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https://www.readbyqxmd.com/read/27914125/having-a-physician-rather-than-a-place-as-a-usual-source-of-care-would-be-better-from-2012-korea-health-panel-data
#1
Kyeong Min Kim, Hyunsoo Jeon, Jae Ho Lee
A usual source of care (USC) in primary care improves health care quality and can result in improved health. However, current research about the type of USC (place only vs. physician with a place) is insufficient as an evidence to support the value of primary care. We analyzed data from the 2012 Korea Health Panel survey of adults aged 18 years or older (n = 11,873) who reported whether having a USC or not to compare the effects by type of USC on medical care use and out-of-pocket costs. Descriptive analysis showed significant differences in the distributions of sociodemographic and health status factors except frequency of outpatient visit by type of USC...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27913943/the-cost-effectiveness-of-interventions-targeting-lifestyle-change-for-the-prevention-of-diabetes-in-a-swedish-primary-care-and-community-based-prevention-program
#2
Anne Neumann, Lars Lindholm, Margareta Norberg, Olaf Schoffer, Stefanie J Klug, Fredrik Norström
BACKGROUND: Policymakers need to know the cost-effectiveness of interventions to prevent type 2 diabetes (T2D). The objective of this study was to estimate the cost-effectiveness of a T2D prevention initiative targeting weight reduction, increased physical activity and healthier diet in persons in pre-diabetic states by comparing a hypothetical intervention versus no intervention in a Swedish setting. METHODS: A Markov model was used to study the cost-effectiveness of a T2D prevention program based on lifestyle change versus a control group where no prevention was applied...
December 2, 2016: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/27913941/the-enigma-of-value-in-search-of-affordable-and-accessible-health-care
#3
EDITORIAL
Thomas D Szucs, Martina Weiss, Guido Klaus
In times of shrinking resources and pharmaceutical breakthrough situations, our value-assessing systems are stretched to their very limits. Assessing value is highly complex. Current value-assessment systems risk neglecting important factors, such as therapy duration, budget impact, or the importance of combination therapies. Especially when dealing with breakthrough therapies within high-prevalence indications, these factors play an important role in health care spending. When it comes to assessing value in Switzerland, the system is innovation and access-friendly; the price level of pharmaceutical products, however, is relatively high in comparison to neighboring countries...
December 2, 2016: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/27913318/walsh-hadamard-based-3d-steganography-for-protecting-sensitive-information-in-point-of-care
#4
Alsharif Abuadbba, Ibrahim Khalil
Remote points-of-care has recently had a lot of attention for their advantages such as saving lives and cost reduction. The transmitted streams usually contain (1) normal biomedical signals (e.g. ECG) and (2) highly private information (e.g. patient identity). Despite the obvious advantages, the primary concerns are privacy and authenticity of the transferred data. Therefore, this paper introduces a novel steganographic mechanism that ensures (1) strong privacy preservation of private information by random concealing inside the transferred signals employing a key, and (2) evidence of originality for the biomedical signals...
November 29, 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/27912868/correlation-between-total-solar-irradiance-and-glycated-hemoglobin-2-to-3-months-later-in-patients-with-diabetes-a-big-data-analysis
#5
Shigesumi Kinchiku, Kazuhiko Kotani, Yukiko Maruguchi, Anna Aikou, Hitoshi Uenomachi, Shouko Kajiya
OBJECTIVES: Much attention has been paid recently to a relationship between glucose metabolism and weather. This study investigated the temporal correlation between total solar irradiance (TSI) and glycated hemoglobin (A1C) values in patients with diabetes. METHODS: In 1531 patients with diabetes who received follow-up care between 2009 and 2013 (type 1 diabetes, 123 patients; type 2 diabetes, 1408 patients; male 53.6%; mean age, 61.2 years), A1C levels were measured a total of 58,830 times...
December 2016: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/27912108/encouraging-early-discussion-of-life-expectancy-and-end-of-life-care-a-randomised-controlled-trial-of-a-nurse-led-communication-support-program-for-patients-and-caregivers
#6
Adam Walczak, Phyllis N Butow, Martin H N Tattersall, Patricia M Davidson, Jane Young, Ronald M Epstein, Daniel S J Costa, Josephine M Clayton
BACKGROUND: Patients are often not given the information needed to understand their prognosis and make informed treatment choices, with many consequently experiencing less than optimal care and quality-of-life at end-of-life. OBJECTIVES: To evaluate the efficacy of a nurse-facilitated communication support program for patients with advanced, incurable cancer to assist them in discussing prognosis and end-of-life care. DESIGN: A parallel-group randomised controlled trial design was used...
October 21, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27911937/an-investigation-of-the-outcomes-of-pgy-students-cognition-of-and-persistent-behavior-in-learning-through-the-intervention-of-the-flipped-classroom-in-taiwan
#7
Sheng-Der Hsu, Cheng-Jueng Chen, Wei-Kuo Chang, Yih-Jin Hu
The Postgraduate Year (PGY) Program allows doctors-in-training to learn about the diagnosis, treatment and nursing of various common, general diseases. These items form the core curriculum and are mostly learned through caring for patients and clinical teaching. Doctors-in-training are evaluated for their knowledge through written tests or assignments, based on which the effectiveness of their training is also assessed; however, this generally produces a negative learning attitude among them. So we introduced the flipped classroom into PGY training program to change PGY students' learning behavior...
2016: PloS One
https://www.readbyqxmd.com/read/27911103/tools-for-outcome-prediction-in-patients-with-community-acquired-pneumonia
#8
Faheem Khan, Mark B Owens, Marcos Restrepo, Pedro Povoa, Ignacio Martin-Loeches
Community-acquired pneumonia (CAP) is one of the most common causes of mortality world-wide. The mortality rate of patients with CAP is influenced by the severity of the disease, treatment failure and the requirement for hospitalization and/or intensive care unit (ICU) management, all of which may be predicted by biomarkers and clinical scoring systems. Areas Covered: We review the recent literature examining the efficacy of established and newly-developed clinical scores, biological and inflammatory markers such as C-Reactive protein (CRP), procalcitonin (PCT) and Interleukin-6 (IL-6), whether used alone or in conjunction with clinical severity scores to assess the severity of CAP, predict treatment failure, guide acute in-hospital or ICU admission and predict mortality...
December 2, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27910831/high-z-structures-of-organic-molecules-their-diversity-and-organizing-principles
#9
Carolyn Pratt Brock
A list has been compiled of 284 well determined organic structures having more than four crystallographically independent molecules or formula units (i.e. Z' > 4). Another 22 structures were rejected because the space group or unit cell was probably misassigned; the rate for that type of error is then only 7%. The space-group frequencies are unusual; half the structures are in Sohncke groups, partly because the fraction of enantiopure structures of resolvable enantiomers is higher than for lower Z' structures...
December 1, 2016: Acta Crystallographica Section B, Structural Science, Crystal Engineering and Materials
https://www.readbyqxmd.com/read/27909603/analyzing-exposures-to-electromagnetic-fields-in-an-intensive-care-unit
#10
Necati Gökmen, Sabri Erdem, Kadir Atilla Toker, Elvan Öçmen, Başak Ilgım Gökmen, Ahmet Özkurt
OBJECTIVE: In this study, we conducted a numerical analysis of exposure to electromagnetic fields (EMFs) in a hospital's intensive care unit that is one of the most crucial one in terms of hazardous areas among all service units. This is a new study for measuring exposure to EMFs in an intensive care unit as well as other healthcare services in Turkey. METHODS: We measured the EMFs in the intensive care unit with a SRM-3006 (selective radiation metre), which was used for measurement of the absolute and the limit values of high frequency EMFs...
October 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27909086/the-12-item-psoriatic-arthritis-impact-of-disease-questionnaire-construct-validity-reliability-and-interpretability-in-a-clinical-setting
#11
Marco Di Carlo, Andrea Becciolini, Valentina Lato, Chiara Crotti, Ennio Giulio Favalli, Fausto Salaffi
OBJECTIVE: To study, in a real-life setting, the construct validity, the reliability, and the interpretability of the 12-item Psoriatic Arthritis Impact of Disease (PsAID-12) questionnaire in patients with psoriatic arthritis (PsA). METHODS: In 144 consecutive patients with PsA (81 men and 63 women, mean age of 51.4 ± 12.8 yrs, and 77 receiving biologic treatment), the PsAID-12 and other patient-reported outcomes (PRO) were collected, such as the Dermatology Life Quality Index...
December 1, 2016: Journal of Rheumatology
https://www.readbyqxmd.com/read/27906166/which-brca-genetic-testing-programs-are-ready-for-implementation-in-health-care-a-systematic-review-of-economic-evaluations
#12
Elvira D'Andrea, Carolina Marzuillo, Corrado De Vito, Marco Di Marco, Erica Pitini, Maria Rosaria Vacchio, Paolo Villari
PURPOSE: There is considerable evidence regarding the efficacy and effectiveness of BRCA genetic testing programs, but whether they represent good use of financial resources is not clear. Therefore, we aimed to identify the main health-care programs for BRCA testing and to evaluate their cost-effectiveness. METHODS: We performed a systematic review of full economic evaluations of health-care programs involving BRCA testing. RESULTS: Nine economic evaluations were included, and four main categories of BRCA testing programs were identified: (i) population-based genetic screening of individuals without cancer, either comprehensive or targeted based on ancestry; (ii) family history (FH)-based genetic screening, i...
December 2016: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/27905957/factors-associated-with-no-shows-and-rescheduling-mri-appointments
#13
Majeed O AlRowaili, Anwar E Ahmed, Hasan A Areabi
BACKGROUND: One of the major challenges facing global radiology services comes from delays connected to long waiting lists for magnetic resonance imaging (MRI) procedures. Such delays in diagnostic procedures could lead to poorer patient care outcomes. This study intended to estimate the rate of "No-Shows" or "Reschedule" MRI appointments. We also investigated the factors correlating No-Shows and Reschedule MRI appointments. METHODS: A cross-sectional study was conducted in Saudi Arabia using data obtained via MRI schedule reviews and self-administrated questionnaires...
December 1, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27905909/development-of-a-measure-of-model-fidelity-for-mental-health-crisis-resolution-teams
#14
Brynmor Lloyd-Evans, Gary R Bond, Torleif Ruud, Ada Ivanecka, Richard Gray, David Osborn, Fiona Nolan, Claire Henderson, Oliver Mason, Nicky Goater, Kathleen Kelly, Gareth Ambler, Nicola Morant, Steve Onyett, Danielle Lamb, Sarah Fahmy, Ellie Brown, Beth Paterson, Angela Sweeney, David Hindle, Kate Fullarton, Johanna Frerichs, Sonia Johnson
BACKGROUND: Crisis Resolution Teams (CRTs) provide short-term intensive home treatment to people experiencing mental health crisis. Trial evidence suggests CRTs can be effective at reducing hospital admissions and increasing satisfaction with acute care. When scaled up to national level however, CRT implementation and outcomes have been variable. We aimed to develop and test a fidelity scale to assess adherence to a model of best practice for CRTs, based on best available evidence. METHODS: A concept mapping process was used to develop a CRT fidelity scale...
December 1, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27905815/medicare-program-merit-based-incentive-payment-system-mips-and-alternative-payment-model-apm-incentive-under-the-physician-fee-schedule-and-criteria-for-physician-focused-payment-models-final-rule-with-comment-period
#15
(no author information available yet)
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repeals the Medicare sustainable growth rate (SGR) methodology for updates to the physician fee schedule (PFS) and replaces it with a new approach to payment called the Quality Payment Program that rewards the delivery of high-quality patient care through two avenues: Advanced Alternative Payment Models (Advanced APMs) and the Merit-based Incentive Payment System (MIPS) for eligible clinicians or groups under the PFS. This final rule with comment period establishes incentives for participation in certain alternative payment models (APMs) and includes the criteria for use by the Physician-Focused Payment Model Technical Advisory Committee (PTAC) in making comments and recommendations on physician-focused payment models (PFPMs)...
November 4, 2016: Federal Register
https://www.readbyqxmd.com/read/27905814/medicare-and-medicaid-programs-cy-2017-home-health-prospective-payment-system-rate-update-home-health-value-based-purchasing-model-and-home-health-quality-reporting-requirements-final-rule
#16
(no author information available yet)
This final rule updates the Home Health Prospective Payment System (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor; effective for home health episodes of care ending on or after January 1, 2017. This rule also: Implements the last year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates; updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 2nd-year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between CY 2012 and CY 2014; finalizes changes to the methodology used to calculate payments made under the HH PPS for high-cost "outlier" episodes of care; implements changes in payment for furnishing Negative Pressure Wound Therapy (NPWT) using a disposable device for patients under a home health plan of care; discusses our efforts to monitor the potential impacts of the rebasing adjustments; includes an update on subsequent research and analysis as a result of the findings from the home health study; and finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model, which was implemented on January 1, 2016; and updates to the Home Health Quality Reporting Program (HH QRP)...
November 3, 2016: Federal Register
https://www.readbyqxmd.com/read/27905622/-gastos-hospitalarios-por-neumon%C3%A3-a-neumoc%C3%A3-ccica-invasora-en-adultos-en-un-hospital-general-en-chile
#17
Álvaro Alarcón, Isabel Lagos, Alberto Fica
: Pneumococcal infections are important for their morbidity and economic burden, but there is no economical data from adults patients in Chile. AIMS: Estimate direct medical costs of bacteremic pneumococcal pneumonia among adult patients hospitalized in a general hospital and to evaluate the sensitivity of ICD 10 discharge codes to capture infections from this pathogen. METHODS: Analysis of hospital charges by components in a group of patients admitted for bacteremic pneumococcal pneumonia, correction of values by inflation and conversion from CLP to US$...
August 2016: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/27905076/improvement-of-time-in-therapeutic-range-with-warfarin-by-pharmaceutical-intervention
#18
Alvaro Víquez-Jaikel, Victoria Hall-Ramírez, Allan Ramos-Esquivel
Background Anticoagulation therapy with warfarin is highly effective for prevention and treatment of thromboembolic disorders. Nevertheless, its management is challenging especially in developing countries, where the medical access is difficult and patient education is poor. Objective To determine the effect of pharmaceutical intervention (PI) on the time in therapeutic range (TTR) of a group of anticoagulated patients from our referral center. Method A group of consecutive outpatients previously treated by usual medical care underwent PI...
November 30, 2016: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/27905060/perioperative-risk-adjustment-for-total-shoulder-arthroplasty-are-simple-clinically-driven-models-sufficient
#19
David N Bernstein, Aakash Keswani, David Ring
BACKGROUND: There is growing interest in value-based health care in the United States. Statistical analysis of large databases can inform us of the factors associated with and the probability of adverse events and unplanned readmissions that diminish quality and add expense. For example, increased operating time and high blood urea nitrogen (BUN) are associated with adverse events, whereas patients on antihypertensive medications were more likely to have an unplanned readmission. Many surgeons rely on their knowledge and intuition when assessing the risk of a procedure...
November 30, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27905020/laparoscopic-versus-open-cholecystectomy-a-cost-effectiveness-analysis-at-rwanda-military-hospital
#20
Allison Silverstein, Ainhoa Costas-Chavarri, Mussa R Gakwaya, Joseph Lule, Swagoto Mukhopadhyay, John G Meara, Mark G Shrime
BACKGROUND: Laparoscopic cholecystectomy is first-line treatment for uncomplicated gallstone disease in high-income countries due to benefits such as shorter hospital stays, reduced morbidity, more rapid return to work, and lower mortality as well-being considered cost-effective. However, there persists a lack of uptake in low- and middle-income countries. Thus, there is a need to evaluate laparoscopic cholecystectomy in comparison with an open approach in these settings. METHODS: A cost-effectiveness analysis was performed to evaluate laparoscopic and open cholecystectomies at Rwanda Military Hospital (RMH), a tertiary care referral hospital in Rwanda...
November 30, 2016: World Journal of Surgery
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