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https://www.readbyqxmd.com/read/29161536/multiple-health-conditions-and-barriers-to-healthcare-among-older-australians-prevalence-reasons-and-types-of-barriers
#1
Jeromey B Temple, Ruth Williams
Accompanying population ageing is an increase in the number of older Australians living with multiple health conditions and disabilities (Australian Institute of Health and Welfare 2014). This study sought to examine the barriers to accessing healthcare faced by older Australians. Utilising the 2014 Australian Bureau of Statistics General Social Survey, it was found that 6% of respondents aged 50 years and over reported experiencing a barrier to accessing healthcare within the previous 12 months. Those with multiple health conditions are at a considerably higher risk of experiencing a barrier to healthcare (21% with four or more disabilities) compared with people with no or fewer health conditions, and this risk persists once wide-ranging control variables are included...
November 22, 2017: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/29161521/lessons-from-the-camden-coalition-of-healthcare-providers-first-medicaid-shared-savings-performance-evaluation
#2
Aaron Truchil, Natasha Dravid, Stephen Singer, Zachary Martinez, Teagan Kuruna, Scott Waulters
Accountable Care Organizations (ACOs) aim to reduce health care costs while improving patient outcomes. Camden Coalition of Healthcare Providers' (Camden Coalition) work already aligned with this aim before receiving state approval to operate a certified Medicaid ACO in New Jersey. Upon its formation, the Camden Coalition ACO partnered with UnitedHealthcare and, through state legislation, Rutgers Center for State Health Policy (CSHP) was established as its external evaluator. In evaluating the Camden Coalition ACO, Rutgers CSHP built on the Medicare Shared Savings model, but modified it based on the understanding that the Medicaid population differs from the Medicare population...
November 21, 2017: Population Health Management
https://www.readbyqxmd.com/read/29161400/the-evolution-of-robotic-surgery-surgical-and-anaesthetic-aspects
#3
H Ashrafian, O Clancy, V Grover, A Darzi
Robotic surgery pushes the frontiers of innovation in healthcare technology towards improved clinical outcomes. We discuss the evolution to five generations of robotic surgical platforms including stereotactic, endoscopic, bioinspired, microbots on the millimetre scale, and the future development of autonomous systems. We examine the challenges, obstacles and limitations of robotic surgery and its future potential including integrated real-time anatomical and immune-histological imaging and data assimilation with improved visualisation, haptic feedback and robot-surgeon interactivity...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29161388/critical-care-at-the-end-of-life-balancing-technology-with-compassion-and-agreeing-when-to-stop
#4
H Montgomery, M Grocott, M Mythen
Modern intensive care saves lives. However, the substantial related financial costs are, for many, married to substantial costs in terms of suffering. In the most sick, the experience of intensive care is commonly associated with the development of profound physical debility, which may last years after discharge. Likewise, the negative psychological impact commonly experienced by such patients during their care is now widely recognized, as is the persistence of psychological morbidity. Such issues become increasingly important as the population of the frail elderly increases, and the health and social care services face budgetary restriction...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29161262/the-value-of-confirmatory-testing-in-early-infant-hiv-diagnosis-programmes-in-south-africa-a-cost-effectiveness-analysis
#5
Lorna Dunning, Jordan A Francke, Divya Mallampati, Rachel L MacLean, Martina Penazzato, Taige Hou, Landon Myer, Elaine J Abrams, Rochelle P Walensky, Valériane Leroy, Kenneth A Freedberg, Andrea Ciaranello
BACKGROUND: The specificity of nucleic acid amplification tests (NAATs) used for early infant diagnosis (EID) of HIV infection is <100%, leading some HIV-uninfected infants to be incorrectly identified as HIV-infected. The World Health Organization recommends that infants undergo a second NAAT to confirm any positive test result, but implementation is limited. Our objective was to determine the impact and cost-effectiveness of confirmatory HIV testing for EID programmes in South Africa...
November 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29160967/holistic-care-of-hemodialysis-access-in-patients-with-kidney-failure
#6
Michael V Bueno, Christine L Latham
Kidney failure requiring hemodialysis is a chronic illness that has physical, psychosocial, and financial consequences. Patients with kidney failure receiving hemodialysis need a renewed focus on self-care, prevention, and community-based health management to reduce healthcare costs and complications, and improve outcomes and quality of life, while living with an altered lifestyle. A holistic chronic care model was applied as a guideline for healthcare professionals involved with this population to more effectively engage people with kidney failure in their management of their hemodialysis access...
July 2017: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
https://www.readbyqxmd.com/read/29160914/hospital-variation-in-costs-a-challenge-to-the-value-proposition
#7
Aaron B Caughey, Jonathan M Snowden
There is variation from clinician to clinician and institution to institution within the healthcare industry. This was identified by Wennberg in seminal work more than four decades ago.(Wennberg J. Science. 1973;182:1102-8) Since that time, variation in the provision of healthcare has been demonstrated in numerous settings and is thought to be related to the local and regional healthcare culture. Additionally, not only has a difference in health care utilization been demonstrated, but also health care costs...
November 21, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29159790/vitamin-d-supplementation-in-pregnancy-a-survey-of-compliance-with-recommendations
#8
C M Windrim, D A Crosby, K Mitchell, C Brophy, R Mahony, M Higgins
BACKGROUND: Vitamin D deficiency in pregnancy has important maternal and fetal implications, with increased risk of developing gestational diabetes, preeclampsia, preterm birth and small for gestational age birthweight. It is recommended that every pregnant woman should take 5 μg (200 IU) of vitamin D per day during pregnancy and lactation. AIMS: This study aimed to determine the prevalence of women taking vitamin D supplementation and to identify the reasons for patients not taking supplementation within women attending an antenatal clinic in Dublin...
November 20, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29159785/improving-the-hospital-quality-of-care-during-winter-periods-by-optimizing-budget-allocation-between-rotavirus-vaccination-and-bed-expansion
#9
Thibaut Dort, Nadia Schecroun, Baudouin Standaert
BACKGROUND: During each winter the hospital quality of care (QoC) in pediatric wards decreases due to a surge in pediatric infectious diseases leading to overcrowded units. Bed occupancy rates often surpass the good hospital bed management threshold of 85%, which can result in poor conditions in the workplace. This study explores how QoC-scores could be improved by investing in additional beds and/or better vaccination programs against vaccine-preventable infectious diseases. METHODS: The Cobb-Douglas model was selected to define the improvement in QoC (%) as a function of two strategies (rotavirus vaccination coverage [%] and addition of extra hospital beds [% of existing beds]), allowing improvement-isocurves to be produced...
November 20, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/29159605/outcomes-of-emergency-laparotomy-el-care-protocol-at-tertiary-care-center-from-low-middle-income-country-lmic
#10
Nitin Vashistha, Dinesh Singhal, Sandeep Budhiraja, Bharat Aggarwal, Raj Tobin, Kamal Fotedar
BACKGROUND: Emergency laparotomy mortality ranges between 10 and 20% in best of Western healthcare systems and is currently a major focus for quality improvement programs. In contrast, emergency surgery scenario in LMIC is largely undefined, often neglected and complex (large burden of diseases but only limited capacity for adequate treatment). We evaluated the efficacy of 'EL care protocol' aimed at cost-effective optimal utilization of best available local expertise and infrastructure...
November 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29159273/a-health-economic-evaluation-of-needle-based-confocal-laser-endomicroscopy-for-the-diagnosis-of-pancreatic-cysts
#11
Claude Le Pen, Laurent Palazzo, Bertrand Napoléon
Background and study aims:  The low sensitivity of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), especially for the diagnosis of serous cystadenomas (SCAs), can be associated with diagnostic uncertainty that can regularly lead to unnecessary surgical procedures. Needle-based confocal laser endomicroscopy (nCLE) used with EUS-FNA improves diagnostic accuracy, helping to reduce unnecessary surgery and patient follow-up. This study was conducted to evaluate the economic benefit of EUS-FNA + nCLE...
October 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29158552/care-and-cost-consequences-of-pediatric-whole-genome-sequencing-compared-to-chromosome-microarray
#12
Robin Z Hayeems, Jasmin Bhawra, Kate Tsiplova, M Stephen Meyn, Nasim Monfared, Sarah Bowdin, D James Stavropoulos, Christian R Marshall, Raveen Basran, Cheryl Shuman, Shinya Ito, Iris Cohn, Courtney Hum, Marta Girdea, Michael Brudno, Ronald D Cohn, Stephen W Scherer, Wendy J Ungar
The clinical use of whole-genome sequencing (WGS) is expected to alter pediatric medical management. The study aimed to describe the type and cost of healthcare activities following pediatric WGS compared to chromosome microarray (CMA). Healthcare activities prompted by WGS and CMA were ascertained for 101 children with developmental delay over 1 year. Activities following receipt of non-diagnostic CMA were compared to WGS diagnostic and non-diagnostic results. Activities were costed in 2016 Canadian dollars (CDN)...
November 20, 2017: European Journal of Human Genetics: EJHG
https://www.readbyqxmd.com/read/29157888/quality-measurement-affecting-surgical-practice-utility-versus-utopia
#13
REVIEW
Leonard R Henry, Urs W von Holzen, Michael J Minarich, Ashley N Hardy, Wilbur A Beachy, M Susan Franger, Roderich E Schwarz
The Triple Aim: improving healthcare quality, cost and patient experience has resulted in massive healthcare "quality" measurement. For many surgeons the origins, intent and strengths of this measurement barrage seems nebulous-though their shortcomings are noticeable. This article reviews the major organizations and programs (namely the Centers for Medicare and Medicaid Services) driving the somewhat burdensome healthcare quality climate. The success of this top-down approach is mixed, and far from convincing...
November 11, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29157786/the-seasonal-variability-of-surgical-site-infections-in-knee-and-hip-arthroplasty
#14
Chris A Anthony, Ryan A Peterson, Daniel K Sewell, Linnea A Polgreen, Jacob E Simmering, John J Callaghan, Philip M Polgreen
BACKGROUND: Surgical site infections (SSIs) after total knee (TKA) and total hip (THA) arthroplasty are devastating to patients and costly to healthcare systems. The purpose of this study is to investigate the seasonality of TKA and THA SSIs at a national level. METHODS: All data were extracted from the National Readmission Database for 2013 and 2014. Patients were included if they had undergone TKA or THA. We modeled the odds of having a primary diagnosis of SSI as a function of discharge date by month, payer status, hospital size, and various patient co-morbidities...
November 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29155982/economic-and-survival-burden-of-dysphagia-among-inpatients-in-the-united-states
#15
D A Patel, S Krishnaswami, E Steger, E Conover, M F Vaezi, M R Ciucci, D O Francis
The inpatient burden of dysphagia has primarily been evaluated in patients with stroke. It is unclear whether dysphagia, irrespective of cause, is associated with worse clinical outcomes and higher costs compared to inpatients with similar demographic, hospital, and clinical characteristics without dysphagia. The aim of this study is to assess how a dysphagia diagnosis affects length of hospital stay (LOS), costs, discharge disposition, and in-hospital mortality among adult US inpatients. Annual and overall dysphagia prevalence, LOS, hospital charges, inpatient care costs, discharge disposition, and in-hospital mortality were measured using the AHRQ Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (2009-2013)...
November 16, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29155557/wearable-nanoplasmonic-patch-detecting-sun-uv-exposure
#16
Jessica G Barajas-Carmona, Leydi Francisco-Aldana, Eden Morales-Narváez
Sun exposure is known to yield beneficial health outcomes, including synthesis of adequate levels of vitamin D, beneficial modulation of blood pressure and is a valuable factor in mental health care. However, the increasing incidence of sun/UV exposure-related illness, such as skin cancer, is seriously concerning public health authorities as well as the scientific community. Consequently, moderate sun/UV exposure is strongly recommended. A wearable nanoplasmonic patch whose original color changes upon sun exposure due to its UV-responsive capabilities that are visually detectable has been engineered...
November 20, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/29155500/chinese-medicine-for-diabetic-kidney-disease-in-china
#17
REVIEW
Yumin Wen, Meihua Yan, Bingxuan Zhang, Ping Li
Diabetic kidney disease (DKD) is a major global public health concern due to its high prevalence and mortality, and high healthcare cost. Conventional Western therapies for DKD fail to provide favourable efficacy. Chinese medicine (CM) has been widely used to combat DKD in China and other Asian countries. The clinical effects and mechanism of CM in treating DKD have not been fully elucidated. This review summarizes current knowledge of CM therapeutic modalities for DKD, especially Chinese herbal medicine (CHM), and potential mechanisms...
December 2017: Nephrology
https://www.readbyqxmd.com/read/29155406/biocompatible-antimicrobial-cotton-fibres-for-healthcare-industries-a-biogenic-approach-for-synthesis-of-bio-organic-coated-silver-nanoparticles
#18
Sahebrao B Kashid, Jaya R Lakkakula, Deepak S Chauhan, Rohit Srivastava, Rajesh W Raut
Cotton fibres coated with biogenically fabricated silver nanoparticles (SNPs) are most sought material because of their enhanced activity and biocompatibility. After successful synthesis of SNPs on cotton fibres using leaf extract of Vitex negundo Linn, the fibres were studied using diffuse reflectance spectroscopy, scanning electron microscopy, nanoparticle tracking analysis, energy dispersive X-ray, and inductively coupled plasma atomic emission spectrometry. The characterisation revealed uniformly distributed spherical agglomerates of SNPs having individual particle size around 50 nm with the deposition load of 423 μg of silver per gram of cotton...
December 2017: IET Nanobiotechnology
https://www.readbyqxmd.com/read/29155340/ambulatory-anterior-cervical-discectomy-and-fusion-is-associated-with-a-higher-risk-of-revision-surgery-and-perioperative-complications-an-analysis-of-a-large-nationwide-database
#19
Armin Arshi, Christopher Wang, Howard Y Park, Gideon W Blumstein, Zorica Buser, Jeffrey C Wang, Arya N Shamie, Don Y Park
BACKGROUND CONTEXT: With the changing landscape of healthcare, outpatient spine surgery is being more commonly performed to reduce cost and improve efficiency. Anterior cervical discectomy and fusion (ACDF) is one of the most common spine surgeries performed and demand is expected to increase with an aging population. PURPOSE: To determine the nationwide trends and relative complication rates associated with outpatient ACDF. STUDY DESIGN/SETTING: Large-scale retrospective case control study PATIENT SAMPLE: Humana-insured patients who underwent 1-2 level ACDF as either outpatients or inpatients from 2011-2016 OUTCOME MEASURES: Incidence and adjusted odds ratio (OR) of postoperative medical and surgical complications within one year of the index surgery METHODS: A retrospective review was performed of the PearlDiver® Humana insurance records database to identify patients undergoing 1-2 level ACDF (CPT-22551 AND ICD-9-816...
November 16, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29155338/financial-toxicity-in-bladder-cancer-patients-reasons-for-delay-in-care-and-effect-on-quality-of-life
#20
Marianne M Casilla-Lennon, Seul Ki Choi, Allison M Deal, Jeannette T Bensen, Gopal Narang, Pauline Filippou, Benjamin McCormick, Raj Pruthi, Eric Wallen, Hung-Jui Tan, Michael Woods, Matthew Nielsen, Angela Smith
PURPOSE: Costly surveillance and treatment of bladder cancer can lead to financial toxicity (FT), a treatment-related financial burden. Our objective was to define the prevalence of FT among bladder cancer patients and identify delays in care and its effect on health-related quality of life (HRQOL). METHODS: We identified bladder cancer patients in the UNC Health Registry/Cancer Survivorship Cohort. FT was defined as agreement with having "to pay more for medical care than you can afford...
November 16, 2017: Journal of Urology
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