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https://www.readbyqxmd.com/read/28351118/how-will-repealing-the-aca-affect-medicaid-impact-on-health-care-coverage-delivery-and-payment
#1
Sara Rosenbaum, Sara Rothenberg, Sara Schmucker, Rachel Gunsalus, J. Zoë Beckerman
ISSUE: The Affordable Care Act enhanced Medicaid's role as a health care purchaser by expanding eligibility and broadening the range of tools and strategies available to states. All states have embraced delivery and payment reform as basic elements of their programs. GOAL: To examine the effects of reducing the size and scope of Medicaid under legislation to repeal the ACA. FINDINGS AND CONCLUSIONS: Were the ACA's Medicaid expansion to be eliminated and were federal Medicaid funding to experience major reductions through block grants or per capita caps, the effects on system transformation would be significant...
March 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28350940/recent-and-emerging-advances-in-spinal-deformity
#2
Justin S Smith, Christopher I Shaffrey, Shay Bess, Mohammed F Shamji, Darrel Brodke, Lawrence G Lenke, Michael G Fehlings, Virginie Lafage, Frank Schwab, Alexander R Vaccaro, Christopher P Ames
BACKGROUND: Over the last several decades, significant advances have occurred in the assessment and management of spinal deformity. OBJECTIVE: The primary focus of this narrative review is on recent advances in adult thoracic, thoracolumbar, and lumbar deformities, with additional discussions of advances in cervical deformity and pediatric deformity. METHODS: A review of recent literature was conducted. RESULTS: Advances in adult thoracic, thoracolumbar, and lumbar deformities reviewed include the growing applications of stereoradiography, development of new radiographic measures and improved understanding of radiographic alignment objectives, increasingly sophisticated tools for radiographic analysis, strategies to reduce the occurrence of common complications, and advances in minimally invasive techniques...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350643/delayed-referral-results-in-missed-opportunities-for-organ-donation-after-circulatory-death
#3
Kristina Krmpotic, Clare Payne, Cynthia Isenor, Sonny Dhanani
OBJECTIVES: Rates of organ donation and transplantation have steadily increased in the United States and Canada over the past decade, largely attributable to a notable increase in donation after circulatory death. However, the number of patients awaiting solid organ transplantation continues to remain much higher than the number of organs transplanted each year. The objective of this study was to determine the potential to increase donation rates further by identifying gaps in the well-established donation after circulatory death process in Ontario...
March 27, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28350517/anti-inflammatory-diet-in-clinical-practice
#4
Mari Anoushka Ricker, William Christian Haas
Recently, there has been an increase in the research regarding the impact of acute and chronic inflammation on health and disease. Specific foods are now known to exert strong effects on inflammatory pathways within the body. Carefully selecting foods that are anti-inflammatory in nature while avoiding foods that are proinflammatory is central to an anti-inflammatory diet plan. Ultimately, the plan models a pattern of eating that (1) focuses on eating whole, plant-based foods that are rich in healthy fats and phytonutrients and (2) maintains a stable glycemic response...
March 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28350476/initial-experience-with-honoring-choices-wisconsin-implementation-of-an-advance-care-planning-pilot-in-a-tertiary-care-setting
#5
Wendy L Peltier, Faiz Gani, Jennifer Blissitt, Katherine Walczak, Kristi Opper, Arthur R Derse, Fabian M Johnston
BACKGROUND: Although previous research on advance care planning (ACP) has associated ACP with improved quality of care at the end of life, the appropriate use of ACP remains limited. OBJECTIVE: To evaluate the impact of a pilot program using the "Honoring Choices Wisconsin" (HCW) model for ACP in a tertiary care setting, and to understand barriers to system-wide implementation. DESIGN: Retrospective review of prospectively collected data. SETTING/SUBJECTS: Patients who received medical or surgical oncology care at Froedtert and the Medical College of Wisconsin...
March 28, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28350430/insurance-coverage-access-to-care-and-medical-debt-since-the-aca-a-look-at-california-florida-new-york-and-texas
#6
Munira Z Gunja, Sara R Collins, Michelle McEvoy Doty, Sophie Beutel
ISSUE: The Affordable Care Act has significantly increased health insurance coverage and access to care among U.S. adults nationwide. However, the law gives states flexibility in implementing certain provisions, leading to wide variations between states in consumers’ experiences. GOAL: To examine the differences in insurance coverage, access to care, and medical bill problems in the four largest states—California, Florida, New York, and Texas—all of which have made different choices in implementing the law...
March 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28346626/preparing-residents-for-teaching-careers-the-faculty-for-tomorrow-resident-workshop
#7
Steven Lin, Paul Gordon
BACKGROUND AND OBJECTIVES: Progress toward growing the primary care workforce is at risk of being derailed by an emerging crisis: a critical shortage of family medicine faculty. In response to the faculty shortage, the Society of Teachers of Family Medicine (STFM) launched a 2-year initiative called "Faculty for Tomorrow" (F4T). The F4T Task Force created a workshop designed to increase residents' interest in, and prepare them for, careers in academic family medicine. We aimed to evaluate the effectiveness of this workshop...
March 2017: Family Medicine
https://www.readbyqxmd.com/read/28346606/evidence-based-redesign-of-the-comlex-usa-series
#8
John R Gimpel, Dorothy Horber, Jeanne M Sandella, Janice A Knebl, John E Thornburg
To ensure that the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) reflects the evolving practice of osteopathic medicine, the National Board of Osteopathic Medical Examiners has developed new content and format specifications for an enhanced, competency-based examination program to be implemented with COMLEX-USA Level 3 in 2018. This article summarizes the evidence-based design processes that served as the foundation for blueprint development and the evidence supporting its validity...
April 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/28346605/does-including-public-health-students-on-interprofessional-teams-increase-attainment-of-interprofessional-practice-competencies
#9
Pamela Ann Duffy, Julie A Ronnebaum, Teri A Stumbo, Kari Nies Smith, Rachel A Reimer
CONTEXT: Interprofessional education (IPE) creates dynamic experiential learning that can address social determinants of health that influence health outcomes. OBJECTIVE: To examine the effects of including public health students on IPE teams on the interprofessional practice domain constructs (values/ethics, roles/responsibilities, interprofessional communication, and teams and teamwork). METHODS: This single-case, mixed-methods study was performed using a grounded theory approach...
April 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/28346574/size-matters-differences-in-nutritional-care-between-small-medium-and-large-nursing-homes-in-germany
#10
C Burger, E Kiesswetter, A Gietl, U Pfannes, U Arens-Azevedo, C C Sieber, D Volkert
OBJECTIVES: The aim of this study is to comprehensively describe nutritional care in German nursing homes (NHs) and to examine if nutritional care differs between small, medium and large NHs. DESIGN: Nationwide cross-sectional postal survey. SETTING: Nursing homes. PARTICIPANTS: 541 NHs across Germany. MEASUREMENTS: Information on structural NH characteristics and nutritional care (food provision and menu planning, nursing care, and management and quality assurance) was collected by means of a questionnaire addressed to the management of a random sample of German NHs...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/28346519/views-of-senior-health-personnel-about-quality-of-emergency-obstetric-care-a-qualitative-study-in-nigeria
#11
Friday Okonofua, Abdullahi Randawa, Rosemary Ogu, Kingsley Agholor, Ola Okike, Rukayat Adeola Abdus-Salam, Mohammed Gana, Eghe Abe, Adetoye Durodola, Hadiza Galadanci
BACKGROUND: Late arrival in hospital by women experiencing pregnancy complications is an important background factor leading to maternal mortality in Nigeria. The use of effective and timely emergency obstetric care determines whether women survive or die, or become near-miss cases. Healthcare managers have the responsibility to deploy resources for implementing emergency obstetric care. OBJECTIVES: To determine the nature of institutional policies and frameworks for managing obstetric complications and reducing maternal deaths in Nigeria...
2017: PloS One
https://www.readbyqxmd.com/read/28346499/a-farm-level-precision-land-management-framework-based-on-integer-programming
#12
Qi Li, Guiping Hu, Talukder Zaki Jubery, Baskar Ganapathysubramanian
Farmland management involves several planning and decision making tasks including seed selection and irrigation management. A farm-level precision farmland management model based on mixed integer linear programming is proposed in this study. Optimal decisions are designed for pre-season planning of crops and irrigation water allocation. The model captures the effect of size and shape of decision scale as well as special irrigation patterns. The authors illustrate the model with a case study on a farm in the state of California in the U...
2017: PloS One
https://www.readbyqxmd.com/read/28346339/a-power-planning-algorithm-based-on-rpl-for-ami-wireless-sensor-networks
#13
Marcio L F Miguel, Edgard Jamhour, Marcelo E Pellenz, Manoel C Penna
The advanced metering infrastructure (AMI) is an architecture for two-way communication between electric, gas and water meters and city utilities. The AMI network is a wireless sensor network that provides communication for metering devices in the neighborhood area of the smart grid. Recently, the applicability of a routing protocol for low-power and lossy networks (RPL) has been considered in AMI networks. Some studies in the literature have pointed out problems with RPL, including sub-optimal path selection and instability...
March 25, 2017: Sensors
https://www.readbyqxmd.com/read/28346267/generalizing-study-results-a-potential-outcomes-perspective
#14
Catherine R Lesko, Ashley L Buchanan, Daniel Westreich, Jessie K Edwards, Michael G Hudgens, Stephen R Cole
Great care is taken in epidemiologic studies to ensure the internal validity of causal effect estimates; however, external validity has received considerably less attention. When the study sample is not a random sample of the target population, the sample average treatment effect, even if internally valid, cannot usually be expected to equal the average treatment effect in the target population. The utility of an effect estimate for planning purposes and decision making will depend on the degree of departure from the true causal effect in the target population due to problems with both internal and external validity...
March 24, 2017: Epidemiology
https://www.readbyqxmd.com/read/28345444/budgetary-impact-of-cabazitaxel-use-after-docetaxel-treatment-for-metastatic-castration-resistant-prostate-cancer
#15
Kyle Flannery, Ed Drea, Louis Hudspeth, Shelby Corman, Xin Gao, Mei Xue, Raymond Miao
BACKGROUND: With the approval of several new treatments for metastatic castration-resistant prostate cancer (mCRPC), budgetary impact is a concern for health plan decision makers. Budget impact models (BIMs) are becoming a requirement in many countries as part of formulary approval or reimbursement decisions. Cabazitaxel is a second-generation taxane developed to overcome resistance to docetaxel and is approved for the treatment of patients with mCRPC previously treated with a docetaxel-containing regimen...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28345443/economic-burden-of-irritable-bowel-syndrome-with-diarrhea-retrospective-analysis-of-a-u-s-commercially-insured-population
#16
Jessica L Buono, Kush Mathur, Amelia J Averitt, David A Andrae
BACKGROUND: The economic burden associated with irritable bowel syndrome with diarrhea (IBS-D) is not well understood. OBJECTIVES: To (a) evaluate total annual all-cause, gastrointestinal (GI)-related, and symptom-related (i.e., IBS, diarrhea, abdominal pain) health care resource use and costs among IBS-D patients in a U.S. commercially insured population and (b) estimate incremental all-cause health care costs of IBS-D patients versus matched controls. METHODS: Patients aged ≥ 18 years with 12 months of continuous medical and pharmacy benefit eligibility in 2013 were identified from the Truven Health MarketScan research database...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28345441/prevalence-and-cost-of-subsequent-fractures-among-u-s-patients-with-an-incident-fracture
#17
Jessica Weaver, Shiva Sajjan, E Michael Lewiecki, Steven T Harris, Panagiotis Marvos
BACKGROUND: The prevalence and cost of subsequent fractures among patients with an incident fracture are not well defined. OBJECTIVE: To assess the prevalence of, and costs associated with, subsequent fractures in the year after an incident fracture. METHODS: This was a retrospective claims database analysis using data from Humana Medicare Advantage claims (Medicare group) and Optum Insight Clinformatics Data Mart commercial claims (commercial group)...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28345436/characterizing-health-care-utilization-direct-costs-and-comorbidities-associated-with-interstitial-cystitis-a-retrospective-claims-analysis
#18
Amy Tung, Zsolt Hepp, Aasthaa Bansal, Emily Beth Devine
BACKGROUND: Interstitial cystitis (IC) is a debilitating condition that affects up to 5% of the U.S. POPULATION: This condition is characterized by bladder pain, urinary urgency and frequency, nocturia, and, in some patients, bladder lesions called Hunner's lesions (HL). IC patients who have HL experience a clinical course that is distinct from those without HL and, as a result, respond differently to existing treatments. Without effective and lasting therapeutic options, IC patients are expected to experience a reduced quality of life and be a significant economic burden...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28345435/predicting-adherence-and-persistence-with-oral-bisphosphonate-therapy-in-an-integrated-health-care-delivery-system
#19
Rita L Hui, Annette L Adams, Fang Niu, Bruce Ettinger, David K Yi, Malini Chandra, Joan C Lo
BACKGROUND: Examining drug exposure is essential to pharmacovigilance, especially for bisphosphonate (BP) therapy. OBJECTIVE: To examine differences in 4 measures of oral BP exposure: treatment discontinuation, adherence, persistence, and nonpersistence. METHODS: Among women aged ≥ 50 years who initiated oral BP therapy during 2002-2007 with at least 3 years of health plan membership follow-up, discontinuation was defined by evidence of no further treatment during the study observation period...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28345434/effect-of-diabetes-treatment-related-attributes-on-costs-to-type-2-diabetes-patients-in-a-real-world-population
#20
Jie Meng, Roman Casciano, Yi-Chien Lee, Lee Stern, Dmitry Gultyaev, Liyue Tong, Brice Kitio-Dschassi
BACKGROUND: Type 2 diabetes mellitus (T2DM) results in a substantial economic burden on patients, health care systems, and society. Most literature assessing the cost of T2DM focuses on the long-term complications of the disease, the association between glucose control and cost, and patient characteristics resulting in poor and costly outcomes. However, it is likely that attributes specific to diabetes therapy can affect the use of costly resources. OBJECTIVE: To estimate the effect of diabetes treatment-related attributes, such as improved efficacy, adherence, and reduced risk for hypoglycemia, on costs to T2DM patients...
April 2017: Journal of Managed Care & Specialty Pharmacy
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