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https://www.readbyqxmd.com/read/29240798/the-cost-of-comorbidities-in-treatment-for-hiv-aids-in-california
#1
David S Zingmond, Kodi B Arfer, Jennifer L Gildner, Arleen A Leibowitz
BACKGROUND: Antiretroviral therapy has increased longevity for people living with HIV (PLWH). As a result, PLWH increasingly experience the common diseases of aging and the resources needed to manage these comorbidities are increasing. This paper characterizes the number and types of comorbidities diagnosed among PLWH covered by Medicare and examines how non-HIV comorbidities relate to outpatient, inpatient, and pharmaceutical expenditures. METHODS: The study examined Medicare expenditures for 9767 HIV-positive Californians enrolled in Medicare in 2010 (7208 persons dually covered by Medicare and Medicaid and 2559 with Medicare only)...
2017: PloS One
https://www.readbyqxmd.com/read/29240730/quickstats-percentage-of-visits-by-patients-aged-%C3%A2-18-years-to-office-based-physicians%C3%A2-made-by-patients-with-%C3%A2-2-selected-diagnosed-chronic-conditions-%C3%A2-by-physician-specialty-category-and-patient-age-group-national-ambulatory-medical-care-survey-2015
#2
(no author information available yet)
In 2015, the percentage of office-based physician visits by adults with two or more diagnosed chronic conditions was 53.1% for primary care physicians, 38.5% for medical specialists, and 23.9% for surgeons. This pattern was observed for each of the age groups studied. The percentage of visits increased with age group, regardless of specialty category.
December 15, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29240568/the-epidemiology-of-pediatric-head-injury-treated-outside-of-hospital-emergency-departments
#3
Cheryl K Zogg, R Sterling Haring, Likang Xu, Joseph K Canner, Hatim A AlSulaim, Zain G Hashmi, Ali Salim, Lilly D Engineer, Adil H Haider, Jeneita M Bell, Eric B Schneider
BACKGROUND: Although head trauma-related deaths, hospitalizations, and emergency department visits are well characterized, few studies describe pediatric patients presenting outside of emergency departments. We compared the epidemiology and extent of healthcare-seeking pediatric (0-17y) patients presenting in outpatient settings with those of patients seeking non-hospitalized emergency department care. METHODS: We used MarketScan Medicaid and commercial claims, 2004-2013, to identify patients managed in two outpatient settings (physician's offices/clinics, urgent care) and the emergency department...
December 13, 2017: Epidemiology
https://www.readbyqxmd.com/read/29239156/do-patients-require-escorts-or-carers-for-discharge-following-day-surgery-and-office-based-anesthesia-both-sides-of-the-debate-explored
#4
Keira P Mason, Christopher M Burkle
Over the past few years, there has been a rapid rise in office-based procedures, out of hospital and day surgery procedures, particularly as an effort to combat the escalating costs of hospital- based services. Coincident with this burgeoning demand for office based anesthesia, is the accompanying increased risk of anesthesia and sedation-related complications. In the 1990's and 2000's, the risk of mortality was higher for anesthetics and sedations performed outside of the operating theater setting. Although guidelines exist for ambulatory and office based anesthesia, they are being continuously reviewed and reconsidered...
December 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29237650/needs-of-cancer-patients-in-palliative-care-during-medical-visits-qualitative-study
#5
Dominik Melhem, Serge Daneault
OBJECTIVE: To explore the needs of cancer patients in palliative care and to determine how care providers, including family physicians, could meet these needs more fully. DESIGN: Qualitative study performed using semistructured interviews. SETTING: Palliative care departments (ambulatory and intrahospital). PARTICIPANTS: Twelve patients with a diagnosis of cancer deemed to be in the palliative phase, who had already received either chemotherapy or radiation treatment...
December 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29237045/informing-antimicrobial-stewardship-factors-associated-with-inappropriate-antimicrobial-prescribing-in-primary-care
#6
Alexander Singer, Sergio Fanella, Leanne Kosowan, Jamie Falk, Brenden Dufault, Kevin Hamilton, Ashley Walus
Background: Antimicrobial stewardship (AS) programs promote the optimal use of antimicrobials and safe patient care. With most antimicrobials prescribed in the ambulatory setting, establishing benchmark data is imperative to gauge the impact of future AS initiatives. Objectives: To determine the frequency of potentially inappropriate antimicrobial prescribing in primary care practices in Manitoba, Canada and to assess the association between potentially inappropriate antimicrobial prescribing and patient, prescriber and practice-related factors...
December 10, 2017: Family Practice
https://www.readbyqxmd.com/read/29235983/characteristics-of-office-based-physician-visits-2014
#7
Jill J Ashman, Pinyao Rui, Titilayo Okeyode
Key findings Data from the National Ambulatory Medical Care Survey ● In 2014, there were an estimated 282 office-based physician visits per 100 persons. ● The visit rate among females exceeded the rate for males, and the rates for both infants and older adults exceeded the rates for those aged 1-64 years. ● Compared with other age groups, a higher percentage of visits by adults aged 18-64 indicated no insurance. ● A larger percentage of visits by children under age 18 years were for either preventive care or a new problem, compared with adults aged 18 and over...
December 2017: NCHS Data Brief
https://www.readbyqxmd.com/read/29235658/baseline-characteristics-and-outcomes-of-older-adults-seeking-care-in-ambulatory-urgent-care-clinics
#8
Bernardo J Reyes, Javier M Lopez, Diana J Galindo, Maria Briceno, Joseph G Ouslander
OBJECTIVES: To determine the most common clinical conditions associated with older adults visiting Urgent care centers (UCCs) and the potential need for further resource use. DESIGN: Cross-sectional retrospective study. SETTING: Nonprofit academic medical center with campuses and multiple satellite offices in Ohio and Florida. PARTICIPANTS: Individuals aged 55 and older who visited UCCs between August 2014 and March 2015 (N = 9,445; average age 63...
December 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29234971/elective-ambulatory-surgical-care-in-ireland-why-it-needs-to-be-better-coded-classified-and-managed
#9
Frank Keane, Laura Hammond, Gerry Kelliher, Ken Mealy
BACKGROUND: In the year to July 2017, surgical disciplines accounted for 73% of the total national inpatient and day case waiting list and, of these, day cases accounted for 72%. Their proper classification is therefore important so that patients can be managed and treated in the most suitable and efficient setting. AIMS: We set out to sub-classify the different elective surgical day cases treated in Irish public hospitals in order to assess their need to be managed as day cases and the consistency of practice between hospitals...
December 12, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29233576/changing-epidemiology-of-haemophilus-influenzae-in-children
#10
REVIEW
David F Butler, Angela L Myers
Haemophilus influenzae remains a common cause of illness in children throughout the world. Before the introduction of vaccination, H influenzae type b (Hib) disease was the leading cause of bacterial meningitis in young children and a frequent cause of pneumonia, epiglottitis, and septic arthritis. Clinicians should remain diligent in counseling parents on the dangers of Hib and provide vaccination starting at 2 months of age. The epidemiology of invasive H influenzae disease is shifting. It is imperative that clinicians recognize the changing epidemiology and antibiotic resistance patterns for H influenzae to optimize care in hospital and ambulatory settings...
December 9, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/29233572/hospitalization-of-hiv-positive-patients-significant-demand-affecting-all-hospital-sectors
#11
R Seng, P Mutuon, J Riou, C Duvivier, L Weiss, J D Lelievre, L Meyer, D Vittecoq, O Zak Dit Zbar, J Frenkiel, M Frank-Soltysiak, F Boue, C Rapp, A Sobel, G Brucker, C Goujard, D Salmon
BACKGROUND: In a context of the evolution of severe morbidities in patients living with HIV (PLWH), the aim of this study was to describe reasons for hospitalization and the mode of care for the patients requiring hospitalization. METHODS: All admissions (≥24h) of PLWH to 10 hospitals in the south of Paris (COREVIH Ile-de-France Sud) between 1/1/2011 and 12/31/2011 were identified. The hospital database and the file of patients followed in the HIV referral department of each hospital were matched...
December 9, 2017: Revue D'épidémiologie et de Santé Publique
https://www.readbyqxmd.com/read/29233446/overview-of-a-pharmacist-anticoagulation-certificate-program
#12
Julienne K Kirk, Rebecca Edwards, Andrew Brewer, Cathey Miller, Bryan Bray, James B Groce
BACKGROUND AND PURPOSE: To describe the design of an ongoing anticoagulation certificate program and annual renewal update for pharmacists. EDUCATIONAL ACTIVITY AND SETTING: Components of the anticoagulation certificate program include home study, pre- and posttest, live sessions, case discussions with evaluation and presentation, an implementation plan, and survey information (program evaluation and use in practice). Clinical reasoning skills were assessed through case work-up and evaluation prior to live presentation...
July 2017: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29233419/implementation-and-impact-of-a-chronic-kidney-disease-elective-for-second-year-pharmacy-students
#13
Christina H Sherrill
BACKGROUND AND PURPOSE: Pharmacists can make a great impact on the management of chronic kidney disease (CKD), which is a highly prevalent and costly disorder. This article describes the implementation and impact of a CKD elective course for second-year pharmacy students, which aimed to expose students to CKD and enhance their ability to care for these patients. EDUCATIONAL ACTIVITY AND SETTING: Topics associated with CKD were covered in a fifteen-week, three credit hour course...
March 2017: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29233281/debate-as-an-alternative-method-for-medical-literature-evaluation
#14
Rebecca Toor, Kathryn Samai, Ryan Wargo
BACKGROUND AND PURPOSE: To determine the student impression of utilizing a debate style journal club as an alternative approach for preceptors to teach medical literature evaluation skills to pharmacy students undergoing Advance Pharmacy Practice Experiences (APPE) in both acute care and ambulatory care. EDUCATIONAL ACTIVITY AND SETTING: Students were asked to debate on a controversial topic or two drugs with similar indications. Each side had to research supporting evidence based medicine and use literature appraisal skills to incorporate the information logically into an oral debate style format...
May 2017: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29233279/pharmacy-student-engagement-in-the-evaluation-of-medication-documentation-within-an-ambulatory-care-electronic-medical-record
#15
Tatum Mead, Stephanie Schauner
BACKGROUND AND PURPOSE: An abundance of literature supports the benefits of electronic medical records (EMR) for improving overall healthcare quality. Identifying preventative care opportunities, reducing medical and medication related errors and incorporating clinical practice guidelines are just a few attributes of EMR implementation. The goals of this study were to engage experiential pharmacy students in the assessment of medication related documentation discrepancies in a newly implemented EMR system and to provide exposure to various aspects of conducting research...
May 2017: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29232736/-left-ventricular-assist-device-therapy-ways-to-improve-the-ambulatory-care
#16
Caspar Burkhard-Meier, Michiel Morshuis
The use of left-ventricular assist device therapy (LVAD) in terminal heart failure patients is increasing. Many patients are receiving LVAD-therapy as final solution (destination therapy). After discharge from the implanting heart center patient-centered care has to be implemented on an outpatient basis. A responsible ambulatory treatment of this severe heart failure population requires knowledge about LVAD specific problems (general medical care, long term complications, device management). The referring cardiologist as well as the private practitioner should be more involved in the care of patients with LVAD...
December 12, 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29226443/lessons-from-analyzing-the-medical-costs-of-civilian-terror-victims-planning-resources-allocation-for-a-new-era-of-confrontations
#17
Eytan Ellenberg, Mark I Taragin, Jay R Hoffman, Osnat Cohen, Daniella Luft-Afik, Zvia Bar-On, Ishay Ostfeld
Policy Points: Across the globe, the threat from terrorist attacks is rising, which requires a careful assessment of long-term medical support. We found 3 major sources of costs: hospital expenditures, mental health services dedicated to acute stress reactions, and ambulatory follow-up. During the first year, most of the costs were related to hospitalization and support for stress relief. During the second year, ambulatory and rehabilitation costs continued to grow. Public health specialists should consider these major components of costs and their evolution over time to properly advise the medical and social authorities on allocating resources for the medical and nonmedical support of civilian casualties resulting from war or terror...
December 2017: Milbank Quarterly
https://www.readbyqxmd.com/read/29226221/male-and-female-residents-in-postgraduate-medical-education-a-gender-comparative-analysis-of-differences-in-career-perspectives-and-their-conditions-in-germany
#18
Stine Ziegler, Thomas Zimmermann, Lea Krause-Solberg, Martin Scherer, Hendrik van den Bussche
Aim: This article focuses on the gender-specific career differences of residents in their postgraduate medical education in Germany. In particular the structural obstacles female physicians have to overcome during residency are investigated. Moreover, the study examines the position preferences of male and female physicians in the hospital and in how far occupational self-efficacy corresponds to the interest in a hospital leading position. Methods: The KarMed-Study's database consists of annual postal surveys throughout the entire residency of medical students, who were in their "Practical Year" in 2008/2009...
2017: GMS Journal for Medical Education
https://www.readbyqxmd.com/read/29225926/does-expanding-primary-healthcare-improve-hospital-efficiency-evidence-from-a-panel-analysis-of-avoidable-hospitalisations-in-5506-municipalities-in-brazil-2000-2014
#19
Everton Nunes da Silva, Timothy Powell-Jackson
Background: Hospitals account for the major share of health expenditure. Primary healthcare may improve efficiency at the hospital level by reducing avoidable admissions. We examined whether rapid expansion of primary healthcare in the context of Brazil's Family Health Strategy (FHS) was associated with a reduction in avoidable hospitalisations. Methods: We constructed panel data for 5506 municipalities over 2000-2014. Our primary outcome was the rate of avoidable hospitalisations, defined with reference to the official list of ambulatory care sensitive conditions (ACSC)...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29224940/results-of-nonoperative-management-of-acute-limb-ischemia-in-infants
#20
S Keisin Wang, Gary W Lemmon, Natalie A Drucker, Raghu L Motaganahalli, Michael C Dalsing, Ashley R Gutwein, Brian W Gray, Michael P Murphy
OBJECTIVE: Acute limb ischemia (ALI) in infants poses a challenge to the clinician secondary to poor operative outcomes, limb loss risk, and lifelong morbidity. This retrospective study reviewed a 10-year institutional experience with the nonoperative management of ALI in infants. METHODS: Infants (aged ≤12 months) diagnosed with ALI by duplex ultrasound and treated with initial nonoperative management at a tertiary care children's hospital were identified through vascular laboratory arterial duplex ultrasound records and International Classification of Diseases and Current Procedural Terminology codes associated with ALI...
December 7, 2017: Journal of Vascular Surgery
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