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https://www.readbyqxmd.com/read/28523341/cost-of-unnecessary-testing-in-the-evaluation-of-pediatric-syncope
#1
Connor Redd, Cameron Thomas, Martha Willis, Michelle Amos, Jeffrey Anderson
Syncope is a common and a typically benign clinical problem in children and adolescents. The majority of tests ordered in otherwise healthy pediatric patients presenting with syncope have low diagnostic yield. This study quantifies testing and corresponding patient charges in a group of pediatric patients presenting for outpatient evaluation for syncope. Patients seen between 3/2011 and 4/2013 in the multi-disciplinary Syncope Clinic at Cincinnati Children's Hospital Medical Center were enrolled in a registry which was reviewed for patient information...
May 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28514804/-changes-in-the-use-of-health-insurance-services-before-and-after-a-father-child-measure
#2
Felix Barre, Jelena Epping
Introduction Since 2002 inpatient preventive and rehabilitative measures for fathers and their children (F-C-M) are available in the German health system (§§ 24 and 41 SGB V). So far there is no data on health disorders of the fathers in F-C-M. The aim of this study is to examine whether participants of F-C-M are more prone to health problems than fathers who are not participating in F-C-M and whether participation in F-C-M contributes to improved health. To do so, the change in the use of outpatient care services is examined and compared to the use of mentioned services by fathers who are not participating in an F-C-M...
May 17, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28509811/implementation-of-a-new-method-to-track-propofol-in-an-endoscopy-unit
#3
Catherine Horvath
AIM: Propofol is a widely used anesthesia induction agent and is easily accessible in most healthcare facilities. Unlike regulated or schedule drugs, propofol is inconsistently tracked, leading to inaccurate inventories, incorrect billing, and unrecognized diversion. The goal of this project was to implement a new method of tracking propofol in a single setting, with the aim of accounting for 100% of the drug. METHODS: For two, 2-week observation periods, data were extracted from an automated medication management system or pharmacy inventory system, anesthesia records, and pharmacy billing sheets for cases in a Gastrointestinal (GI) Endoscopy Unit, and compared pre-implementation and post-implementation of a new tracking and accounting protocol...
April 29, 2017: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/28507288/identifying-individuals-with-physician-diagnosed-chronic-obstructive-pulmonary-disease-in-primary-care-electronic-medical-records-a-retrospective-chart-abstraction-study
#4
Theresa M Lee, Karen Tu, Laura L Wing, Andrea S Gershon
Little is known about using electronic medical records to identify patients with chronic obstructive pulmonary disease to improve quality of care. Our objective was to develop electronic medical record algorithms that can accurately identify patients with obstructive pulmonary disease. A retrospective chart abstraction study was conducted on data from the Electronic Medical Record Administrative data Linked Database (EMRALD(®)) housed at the Institute for Clinical Evaluative Sciences. Abstracted charts provided the reference standard based on available physician-diagnoses, chronic obstructive pulmonary disease-specific medications, smoking history and pulmonary function testing...
May 15, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28506414/unintentional-recurrent-laryngeal-nerve-injuries-following-thyroidectomy-is-it-the-surgeon-who-pays-the-bill
#5
REVIEW
C Gambardella, A Polistena, A Sanguinetti, R Patrone, S Napolitano, D Esposito, D Testa, V Marotta, A Faggiano, P G Calò, N Avenia, G Conzo
BACKGROUND: Thyroidectomy is one of the most common intervention in general surgery and, after the turn of the century, its rate has sharply increased, along with a worldwide increased incidence of differentiated thyroid cancers. Therefore, injuries of the recurrent laryngeal nerve have become one of the most frequent cause of surgical malpractice claims, mostly following surgery for benign pathology. MAIN BODY: Even if the incidence of definitive paralysis is generally lower than 3%, during the last 20 years in Italy, the number of claims for damages has sharply raised...
May 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28493177/what-is-single-payer-health-care-a-review-of-definitions-and-proposals-in-the-u-s
#6
Jodi L Liu, Robert H Brook
BACKGROUND: Single-payer systems have been proposed as a health care reform alternative in the United States. However, there is no consensus on the definition of single-payer. Most definitions characterize single-payer as one entity that collects funds and pays for health care on behalf on an entire population. Increased flexibility for state health care reform may provide opportunities for state-based single-payer systems to be considered. OBJECTIVE: To explore the concept of single-payer and to describe the contents of single-payer health care proposals...
May 10, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28492523/evaluation-of-identifier-field-agreement-in-linked-neonatal-records
#7
E S Hall, K Marsolo, J M Greenberg
OBJECTIVE: To better address barriers arising from missing and unreliable identifiers in neonatal medical records, we evaluated agreement and discordance among traditional and non-traditional linkage fields within a linked neonatal data set. STUDY DESIGN: The retrospective, descriptive analysis represents infants born from 2013 to 2015. We linked children's hospital neonatal physician billing records to newborn medical records originating from an academic delivery hospital and evaluated rates of agreement, discordance and missingness for a set of 12 identifier field pairs used in the linkage algorithm...
May 11, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28490921/use-of-physician-services-during-the-survivorship-phase-a-multi-province-study-of-women-diagnosed-with-breast-cancer
#8
C Kendell, K M Decker, P A Groome, M L McBride, L Jiang, M K Krzyzanowska, G Porter, D Turner, R Urquhart, M Winget, E Grunfeld
INTRODUCTION: Oncologists have traditionally been responsible for providing routine follow-up care for cancer survivors; in recent years, however, primary care providers (pcps) are taking a greater role in care during the follow-up period. In the present study, we used a longitudinal multi-province retrospective cohort study to examine how primary care and specialist care intersect in the delivery of breast cancer follow-up care. METHODS: Various databases (registry, clinical, and administrative) were linked in each of four provinces: British Columbia, Manitoba, Ontario, and Nova Scotia...
April 2017: Current Oncology
https://www.readbyqxmd.com/read/28490904/clinical-epidemiology-in-the-era-of-big-data-new-opportunities-familiar-challenges
#9
Vera Ehrenstein, Henrik Nielsen, Alma B Pedersen, Søren P Johnsen, Lars Pedersen
Routinely recorded health data have evolved from mere by-products of health care delivery or billing into a powerful research tool for studying and improving patient care through clinical epidemiologic research. Big data in the context of epidemiologic research means large interlinkable data sets within a single country or networks of multinational databases. Several Nordic, European, and other multinational collaborations are now well established. Advantages of big data for clinical epidemiology include improved precision of estimates, which is especially important for reassuring ("null") findings; ability to conduct meaningful analyses in subgroup of patients; and rapid detection of safety signals...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28490467/dose-optimization-to-minimize-radiation-risk-for-children-undergoing-ct-and-nuclear-medicine-imaging-is-misguided-and-detrimental
#10
Jeffry A Siegel, Bill Sacks, Charles W Pennington, James S Welsh
A debate exists within the medical community on whether the linear no-threshold (LNT) model of ionizing radiation exposure accurately predicts subsequent radiogenic cancer incidence. We evaluate the evidence that refutes LNT, and its corollary efforts to reduce radiation exposures for CT and nuclear medicine imaging in accord with ALARA (as low as reasonable achievable), particularly for children. Further, we review studies demonstrating that children are not, in fact, more radiosensitive than adults in the radiological imaging dose range, rendering dose reduction for children unjustifiable and counterproductive...
May 10, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/28483774/observed-cost-and-variations-in-short-term-cost-effectiveness-of-therapy-for-ischemic-stroke-in-interventional-management-of-stroke-ims-iii
#11
Kit N Simpson, Annie N Simpson, Patrick D Mauldin, Yuko Y Palesch, Sharon D Yeatts, Dawn Kleindorfer, Thomas A Tomsick, Lydia D Foster, Andrew M Demchuk, Pooja Khatri, Michael D Hill, Edward C Jauch, Tudor G Jovin, Bernard Yan, Rüdiger von Kummer, Carlos A Molina, Mayank Goyal, Wouter J Schonewille, Mikael Mazighi, Stefan T Engelter, Craig Anderson, Judith Spilker, Janice Carrozzella, Karla J Ryckborst, L Scott Janis, Joseph P Broderick
BACKGROUND: Examination of linked data on patient outcomes and cost of care may help identify areas where stroke care can be improved. We report on the association between variations in stroke severity, patient outcomes, cost, and treatment patterns observed over the acute hospital stay and through the 12-month follow-up for subjects receiving endovascular therapy compared to intravenous tissue plasminogen activator alone in the IMS (Interventional Management of Stroke) III Trial. METHODS AND RESULTS: Prospective data collected for a prespecified economic analysis of the trial were used...
May 8, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28480575/comprehensive-headache-experience-in-collegiate-student-athletes-an-initial-report-from-the-ncaa-headache-task-force
#12
Tad Seifert, Alicia Sufrinko, Robert Cowan, W Scott Black, Dave Watson, Bill Edwards, Scott Livingston, Keith Webster, David Akers, Mathew Lively, Anthony P Kontos
BACKGROUND: The prevalence of primary headache disorders in the general population provides a unique challenge in the evaluation of headache occurring in the context of sport. Despite a wealth of studies exploring the epidemiology of headache in the layperson, little is known about the prevalence and nature of headaches in collegiate student-athletes. These scenarios are challenging in the return to play context, as it is often unclear whether an athlete has an exacerbation of a primary headache disorder, new onset headache unrelated to trauma, or has suffered a concussive injury...
May 7, 2017: Headache
https://www.readbyqxmd.com/read/28480184/trauma-surgery-without-proper-compensation-under-the-current-korean-national-health-insurance-system
#13
Kyoungwon Jung, Yunjung Heo, John Cook-Jong Lee, Mijin Lee, Suni Son, Hee Suk Park, Joo-Ok Kim, Jeong Hee Lee
PURPOSE: This study aimed to evaluate the situations and problems of the current health insurance fees for trauma surgeries. METHODS: We reviewed the medical records and billing data from trauma surgeries performed in the hospital from August 2012 to July 2014. The name and number of surgeries were investigated and the code and number of operations prescribed by surgeons were compared with the number of cases actually billed to insurance. In addition, the results returned by the Health Insurance Review & Assessment Services (HIRA) after deduction were investigated and compared to verify the insurance review findings...
May 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28479117/health-care-services-utilization-during-the-last-6-months-of-life-among-patients-with-bladder-cancer-who-underwent-radical-cystectomy-in-quebec-canada
#14
Ahmed S Zakaria, Fabiano Santos, Alice Dragomir, Wassim Kassouf, Simon Tanguay, Armen Aprikian
INTRODUCTION AND OBJECTIVES: Management of bladder cancer imposes a great economic challenge on the health care system; with the greatest share of this burden attributed to radical cystectomy (RC) and prolonged postoperative follow-up. Our aim was to characterize health care services utilization and evaluate associated cost predictors during the last 6 months of life in patients who had RC. METHODS: We conducted a retrospective study within a cohort of 2,988 patients who had RC from 2000 to 2009...
May 4, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28473459/medicare-s-top-billing-doctor-is-convicted-of-medical-fraud
#15
Owen Dyer
No abstract text is available yet for this article.
May 4, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28473087/acr-appropriateness-criteria-%C3%A2-sudden-onset%C3%A2-of%C3%A2-cold-painful-leg
#16
Clifford R Weiss, Ezana M Azene, Bill S Majdalany, Ali F AbuRahma, Jeremy D Collins, Christopher J Francois, Marie D Gerhard-Herman, Heather L Gornik, John M Moriarty, Patrick T Norton, Thomas Ptak, Stephen P Reis, Frank J Rybicki, Sanjeeva P Kalva
Acute limb ischemia (ALI) requires urgent diagnosis and treatment to prevent limb loss. Invasive digital subtraction arteriography (DSA) is the gold standard for diagnosing ALI. DSA is the only diagnostic modality that permits simultaneous treatment of acute arterial occlusion. Noninvasive imaging with MRA or CT angiography may also be appropriate before treatment, especially when the diagnosis of ALI is in doubt or where DSA is unavailable. Other imaging and noninvasive physiologic tests may prove important for longer term management but are less recommended in the acute setting...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473082/acr-appropriateness-criteria-%C3%A2-pulsatile-abdominal-mass-suspected-abdominal-aortic%C3%A2-aneurysm
#17
Stephen P Reis, Bill S Majdalany, Ali F AbuRahma, Jeremy D Collins, Christopher J Francois, Suvranu Ganguli, Heather L Gornik, A Tuba Kendi, Minhajuddin S Khaja, Patrick T Norton, Patrick D Sutphin, Frank J Rybicki, Sanjeeva P Kalva
Clinical palpation of a pulsating abdominal mass alerts the clinician to the presence of a possible abdominal aortic aneurysm (AAA). Imaging studies are important in diagnosing and categorizing the extent of the aneurysm and may aid in treatment planning. The consensus of the literature supports the use of ultrasound as the initial screening test in patients with suspected AAA. Population-based ultrasound screening studies have been recommended and have proved effective for male patients > 65 years of age...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473067/acr-appropriateness-criteria-%C3%A2-chylothorax-treatment-planning
#18
Bill S Majdalany, Douglas A Murrey, Baljendra S Kapoor, Thomas R Cain, Suvranu Ganguli, Michael S Kent, Fabien Maldonado, Joseph J McBride, Jeet Minocha, Stephen P Reis, Jonathan M Lorenz, Sanjeeva P Kalva
Chylothorax is an uncommon but serious medical condition, which arises when intestinal lymphatic fluid leaks into the pleural space. Treatment strategies depend on the daily output and underlying etiology, which may be due to direct injury to lymphatic vessels or a nontraumatic disorder. Chest radiographs confirm the presence of pleural fluid and lateralize the process. In the setting of direct injury, lymphangiography can often be both diagnostic and facilitate a minimally invasive attempt at therapy. CT and MRI in this setting may be appropriate for cases when lymphangiography is not diagnostic...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28461346/medicaid-expansion-increased-coverage-improved-affordability-and-reduced-psychological-distress-for-low-income-parents
#19
Stacey McMorrow, Jason A Gates, Sharon K Long, Genevieve M Kenney
Despite receiving less attention than their childless counterparts, low-income parents also experienced significant expansions of Medicaid eligibility under the Affordable Care Act (ACA). We used data for the period 2010-15 from the National Health Interview Survey to examine the impacts of the ACA's Medicaid expansion on coverage, access and use, affordability, and health status for low-income parents. We found that eligibility expansions increased coverage, reduced problems paying medical bills, and reduced severe psychological distress...
May 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28459608/the-influence-of-comorbid-asthma-on-the-severity-of-symptoms-in-children-with-attention-deficit-hyperactivity-disorder
#20
Adrienne P Borschuk, Casey Rodweller, Cynthia F Salorio
OBJECTIVE: The current study examined the association between asthma and attention-deficit hyperactivity disorder (ADHD) symptoms in a clinical pediatric sample. METHODS: Demographic and neuropsychological data for children with a billing diagnosis of ADHD were extracted from a clinical database. Families completed standard rating scales. Seventy-one patients with a co-morbid asthma diagnosis were identified and matched by age to a group of 71 patients with only ADHD...
May 1, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
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