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https://www.readbyqxmd.com/read/29792371/biologics-monitoring-incongruity-between-recommendations-and-clinician-monitoring-trends
#1
Anish Nadkarni, Kimberly Hyde, Leah A Cardwell, Steven R Feldman
BACKGROUND: Biologics are a commonly used treatment for moderate to severe psoriasis. Monitoring laboratory test overuse provide little definitive benefit to patients. OBJECTIVE: We aim to query a Humana database to gain insight regarding current dermatologist laboratory monitoring practices for psoriasis patients on biologics. METHODS: Data were obtained from the Humana database. Our cohort included 333 patients with primary ICD-9 diagnosis of psoriasis (696...
May 24, 2018: Journal of Dermatological Treatment
https://www.readbyqxmd.com/read/29792122/drug-cost-avoidance-in-clinical-trials-of-breast-cancer
#2
M Mañes-Sevilla, R Romero-Jiménez, A Herranz-Alonso, M Sánchez-Fresneda, E Gonzalez-Haba, R Collado-Borrel, J Benedi-González, M Sanjurjo-Sáez
Background The objectives of this study were to determine if clinical trials in breast cancer, with an investigational drug, created direct drug cost savings for the healthcare system related to cost avoidance of the best standard of care treatments used in these studies. The aim was to quantify this potential drug cost avoidance. Methods We conducted a retrospective observational study of the drug cost avoidance during the study period (2014-2016). We included clinical trials with investigational drug, managed by pharmacy department and provided by the sponsor...
January 1, 2018: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29792114/innovating-urinary-catheter-design-an-introduction-to-the-engineering-challenge
#3
Cathy Murphy
Every day, people around the world rely on intermittent and indwelling urinary catheters to manage bladder dysfunction, but the potential or actual harm caused by these devices is well-recognised. Current catheter designs can cause urinary tract infection and septicaemia, bladder and urethral trauma and indwelling devices frequently become blocked. Furthermore, the devices can severely disrupt users' lives, limiting their daily activities and can be costly to manage for healthcare providers. Despite this, little significant design innovation has taken place in the last 80 years...
May 1, 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/29791714/the-problem-of-seroma-after-ventral-hernia-repair
#4
Nathaniel Stoikes, Esra Roan, David Webb, Guy R Voeller
Seroma is a common postoperative finding after ventral hernia repair with an incidence of 20%. Often, it can be managed conservatively, but in the case of persistent or chronic seroma, reinterventions may be required. Closed drain suction has been the mainstay of seroma management for the last 40 years. Other alternative technologies have been evaluated to improve outcomes with mixed results. Because seroma is common, it is often an accepted outcome. Patient morbidity and costs to the healthcare system are underestimated, which begs for a re-evaluation of the current state of seroma management that is nearly a half-century old...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29791084/the-hospital-readmissions-reduction-program-learning-from-failure-of-a-healthcare-policy
#5
REVIEW
Ankur Gupta, Gregg C Fonarow
Heart failure is the leading cause of readmissions in patients aged ≥65 years with high associated societal and economic costs. The utilization metric of 30-day risk standardized readmission rates (RSRRs) has therefore become a target to reduce healthcare costs. In this review, we discuss in detail the implementation, effectiveness, and unintended consequences of the Hospital Readmissions Reduction Program (HRRP)-the major healthcare policy approach in the U.S. to reduce readmissions by financially penalizing hospitals with higher than average 30-day RSRRs...
May 23, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29790444/data-envelopment-analysis-for-estimating-efficiency-of-intensive-care-units-a-case-study-in-iran
#6
Mohammad Amin Bahrami, Sima Rafiei, Mahdieh Abedi, Roohollah Askari
Purpose As hospitals are the most costly service providers in every healthcare systems, special attention should be given to their performance in terms of resource allocation and consumption. The purpose of this paper is to evaluate technical, allocative and economic efficiency in intensive care units (ICUs) of hospitals affiliated by Yazd University of Medical Sciences (YUMS) in 2015. Design/methodology/approach This was a descriptive, analytical study conducted in ICUs of seven training hospitals affiliated by YUMS using data envelopment analysis (DEA) in 2015...
May 14, 2018: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/29790443/improvement-of-laboratory-turnaround-time-using-lean-methodology
#7
Shradha Gupta, Sahil Kapil, Monica Sharma
Purpose The purpose of this paper is to discuss the implementation of lean methodology to reduce the turnaround time (TAT) of a clinical laboratory in a super speciality hospital. Delays in report delivery lead to delayed diagnosis increased waiting time and decreased customer satisfaction. The reduction in TAT will lead to increased patient satisfaction, quality of care, employee satisfaction and ultimately the hospital's revenue. Design/methodology/approach The generic causes resulting in increasing TAT of clinical laboratories were identified using lean tools and techniques such as value stream mapping (VSM), Gemba, Pareto Analysis and Root Cause Analysis...
May 14, 2018: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/29790202/incidence-and-cost-of-medication-harm-in-older-adults-following-hospital-discharge-a-multicentre-prospective-study-in-the-uk
#8
Nikesh Parekh, Khalid Ali, Jennifer M Stevenson, J Graham Davies, Rebekah Schiff, Tischa Van der Cammen, Jatinder Harchowal, James Raftery, Chakravarthi Rajkumar
AIMS: Polypharmacy is increasingly common in older adults, placing them at risk of medication-related harm (MRH). Patients are particularly vulnerable to problems with their medications in the period following hospital discharge due to medication changes, and poor information transfer between hospital and primary care. The aim of this study was to investigate the incidence, severity, preventability and cost of medication-related harm (MRH) in older adults in England post-discharge. METHODS: An observational multicentre prospective cohort study recruited 1280 older adults (median age 82 years) from five teaching hospitals in Southern England, UK...
May 22, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29790073/effect-of-low-back-pain-risk-stratification-strategy-on-patient-outcomes-and-care-processes-the-match-randomized-trial-in-primary-care
#9
Dan Cherkin, Benjamin Balderson, Rob Wellman, Clarissa Hsu, Karen J Sherman, Sarah C Evers, Rene Hawkes, Andrea Cook, Martin D Levine, Diane Piekara, Pam Rock, Katherine Talbert Estlin, Georgie Brewer, Mark Jensen, Anne-Marie LaPorte, John Yeoman, Gail Sowden, Jonathan C Hill, Nadine E Foster
BACKGROUND: The STarT Back strategy for categorizing and treating patients with low back pain (LBP) improved patients' function while reducing costs in England. OBJECTIVE: This trial evaluated the effect of implementing an adaptation of this approach in a US setting. DESIGN: The Matching Appropriate Treatments to Consumer Healthcare needs (MATCH) trial was a pragmatic cluster randomized trial with a pre-intervention baseline period. Six primary care clinics were pair randomized, three to training in the STarT Back strategy and three to serve as controls...
May 22, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29790040/building-behavioral-health-homes-clinician-and-staff-perspectives-on-creating-integrated-care-teams
#10
Tracy Anastas, Elizabeth Needham Waddell, Sonya Howk, Mark Remiker, Gretchen Horton-Dunbar, L J Fagnan
Adults with serious mental illness and substance use disorders have elevated risk of mortality and higher healthcare costs compared to the general population. As these disparities have been linked to poor management of co-occurring chronic conditions in primary care, the behavioral health setting may be a preferred setting for routine medical screening and treatment. This qualitative study describes early stages of integrating care teams in emerging medical homes based in mental health and addiction treatment settings...
May 22, 2018: Journal of Behavioral Health Services & Research
https://www.readbyqxmd.com/read/29789498/tools-for-detection-of-schistosomiasis-in-resource-limited-settings
#11
REVIEW
Olumide Ajibola, Bashar Haruna Gulumbe, Anthonius Anayochukwu Eze, Emmanuel Obishakin
Schistosomiasis is a debilitating disease affecting over 200 million people, with the highest burden of morbidity and mortality in African countries. Despite its huge impact on the health and socio-economic burden of the society, it remains a neglected tropical disease, with limited attention from governments and stakeholders in healthcare. One of the critical areas that is hugely under-developed is the development of accurate diagnostics for both intestinal and urogenital schistosomiasis. Diagnosis of schistosomiasis is important for the detection and treatment of disease in endemic and non-endemic settings...
May 23, 2018: Medical Sciences: Open Access Journal
https://www.readbyqxmd.com/read/29789227/cost-effectiveness-analysis-of-sensor-augmented-pump-therapy-with-low-glucose-suspend-in-patients-with-type-1-diabetes-mellitus-and-high-risk-of-hypoglycemia-in-spain
#12
Ignacio Conget, Pilar Martín-Vaquero, Stéphane Roze, Isabel Elías, Cristina Pineda, María Álvarez, Alexis Delbaere, Francisco Javier Ampudia-Blasco
OBJECTIVE: To compare the cost-effectiveness of sensor-augmented pump therapy (SAP) [continuous subcutaneous insulin infusion (CSII) plus real-time continuous glucose monitoring (RT-CGM)] with low glucose suspend (MiniMed™ Veo™) and CSII alone in patients with type 1 diabetes mellitus (T1DM) at high risk of hypoglycemia in Spain. METHODS: The IQVIA CORE Diabetes Model was used to estimate healthcare outcomes as life-years gained (LYGs) and quality-adjusted life years (QALYs), and to project lifetime costs...
May 19, 2018: Endocrinología, Diabetes y Nutrición
https://www.readbyqxmd.com/read/29789217/outcomes-and-cost-of-open-versus-endovascular-repair-of-intact-thoracoabdominal-aortic-aneurysm
#13
Satinderjit Locham, Hanaa Dakour-Aridi, Besma Nejim, Jasninder Dhaliwal, Widian Alshwaily, Mahmoud Malas
OBJECTIVE: Many previous studies have evaluated the outcomes of open and endovascular repair of thoracoabdominal aortic aneurysms (TAAAs). However, little is known about the differences in cost of these procedures and the potential factors driving these differences. The aim of this study was to evaluate the outcomes and cost of open aortic repair (OAR) vs endovascular repair of intact TAAA. METHODS: All patients undergoing repair for intact TAAA were identified in the Premier Healthcare Database (July 2009-March 2015)...
May 19, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29788982/tisu-extracorporeal-shockwave-lithotripsy-as-first-treatment-option-compared-with-direct-progression-to-ureteroscopic-treatment-for-ureteric-stones-study-protocol-for-a-randomised-controlled-trial
#14
Samuel McClinton, Sarah Cameron, Kathryn Starr, Ruth Thomas, Graeme MacLennan, Alison McDonald, Thomas Lam, James N'Dow, Mary Kilonzo, Robert Pickard, Ken Anson, Frank Keeley, Neil Burgess, Charles Terry Clark, Sara MacLennan, John Norrie
BACKGROUND: Urinary stone disease is very common with an estimated prevalence among the general population of 2-3%. Ureteric stones are associated with severe pain as they pass through the urinary tract and have significant impact on patients' quality of life due to the detrimental effect on their ability to work and need for hospitalisation. Most ureteric stones can be expected to pass spontaneously with supportive care. However, between one-fifth and one-third of cases require an intervention...
May 22, 2018: Trials
https://www.readbyqxmd.com/read/29788203/do-cost-containment-policies-save-money-and-influence-physicians-prescribing-behavior-lessons-from-south-korea-s-drug-policy-for-diabetes-medication
#15
Shin-On Kang, Seung Ju Kim, Sohee Park, Sung-In Jang, Eun-Cheol Park
Objective: We evaluate the effects of drug price reduction policy on pharmaceutical expenditure and prescription patterns in diabetes medication. Design: An interrupted time series study design using generalized estimating equations. Setting: This study used National Health Insurance claim data from 2010 to 2013. Participants: A total of 68 127 diabetes patients and 12 465 hospitals. Intervention(s): The drug price reduction policy...
May 17, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29788022/hospitalizations-in-children-with-a-penicillin-allergy-label-an-assessment-of-healthcare-impact
#16
Bernardo Sousa-Pinto, Luís Araújo, Alberto Freitas, Luís Delgado
BACKGROUND: Beta-lactam allergy is overdiagnosed. Diagnosis of penicillin allergy has been associated with a greater use of hospital resources and an increased risk of antibiotic-resistant infections, although this issue remains poorly studied in children. We aimed to compare patient characteristics and use of hospital resources in hospitalized children with and without a record of penicillin allergy. METHODS: We identified all hospitalizations in children labelled as being allergic to penicillin in a database containing all hospitalizations in Portuguese public hospitals between 2000 and 2014, and compared these with a similar number of age-, sex-, and main diagnosis-matched hospitalizations without a penicillin allergy label...
May 22, 2018: International Archives of Allergy and Immunology
https://www.readbyqxmd.com/read/29787695/incidence-of-musculoskeletal-injury-in-us-army-unit-types-a-prospective-cohort-study
#17
Deydre S Teyhen, Stephen L Goffar, Scott W Shaffer, Kyle Kiesel, Robert J Butler, Ann-Maree Tedaldi, Jennifer C Prye, Daniel I Rhon, Phillip J Plisky
Study Design A prospective observational cohort. Background Musculoskeletal injuries during military service are a primary source of disability resulting in 2.4 million annual health care visits and 25 million limited-duty days. While the injury incidence during basic training is well documented there is little understanding of injury distribution by organization type in the Army following initial training. Objective Compare injury incidence, distribution, and impact across various military units. Methods Comprehensive injury data from subject questionnaires and medical chart reviews were collected for 1430 initially healthy Army personnel representing combat, combat support, combat service support, and ranger units over 12 months...
May 22, 2018: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/29787590/cost-effectiveness-of-an-autoantibody-test-earlycdt-lung-as-an-aid-to-early-diagnosis-of-lung-cancer-in-patients-with-incidentally-detected-pulmonary-nodules
#18
John Edelsberg, Derek Weycker, Mark Atwood, Geoffrey Hamilton-Fairley, James R Jett
OBJECTIVE: Patients who have incidentally detected pulmonary nodules and an estimated intermediate risk (5-60%) of lung cancer frequently are followed via computed tomography (CT) surveillance to detect nodule growth, despite guidelines for a more aggressive diagnostic strategy. We examined the cost-effectiveness of an autoantibody test (AABT)-Early Cancer Detection Test-Lung (EarlyCDT-LungTM)-as an aid to early diagnosis of lung cancer among such patients. METHODS: We developed a decision-analytic model to evaluate use of the AABT versus CT surveillance alone...
2018: PloS One
https://www.readbyqxmd.com/read/29787389/liposomal-bupivacaine-does-not-reduce-inpatient-opioid-prescription-or-related-complications-after-knee-arthroplasty-a-database-analysis
#19
Lukas Pichler, Jashvant Poeran, Nicole Zubizarreta, Crispiana Cozowicz, Eric C Sun, Madhu Mazumdar, Stavros G Memtsoudis
BACKGROUND: Although some trials suggest benefits of liposomal bupivacaine, data on real-world use and effectiveness is lacking. This study analyzed the impact of liposomal bupivacaine use (regardless of administration route) on inpatient opioid prescription, resource utilization, and opioid-related complications among patients undergoing total knee arthroplasties with a peripheral nerve block. It was hypothesized that liposomal bupivacaine has limited clinical influence on the studied outcomes...
May 21, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29786153/vasa-previa-screening-strategies-a-decision-and-cost-effectiveness-analysis
#20
R G Sinkey, A O Odibo
OBJECTIVE: The aim of this study is to perform a decision and cost-effectiveness analysis comparing four screening strategies for the antenatal diagnosis of vasa previa among singleton pregnancies. METHODS: A decision-analytic model was constructed comparing vasa previa screening strategies. Published probabilities and costs were applied to four transvaginal screening scenarios which occurred at the time of mid-trimester ultrasound: no screening, ultrasound-indicated screening, screening pregnancies conceived by in vitro fertilization (IVF), and universal screening...
May 22, 2018: Ultrasound in Obstetrics & Gynecology
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