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Patient-centered medical home

Klaus Felix Stein, Adriana Miclescu
Background In recent years, multidisciplinary rehabilitation (MDR) became an alternative treatment option for chronic non-cancer pain. MDR is mostly available in specialized pain units, usually at rehabilitation centers where the level of knowledge and therapeutically options to treat pain conditions are considered to be high. There is strong evidence that MDR in specialized pain units is affecting pain and improves the quality of life in a sustainable manner. There are few studies about MDR outcome in primary health care, especially in those units situated in rural areas and with a different population than that encountered in specialized hospitals...
December 29, 2017: Scandinavian Journal of Pain
Sarah Vilpert, Stéfanie Monod, Hélène Jaccard Ruedin, Jürgen Maurer, Lionel Trueb, Bertrand Yersin, Christophe Büla
BACKGROUND: Emergency Department (ED) are challenged by the increasing number of visits made by the heterogeneous population of elderly persons. This study aims to 1) compare chief complaints (triage categories) and level of priority; 2) to investigate their association with hospitalization after an ED visit; 3) to explore factors explaining the difference in hospitalization rates among community-dwelling older adults aged 65-84 vs 85+ years. METHODS: All ED visits of patients age 65 and over that occurred between 2005 and 2010 to the University of Lausanne Medical Center were analyzed...
June 15, 2018: BMC Health Services Research
Chancellor F Gray, Hernan A Prieto, Andrew T Duncan, Hari K Parvataneni
Background: Total joint arthroplasty (TJA) remains the highest expenditure in the Centers for Medicare and Medicaid Services (CMS) budget. One model to control cost is the Comprehensive Care for Joint Replacement (CJR) model. There has been no published literature to date examining the efficacy of CJR on value-based outcomes. The purpose of this study was to determine the efficacy and sustainability of a multidisciplinary care redesign for total joint arthroplasty under the CJR paradigm at an academic tertiary care center...
June 2018: Arthroplasty Today
Nicole J Brandt, Chad Worz, Sharon F Clackum
Skilled nursing facilities and nursing homes are a care setting that offers increasing opportunities for pharmacists to be leaders when addressing the new updated Centers for Medicare and Medicaid Services requirements coupled with the enhanced quality measures reporting. Additionally, the complexity of the medication-related needs and comorbidities of the patients served in long-term care facilities promotes pharmacists practicing to the top of their license. Medication stewardship needs to be an interdisciplinary team activity led by the pharmacist...
June 11, 2018: Pharmacotherapy
Juliet C Yonek, Neil Jordan, Dorothy Dunlop, Rachel Ballard, Jane Holl
PURPOSE: The patient-centered medical home (PCMH) has emerged as an optimal primary care model for all youth; however, little is known about the extent to which adolescents in need of mental health (MH) treatment receive care consistent with the PCMH. This study assessed (1) 10-year trends in PCMH care among U.S. adolescents according to MH need and (2) variations in PCMH care and its subcomponents among adolescents with MH need, by individual and family characteristics. METHODS: This was a secondary analysis of Medical Expenditure Panel Survey data (2004-2013)...
June 7, 2018: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Alexander S Young, Amy N Cohen, Evelyn T Chang, Anthony W P Flynn, Alison B Hamilton, Rebecca Oberman, Merlyn Vinzon
BACKGROUND: People with serious mental illness (SMI) die many years prematurely, with rates of premature mortality two to three times greater than the general population. Most premature deaths are due to "natural causes," especially cardiovascular disease and cancer. Often, people with SMI are not well engaged in primary care treatment and do not receive high-value preventative and medical services. There have been numerous efforts to improve this care, and few controlled trials, with inconsistent results...
June 7, 2018: BMC Health Services Research
Samantha M Ross, Ellen Smit, Erica Twardzik, Samuel W Logan, Beth M McManus
Objective To determine, among a sample of young CSHCN with developmental conditions, (1) characteristics associated with receipt of both patient-centered medical home (PCMH) and Part C early intervention, (2) the association between each PCMH criterion and receipt of Part C generally, and (3) for CSHCN with disabilities versus delays. Methods Secondary data analysis of the 2009/10 National Survey of CSHCN. Sample included CSHCN (n = 755) birth to 3 years with a developmental disability or delay that affected their function...
June 5, 2018: Maternal and Child Health Journal
Lisa Stehno-Bittel, Lisa VanHoose
No abstract text is available yet for this article.
June 4, 2018: Journal of General Internal Medicine
Jean Yoon, Evelyn Chang, Lisa V Rubenstein, Angel Park, Donna M Zulman, Susan Stockdale, Michael K Ong, David Atkins, Gordon Schectman, Steven M Asch
Background: Primary care models that offer comprehensive, accessible care to all patients may provide insufficient resources to meet the needs of patients with complex conditions who have the greatest risk for hospitalization. Objective: To assess whether augmenting usual primary care with team-based intensive management lowers utilization and costs for high-risk patients. Design: Randomized quality improvement trial. ( NCT03100526)...
June 5, 2018: Annals of Internal Medicine
Rahul Jain, Leslie Gibson, Natalie Coburn
Prehabilitation is the improvement of patient health in anticipation of a physiological stressor, such as major surgery. Prehabilitation optimizes health by taking a proactive approach to promoting exercise, nutrition, and lifestyle modifications. Engaging patients in the pre-operative phase provides an opportunity to positively impact their recovery and return to functional baseline by reducing post-operative deconditioning. At the Odette Cancer Centre at Sunnybrook Health Sciences Centre in Toronto, Canada, the Interprofessional Multidisciplinary Prehabilitation Assessment Consultation Team (IMPACT-Surgical Oncology) was developed...
June 3, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Joseph W Rossano, Ryan S Cantor, Dingwei Dai, Pirouz Shamszad, Yuan-Shung Huang, Matthew Hall, Kimberly Y Lin, R Erik Edens, P Eugene Parrino, James K Kirklin
BACKGROUND: Few data exist on resource utilization with pediatric ventricular assist devices (VADs). We tested the hypothesis that device type and adverse events are associated with increased resource utilization in pediatric patients supported with VADs. METHODS AND RESULTS: The Pediatric Interagency Registry for Mechanically Assisted Circulatory Support, a national registry of VADs in patients <19 years old, and the Pediatric Health Information System, an administrative database, were merged...
June 1, 2018: Journal of the American Heart Association
Maya Beganovic, Kerry L LaPlante
Up to 50% of hospital-administered and 70% of nursing home-administered antimicrobials are inappropriately prescribed. There is a great need to focus local, national and global efforts on appropriate antibiotic use. Formal programs dedicated to appropriate antibiotic use have been established in most US hospitals. These antimicrobial stewardship programs (ASP) exist to ensure that the correct drug, dose and duration of an antimicrobial is given, and only when there is a true bacterial infection (as opposed to bacterial colonization or a viral infection)...
June 1, 2018: Rhode Island Medical Journal
Catherine Hafner, François R Jornayvaz
The prevalence of patients with type 2 diabetes who are hospitalized is constantly increasing. A minority of facilities have standardized hospital protocols for the diabetic patient regarding medication and continuity of care. This article offers practical tools to optimize the transition of diabetic patients because they are more at risk of readmission and adverse events. Establishing a structured and personalized discharge plan can help anticipate the hospital discharge and approach, in a more standardized way the different stages of an optimized transition...
May 30, 2018: Revue Médicale Suisse
Imad El Majzoub, Christopher El Khuri, Karim Hajjar, Ralphe Bou Chebl, Farid Talih, Maha Makki, Aurelie Mailhac, Gilbert Abou Dagher
Background: Emergency Department (ED) visits for suicide attempts have been described worldwide; however, the populations studied were predominantly Western European, North American, or East Asian. This study aims to describe the epidemiology of ED patients presenting post-suicide attempt to an academic medical center in Lebanon and to report on factors that affect ED disposition. Methods: A retrospective cohort study was conducted between 2009 and 2015. Patients of any age group were included if they had presented to the ED after a suicide attempt...
2018: Annals of General Psychiatry
Matthew R Augustine, Karin M Nelson, Stephan D Fihn, Edwin S Wong
The patient-centered medical home (PCMH) expands access by providing care same-day, by phone, and after hours; however, little is known about which patients seek these services. We examined the association of patient, clinical, and local economic characteristics with the self-reported use of 5 routine and nonroutine ways to access primary care within the Veterans Health Administration. We identified sets of characteristics, including gender- and age-specific, racial and ethnic, and socioeconomic differences of how veterans report seeking primary care...
July 2018: Journal of Ambulatory Care Management
Latifa Mohammad Baynouna Al Ketbi, Mariam Mohammad Al Kwuiti, Hanan Abdulbaqi, Mouza Hamad Al Kwuiti, Shamma Al Alawi, Amal Al Zarouni, Fathyia Al Awadhi, Durra Al Bloushi, Amal Al Harbi, Bakr Saadon, Omar Al Jabri
This study describes the transformation of Abu Dhabi Ambulatory Healthcare Services into patient-centered medical homes (PCMH) in 3 pilot sites by applying the National Commission for Quality Assurance (NCQA) PCMH standards. The intervention was system redesign, population management, team building, and optimizing electronic medical records toward patient-centered care. The pilot centers outperformed non-pilot centers in clinical key performance indicators. Based on the NCQA 2011 PCMH criteria, the pilot achieved 84% compared with 42% at the start of the project...
July 2018: Journal of Ambulatory Care Management
Cristina Roman, Gail Edwards, Michael Dooley, Biswadev Mitra
PURPOSE: Results of a systematic literature review to identify roles for emergency medicine (EM) pharmacists beyond traditionally reported activities and to quantify the benefits of these roles in terms of patient outcomes are reported. SUMMARY: Emergency department (ED)-based clinical pharmacy is a rapidly growing practice area that has gained support in a number of countries globally, particularly over the last 5-10 years. A systematic literature search covering the period 1995-2016 was conducted to characterize emerging EM pharmacist roles and the impact on patient outcomes...
June 1, 2018: American Journal of Health-system Pharmacy: AJHP
Ifeanyi Beverly Chukwudozie, Marian L Fitzgibbon, Linda Schiffer, Michael Berbaum, Cheryl Gilmartin, Pyone David, Eson Ekpo, Michael J Fischer, Anna C Porter, Alana Aziz-Bradley, Denise M Hynes
Patients with chronic kidney disease have a high disease burand may benefit from primary care services and care coord A medical home model with direct access to primary care services is one approach that may address this need, yet has not been examined. As a substudy of the Patient-Centered Outcomes Research Institute (PCORI) patient-centered medical home for kidney disease (PCMH-KD) health system intervention study, we examined the uptake of free primary care physician (PCP) services. The PCORI PCMH-KD study was an initial step toward integrating PCPs, a nurse coordinator, a pharmacist, and community health workers (CHWs) within the health care delivery team...
May 23, 2018: Translational Behavioral Medicine
Jennifer Tsui, Shawna V Hudson, Ellen B Rubinstein, Jenna Howard, Elisabeth Hicks, Autumn Kieber-Emmons, Alicja Bator, Heather S Lee, Jeanne Ferrante, Benjamin F Crabtree
There are currently 15.5 million cancer survivors in USA who are increasingly relying on primary care providers for their care. Patient-Centered Medical Homes (PCMHs) have the potential to meet the unique needs of cancer survivors; but, few studies have examined PCMH attributes as potential resources for delivering survivorship care. This study assesses the current care coordination infrastructure in advanced PCMHs, known to be innovative, and explores their capacity to provide cancer survivorship care. We conducted comparative case studies of a purposive sample (n = 9) of PCMHs to examine current care coordination infrastructure and capacity through a mixed- methods analysis...
May 23, 2018: Translational Behavioral Medicine
Elias Wagner, Florian Raabe, Gabriele Martin, Catja Winter, Diana Plörer, Daniela L Krause, Kristina Adorjan, Gabriele Koller, Oliver Pogarell
BACKGROUND AND OBJECTIVES: Numbers of drug-related deaths have been growing in Europe and the USA, especially those attributable to mixed drug consumption. Overdose deaths account for about one third up to one half of all illicit drug deaths worldwide. In most cases opioids are involved. Opioid maintenance treatment (OMT) is a well-established therapy option among people with opioid dependence. The aim of this study was to assess concomitant substance abuse in opioid-dependent patients under OMT in two centers in Munich, Germany...
May 24, 2018: American Journal on Addictions
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