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https://www.readbyqxmd.com/read/28437195/home-health-chains-and-practice-patterns-evidence-of-2008-medicare-reimbursement-revision
#1
Sean Shenghsiu Huang, Hyunjee Kim
Home health agencies (HHAs) are known to exploit the Medicare reimbursement schedule by targeting a specific number of therapy visits. These targeting behaviors cause unnecessary medical spending. The Centers for Medicare & Medicaid Services estimates that during fiscal year 2015, Medicare made more than $10 billion in improper payments to HHAs. Better understanding of heterogeneous gaming behaviors among HHAs can inform policy makers to more effectively oversee the home health care industry. This article aims to study how home health chains adjust and adopt new targeting behaviors as compared to independent agencies under the new reimbursement schedule...
February 23, 2017: Population Health Management
https://www.readbyqxmd.com/read/28435754/establishing-successful-patient-centered-medical-homes-in-rural-hawai-i-three-strategies-to-consider
#2
Melissa Nelson Scribner, Kasey Kehoe
The challenges to healthcare delivery posed by Hawai'i's unique geography, physician shortages, and dispersed population are of particular importance in light of implementing the Affordable Care Act (ACA). This study draws on central goals laid out in the ACA - to decrease costs, increase access, and improve patient outcomes. The use of the Patient-Centered Medical Homes (PCMHs) is a care model that has the potential to meet all three goals. How to identify the most effective way to develop PCMHs in the specific context of Hawai'i is the focus of this study...
March 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28435481/a-patient-centered-emergency-department-management-strategy-for-sickle-cell-disease-super-utilizers
#3
Grant G Simpson, Hallie R Hahn, Alex A Powel, Robert R Leverence, Linda A Morris, Lara G Thompson, Marc S Zumberg, Deepa J Borde, Joseph A Tyndall, Jonathan J Shuster, Donald M Yealy, Brandon R Allen
INTRODUCTION: A subpopulation of sickle-cell disease patients, termed super-utilizers, presents frequently to emergency departments (EDs) for vaso-occlusive events and may consume disproportionate resources without broader health benefit. To address the healthcare needs of this vulnerable patient population, we piloted a multidisciplinary intervention seeking to create and use individualized patient care plans that alter utilization through coordinated care. Our goals were to assess feasibility primarily, and to assess resource use secondarily...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435423/quality-of-care-and-job-satisfaction-in-the-european-home-care-setting-research-protocol
#4
Liza Van Eenoo, Henriëtte van der Roest, Hein van Hout, Anja Declercq
INTRODUCTION: Since the European population is ageing, a growing number of elderly will need home care. Consequently, high quality home care for the elderly remains an important challenge. Job satisfaction among care professionals is regarded as an important aspect of the quality of home care. AIM: This paper describes a research protocol to identify elements that have an impact on job satisfaction among care professionals and on quality of care for older people in the home care setting of six European countries...
August 31, 2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28435321/a-behavioral-medicine-intervention-for-community-dwelling-older-adults-with-chronic-musculoskeletal-pain-protocol-for-a-randomized-controlled-trial
#5
Sara Cederbom, Eva Denison, Astrid Bergland
BACKGROUND: Chronic musculoskeletal pain is a major health problem among older adults, particularly those who live alone and/or those who are dependent on formal care. Chronic pain is associated with mobility problems, falls, fear of falling, catastrophizing thoughts, and a lower quality of life. Research shows that physical therapy interventions based on behavioral medicine approaches are beneficial for middle-aged adults with chronic pain. However, there appears to be no previous randomized controlled trials (RCTs) based on this theoretical framework that have examined the effect on older adults with chronic musculoskeletal pain who live alone at home and are dependent on formal care to manage their everyday lives...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28434459/becoming-parent-and-nurse-high-fidelity-simulation-in-teaching-ambulatory-central-line-infection-prevention-to-parents-of-children-with-cancer
#6
Carol E Heiser Rosenberg, Mary F Terhaar, Judith A Ascenzi, Anna Walbert, K Michelle Kokoszka, Julianne S Perretta, Marlene R Miller
BACKGROUND: Ambulatory central-line infections in children with cancer are life-threatening. Infections are two to three times more frequent in outpatients than inpatients, for whom evidence-based bundles have decreased morbidity. Most cancer care now takes place at home, where parents perform many of the same tasks as nurses. However, parents often feel stressed and unprepared. To address this, high-fidelity simulation, which has been effective for teaching novice nurses, was evaluated for parent central-line education...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28434275/cost-effectiveness-of-a-transitional-home-based-palliative-care-program-for-patients-with-end-stage-heart-failure
#7
Frances Kam Yuet Wong, Ching So, Alina Yee Man Ng, Po-Tin Lam, Jeffrey Sheung Ching Ng, Nancy Hiu Yim Ng, June Chau, Michael Mau Kwong Sham
BACKGROUND: Studies have shown positive clinical outcomes of specialist palliative care for end-stage heart failure patients, but cost-effectiveness evaluation is lacking. AIM: To examine the cost-effectiveness of a transitional home-based palliative care program for patients with end-stage heart failure patients as compared to the customary palliative care service. DESIGN: A cost-effectiveness analysis was conducted alongside a randomized controlled trial (Trial number: NCT02086305)...
April 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28433877/affordances-in-the-home-environment-for-motor-development-validity-and-reliability-for-the-use-in-daycare-setting
#8
Alessandra Bombarda Müller, Nadia Cristina Valentini, Paulo Felipe Ribeiro Bandeira
The range of stimuli provided by physical space, toys and care practices contributes to the motor, cognitive and social development of children. However, assessing the quality of child education environments is a challenge, and can be considered a health promotion initiative. This study investigated the validity of the criterion, content, construct and reliability of the Affordances in the Home Environment for Motor Development - Infant Scale (AHEMD-IS), version 3-18 months, for the use in daycare settings...
April 20, 2017: Infant Behavior & Development
https://www.readbyqxmd.com/read/28433757/surgical-volunteerism-or-voluntourism-are-we-doing-more-harm-than-good
#9
EDITORIAL
Faheem Ahmed, Madeline Grade, Carl Malm, Sophia Michelen, Na'eem Ahmed
The significant rise in the number of international health electives undertaken by medical students and doctors in the US, Canada and UK reflects acknowledgement of the inter-connected nature of these challenges to health systems and the drive to help solve them. However, the next generation of international volunteers often operate under a conflicting duality: whilst many of their role models have devoted their lives to global health following a similar volunteering experience, there are pervasive ethical problems associated with short-term global health work that must be identified and addressed to ensure positive outcomes for all parties involved...
April 19, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28433120/additional-cost-because-of-pneumonia-in-nursing-home-residents-results-from-the-incidence-of-pneumonia-and-related-consequences-in-nursing-home-resident-study
#10
Nadège Costa, Emiel O Hoogendijk, Michael Mounié, Robert Bourrel, Yves Rolland, Bruno Vellas, Laurent Molinier, Matteo Cesari
OBJECTIVES: Pneumonia is a frequent condition in older people. Our aim was to examine the total healthcare cost related to pneumonia in nursing home (NH) residents over a 1-year follow-up period. DESIGN: This was a prospective, longitudinal, observational, and multicenter study that was a part of the Incidence of Pneumonia and related Consequences in Nursing Home Resident study. SETTING: Thirteen NHs located in Languedoc Roussillon and Midi-Pyrénées regions in France were included...
May 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28432210/a-randomised-controlled-trial-of-a-complex-intervention-to-reduce-children-s-exposure-to-secondhand-smoke-in-the-home
#11
Elena Ratschen, Rebecca Thorley, Laura Jones, Magdalena Opazo Breton, Juliette Cook, Ann McNeill, John Britton, Tim Coleman, Sarah Lewis
OBJECTIVES: Exposing children to secondhand tobacco smoke (SHS) causes significant harm and occurs predominantly through smoking by caregivers in the family home. We report a trial of a complex intervention designed to reduce secondhand smoke exposure of children whose primary caregiver feels unable or unwilling to quit smoking. DESIGN: An open-label, parallel, randomised controlled trial. SETTING: Deprived communities in Nottingham City and County, England PARTICIPANTS: Caregivers resident in Nottingham City and County in England who were at least 18 years old, the main caregiver of a child aged under 5 years living in their household, and reported that they were smoking tobacco inside their home...
April 21, 2017: Tobacco Control
https://www.readbyqxmd.com/read/28431853/transmission-of-methicillin-resistant-staphylococcus-aureus-to-health-care-worker-gowns-and-gloves-during-care-of-residents-in-veterans-affairs-nursing-homes
#12
Lisa Pineles, Daniel J Morgan, Alison Lydecker, J Kristie Johnson, John D Sorkin, Patricia Langenberg, Natalia Blanco, Alan Lesse, John Sellick, Kalpana Gupta, Luci Leykum, Jose Cadena, Nickie Lepcha, Mary-Claire Roghmann
BACKGROUND: This was an observational study designed to estimate the frequency of methicillin-resistant Staphylococcus aureus (MRSA) transmission to gowns and gloves worn by health care workers (HCWs) interacting with Veterans Affairs Community Living Center (VA nursing home) residents to inform MRSA prevention policies. METHODS: Participants included residents and HCWs from 7 VA nursing homes in 4 states and Washington, DC. Residents were cultured for MRSA at the anterior nares, perianal skin, and wound (if present)...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28431565/traditional-birth-attendant-reorientation-and-motherpacks-incentive-s-effect-on-health-facility-delivery-uptake-in-narok-county-kenya-an-impact-analysis
#13
John Emmanuel Kitui, Vaughan Dutton, Dirk Bester, Rachel Ndirangu, Susan Wangai, Stephen Ngugi
BACKGROUND: A community health programme in Narok County in Kenya aimed to improve skilled birth assistance during childbirth through two demand side interventions. First, traditional birth attendants (TBAs) were co-opted into using their influence to promote use of skilled birth attendants (SBAs) at health facilities during delivery, and to accompany pregnant women to health facilities in return for a Ksh500 (Approximately USD5 as of August 2016) cash incentive for each pregnant mother they accompanied...
April 21, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28431515/the-effectiveness-of-creating-an-online-life-story-book-on-persons-with-early-dementia-and-their-informal-caregivers-a-protocol-of-a-randomized-controlled-trial
#14
Teuntje R Elfrink, Sytse U Zuidema, Miriam Kunz, Gerben J Westerhof
BACKGROUND: Dementia has a high burden for patients, informal caregivers and society. Given changes in care systems, more persons with dementia will live longer at home. However, living at home (with dementia) with a good quality of life is not easy to achieve. Dementia is often accompanied by neuropsychiatric symptoms like apathy, agitation, depression, and anxiety, which have a negative impact on quality of life. Whereas cognitive deterioration can hardly be influenced, it is possible to reduce neuropsychiatric symptoms...
April 21, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28429988/patient-safety-in-nursing-homes-in-sweden-nurses-views-on-safety-and-their-role
#15
Frieda Andersson, Katarina Hjelm
Objective Knowledge about patient safety in nursing homes is limited. The aim of this study was to describe what patient safety means to nurses working in nursing homes for the elderly and how these nurses address patient safety. Method Qualitative study of semi-structured interviews with 15 nurses aged 27-62 years. Qualitative content analysis was applied. Results Nurses describe the meaning of patient safety in terms of proper care and treatment, and a sense of security. Based on nurses' description of patient safety, several factors were identified as prerequisites to achieve safe health care: competence; clear information transfer between health care organizations; continuity of care and appropriate environment...
January 1, 2017: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/28428732/access-to-information-and-counselling-older-cancer-patients-self-report-a-cross-sectional-survey
#16
Kristin Vassbotn Guldhav, Randi Jepsen, Siri Ytrehus, Ellen Karine Grov
BACKGROUND: An increasingly older population, improved diagnostics and treatment increase the number of older cancer survivors, thus more than 60% of those affected by cancer are over the age of 65. Symptom relief and the prevention of functional impairment are important tasks for home care nursing, considering that patients can live a long time with their cancer disease and related side effects. The aim of this study was to investigate the extent to which cancer patients over the age of 65 reported access to information and counselling from home care nursing services, including those offered by the cancer coordinator...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28428728/randomized-face-to-face-vs-home-exercise-interventions-in-pregnant-women-with-gestational-diabetes
#17
Danielle Symons Downs, Jennifer M Dinallo, Leann L Birch, Ian M Paul, Jan S Ulbrecht
OBJECTIVES: Evaluate effects of a theoretically-based, semi-intensive (Face-to-Face; F2F) exercise intervention and minimum-contact (Home) exercise intervention to the standard care (Control) on exercise, its motivational determinants, blood glucose levels, and insulin use of pregnant women with gestational diabetes mellitus (GDM). DESIGN: Randomized control trial with two intervention arms and control (standard care). METHOD: Participants (N=65) were randomized to a Control (standard prenatal care/GDM dietary counseling), Home (standard care + phone education/support + home exercise), or F2F (standard care + on-site education/support + guided exercise with instructor on 2 days/week) group from ~20 weeks gestation to delivery...
May 2017: Psychology of Sport and Exercise
https://www.readbyqxmd.com/read/28427779/fish-oil-lc-pufas-do-not-affect-blood-coagulation-parameters-and-bleeding-manifestations-analysis-of-8-clinical-studies-with-selected-patient-groups-on-omega-3-enriched-medical-nutrition
#18
Stephanie Jeansen, Renger F Witkamp, Jossie A Garthoff, Ardy van Helvoort, Philip C Calder
BACKGROUND & AIMS: The increased consumption of fish oil enriched-products exposes a wide diversity of people, including elderly and those with impaired health to relatively high amounts of n-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFAs). There is an ongoing debate around the possible adverse effects of n-3 LC-PUFAs on bleeding risk, particularly relevant in people with a medical history of cardiovascular events or using antithrombotic drugs. METHODS: This analysis of 8 clinical intervention studies conducted with enteral medical nutrition products containing fish oil as a source of n-3 LC-PUFAs addresses the occurrence of bleeding-related adverse events and effects on key coagulation parameters (Prothrombin Time [PT], (activated) and Partial Thromboplastin Time [(a)PTT])...
March 29, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28427763/exploring-patient-experiences-and-perspectives-of-a-heart-failure-telerehabilitation-program-a-mixed-methods-approach
#19
Rita Hwang, Allison Mandrusiak, Norman R Morris, Robyn Peters, Dariusz Korczyk, Jared Bruning, Trevor Russell
OBJECTIVES: To describe patient experiences and perspectives of a group-based heart failure (HF) telerehabilitation program delivered to the homes via online video-conferencing. BACKGROUND: Limited information currently exists on patient experiences of telerehabilitation for HF. Patient feedback and end-user perspectives provide important information regarding the acceptability of this new delivery model which may have a substantial impact on future uptake. METHODS: We used mixed-methods design with purposive sampling of patients with HF...
April 17, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28427396/demdata-the-austrian-czech-institutional-long-term-care-project-design-and-protocol-of-a-two-centre-cross-sectional-study
#20
Stefanie Auer, Elisabeth Linsmayer, Anna Beránková, Patrick Pascher, Bernadette Firlinger, Doris Prischl, Paulina Ratajczak, Edith Span, Iva Holmerova
BACKGROUND: The organization of long-term care is one of the main challenges of public health and health policies in Europe and worldwide, especially in terms of care concepts for people with dementia. In Austria and the Czech Republic the majority of elderly institutionalized persons with dementia are cared for in nursing homes. It is however unclear, how many persons living in nursing homes in Austria and in the Czech Republic are suffering from cognitive impairment and dementia. In addition, basic information on the nutritional status, the status of mobility and the medication prescription patterns are often missing...
April 20, 2017: BMC Health Services Research
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