STUDY DESIGN: Economic evaluation alongside a randomized trial of cognitive-behavioral therapy (CBT) and mindfulness-based stress reduction (MBSR) versus usual care alone (UC) for chronic low-back pain (CLBP). OBJECTIVE: Determine the one-year cost-effectiveness of CBT and MBSR compared to UC. SUMMARY OF BACKGROUND DATA: CLBP is expensive in terms of healthcare costs and lost productivity. Mind-body interventions have been found effective for back pain, but their cost-effectiveness is unexplored...
July 24, 2017: Spine
https://www.readbyqxmd.com/read/28742535/-anonymous-meltdown-content-themes-emerging-in-a-nonfacilitated-peer-only-unstructured-asynchronous-online-support-group-for-family-caregivers
#3
Cynthia A Diefenbeck, Paula R Klemm, Evelyn R Hayes
By providing care for loved ones in the home, family caregivers save millions of dollars for our overtaxed healthcare system. Support groups can lighten the psychological burden of caregiving. Nonprofessionally facilitated (or peer) online caregiver support groups can help meet a critical need in healthcare as a low-cost resource for caregivers. Online caregiver peer support groups can promote the health and well-being of family caregivers and, by extension, the patients themselves, resulting in cost-savings for society...
July 25, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28742431/impact-of-direct-to-consumer-store-and-forward-teledermatology-on-access-to-care-satisfaction-utilization-and-costs-in-a-commercial-health-plan-population
#4
Jay Rajda, Mark P Seraly, Joaquim Fernandes, Kyle Niejadlik, Henry Wei, Kathe Fox, Gregory Steinberg, Harold L Paz
PURPOSE: Store-and-forward teledermatology can improve access to dermatology by enabling asynchronous consults. This study assesses it on access, satisfaction, utilization, and costs in a commercial health plan setting. METHODOLOGY: In this prospective observational study with matched control, 47,411 individuals were provided access to teledermatology services staffed by board-certified, licensed dermatologists for 6 months. Two hundred forty-three individuals used the service...
July 21, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28742377/reducing-delay-in-diagnosis-multistage-recommendation-tracking
#5
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/28742372/health-care-price-transparency-and-communication-implications-for-radiologists-and-patients-in-an-era-of-expanding-shared-decision-making
#6
Gelareh Sadigh, Ruth C Carlos, Elizabeth A Krupinski, Carolyn C Meltzer, Richard Duszak
OBJECTIVE: The purpose of this article is to review the literature on communicating transparency in health care pricing, both overall and specifically for medical imaging. Focus is also placed on the imperatives and initiatives that will increasingly impact radiologists and their patients. CONCLUSION: Most Americans seek transparency in health care pricing, yet such discussions occur in fewer than half of patient encounters. Although price transparency tools can help decrease health care spending, most are used infrequently and most lack information about quality...
July 25, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28741740/ultrafine-fine-and-black-carbon-particle-concentrations-in-california-child-care-facilities
#7
Fraser W Gaspar, Randy Maddalena, Jeffery Williams, Rosemary Castorina, Zhong-Min Wang, Kazukiyo Kumagai, Thomas E McKone, Asa Bradman
Although many U.S. children spend time in child care, little information exists on exposures to airborne particulate matter (PM) in this environment, even though PM may be associated with asthma and other respiratory illness, which is a key concern for young children. To address this data gap, we measured ultrafine particles (UFP), PM2.5 , PM10 , and black carbon in 40 California child care facilities and examined associations with potential determinants. We also tested a low-cost optical particle measuring device (Dylos monitor)...
July 25, 2017: Indoor Air
https://www.readbyqxmd.com/read/28741420/outreach-syncope-clinic-managed-by-a-nurse-practitioner-outcome-and-cost-effectiveness
#8
Mohamed H Hamdan, Kathleen E Walsh, Michele Brignole, Jamie Key
Introduction The purpose of this study was to assess the clinical and financial outcomes of a novel outreach syncope clinic. Methods We compared the clinical outcome of the Faint and Fall Clinic at the American Center (January-June 2016) with that of the University of Wisconsin Health and Clinics Faint and Fall Clinic (January 2013-December 2014). The American Center-Faint and Fall Clinic is run solely by a nurse practitioner, assisted by online faint-decision software and consultancy of a faint specialist through video-conferencing...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28741307/modelling-cost-effectiveness-and-health-gains-of-a-universal-vs-prioritized-hcv-treatment-policy-in-a-real-life-cohort
#9
Loreta A Kondili, Federica Romano, Francesca Romana Rolli, Matteo Ruggeri, Stefano Rosato, Maurizia Rossana Brunetto, Anna Linda Zignego, Alessia Ciancio, Alfredo Di Leo, Giovanni Raimondo, Carlo Ferrari, Gloria Taliani, Guglielmo Borgia, Teresa Antonia Santantonio, Pierluigi Blanc, Giovanni Battista Gaeta, Antonio Gasbarrini, Luchino Chessa, Elke Maria Erne, Erica Villa, Donatella Ieluzzi, Francesco Paolo Russo, Pietro Andreone, Maria Vinci, Carmine Coppola, Liliana Chemello, Salvatore Madonia, Gabriella Verucchi, Marcello Persico, Massimo Zuin, Massimo Puoti, Alfredo Alberti, Gerardo Nardone, Marco Massari, Giuseppe Montalto, Giuseppe Foti, Maria Grazia Rumi, Maria Giovanna Quaranta, Americo Cicchetti, Antonio Craxì, Stefano Vella
We evaluated the cost-effectiveness of two alternative DAA treatment policies in a real-life cohort of HCV-infected patients: Policy 1 - "universal": treat all patients, regardless of the fibrosis stage; Policy 2 - treat only "prioritized" patients, delay treatment of the remaining patients until reaching stage F3. A liver disease progression Markov model, which used a lifetime horizon and healthcare system perspective, was applied to the PITER cohort (representative of Italian HCV-infected patients in care)...
July 24, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28740850/the-role-of-dog-population-management-in-rabies-elimination-a-review-of-current-approaches-and-future-opportunities
#10
REVIEW
Louise H Taylor, Ryan M Wallace, Deepashree Balaram, Joann M Lindenmayer, Douglas C Eckery, Beryl Mutonono-Watkiss, Ellie Parravani, Louis H Nel
Free-roaming dogs and rabies transmission are integrally linked across many low-income countries, and large unmanaged dog populations can be daunting to rabies control program planners. Dog population management (DPM) is a multifaceted concept that aims to improve the health and well-being of free-roaming dogs, reduce problems they may cause, and may also aim to reduce dog population size. In theory, DPM can facilitate more effective rabies control. Community engagement focused on promoting responsible dog ownership and better veterinary care could improve the health of individual animals and dog vaccination coverage, thus reducing rabies transmission...
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/28740663/evaluation-of-platelet-lymphocyte-ratio-and-90-day-mortality-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease
#11
Praneel Kumar, Stephanie Law, Krishna B Sriram
BACKGROUND: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have high mortality and health care costs. The platelet to lymphocyte ratio (PLR) is a marker of inflammation and has been reported to be elevated in patients with AECOPD compared to stable state. In this study, we sought to evaluate the association of the PLR in patients with AECOPD with 90-day mortality. METHODS: We conducted a retrospective cohort study of patients admitted to our institution with a primary diagnosis of AECOPD between January 2014 and July 2014...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740619/should-new-health-technology-be-available-only-for-patients-able-and-willing-to-pay
#12
REVIEW
Piet Calcoen, Albert Boer, Wynand P M M van de Ven
New health technology comes on the market at a rapid pace and - sometimes - at a huge cost. Providing access to new health technology is a serious challenge for many countries with mandatory health insurance. This article analyses access to new health technology in Belgium and the Netherlands, using eight concrete examples as a starting point for comparing the two - neighbouring - countries. Contrary to the Netherlands, out-of-pocket payments for new health technology are widely accepted and practiced in Belgium...
2017: Journal of Market Access & Health Policy
https://www.readbyqxmd.com/read/28740444/effective-deployment-of-technology-supported-management-of-chronic-respiratory-conditions-a-call-for-stakeholder-engagement
#13
Richard W Costello, Alexandra L Dima, Dermot Ryan, R Andrew McIvor, Kay Boycott, Alison Chisholm, David Price, John D Blakey
BACKGROUND: Healthcare systems are under increasing strain, predominantly due to chronic non-communicable diseases. Connected healthcare technologies are becoming ever more capable and their components cheaper. These innovations could facilitate both self-management and more efficient use of healthcare resources for common respiratory diseases such as asthma and chronic obstructive pulmonary disease. However, newer technologies can only facilitate major changes in practice, and cannot accomplish them in isolation...
2017: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/28740411/subgroup-analysis-of-telehealthcare-for-patients-with-chronic-obstructive-pulmonary-disease-the-cluster-randomized-danish-telecare-north-trial
#14
Flemming Witt Udsen, Pernille H Lilholt, Ole K Hejlesen, Lars H Ehlers
PURPOSE: Results from the Danish cluster-randomized trial of telehealthcare to 1,225 patients with chronic obstructive pulmonary disease (COPD), the Danish Telecare North Trial, concluded that the telehealthcare solution was unlikely to be cost-effective, by applying international willingness-to-pay threshold values. The purpose of this article was to assess potential sources of variation across subgroups, which could explain overall cost-effectiveness results or be utilized in future economic studies in telehealthcare research...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28740397/eligibility-for-alirocumab-or-evolocumab-treatment-in-1090-hypercholesterolemic-patients-referred-to-a-regional-cholesterol-treatment-center-with-ldl-cholesterol-%C3%A2-70-mg-dl-despite-maximal-tolerated-ldl-cholesterol-lowering-therapy
#15
Vybhav Jetty, Charles J Glueck, Kevin Lee, Naila Goldenberg, Marloe Prince, Ashwin Kumar, Michael Goldenberg, Ishan Anand, Ping Wang
BACKGROUND: Proprotein convertase subtilisin/kexin type 9 inhibitors, Praluent (alirocumab [ALI]) and Repatha (evolocumab [EVO]) have been approved as adjuncts to the standard-of-care maximal-tolerated dose (MTD) of low-density lipoprotein cholesterol (LDLC)-lowering therapy (LLT), statin therapy, in heterozygous (HeFH) (ALI or EVO) or homozygous (EVO) familial hypercholesterolemia, or clinical atherosclerotic cardiovascular disease (CVD) where LDLC lowering is insufficient (both). Since LDLC lowering has been revolutionized by ALI and EVO, specialty pharmaceutical pricing models will be applied to a mass market...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28740385/application-of-nanodiagnostics-in-point-of-care-tests-for-infectious-diseases
#16
REVIEW
Yongzhong Wang, Li Yu, Xiaowei Kong, Leming Sun
Although tremendous efforts have been put into the treatment of infectious diseases to prevent epidemics and mortality, it is still one of the major health care issues that have a profound impact on humankind. Therefore, the development of specific, sensitive, accurate, rapid, low-cost, and easy-to-use diagnostic tools is still in urgent demand. Nanodiagnostics, defined as the application of nanotechnology to medical diagnostics, can offer many unique opportunities for more successful and efficient diagnosis and treatment for infectious diseases...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28740375/clinical-and-economic-burden-of-dyspnea-and-other-copd-symptoms-in-a-managed-care-setting
#17
Judith J Stephenson, Debra Wertz, Tao Gu, Jeetvan Patel, Anand A Dalal
PURPOSE: The degree to which symptoms such as dyspnea affect patients with COPD is individualized. To address the gap between clinical symptom measures and self-perceived disease burden, we investigated the symptom status of adult patients with COPD and followed with an administrative claims analysis of health care resource utilization and costs. METHODS: This was a hybrid US observational study consisting of a cross-sectional patient survey followed by a retrospective analysis of administrative claims data...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28738984/transfusing-wisely-clinical-decision-support-improves-blood-transfusion-practices
#18
Ian Jenkins, Jay J Doucet, Brian Clay, Patricia Kopko, Donald Fipps, Eema Hemmen, Debra Paulson
BACKGROUND: The cost and risks of red blood cell (RBC) transfusions, along with evidence of overuse, suggest that improving transfusion practices is a key opportunity for health systems to improve both the quality and value of patient care. Previous work, which included a BestPractice Advisory (BPA), was adapted in a quality improvement project designed to reduce both exposure to unnecessary blood products and costs. METHODS: A prospective, pre-post study was conducted at an academic medical center with a diverse patient population...
August 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28738685/assessing-the-effect-of-the-vha-pcmh-model-on-utilization-patterns-among-veterans-with-ptsd
#19
Ian Randall, Charles Maynard, Gary Chan, Beth Devine, Chris Johnson
OBJECTIVES: The Veterans Health Administration (VHA) implemented a patient-centered medical home (PCMH)-based Patient Aligned Care Teams (PACT) model in 2010. We examined its effects on the utilization of health services among US veterans with posttraumatic stress disorder (PTSD). STUDY DESIGN: We analyzed VHA clinical and administrative data to conduct an interrupted time series study. Encounter-level data were obtained for the period of April 1, 2005, through March 31, 2014...
May 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28738684/drivers-of-excess-costs-of-opioid-abuse-among-a-commercially-insured-population
#20
Lauren M Scarpati, Noam Y Kirson, Miriam L Zichlin, Zitong B Jia, Howard G Birnbaum, Jaren C Howard
OBJECTIVES: To replicate and extend a recently published analysis of the drivers of excess costs of opioid abuse. STUDY DESIGN: Retrospective data analysis using de-identified claims data from the Truven MarketScan Commercial Claims and Encounter database. METHODS: Medical and prescription drug claims from beneficiaries covered by large self-insured US companies were used to select patients with incident diagnoses of opioid abuse between 2012 and 2015...
May 2017: American Journal of Managed Care
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