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https://www.readbyqxmd.com/read/29160426/impact-assessment-of-an-automated-drug-dispensing-system-in-a-tertiary-hospital
#1
Débora de-Carvalho, José Luiz Alvim-Borges, Cristiana Maria Toscano
OBJECTIVE: To evaluate the costs and patient safety of a pilot implementation of an automated dispensing cabinet in a critical care unit of a private tertiary hospital in São Paulo/Brazil. METHODS: This study considered pre- (January-August 2013) and post- (October 2013-October 2014) intervention periods. We considered the time and cost of personnel, number of adverse events, audit adjustments to patient bills, and urgent requests and returns of medications to the central pharmacy...
October 2017: Clinics
https://www.readbyqxmd.com/read/29155848/an-electronic-health-record-based-model-predicts-statin-adherence-ldl-cholesterol-and-cardiovascular-disease-in-the-united-states-military-health-system
#2
Joseph E Lucas, Taylor C Bazemore, Celan Alo, Patrick B Monahan, Deepak Voora
HMG-CoA reductase inhibitors (or "statins") are important and commonly used medications to lower cholesterol and prevent cardiovascular disease. Nearly half of patients stop taking statin medications one year after they are prescribed leading to higher cholesterol, increased cardiovascular risk, and costs due to excess hospitalizations. Identifying which patients are at highest risk for not adhering to long-term statin therapy is an important step towards individualizing interventions to improve adherence. Electronic health records (EHR) are an increasingly common source of data that are challenging to analyze but have potential for generating more accurate predictions of disease risk...
2017: PloS One
https://www.readbyqxmd.com/read/29150201/nations-within-a-nation-variations-in-epidemiological-transition-across-the-states-of-india-1990-2016-in-the-global-burden-of-disease-study
#3
(no author information available yet)
BACKGROUND: 18% of the world's population lives in India, and many states of India have populations similar to those of large countries. Action to effectively improve population health in India requires availability of reliable and comprehensive state-level estimates of disease burden and risk factors over time. Such comprehensive estimates have not been available so far for all major diseases and risk factors. Thus, we aimed to estimate the disease burden and risk factors in every state of India as part of the Global Burden of Disease (GBD) Study 2016...
November 13, 2017: Lancet
https://www.readbyqxmd.com/read/29141197/medical-abortion-reversal-science-and-politics-meet
#4
Khadijah Z Bhatti, Antoinette T Nguyen, Gretchen S Stuart
Medical abortion is a safe, effective, and acceptable option for patients seeking an early non-surgical abortion. In 2014, medical abortion accounted for nearly one-third (31%) of all abortions performed in the United States. State-level attempts to restrict reproductive and sexual health have recently included bills that require physicians to inform women that a medical abortion is reversible. In this commentary, we will review the history, current evidence-based regimen, and regulation of medical abortion...
November 12, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29117725/experiencing-financial-hardship-associated-with-medical-bills-and-its-effects-on-health-care-behavior-a-2-year-panel-study
#5
Sunha Choi
Using 2-year panel data, this study examined (1) whether experiencing financial hardship associated with out-of-pocket medical expenditures affected delaying/missing necessary health care in the following year; (2) whether such financial hardship mediated the effects of predisposing, enabling, and need characteristics on timely health care access (i.e., significant indirect effects); and (3)whether such mediating effects are different by chronic health status (i.e., moderated mediation) among U.S. adults. The 2011 National Health Interview Survey was linked to the 2012 Medical Expenditure Panel Survey...
November 1, 2017: Health Education & Behavior: the Official Publication of the Society for Public Health Education
https://www.readbyqxmd.com/read/29117091/the-application-of-observational-practice-and-educational-networking-in-simulation-based-and-distributed-medical-education-contexts
#6
Arthur Welsher, David Rojas, Zain Khan, Laura VanderBeek, Bill Kapralos, Lawrence E M Grierson
INTRODUCTION: Research has revealed that individuals can improve technical skill performance by viewing demonstrations modeled by either expert or novice performers. These findings support the development of video-based observational practice communities that augment simulation-based skill education and connect geographically distributed learners. This study explores the experimental replicability of the observational learning effect when demonstrations are sampled from a community of distributed learners and serves as a context for understanding learner experiences within this type of training protocol...
November 8, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29110802/testosterone-therapy-and-risk-of-acute-myocardial-infarction-in-hypogonadal-men-an-administrative-health-care-claims-study
#7
Hu Li, Lucy Mitchell, Xiang Zhang, Darell Heiselman, Stephen Motsko
BACKGROUND: There are some ongoing debates on the potential link between testosterone therapy (TT) and risk of acute myocardial infarction (MI). AIM: To investigate the association between acute MI and TT use compared with non-use in men having documented hypogonadism (diagnostic International Classification of Diseases, Ninth Revision codes 257.2, 257.8, 257.9, 758.7) in patient claims records. METHODS: This retrospective cohort study used a real-world US-based administrative health care claims database (MarketScan 2004-2013; Truven Health Analytics, Ann Arbor, MI, USA) to compare MI rates between TT-treated men and a cohort of untreated hypogonadal men matched by a calendar time-specific propensity score...
November 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/29106367/telephone-consultations-in-urology-who-when-where-and-why
#8
Anne-Sophie Blais, Joanie Pelletier, Katherine Moore
INTRODUCTION: Telephone consultations are part of a strategy to allow access to medical expertise. Telephone consultations have been fee-for-services benefits in the province of Quebec since 2012.(1) Recent studies have shown that adequate communication is one of the most common means to prevent disability and death.(2) We sought to determine the characteristics of phone consultations made to a tertiary centre's urologists and to characterize their experience. METHODS: We performed a prospective study using all billing receipts filed by 15 academic urologists for phone consultations received during a 10-month period...
November 1, 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/29102388/-end-of-life-debate-citizen-s-point-of-view-about-deep-and-continuous-sedation
#9
J Toporski, T Jonveaux-Rivasseau, C Lamouille-Chevalier
INTRODUCTION: Sedation in palliative care meets a precise definition and corresponds to a medical practice. We assessed the comprehension of this practice by the French population. METHOD: In 2015, citizen expressed their views on the Claeys-Leonetti bill by means of a consultative forum made available on the Internet site of the National Assembly. The content of the messages filed, regarding the right to deep and continuous sedation until death was analyzed using the ALCESTE textual data analysis software, supplemented by a thematic analysis in order to identify the perception that Internet users had of this practice...
November 1, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29102043/long-term-consequences-of-landmine-injury-a-survey-of-civilian-survivors-in-bosnia-herzegovina-20-years-after-the-war
#10
Katherine O Ryken, Matthew Hogue, J Lawrence Marsh, Marin Schweizer
INTRODUCTION: Bosnia-Herzegovina is one of the most landmine-contaminated countries in Europe. Since the beginning of the war in 1992, there have been 7968 recorded landmine victims, with 1665 victims since the end of the war in 1995. While many of these explosions result in death, a high proportion of these injuries result in amputation, leading to a large number of disabled individuals. OBJECTIVE: The purpose of this study is to conduct a survey of civilian landmine victims in Bosnia-Herzegovina in order to assess the effect of landmine injuries on physical, mental, and social well-being...
August 25, 2017: Injury
https://www.readbyqxmd.com/read/29078769/this-moral-coil-a-cross-sectional-survey-of-canadian-medical-student-attitudes-toward-medical-assistance-in-dying
#11
Eli Xavier Bator, Bethany Philpott, Andrew Paul Costa
BACKGROUND: In February, 2015, the Supreme Court of Canada struck down the ban on medical assistance in dying (MAiD). In June, 2016, the federal government passed Bill C-14, permitting MAiD. Current medical students will be the first physician cohort to enter a system permissive of MAiD, and may help to ensure equitable access to care. This study assessed medical student views on MAiD, factors influencing these views, and opportunities for medical education. METHODS: An exploratory cross-sectional survey was developed and distributed to medical students across all years of a three-year Canadian undergraduate medical program...
October 27, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/29065228/myxofibrosarcoma-of-unusual-sites
#12
B Joel Tjarks, Jennifer S Ko, Steven D Billings
INTRODUCTION: Myxofibrosarcoma classically presents as a painless mass in the proximal extremities. Cutaneous myxofibrosarcomas arising in the head and neck and distal extremities are extremely uncommon. We present a series of six cases of myxofibrosarcoma presenting in the head and neck and acral locations. METHODS: Archives were searched using the term "myxofibrosarcoma" over a 6-year period (2009-2015). The clinicopathologic features of myxofibrosarcoma were recorded...
October 24, 2017: Journal of Cutaneous Pathology
https://www.readbyqxmd.com/read/29064584/accuracy-of-a-patient-specific-3d-printed-drill-guide-for-placement-of-cervical-transpedicular-screws
#13
Sinead E Hamilton-Bennett, Bill Oxley, Sebastien Behr
OBJECTIVE: To develop a patient-specific 3-dimensional (3D) printed drill guide for placement of cervical transpedicular screws and to assess its accuracy. STUDY DESIGN: Prospective case-series. SAMPLE POPULATION: Thirty-two cervical pedicle screws (CPS) placed in 3 large breed dogs. METHODS: Computed tomographic (CT) data of the cervical vertebrae were exported to a medical image processing software and 3D virtual vertebral models were created for each vertebra...
October 24, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29054492/a-cost-analysis-of-an-interdisciplinary-pediatric-chronic-pain-clinic
#14
Nicole E Mahrer, Jeffrey I Gold, Michael Luu, Patricia Herman
Chronic pain is characterized by high rates of functional impairment, healthcare utilization, and associated costs. Research supports the use of comprehensive, interdisciplinary treatment approaches. However, many hospitals hesitate to offer this full range of services, especially to Medi-Cal/Medicaid patients whose services are reimbursed at low rates. This cost analysis examines the impact on hospital and insurance costs of patients' enrollment in an interdisciplinary pediatric pain clinic, which includes medication management, psychotherapy, biofeedback, acupuncture, and massage...
October 17, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29049517/-job-lock-among-long-term-survivors-of-childhood-cancer-a-report-from-the-childhood-cancer-survivor-study
#15
Anne C Kirchhoff, Ryan Nipp, Echo L Warner, Karen Kuhlthau, Wendy M Leisenring, Karen Donelan, Julia Rabin, Giselle K Perez, Kevin C Oeffinger, Paul C Nathan, Leslie L Robison, Gregory T Armstrong, Elyse R Park
Importance: Childhood cancer survivors may be reluctant to make changes in their employment because of access to health insurance. Objective: To examine the prevalence of "job lock" (staying at a job to keep work-related health insurance) in a sample drawn from an established, multi-institutional cohort of full-time employed childhood cancer survivors compared with a random sample of siblings and to explore factors associated with job lock among cancer survivors...
October 19, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/29049512/time-requirements-for-electronic-health-record-use-in-an-academic-ophthalmology-center
#16
Sarah Read-Brown, Michelle R Hribar, Leah G Reznick, Lorinna H Lombardi, Mansi Parikh, Winston D Chamberlain, Steven T Bailey, Jessica B Wallace, Thomas R Yackel, Michael F Chiang
Importance: Electronic health record (EHR) systems have transformed the practice of medicine. However, physicians have raised concerns that EHR time requirements have negatively affected their productivity. Meanwhile, evolving approaches toward physician reimbursement will require additional documentation to measure quality and cost of care. To date, little quantitative analysis has rigorously studied these topics. Objective: To examine ophthalmologist time requirements for EHR use...
November 1, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29048570/earlier-pediatric-psychology-consultation-predicts-lower-stem-cell-transplantation-hospital-costs
#17
Meghan E McGrady, Naomi E Joffe, Ahna L H Pai
Objective: The purpose of this study was to examine the hypothesis that earlier time to psychology consultation would predict lower costs for the initial stem cell transplant (SCT) hospitalization among patients receiving care at a children's hospital. Methods: A retrospective medical record review identified 75 patients (ages 0-32 years) with one or more visits by a licensed clinical psychologist during the initial SCT hospitalization from 2010 to 2014. Demographic and clinical variables were obtained from the electronic medical record and hospitalization costs were obtained from patient billing records...
October 11, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/29045355/complexity-of-chronic-conditions-impact-on-end-of-life-expense-trajectories-of-medicare-decedents
#18
Suzanne S Sullivan, Junxin Li, Yow-Wu Bill Wu, Sharon Hewner
OBJECTIVE: The aim of this study is to determine if the pattern of monthly medical expense can be used to identify individuals at risk of dying, thus supporting providers in proactively engaging in advanced care planning discussions. BACKGROUND: Identifying the right time to discuss end of life can be difficult. Improved predictive capacity has made it possible for nurse leaders to use large data sets to guide clinical decision making. METHODS: We examined the patterns of monthly medical expense of Medicare beneficiaries with life-limiting illness during the last 24 months of life using analysis of variance, t tests, and stepwise hierarchical linear modeling...
November 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/29029685/using-structured-and-unstructured-data-to-identify-patients-need-for-services-that-address-the-social-determinants-of-health
#19
Joshua R Vest, Shaun J Grannis, Dawn P Haut, Paul K Halverson, Nir Menachemi
INTRODUCTION: Increasingly, health care providers are adopting population health management approaches that address the social determinants of health (SDH). However, effectively identifying patients needing services that address a SDH in primary care settings is challenging. The purpose of the current study is to explore how various data sources can identify adult primary care patients that are in need of services that address SDH. METHODS: A cross-sectional study described patients in need of SDH services offered by a safety-net hospital's federally qualified health center clinics...
November 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29029354/cost-analysis-of-sending-routine-pathology-specimens-following-total-joint-arthroplasty-in-the-age-of-bundled-payments
#20
Hayden S Holbrook, Johannes F Plate, Maxwell K Langfitt, Jason E Lang, John S Shields
Bundled payment plans are being developed as a means to curb healthcare spending. Routine histology following total hip arthroplasties (THA) and total knee arthroplasties (TKA) is standard practice at many institutions. Recently, the value of this practice has been questioned as histologic diagnoses in THA and TKA rarely differ from the clinical diagnoses. The goal of this study is to identify discrepant and discordant diagnoses following THA and TKA at an academic medical center and to calculate the cost-saving potential in the setting of a bundled payment plan...
October 12, 2017: Surgical Technology International
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