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https://www.readbyqxmd.com/read/29474312/benchmarking-implications-analysis-of-medicare-accountable-care-organizations-spending-level-and-quality-of-care
#1
Young-Rock Hong, Frederick Kates, Soon Ju Song, Nayoung Lee, R Paul Duncan, Nicole M Marlow
Early evidence has shown that Accountable Care Organizations (ACOs) have achieved some success in improving the quality of care and reducing Medicare costs. However, it has been argued that the ACO rewarding model may disproportionately affect relatively low-spending (LS; considered as efficient) organizations that have fewer options to cut unnecessary services compared with high-spending (HS; inefficient) organizations. We conducted a cross-sectional retrospective study to compare ACO financial and quality of care performance between HS-ACO and LS-ACO...
February 16, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29466919/what-qualities-in-a-potential-hiv-pre-exposure-prophylaxis-service-are-valued-by-black-men-who-have-sex-with-men-in-london-a-qualitative-acceptability-study
#2
T Charles Witzel, Will Nutland, Adam Bourne
Black men who have sex with men (BMSM) have higher HIV incidence and prevalence when compared to other MSM, despite similar levels of condom use and testing. Pre-exposure prophylaxis (PrEP) could be a useful intervention to reduce these inequalities. This research therefore aims to understand the dimensions of acceptability of a potential PrEP service for BMSM aged 18-45 years in London. In-depth semi-structured interviews were conducted with 25 PrEP-eligible BMSM between April and August 2016. Interviews were recorded and transcribed verbatim, then subject to a thematic framework analysis, informed by intersectionality theory...
January 1, 2018: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/29466311/miot-slice-for-5g-systems-design-and-performance-evaluation
#3
Riccardo Trivisonno, Massimo Condoluci, Xueli An, Toktam Mahmoodi
Network slicing is a key feature of the upcoming 5G networks allowing the design and deployment of customized communication systems to integrate services provided by vertical industries. In this context, massive Internet of Things (mIoT) is regarded as a compelling use case, both for its relevance from business perspective, and for the technical challenges it poses to network design. With their envisaged massive deployment of devices requiring sporadic connectivity and small data transmission, yet Quality of Service (QoS) constrained, mIoT services will need an ad-hoc end-to-end (E2E) slice, i...
February 21, 2018: Sensors
https://www.readbyqxmd.com/read/29462884/an-efficient-framework-model-for-optimizing-routing-performance-in-vanets
#4
Nori M Al-Kharasani, Zuriati Ahmad Zulkarnain, Shamala Subramaniam, Zurina Mohd Hanapi
Routing in Vehicular Ad hoc Networks (VANET) is a bit complicated because of the nature of the high dynamic mobility. The efficiency of routing protocol is influenced by a number of factors such as network density, bandwidth constraints, traffic load, and mobility patterns resulting in frequency changes in network topology. Therefore, Quality of Service (QoS) is strongly needed to enhance the capability of the routing protocol and improve the overall network performance. In this paper, we introduce a statistical framework model to address the problem of optimizing routing configuration parameters in Vehicle-to-Vehicle (V2V) communication...
February 15, 2018: Sensors
https://www.readbyqxmd.com/read/29461992/healthcare-s-future-strategic-investment-in-technology
#5
Michael A Franklin
Recent and rapid advances in the implementation of technology have greatly affected the quality and efficiency of healthcare delivery in the United States. Simultaneously, diverse generational pressures-including the consumerism of millennials and unsustainable growth in the costs of care for baby boomers-have accelerated a revolution in healthcare delivery that was marked in 2010 by the passage of the Affordable Care Act.Against this backdrop, Maryland and the Centers for Medicare & Medicaid Services entered into a partnership in 2014 to modernize the Maryland All-Payer Model...
April 2018: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/29461991/technology-s-role-in-quality-improvement-and-operational-efficiency
#6
Judy Blauwet, Mandy Bell
Technology for technology's sake is never a good idea. There must be a purpose behind it. It must help us do our jobs better. Technology allows healthcare to remain affordable and, as such, accessible. Technology must increase access to care, improve safety, make test results more reliable, and help teams communicate better for a seamless care experience.Avera Health, a health system based in Sioux Falls, South Dakota, comprises 330 facilities in 100 communities in five states. Sponsored by the Benedictine and Presentation Sisters, Avera is a healthcare ministry whose employees deliver high-quality care with compassion...
April 2018: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/29461675/improving-eye-care-services-with-a-lean-approach
#7
Juha-Matti Lindholm, Ilkka Laine, Heli Hippala, Petteri Ylinen, Raimo Tuuminen
PURPOSE: Effective provision of eye care services in government-financed hospitals is essential to balance the discrepancy between growing demand and limited resources. We aimed to improve efficiency of the treatment protocol for Nd:YAG laser posterior capsulotomy. Predetermined quality targets were a patient-oriented and patient-safe approach and the development of a clinical care process with purposeful use of competences. METHODS: We utilized a lean process improvement methodology to develop a streamlined Nd:YAG laser posterior capsulotomy treatment protocol...
February 20, 2018: Acta Ophthalmologica
https://www.readbyqxmd.com/read/29458335/integrated-children-s-clinic-care-iccc-versus-a-self-directed-care-pathway-for-children-with-a-chronic-health-condition-a-multi-centre-randomised-controlled-trial-study-protocol
#8
Thuy Thanh Frakking, John Waugh, Hsien-Jin Teoh, Doug Shelton, Susan Moloney, Donna Ward, Michael David, Matthew Barber, Hannah Carter, Sharon Mickan, Kelly Weir
BACKGROUND: Children with chronic health conditions have better health-related outcomes when their care is managed in a personalised and coordinated way. However, increased demand on Australian ambulatory care hospital services has led to longer waitlist times to access specialists and appropriate intervention services; placing vulnerable children at increased risk of poorer short-term (e.g. social difficulties) and long-term (e.g. convictions) health and social outcomes. Traditional approaches to increasing frequency and service of delivery are expensive and can have minimal impact on caregiver burden...
February 19, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29455686/cost-utility-analysis-of-private-contracting-to-reduce-public-waiting-times-for-joint-replacement-surgery
#9
Jonathan Karnon, Bahareh Mesgarian Haghighi, Babu Sajjad, Sokunthea Yem, Anuji Gamage, Aaron Thorpe
OBJECTIVES: Earlier treatment of publicly funded patients may achieve health gains that justify the additional costs of reducing waiting times. This study reports on the cost-effectiveness of implementing a private contracting model to meet alternative maximum waiting time targets for publicly funded patients undergoing total knee replacement surgery in Australia. METHODS: A linked decision tree and cohort Markov model was developed and populated and validated using secondary data sources to represent the pathways, costs, and quality adjusted life-years (QALYs) gained of non-urgent patients with alternative waiting times for total knee replacement surgery to a maximum age of 100 years...
February 19, 2018: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/29452560/health-care-efficiencies-consolidation-and-alternative-models-vs-health-care-and-antitrust-regulation-irreconcilable-differences
#10
Michael W King
Despite the U.S. substantially outspending peer high income nations with almost 18% of GDP dedicated to health care, on any number of statistical measurements from life expectancy to birth rates to chronic disease, 1 the U.S. achieves inferior health outcomes. In short, Americans receive a very disappointing return on investment on their health care dollars, causing economic and social strain. 2 Accordingly, the debates rage on: what is the top driver of health care spending? Among the culprits: poor communication and coordination among disparate providers, paperwork required by payors and regulations, well-intentioned physicians overprescribing treatments, drugs and devices, outright fraud and abuse, and medical malpractice litigation...
November 2017: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29444767/patient-reported-measures-for-person-centered-coordinated-care-a-comparative-domain-map-and-web-based-compendium-for-supporting-policy-development-and-implementation
#11
Helen Lloyd, Hannah Wheat, Jane Horrell, Thavapriya Sugavanam, Benjamin Fosh, Jose M Valderas, James Close
BACKGROUND: Patient-reported measure (PRM) questionnaires were originally used in research to measure outcomes of intervention studies. They have now evolved into a diverse family of tools measuring a range of constructs including quality of life and experiences of care. Current health and social care policy increasingly advocates their use for embedding the patient voice into service redesign through new models of care such as person-centered coordinated care (P3C). If chosen carefully and used efficiently, these tools can help improve care delivery through a variety of novel ways, including system-level feedback for health care management and commissioning...
February 14, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29433508/research-priority-setting-reproductive-health-in-the-occupied-palestinian-territory
#12
Niveen M E Abu-Rmeileh, Rula Ghandour, Marina Tucktuck, Mohammad Obiedallah
BACKGROUND: Occupied Palestinian territory (oPt) is an authority with limited resources. Therefore, research conducted in such a setting should be prioritized and coordinated to follow a national research agenda. This study aims to produce a research agenda for reproductive health in the oPt that can be utilized by reproductive health stakeholders and contribute to the development of policy-based evidence to guide health practice. METHODS: In the current study, we followed research prioritization methods developed by the World Health Organization-Child Health and Nutrition Research Initiative...
February 13, 2018: Reproductive Health
https://www.readbyqxmd.com/read/29432105/learning-a-continuous-time-streaming-video-qoe-model
#13
Deepti Ghadiyaram, Janice Pan, Alan C Bovik
Over-the-top adaptive video streaming services are frequently impacted by fluctuating network conditions that can lead to rebuffering events (stalling events) and sudden bitrate changes. These events visually impact video consumers' quality of experience (QoE) and can lead to consumer churn. The development of models that can accurately predict viewers' instantaneous subjective QoE under such volatile network conditions could potentially enable the more efficient design of quality-control protocols for media-driven services, such as YouTube, Amazon, Netflix, and so on...
May 2018: IEEE Transactions on Image Processing: a Publication of the IEEE Signal Processing Society
https://www.readbyqxmd.com/read/29428192/expanding-access-to-primary-healthcare-for-women-through-a-microfinance-institution-a-case-study-from-rural-guatemala
#14
Marcela Colom, Kirsten Austad, Neftali Sacuj, Karen Larson, Peter Rohloff
The utilization of existing social networks is increasingly being recognized as a powerful strategy for delivering healthcare services to underserved populations in low- and middle-income countries. In Guatemala, multiple barriers prevent access to healthcare services for rural and indigenous populations, and strategies for delivering healthcare in more efficient ways are needed. The case study we describe here is a unique collaboration between a microfinance institution (Friendship Bridge) and a primary care organization (Wuqu' Kawoq | Maya Health Alliance) to scale up healthcare through an existing lending-borrowing social network...
February 7, 2018: Healthcare
https://www.readbyqxmd.com/read/29422099/applying-the-results-based-management-framework-to-the-cerca-multi-component-project-in-adolescent-sexual-and-reproductive-health-a-retrospective-analysis
#15
Kathya Cordova-Pozo, Andrea J Hoopes, Freddy Cordova, Bernardo Vega, Zoyla Segura, Arnold Hagens
BACKGROUND: Adolescent sexual and reproductive health (SRH), problems such as unplanned pregnancies are complex and multifactorial, thus requiring multifaceted prevention interventions. Evaluating the impact of such interventions is important to ensure efficiency, effectiveness and accountability for project funders and community members. In this study, we propose Results Based Management (RBM) as a framework for project management, using the Community Embedded Reproductive Health Care for Adolescents (CERCA) as a case study for RBM...
February 8, 2018: Reproductive Health
https://www.readbyqxmd.com/read/29407255/using-research-evidence-to-inform-staff-learning-needs-in-cross-cultural-communication-in-aged-care-homes
#16
David Gillham, Anita De Bellis, Lily Xiao, Eileen Willis, Ann Harrington, Wendy Morey, Lesley Jeffers
BACKGROUND: Developed countries worldwide are facing an unprecedented demand for aged care services, with recent migrants of diverse linguistic and cultural backgrounds increasingly recruited as care workers while at the same time there is growing cultural diversity among aged care residents. This situation is compounded by rapidly changing technology and varied educational levels of care workers from diverse backgrounds. OBJECTIVES: The objectives were threefold: to identify staff learning needs to enable them to provide high-quality cross-cultural care; to improve team cohesion; and identify preferred learning approaches...
February 2, 2018: Nurse Education Today
https://www.readbyqxmd.com/read/29406372/epidemiology-of-pediatric-critical-care-transport-in-northern-alberta-and-the-western-arctic
#17
Atsushi Kawaguchi, Charlene C Nielsen, Gonzalo G Guerra, L Duncan Saunders, Yutaka Yasui, Allan DeCaen
OBJECTIVE: Specialized pediatric critical care transport teams are essential to pediatric retrieval systems. This study aims to describe the contemporary transports performed by a Canadian pediatric critical care transport team and to compare the treatment and outcomes of children referred from high-level care (hospitals offering pediatric services where an adult ICU exists) and nonhigh-level care (all other hospitals) hospitals. DESIGN: A descriptive cohort study...
February 5, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29404949/molecular-detection-and-genotypic-characterization-of-enteric-adenoviruses-in-a-hospital-wastewater
#18
Chourouk Ibrahim, Abdennaceur Hassen, Pierre Pothier, Selma Mejri, Salah Hammami
Hospital wastewater (HWW) represents a major source of the diffusion of many antibiotics and some toxic pathogenic microorganisms in the aquatic environment. Sanitation services play a critical role in controlling transmission of numerous waterborne pathogens, especially enteric human adenoviruses (HAdVs) that can cause acute gastroenteritis. This study intended to evaluate the human adenoviruses (HAdVs) detection rates, to determine the genotype of these viruses and to assess the efficiency of HAdVs removal in hospital pilot wastewater treatment plant (PWWTP) in Tunis City, Tunisia...
February 5, 2018: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/29402260/equity-and-efficiency-of-medical-service-systems-at-the-provincial-level-of-china-s-mainland-a-comparative-study-from-2009-to-2014
#19
Jingmei Ding, Xuejun Hu, Xianzhi Zhang, Lei Shang, Min Yu, Huoliang Chen
BACKGROUND: The astonishing economic achievements of China in the past few decades have remarkably increased not only the quantity and quality of medical services but also the inequalities in health resources allocation across regions and inefficiency of the medical service delivery. METHODS: A descriptive analysis was used to compare the inequities in inputs and outputs of the provincial medical service systems, a non-radial super-efficiency data envelopment analysis model was then used to estimate the efficiency, and a regression analysis of the panel data was used to explore the determinants...
February 5, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29394425/hospital-readmission-rates-following-ami-potential-interventions-to-improve-efficiency
#20
Jennifer T Nguyen, Kairav Vakil, Selcuk Adabag, Anders Westanmo, Richard Madlon-Kay, Areef Ishani, Santiago Garcia, Edward O McFalls
OBJECTIVES: Quality of care utilization measures for patients admitted to the hospital with an acute myocardial infarction (AMI) include length of stay (LOS) and 30-day readmission rates. Our aim was to test whether efforts resulting in reduced LOS in patients diagnosed as having AMI would result in a higher risk of readmission within 30 days of hospital discharge and whether specific interventions could be targeted to reduce readmissions. METHODS: Using data supplied by the Veterans Affairs Inpatient Evaluation Center, we analyzed both the readmissions within 30 days of an AMI and LOS and determined the timing of readmissions and associated diagnoses...
February 2018: Southern Medical Journal
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