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https://www.readbyqxmd.com/read/28343046/perioperative-hemoglobin-a1c-as-a-predictor-of-deep-infection-following-single-level-lumbar-decompression-in-patients-with-diabetes
#1
Jourdan M Cancienne, Brian C Werner, Dennis Q Chen, Hamid Hassanzadeh, Adam L Shimer
BACKGROUND CONTEXT: Although multiple studies have cited diabetes mellitus as a risk factor decreased functional outcomes, increased infectious complications, and overall increased reoperation rate following degenerative lumbar spinal surgery, few have investigated how perioperative glycemic control influences such complications. PURPOSE: The primary goal of the present study was to use a national database to evaluate the association of perioperative glycemic control as demonstrated by Hemoglobin A1c levels in patients with diabetes undergoing primary, single level decompression without concomitant fusion with the incidence of deep postoperative infection following requiring operative irrigation and debridement...
March 22, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28292485/a-cost-effectiveness-analysis-of-reverse-total-shoulder-arthroplasty-versus-hemiarthroplasty-for-the-management-of-complex-proximal-humeral-fractures-in-the-elderly
#2
Georg Osterhoff, Nathan N O'Hara, Jennifer D'Cruz, Sheila A Sprague, Nick Bansback, Nathan Evaniew, Gerard P Slobogean
BACKGROUND: There is ongoing debate regarding the optimal surgical treatment of complex proximal humeral fractures in elderly patients. OBJECTIVES: To evaluate the cost-effectiveness of reverse total shoulder arthroplasty (RTSA) compared with hemiarthroplasty (HA) in the management of complex proximal humeral fractures, using a cost-utility analysis. METHODS: On the basis of data from published literature, a cost-utility analysis was conducted using decision tree and Markov modeling...
March 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28289120/the-challenges-of-measuring-improving-and-reporting-quality-in-primary-care
#3
Richard A Young, Richard G Roberts, Richard J Holden
We propose a new set of priorities for quality management in primary care, acknowledging that payers and regulators likely will continue to insist on reporting numerical quality metrics. Primary care practices have been described as complex adaptive systems. Traditional quality improvement processes applied to linear mechanical systems, such as isolated single-disease care, are inappropriate for nonlinear, complex adaptive systems, such as primary care, because of differences in care processes, outcome goals, and the validity of summative quality scorecards...
March 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28283236/cost-effectiveness-of-mediastinal-lymph-node-staging-in-non-small-cell-lung-cancer
#4
Katarzyna Czarnecka-Kujawa, Ursula Rochau, Uwe Siebert, Eshetu Atenafu, Gail Darling, Thomas Kenneth Waddell, Andrew Pierre, Marc De Perrot, Marcelo Cypel, Shaf Keshavjee, Kazuhiro Yasufuku
OBJECTIVE: To assess the cost-effectiveness of various modes of mediastinal staging in non-small cell lung cancer (NSCLC) in a single-payer health care system. METHODS: We performed a decision analysis to compare the health outcomes and costs of 4 mediastinal staging strategies: no invasive staging, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), mediastinoscopy, and EBUS-TBNA followed by mediastinoscopy if EBUS-TBNA is negative. We determined incremental cost effectiveness ratios (ICER) for all strategies and performed comprehensive deterministic sensitivity analyses using a willingness to pay threshold of $80,000/quality adjusted life year (QALY)...
February 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28265347/value-added-medicines-what-value-repurposed-medicines-might-bring-to-society
#5
Mondher Toumi, Cécile Rémuzat
Background & objectives: Despite the wide interest surrounding drug repurposing, no common terminology has been yet agreed for these products and their full potential value is not always recognised and rewarded, creating a disincentive for further development. The objectives of the present study were to assess from a wide perspective which value drug repurposing might bring to society, but also to identify key obstacles for adoption of these medicines and to discuss policy recommendations. Methods: A preliminary comprehensive search was conducted to assess how the concept of drug repurposing was described in the literature...
2017: Journal of Market Access & Health Policy
https://www.readbyqxmd.com/read/28254672/is-the-use-of-minimally-invasive-fusion-technologies-associated-with-improved-outcomes-after-elective-interbody-lumbar-fusion-analysis-of-a-nationwide-prospective-patient-reported-outcomes-registry
#6
Matthew J McGirt, Scott L Parker, Praveen Mummaneni, John Knightly, Deborah Pfortmiller, Kevin Foley, Anthony L Asher
BACKGROUND CONTEXT: Over the last decade, clinical investigators and biomedical industry groups have used significant resources to develop advanced technologies that enable less invasive spine fusions. These minimally invasive surgery (MIS) technologies often require increased expenditures by hospitals and payers. While several small single center studies have suggested MIS technologies decrease surgical morbidity and reduce hospital stay, evidence documenting benefit from a patient perspective remains limited...
February 27, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28244494/do-primary-care-provider-strategies-improve-patient-participation-in-colorectal-cancer-screening
#7
Nancy N Baxter, Rinku Sutradhar, Qing Li, Corinne Daly, Gladys N Honein-AbouHaidar, Devon P Richardson, Lisa Del Giudice, Jill Tinmouth, Lawrence Paszat, Linda Rabeneck
OBJECTIVES: Screening rates for colorectal cancer (CRC) remain suboptimal. The impact of provider strategies to enhance screening participation in the population is uncertain. The objective of this study was to determine the effect of provider strategies to increase screening in a single-payer system. METHODS: A population-based survey was conducted in primary care providers (PCPs) linked to patients using administrative data in Ontario, Canada. Patients were due for CRC screening from April 2012 to March 2013...
February 28, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28241256/single-payer-reform-the-only-way-to-fulfill-the-president-s-pledge-of-more-coverage-better-benefits-and-lower-costs
#8
Steffie Woolhandler, David U Himmelstein
No abstract text is available yet for this article.
February 21, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28241203/achieving-universal-coverage-without-turning-to-a-single-payer-lessons-from-3-other-countries
#9
Regina E Herzlinger, Barak D Richman, Richard J Boxer
No abstract text is available yet for this article.
February 27, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28237204/using-multicriteria-approaches-to-assess-the-value-of-health-care
#10
Charles E Phelps, Guruprasad Madhavan
Practitioners of cost-utility analysis know that their models omit several important factors that often affect real-world decisions about health care options. Furthermore, cost-utility analyses typically reflect only single perspectives (e.g., individual, business, and societal), further limiting the value for those with different perspectives (patients, providers, payers, producers, and planners-the 5Ps). We discuss how models based on multicriteria analyses, which look at problems from many perspectives, can fill this void...
February 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28214168/medication-adherence-a-practical-measurement-selection-guide-using-case-studies
#11
Leah L Zullig, Phil Mendys, Hayden B Bosworth
OBJECTIVES: Medication adherence is a complex problem and can be evaluated using a variety of methods. There is no single or perfect strategy to assess adherence. The "best" measure depends on contextual factors. Our objective is to provide a practical, illustrative guide for selecting the most appropriate measure of medication adherence in common contexts. METHODS: We present three case studies - from the perspectives of an academic researcher, health care payer, and clinical care provider - to describe common problems and processes for measuring medication adherence, as well as proposing possible solutions...
February 10, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28212677/fit-for-purpose-perspectives-on-rapid-reviews-from-end-user-interviews
#12
Lisa Hartling, Jeanne-Marie Guise, Susanne Hempel, Robin Featherstone, Matthew D Mitchell, Makalapua L Motu'apuaka, Karen A Robinson, Karen Schoelles, Annette Totten, Evelyn Whitlock, Timothy J Wilt, Johanna Anderson, Elise Berliner, Aysegul Gozu, Elisabeth Kato, Robin Paynter, Craig A Umscheid
BACKGROUND: There is increasing demand for rapid reviews and timely evidence synthesis. The goal of this project was to understand end-user perspectives on the utility and limitations of rapid products including evidence inventories, rapid responses, and rapid reviews. METHODS: Interviews were conducted with key informants representing: guideline developers (n = 3), health care providers/health system organizations (n = 3), research funders (n = 1), and payers/health insurers (n = 1)...
February 17, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28210350/use-of-physician-in-triage-model-in-the-management-of-abdominal-pain-in-an-emergency-department-observation-unit
#13
John R Marshall, Robert Katzer, Shahram Lotfipour, Bharath Chakravarthy, Siri Shastry, Jessica Andrusaitis, Craig L Anderson, Erik D Barton
INTRODUCTION: Given the nationwide increase in emergency department (ED) visits it is of paramount importance for hospitals to find efficient ways to manage patient flow. The purpose of this study was to determine whether there is a significant difference in success rates, length of stay (LOS), and other demographic factors in two cohorts of patients admitted directly to an ED observation unit (EDOU) under an abdominal pain protocol by a physician in triage (bypassing the main ED) versus those admitted via the traditional pathway (evaluated and treated in the main ED prior to EDOU admission)...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28187056/operative-mortality-rates-of-acoustic-neuroma-surgery-a-national-cancer-database-analysis
#14
Shearwood McClelland, Ellen Kim, James D Murphy, Jerry J Jaboin
INTRODUCTION: Optimal acoustic neuroma (AN) management involves choosing between three treatment modalities: microsurgical excision, radiation, or observation with serial imaging. The reported in-hospital mortality rate of surgery for AN in the United States is 0.5%. However, there has yet to be a nationwide examination of the AN surgery mortality rate encompassing the period beyond initial hospital discharge. METHODS: The National Cancer Data Base (NCDB) from 2004 to 2013 identified AN patients receiving surgery...
February 9, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28174000/the-michigan-surgical-home-and-optimization-program-is-a-scalable-model-to-improve-care-and-reduce-costs
#15
Michael J Englesbe, Dane R Grenda, June A Sullivan, Brian A Derstine, Brooke N Kenney, Kyle H Sheetz, William C Palazzolo, Nicholas C Wang, Rebecca L Goulson, Jay S Lee, Stewart C Wang
BACKGROUND: The Michigan Surgical Home and Optimization Program is a structured, home-based, preoperative training program targeting physical, nutritional, and psychological guidance. The purpose of this study was to determine if participation in this program was associated with reduced hospital duration of stay and health care costs. METHODS: We conducted a retrospective, single center, cohort study evaluating patients who participated in the Michigan Surgical Home and Optimization Program and subsequently underwent major elective general and thoracic operative care between June 2014 and December 2015...
February 4, 2017: Surgery
https://www.readbyqxmd.com/read/28139384/comorbidity-effects-on-shoulder-arthroplasty-costs-analysis-of-a-nationwide-private-payer-insurance-data-set
#16
Samuel Rosas, Karim G Sabeh, Leonard T Buller, Tsun Yee Law, Steven P Kalandiak, Jonathan C Levy
BACKGROUND: The purpose of this study was to evaluate the effect of common medical comorbidities on the reimbursements of different shoulder arthroplasty procedures. METHODS: We conducted a retrospective query of a single private payer insurance claims database using PearlDiver (Warsaw, IN, USA) from 2010 to 2014. Our search included the Current Procedural Terminology codes and International Classification of Diseases, Ninth Revision codes for total shoulder arthroplasty (TSA), hemiarthroplasty, and reverse shoulder arthroplasty (RSA)...
January 27, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28115956/whole-breast-irradiation-vs-apbi-using-multicatheter-brachytherapy-in-early-breast-cancer-simulation-of-treatment-costs-based-on-phase-3-trial-data
#17
Aleksandra Harat, Maciej Harat, Roman Makarewicz
PURPOSE: A recent large phase 3 trial demonstrated that the efficacy of accelerated partial-breast irradiation (APBI) in the treatment of early breast cancer is non-inferior to that of whole breast irradiation (WBI) commonly used in this indication. The aim of this study was to compare the costs of treatment with APBI and WBI in a population of patients after conserving surgery for early breast cancer, and to verify if the use of APBI can result in direct savings of a public payer. MATERIAL AND METHODS: The hereby presented cost analysis was based on the results of GEC-ESTRO trial...
December 2016: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28111847/making-economic-evaluations-more-helpful-for-treatment-choices-in-haemophilia
#18
REVIEW
M Drummond, N Houwing, U Slothuus, P Giangrande
AIM: Poorly conducted economic evaluations have the potential to mislead both clinicians, leading to inappropriate treatment choices, and payers who must decide on the reimbursement of treatment costs. This paper reviews the methods used in economic evaluations in haemophilia and proposes standards for conducting and reporting such evaluations in the future. METHODS: A systematic review of economic evaluations in haemophilia published since 2008 was conducted. The reporting and methods of the studies were assessed using the recently published Consolidated Health Economic Evaluation Reporting Guidelines (CHEERS) checklist...
March 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28103923/risk-adjustment-methods-for-all-payer-comparative-performance-reporting-in-vermont
#19
Karl Finison, MaryKate Mohlman, Craig Jones, Melanie Pinette, David Jorgenson, Amy Kinner, Tim Tremblay, Daniel Gottlieb
BACKGROUND: As the emphasis in health reform shifts to value-based payments, especially through multi-payer initiatives supported by the U.S. Center for Medicare & Medicaid Innovation, and with the increasing availability of statewide all-payer claims databases, the need for an all-payer, "whole-population" approach to facilitate the reporting of utilization, cost, and quality measures has grown. However, given the disparities between the different populations served by Medicare, Medicaid, and commercial payers, risk-adjustment methods for addressing these differences in a single measure have been a challenge...
January 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28002151/use-of-biologic-therapy-in-racial-minorities-with-rheumatoid-arthritis-from-2-us-health-care-systems
#20
Gail S Kerr, Christopher Swearingen, Ted R Mikuls, Yusuf Yazici
BACKGROUND: In the United States, there is racial/ethnic disparity in the care of rheumatoid arthritis (RA), yet there are limited data regarding the impact of varied health care systems on treatment outcomes. OBJECTIVE: The aim fo this study was to compare the frequencies of use of disease-modifying antirheumatic drugs and biologic agents in racial minorities with RA in a single-payer and variable-access health systems. METHODS: Rheumatoid arthritis disease status was examined in the Ethnic Minority Rheumatoid Arthritis Consortium (EMRAC) and Veterans Affairs Rheumatoid Arthritis Registry (VARA); frequencies of prednisone and disease-modifying antirheumatic drugs and biologic agent use at enrollment were documented...
January 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
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