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Accountable Care Organization

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https://www.readbyqxmd.com/read/28528171/accountable-care-organizations-and-the-use-of-cancer-screening
#1
Christian P Meyer, Anna Krasnova, Jesse D Sammon, Stuart R Lipsitz, Joel S Weissman, Maxine Sun, Quoc-Dien Trinh
Cancer preventive services, when used appropriately, result in improved health, better quality of life and decreased costs. For these reasons, cancer preventive services represent important priorities within the Affordable Care Act (ACA). Among the many provisions to improve access to preventive services the ACA introduced Accountable Care Organizations (ACOs) as trajectory to deliver coordinated, high-quality care. In order to evaluate this benchmark, we analyzed (in 2016/Boston) screening prevalence of breast cancer, a recommended screening test according to the United States Preventive Services Task Force (USPSTF), and prostate cancer, for which screening is no longer recommended by the USPSTF, among traditional Medicare beneficiaries and those enrolled in ACOs...
May 17, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28520820/association-between-features-of-patient-provider-discussions-and-routine-prostate-specific-antigen-testing
#2
Joshua M Liao, Mark J Ommerborn, Cheryl R Clark
INTRODUCTION: Although the US Preventive Services Task Force recommends against routine prostate cancer screening with prostate-specific antigen (PSA) testing, specialty organizations support screening via shared decision making between providers and selected patients. While discussions about advantages and disadvantages of testing are a feature of patient-centered care, it is unclear how provider recommendations and the presence of a personal doctor influence testing in the presence of such discussions...
2017: PloS One
https://www.readbyqxmd.com/read/28514335/-the-quality-of-medical-care-and-cooperation-of-patients-with-amyotrophic-lateral-sclerosis-in-the-russian-federation
#3
G N Levitsky, R V Chub, A V Kryachkov
The quality of medical care for patients with amyotrophic lateral sclerosis (ALS) in the Russian Federation is analyzed taking into account the cooperation of patients. Two hundred and fifty-one patients with ALS were observed. Ninety-nine patients, including 16 who were followed up, were examined. Other patients (n=152) were consulted indirectly including 28 followed up. It has been shown that 79,8% of the patients are characterized by the low level of cooperation with neurologists regardless of the quality of medical care; 8...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28498188/the-impact-of-structured-mentor-mother-programs-on-presentation-for-early-infant-diagnosis-testing-in-rural-north-central-nigeria-a-prospective-paired-cohort-study
#4
Nadia A Sam-Agudu, Habib O Ramadhani, Christopher Isah, Salome Erekaha, Chinenye Fan-Osuala, Udochisom Anaba, Ebunoluwa A Adejuyigbe, Manhattan Charurat
BACKGROUND: Early infant diagnosis (EID) by 2 months of age is an important prevention of mother-to-child cascade step that serves as an early postpartum indicator of program success. Uptake and timely presentation for infant HIV diagnosis are significant challenges in resource-limited settings. Few studies on maternal peer support (PS) have demonstrated impact on EID. The MoMent study evaluated the impact of structured PS on timely presentation for EID testing in rural North-Central Nigeria...
June 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28495012/what-do-clinicians-treat-diagnoses-or-symptoms-the-incremental-validity-of-a-symptom-based-dimensional-characterization-of-emotional-disorders-in-predicting-medication-prescription-patterns
#5
Monika A Waszczuk, Mark Zimmerman, Camilo Ruggero, Kaiqiao Li, Annmarie MacNamara, Anna Weinberg, Greg Hajcak, David Watson, Roman Kotov
BACKGROUND: Although practice guidelines are based on disorders specified in diagnostic manuals, such as the DSM, practitioners appear to follow symptoms when making treatment decisions. Psychiatric medication is generally prescribed in a transdiagnostic manner, further highlighting how symptoms, not diagnoses, often guide clinical practice. A quantitative approach to nosology promises to provide better guidance as it describes psychopathology dimensionally and its organization reflects patterns of covariation among symptoms...
April 18, 2017: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/28492914/antibiotic-prescribing-for-nonbacterial-acute-upper-respiratory-infections-in-elderly-persons
#6
Michael Silverman, Marcus Povitz, Jessica M Sontrop, Lihua Li, Lucie Richard, Sonny Cejic, Salimah Z Shariff
Background: Reducing inappropriate antibiotic prescribing for acute upper respiratory tract infections (AURIs) requires a better understanding of the factors associated with this practice. Objective: To determine the prevalence of antibiotic prescribing for nonbacterial AURIs and whether prescribing rates varied by physician characteristics. Design: Retrospective analysis of linked administrative health care data. Setting: Primary care physician practices in Ontario, Canada (January-December 2012)...
May 9, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28489474/global-burden-of-sugar-related-dental-diseases-in-168-countries-and-corresponding-health-care-costs
#7
T Meier, P Deumelandt, O Christen, G I Stangl, K Riedel, M Langer
Oral diseases such as dental caries, edentulism (tooth loss), periodontal disease (PD), and oral cancer currently constitute an increased major public health burden across the globe, with significant differences between countries. One of the main drivers of caries, edentulism, and PD is the excessive intake of sugars. Here, we aimed to quantify the global sugar-related dental health and cost burden in the year 2010. This study used a health-econometrical model to calculate the disease burden as well as the direct and indirect costs attributable to the intake of free sugars (mono- and disaccharides [MDS])...
May 1, 2017: Journal of Dental Research
https://www.readbyqxmd.com/read/28483888/alignment-of-canadian-primary-care-with-the-patient-medical-home-model-a-qualico-pc-study
#8
Alan Katz, Nicole Herpai, Glenys Smith, Kris Aubrey-Bassler, Mylaine Breton, Antoine Boivin, William Hogg, Baukje Miedema, Jocelyn Pang, Walter P Wodchis, Sabrina T Wong
PURPOSE: The patient medical home (PMH) model aims to improve patient satisfaction and health outcomes in Canada, but since its introduction in 2009, there has been no evaluation of the extent to which primary care conforms with PMH attributes. Our objective was to compare current primary care across Canada with the 10 goals of the PMH model. METHODS: A cross-sectional survey of primary care organization and delivery was conducted in Canadian provinces to evaluate the PMH-based attributes of primary care practices...
May 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28476605/personal-branding-a-primer-for-radiology-trainees-and-radiologists
#9
Vivek Kalia, Amy K Patel, Andrew K Moriarity, Cheri L Canon
A radiologist's personal brand is a composite of many parts in one's professional life. In an age where work quality and digital footprints are tracked and measured more than ever before, it behooves radiologists to develop and curate their own individual brands in effective ways. Personal branding consists of the decisions we make, both consciously and unconsciously, which affect our reputation and the likelihood of seeking our services in the future for both patients and referring providers. As hospital systems are increasingly adjusting their systems to cater to better patient experiences, it is imperative that radiologists similarly adjust our practice patterns to accommodate the needs of the new paradigm of value-based care...
May 2, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28474711/-case-report-disseminated-cutaneous-leishmaniasis-lcd
#10
Alexandra Mancheno-Valencia, Julia Cabezas-Arteaga, Ketty Sacoto-Aizaga, Roberto Arenas-Guzmáno
The World Health Organization (WHO) has classified leishmaniasis as an uncontrolled and emerging disease. In Ecuador, the only anecdotal cases of diffuse cutaneous leishmaniasis were recorded in 1994 and have not been formally published. This form can be differentiated from classical localized cutaneous leishmaniasis by the number of injuries, the clinical type of the main elementary lesions (papular and acneform), and a weak response to standard treatments. The case we report is a 34-year-old woman who presented with disseminated nodular lesions and ulcers of various sizes with erythematous edges and scars...
March 2017: Gaceta Médica de México
https://www.readbyqxmd.com/read/28472175/characterization-of-3d-printing-techniques-toward-patient-specific-quality-assurance-spine-shaped-phantom-for-stereotactic-body-radiation-therapy
#11
Min-Joo Kim, Seu-Ran Lee, Min-Young Lee, Jason W Sohn, Hyong Geon Yun, Joon Yong Choi, Sang Won Jeon, Tae Suk Suh
Development and comparison of spine-shaped phantoms generated by two different 3D-printing technologies, digital light processing (DLP) and Polyjet has been purposed to utilize in patient-specific quality assurance (QA) of stereotactic body radiation treatment. The developed 3D-printed spine QA phantom consisted of an acrylic body phantom and a 3D-printed spine shaped object. DLP and Polyjet 3D printers using a high-density acrylic polymer were employed to produce spine-shaped phantoms based on CT images. Image fusion was performed to evaluate the reproducibility of our phantom, and the Hounsfield units (HUs) were measured based on each CT image...
2017: PloS One
https://www.readbyqxmd.com/read/28469444/knowledge-and-practices-relating-to-acute-pesticide-poisoning-among-health-care-providers-in-selected-regions-of-tanzania
#12
Elikana Lekei, Aiwerasia V Ngowi, Habib Mkalanga, Leslie London
BACKGROUND: Acute pesticide poisoning (APP) is commonly underdiagnosed in Tanzania. Studies in developing countries suggest that a lack of diagnostic skills among health care providers (HCPs) undermines surveillance for APP. This study aimed at characterizing experience and skills of Tanzanian HCPs regarding APP diagnosis and management. METHODOLOGY: The population included HCPs responsible for managing APP in Kilimanjaro and Arusha regions (n = 91). The resulting sample included 66 respondents (response rate: 73%)...
2017: Environmental Health Insights
https://www.readbyqxmd.com/read/28467402/new-treatments-for-serious-conditions-ethical-implications
#13
REVIEW
N M P King, C E Bishop
Approval of Spinraza (nusinersen) for treatment of spinal muscular atrophy prompts consideration of a number of ethical issues that arise whenever a new treatment is proposed for a serious condition, especially one that is rare and can devastatingly affect children. Patients, families, clinicians, researchers, institutions and policymakers all must take account of the ways that newly available treatments affect informed and shared decision-making about therapeutic and research options. The issues to consider include: addressing what is still uncertain and unknown; the possibility that potential benefits will be exaggerated and potential harms underemphasized in the media, by advocacy organizations, and in consent forms and processes; the high cost of many novel drugs and biologics; the effects of including conditions of variable phenotype in state-mandated newborn screening panels; and how new treatments can change the standard of care, altering what is and is not known about a disorder and posing challenges for decision-making at both individual and policy levels...
May 11, 2017: Gene Therapy
https://www.readbyqxmd.com/read/28467181/pre-clinical-and-clinical-investigations-of-metabolic-zonation-in-liver-diseases-the-potential-of-microphysiology-systems
#14
Alejandro Soto-Gutierrez, Albert Gough, Lawrence A Vernetti, D L Taylor, Satdarshan P Monga
The establishment of metabolic zonation within a hepatic lobule ascribes specific functions to hepatocytes based on unique, location-dependent gene expression patterns. Recently, there have been significant developments in the field of metabolic liver zonation. A little over a decade ago, the role of β-catenin signaling was identified as a key regulator of gene expression and function in pericentral hepatocytes. Since then, additional molecules have been identified that regulate the pattern of Wnt/β-catenin signaling within a lobule and determine gene expression and function in other hepatic zones...
January 1, 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28463931/multiparametric-magnetic-resonance-imaging-of-the-prostate-repeatability-of-volume-and-apparent-diffusion-coefficient-quantification
#15
Andriy Fedorov, Mark G Vangel, Clare M Tempany, Fiona M Fennessy
OBJECTIVES: The aim of this study was to evaluate the repeatability of a region of interest (ROI) volume and mean apparent diffusion coefficient (ADC) in standard-of-care 3 T multiparametric magnetic resonance imaging (mpMRI) of the prostate obtained with the use of endorectal coil. MATERIALS AND METHODS: This prospective study was Health Insurance Portability and Accountability Act compliant, with institutional review board approval and written informed consent...
May 1, 2017: Investigative Radiology
https://www.readbyqxmd.com/read/28461355/bending-the-spending-curve-by-altering-care-delivery-patterns-the-role-of-care-management-within-a-pioneer-aco
#16
John Hsu, Mary Price, Christine Vogeli, Richard Brand, Michael E Chernew, Sreekanth K Chaguturu, Eric Weil, Timothy G Ferris
Accountable care organizations (ACOs) appear to lower medical spending, but there is little information on how they do so. We examined the impact of patient participation in a Pioneer ACO and its care management program on rates of emergency department (ED) visits and hospitalizations and on Medicare spending. We used data for the period 2009-14, exploiting naturally staggered program entry to create concurrent controls to help isolate the program effects. The care management program (the ACO's primary intervention) targeted beneficiaries with elevated but modifiable risks for future spending...
May 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28460861/beyond-volume-indicators-and-centralization-toward-a-broad-perspective-on-policy-for-improving-quality-of-emergency-care
#17
Jeroen Postma, Teun Zuiderent-Jerak
STUDY OBJECTIVE: Policymakers increasingly regard centralization of emergency care as a useful measure to improve quality. However, the clinical studies that are used to justify centralization, arguing that volume indicators are a good proxy for quality of care ("practice makes perfect"), have significant shortcomings. In light of the introduction of a new centralization policy in the Netherlands, we show that the use of volume indicators in emergency care is problematic and does not do justice to the daily care provided in emergency departments (EDs)...
April 28, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28459904/planning-and-designing-the-improving-addiction-care-team-impact-for-hospitalized-adults-with-substance-use-disorder
#18
Honora Englander, Melissa Weimer, Rachel Solotaroff, Christina Nicolaidis, Benjamin Chan, Christine Velez, Alison Noice, Tim Hartnett, Ed Blackburn, Pen Barnes, P. Todd Korthuis
People with substance use disorders (SUD) have high rates of hospitalization and readmission, long lengths of stay, and skyrocketing healthcare costs. Yet, models for improving care are extremely limited. We performed a needs assessment and then convened academic and community partners, including a hospital, community SUD organizations, and Medicaid accountable care organizations, to design a care model for medically complex hospitalized patients with SUD. Needs assessment showed that 58% to 67% of participants who reported active substance use said they were interested in cutting back or quitting...
May 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28457212/implementing-a-community-model-of-mental-health-care-in-chile-impact-on-psychiatric-emergency-visits
#19
Pedro Zitko, Jorge Ramírez, Niina Markkula, Pablo Norambuena, Ana Maria Ortiz, Rafael Sepúlveda
OBJECTIVE: The community model of mental health care (CMMHC) is recommended as the best way to organize mental health care, but evidence of its successful implementation and effectiveness is scarce, particularly in resource-poor settings. This study aimed to evaluate the impact of CMMHC on the rate of psychiatric emergency visits in Santiago, Chile. METHODS: The rate of psychiatric emergency visits from 2006 to 2011 was compared between two health care administrative districts: district 1 (D1), in which CMMHC was being systematically implemented, and D2, where CMMHC implementation was very limited and inconsistent...
May 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28456614/healthcare-provider-perceptions-of-accessible-exam-tables-in-primary-care-implementation-and-benefits-to-patients-with-and-without-disabilities
#20
Allysha C Maragh-Bass, Joan M Griffin, Sean Phelan, Lila J Finney Rutten, Megan A Morris
BACKGROUND: Recent healthcare mandates require availability of accessible medical exam equipment, which may reduce barriers to care for patients with disabilities (PWD). However, more research is needed to explore healthcare provider views on implementation and routine use of accessible equipment. OBJECTIVE: This study qualitatively explored healthcare provider perceptions of: (1) daily use of accessible medical examination tables with PWD; and (2) recommendations for addressing challenges to using this equipment...
April 12, 2017: Disability and Health Journal
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