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https://www.readbyqxmd.com/read/28650948/hip-fracture-treatment-at-orthopaedic-teaching-hospitals-better-care-at-a-lower-cost
#1
Sanjit R Konda, Ariana Lott, Arthur Manoli, Karan Patel, Kenneth A Egol
OBJECTIVE: To compare the cost and outcomes of patients treated at orthopaedic teaching hospitals (OTH) compared to those treated at non-teaching hospitals (NTH) DESIGN:: Retrospective study SETTING:: The Statewide Planning and Research Cooperative Systems (SPARCS) database, which includes all admissions to New York State hospitals from 2000-2011. PATIENTS/PARTICIPANTS: 165,679 isolated closed hip fracture patients aged 65 and older met inclusion criteria. Of these, 57,279 were treated at OTH and 108,400 were treated at NTH...
June 12, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28650922/randomized-trial-of-reducing-ambulatory-malpractice-and-safety-risk-results-of-the-massachusetts-promises-project
#2
Gordon D Schiff, Harry Reyes Nieva, Paula Griswold, Nicholas Leydon, Judy Ling, Frank Federico, Carol Keohane, Bonnie R Ellis, Cathy Foskett, E John Orav, Catherine Yoon, Don Goldmann, Joel S Weissman, David W Bates, Madeleine Biondolillo, Sara J Singer
OBJECTIVE: Evaluate application of quality improvement approaches to key ambulatory malpractice risk and safety areas. STUDY SETTING: In total, 25 small-to-medium-sized primary care practices (16 intervention; 9 control) in Massachusetts. STUDY DESIGN: Controlled trial of a 15-month intervention including exposure to a learning network, webinars, face-to-face meetings, and coaching by improvement advisors targeting "3+1" high-risk domains: test result, referral, and medication management plus culture/communication issues evaluated by survey and chart review tools...
June 23, 2017: Medical Care
https://www.readbyqxmd.com/read/28650870/managing-knowledge-in-transitions-experiences-of-health-care-leaders-in-succession-planning
#3
Shannon L Sibbald, C Nadine Wathen, Anita Kothari
Effective and efficient methods of succession planning are integral to the success of organizations across the health care system. We explored current health organizations' senior leadership transition processes. Participants were in senior level leadership and decision-making positions in hospitals within Ontario, Canada. Most of the participants did not have formal transition plans and instead relied on the human resources department to plan for succession. We discuss these processes through three themes: (1) preplanning for a transition, (2) the transition process, and (3) barriers to successful transitions...
June 23, 2017: Health Care Manager
https://www.readbyqxmd.com/read/28650703/program-implementation-of-option-b%C3%A2-at-a-president-s-emergency-plan-for-aids-relief-supported-hiv-clinic-improves-clinical-indicators-but-not-retention-in-care-in-mbarara-uganda
#4
Kathleen Miller, Winnie Muyindike, Lynn T Matthews, Michael Kanyesigye, Mark J Siedner
2013 WHO guidelines for prevention of mother to child transmission recommend combination antiretroviral therapy (ART) for all pregnant women, regardless of CD4 count (Option B/B+). We conducted a retrospective analysis of data from a government-operated HIV clinic in Mbarara, Uganda before and after implementation of Option B+ to assess the impact on retention in care. We limited our analysis to women not on ART at the time of their first reported pregnancy with CD4 count >350. We fit regression models to estimate relationships between calendar period (Option A vs...
June 26, 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28650337/risk-factors-of-neonatal-mortality-in-faisalabad-pakistan
#5
Sajjad Haider Bhatti, Hiba Izzam Mamuna, Muhammad Aftab, Muhammad Aslam, Nosheen Aslam, Syed Muhammad Ali Shah, Hamad Ahmed, Muhammad Akram
The objective of study was to find out major correlates of neonatal mortality. The main focus was in determining the impact of different demographic and health related characteristics of neonates and their mothers. A planned questionnaire was prepared in order to collect the information from mothers of newborns. The data were collected from different public and private hospitals of Faisalabad district. Discharge condition of neonate (dead or alive) was taken as response. Binary logistic regression was applied in order to unveil the impact of different contributory factors on the chances of neonatal mortality...
March 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28650255/patient-navigation-for-traumatic-brain-injury-promotes-community-re-integration-and-reduces-re-hospitalizations
#6
Emily R Rosario, Laura Espinoza, Stephanie Kaplan, Sepehr Khonsari, Earl Thurndyke, Melissa Bustos, Kayla Vickers, Brittney Navarro, Bonnie Scudder
OBJECTIVE: To determine the effectiveness of a Navigation programme for patients with traumatic brain injury. DESIGN: Prospective programme evaluation. SETTING: Inpatient rehabilitation facility and community settings. PARTICIPANTS: Eighteen individuals who suffered a traumatic brain injury (TBI), were between the ages of 16-70 years, and had a Rancho Score greater than IV. INTERVENTION: Patient navigation programme focused on identifying and addressing barriers to positive outcomes, including coordination of care and facilitating communication among the family and healthcare providers, psychosocial support, caregiver support, adherence to treatment, education, community resources and financial issues...
June 26, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28650249/inpatient-admissions-and-costs-associated-with-persistent-use-of-dalfampridine-extended-release-in-multiple-sclerosis-a-claims-database-analysis
#7
Amy Guo, Alexander Niyazov, Dendy Macaulay, Emi Terasawa, Luke Schmerold, Eric Q Wu, Stephen Krieger
BACKGROUND: While the clinical benefits of dalfampridine extended-release (D-ER) have been established in patients with multiple sclerosis (MS) through multiple clinical trials, there is limited real-world data on D-ER use, in particular the persistent use of D-ER, and associated acute care resource utilization and costs. OBJECTIVE: To examine the real-world association of D-ER use and inpatient admissions and costs among patients with MS. METHODS: This study was a retrospective observational claims analysis of the MarketScan database (April 2009-March 2014)...
July 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28650248/health-services-utilization-among-fee-for-service-medicare-and-medicaid-patients-under-age-65-with-behavioral-health-illness-at-an-urban-safety-net-hospital
#8
Ramon S Cancino, Brian W Jack, John Jarvis, Alice Kate Cummings, Ellie Cooper, Pierre-Yves Cremieux, James F Burgess
BACKGROUND: In 2011, fee-for-service patients with both Medicare and Medicaid (dual eligible) sustained $319.5 billion in health care costs. OBJECTIVE: To describe the emergency department (ED) use and hospital admissions of adult dual eligible patients aged under 65 years who used an urban safety net hospital. METHODS: This was a retrospective database analysis of patients aged between 18 and 65 years with Medicare and Medicaid, who used an urban safety net academic health center between January 1, 2011, and December 31, 2011...
July 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28650246/economic-outcomes-of-first-line-regimen-switching-among-stable-patients-with-hiv
#9
Lisa Rosenblatt, Ami R Buikema, Jerry Seare, Lindsay G S Bengtson, Jonathan Johnson, Feng Cao, Angelina Villasis-Keever
BACKGROUND: Although switching of antiretroviral therapy (ART) is a valid approach for addressing treatment failure in patients with human immunodeficiency virus (HIV), ART changes among those who are well maintained on their current regimens may lead to the development of new side effects or resistance. OBJECTIVE: To examine the effect of first-line regimen switching on subsequent health care utilization and cost among stable HIV patients. METHODS: This was a retrospective claims data study of adult patients with HIV who initiated ART between 2007 and 2013 and had been treated with their initial regimens for at least 6 continuous months...
July 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28649692/urgent-need-to-strengthen-and-expand-screening-and-other-cancer-control-programs-in-the-caricom-caribbean
#10
Renee A Franklin, Donald T Simeon
PURPOSE: With high mortality in breast, cervical, prostate, and colorectal cancers in Caribbean Community (CARICOM) countries, we examined cancer control initiatives including screening as well as the implementation of relevant international and regional mandates. METHODS: Secondary data were used to examine cancer control initiatives, which included the presence of national policies, programs, and screening services as well as the implementation of international and regional mandates...
June 26, 2017: Cancer Causes & Control: CCC
https://www.readbyqxmd.com/read/28649454/methods-guiding-stakeholder-engagement-in-planning-a-pragmatic-study-on-changing-stroke-systems-of-care
#11
Sabina B Gesell, Karen Potvin Klein, Jacqueline Halladay, Janet Prvu Bettger, Janet Freburger, Doyle M Cummings, Barbara J Lutz, Sylvia Coleman, Cheryl Bushnell, Wayne Rosamond, Pamela W Duncan
BACKGROUND: The Comprehensive Post-Acute Stroke Services (COMPASS) Study is one of the first large pragmatic randomized-controlled clinical trials using comparative effectiveness research methods, funded by the Patient-Centered Outcomes Research Institute. In the COMPASS Study, we compare the effectiveness of a patient-centered, transitional care intervention versus usual care for stroke patients discharged home from acute care. Outcomes include stroke patient post-discharge functional status and caregiver strain 90 days after discharge, and hospital readmissions...
April 2017: Journal of clinical and translational science
https://www.readbyqxmd.com/read/28649297/a-scoping-review-of-intimate-partner-violence-assistance-programmes-within-health-care-settings
#12
Sheila Sprague, Taryn Scott, Alisha Garibaldi, Sofia Bzovsky, Gerard P Slobogean, Paula McKay, Hayley Spurr, Erika Arseneau, Muzammil Memon, Mohit Bhandari, Aparna Swaminathan
Background: The lifetime prevalence of intimate partner violence (IPV) for women presenting to health care settings is estimated to be 38-59%. With the goal of providing help to victims of abuse, numerous IPV assistance programmes have been developed and evaluated across multiple health care settings. Objective: Our scoping review provides an overview of this literature to identify key areas for potential evidence-based recommendations and to focus research priorities. Methods: We conducted a search of MEDLINE, Embase, Cumulative Index of Nursing and Allied Health Literature, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and psycINFO...
2017: European Journal of Psychotraumatology
https://www.readbyqxmd.com/read/28649285/introduction-of-the-diagene-study-clinical-characteristics-pathophysiology-and-determinants-of-vascular-complications-of-type-2-diabetes
#13
Thijs T W van Herpt, Roosmarijn F H Lemmers, Mandy van Hoek, Janneke G Langendonk, Ronald J Erdtsieck, Bert Bravenboer, Annelies Lucas, Monique T Mulder, Harm R Haak, Aloysius G Lieverse, Eric J G Sijbrands
BACKGROUND: Type 2 diabetes is a major healthcare problem. Glucose-, lipid-, and blood pressure-lowering strategies decrease the risk of micro- and macrovascular complications. However, a substantial residual risk remains. To unravel the etiology of type 2 diabetes and its complications, large-scale, well-phenotyped studies with prospective follow-up are needed. This is the goal of the DiaGene study. In this manuscript, we describe the design and baseline characteristics of the study...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28649065/poor-adherence-with-ace-inhibitors-is-a-risk-factor-of-cva-with-oral-hypoglycemic-agents-in-diabetic-patients
#14
Muhammad Tariq Aftab, Hasnain Abbas Dharamshi, Ahmed Faraz, Saba Shakeel, Osama Shakeel
Poor adherence with medicine declines the clinical outcome of pharmacotherapy. It may carry serious sequelae especially in case of antihypertensive drugs like cerebrovascular accident (CVA). This study has been planned to find the association of poor adherence with anti-hypertensive with CVA in diabetic and non- diabetic patients. One hundred CVA patients who were admitted through Emergency in Abbasi Shaheed hospital, a tertiary care hospital in Karachi, were recruited from Jun 2013 till Dec 2013. The criteria of inclusion was, diagnosed case of CVA, with primary hypertension, availability of patient's therapeutic record, consent of the patient or legal successor/heir...
March 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28648813/rapid-spread-of-an-ongoing-outbreak-of-zika-virus-disease-in-pregnant-women-in-a-mexican-hospital
#15
Elvira Garza-González, Soraya Mendoza-Olazarán, Raúl R Campos, Ricardo Téllez-Marroquín, Donato Saldívar-Rodríguez, Juan A Soria-López, Abel Santos, Samantha Flores-Treviño, Adrián Camacho-Ortiz
In the first nine weeks of implementation of a Zika Virus Preparedness Plan in a Mexican Public Hospital, we cared for 221 pregnant women with any signal or symptom suggesting ZIKV infection and 99 (44.8%) patients were found to be positive for ZIKV. The median age of patients was 25.3 years (range 13-49). Symptoms in PCR-positive patients were rash (91.4%) followed by headache (53.1%), myalgia (46.9%), arthralgia (45.7%), pruritus (35.8%), retroocular pain (29.6%), conjunctivitis (21%), and fever (21%). The women's epidemiologic exposure history indicates local transmission and a community outbreak...
June 22, 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28648803/sorafenib-in-combination-with-transarterial-chemoembolisation-in-patients-with-unresectable-hepatocellular-carcinoma-tace-2-a-randomised-placebo-controlled-double-blind-phase-3-trial
#16
Tim Meyer, Richard Fox, Yuk Ting Ma, Paul J Ross, Martin W James, Richard Sturgess, Clive Stubbs, Deborah D Stocken, Lucy Wall, Anthony Watkinson, Nigel Hacking, T R Jeffry Evans, Peter Collins, Richard A Hubner, David Cunningham, John Neil Primrose, Philip J Johnson, Daniel H Palmer
BACKGROUND: Transarterial chemoembolisation (TACE) is the standard of care for patients with intermediate stage hepatocellular carcinoma, while the multikinase inhibitor sorafenib improves survival in patients with advanced disease. We aimed to determine whether TACE with sorafenib improves progression-free survival versus TACE with placebo. METHODS: We did a multicentre, randomised, placebo-controlled, phase 3 trial (TACE 2) in 20 hospitals in the UK for patients with unresectable, liver-confined hepatocellular carcinoma...
June 22, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28648752/physiological-and-self-assessed-psychological-stress-induced-by-a-high-fidelity-simulation-course-among-third-year-anaesthesia-and-critical-care-residents-an-observational-study
#17
Pr Thomas Geeraerts
INTRODUCTION: The use of high-fidelity simulators in Medicine can improve knowledge, behavior and practice but may be associated with significant stress. Our objective was to measure physiological and psychological self-assessed intensity of stress before and after a planned simulation training session among third year anesthesia and critical care residents. METHODS: A convenience sample of 27 residents participating in a simulation training course was studied. Stress was evaluated by self-assessment using a numerical scale and by salivary amylase concentration before and after the session...
June 22, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28648711/patient-reported-outcomes-can-be-used-to-identify-patients-at-risk-for-total-knee-arthroplasty-revision-and-potentially-individualize-postsurgery-follow-up
#18
Hilal Maradit Kremers, Walter K Kremers, Daniel J Berry, David G Lewallen
BACKGROUND: Patient-reported outcomes are increasingly used as complementary measures to clinical outcomes in total knee arthroplasty (TKA). However, their prognostic importance has yet to be established. We aimed to determine whether the long-term revision risk in TKA relates to pain and Knee Society Score (KSS) measures at baseline, 1, and 2 years. METHODS: This was a registry-based study of primary TKA procedures at a large tertiary care institution between 1995 and 2010...
May 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28648222/improving-care-teams-functioning-recommendations-from-team-science
#19
Kevin Fiscella, Larry Mauksch, Thomas Bodenheimer, Eduardo Salas
BACKGROUND: Team science has been applied to many sectors including health care. Yet there has been relatively little attention paid to the application of team science to developing and sustaining primary care teams. Application of team science to primary care requires adaptation of core team elements to different types of primary care teams. CORE TEAM ELEMENTS: Six elements of teams are particularly relevant to primary care: practice conditions that support or hinder effective teamwork; team cognition, including shared understanding of team goals, roles, and how members will work together as a team; leadership and coaching, including mutual feedback among members that promotes teamwork and moves the team closer to achieving its goals; cooperation supported by an emotionally safe climate that supports expression and resolution of conflict and builds team trust and cohesion; coordination, including adoption of processes that optimize efficient performance of interdependent activities among team members; and communication, particularly regular, recursive team cycles involving planning, action, and debriefing...
July 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28648219/primary-care-collaboration-to-improve-diagnosis-and-screening-for-colorectal-cancer
#20
Gordon D Schiff, Trudy Bearden, Lindsay Swain Hunt, Jennifer Azzara, Jay Larmon, Russell S Phillips, Sara Singer, Brandon Bennett, Jonathan R Sugarman, Asaf Bitton, Andrew Ellner
BACKGROUND: Colorectal cancer (CRC) is a leading cause of cancer death, reducible by screening and early diagnosis, yet many patients fail to receive recommended screening. As part of an academic improvement collaborative, 25 primary care practices worked to improve CRC screening and diagnosis. METHODS: The project featured triannual learning sessions, monthly conference calls, practice coach support, and monthly reporting. The project phases included literature review and interviews with national leaders/organizations, development of driver diagrams to identify key factors and change ideas, project launch and practice team planning, and a practice improvement phase...
July 2017: Joint Commission Journal on Quality and Patient Safety
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