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https://www.readbyqxmd.com/read/27892907/concierge-medicine-a-viable-business-model-for-some-physicians-of-the-future
#1
David P Paul, Michaeline Skiba
Concierge medicine is a medical management structure that has been in existence since the 1990s. Essentially, a typical concierge medical practice limits its number of patients and provides highly personalized attention that includes comprehensive annual physicals, same-day appointments, preventive and wellness care, and fast, 24/7 response time. Concierge medicine has become popular among both physicians and patients/consumers who are frustrated by the limitations imposed by managed care organizations. From many physicians' perspectives, concierge medicine offers greater autonomy, the opportunity to return to a more manageable patient load, and the chance to improve their incomes that have declined because of increasingly lowered reimbursements for their services...
January 2016: Health Care Manager
https://www.readbyqxmd.com/read/27888569/providing-coverage-for-the-unique-life-long-health-care-needs-of-living-kidney-donors-within-the-framework-of-financial-neutrality
#2
John S Gill, Francis Delmonico, Scott Klarenbach, Alexander Morgan Capron
Organ donation should neither enrich nor impose financial burdens on donors. We describe the scope of health care required for all living kidney donors that reflects contemporary understanding of long-term donor health outcomes, propose an approach to identify donor health conditions which should be covered within the framework of financial neutrality, and propose strategies to pay for this care. Despite the Affordable Care Act in the United States, donors continue to have inadequate coverage for important health conditions that are either donation related or may compromise post-donation kidney function...
November 26, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27881254/health-technology-assessment-international-reference-pricing-and-budget-control-tools-from-china-s-perspective-what-are-the-current-developments-and-future-considerations
#3
Liling Koh, Christoph Glaetzer, Shu Chuen Li, Meng Zhang
BACKGROUND: China is investing considerably in health care reforms to address issues in its health care system. An example is access to innovative drugs, which remains challenging because it is largely dependent on patient self-pay. Recognizing this, the government has invested considerably in its basic medical insurance. As health care expenditure increases, there are growing concerns on budget control. Several health policy tools have been discussed recently such as health technology assessment, international reference pricing, and hospital budget control tools, which can be viewed as addressing the affordability concerns of the government budget...
May 2016: Value in Health Regional Issues
https://www.readbyqxmd.com/read/27855269/enhancing-the-diagnosis-treatment-surveillance-and-control-of-infectious-diseases-in-the-aca-era
#4
Jennifer B Nuzzo, Matthew Watson, Matthew P Shearer
As US public health faces increasing threats from outbreaks, impending changes to the healthcare landscape in the United States may alter the way that health departments are able to detect and control some of the most common infectious diseases. The Patient Protection and Affordable Care Act (ACA) has made significant changes in the way health care is provided in the United States. While many of the clinical, economic, and policy implications of the ACA are well described, there has been limited analysis of changes, if any, in the surveillance and control of infectious diseases of public health importance-such as tuberculosis, sexually transmitted infections, and HIV-that are anticipated or occurring as the ACA is implemented across the United States...
November 17, 2016: Health Security
https://www.readbyqxmd.com/read/27853396/development-of-training-related-health-care-software-by-a-team-of-clinical-educators-their-experience-from-conception-to-piloting
#5
Derfel Ap Dafydd, Ruth Williamson, Philip Blunt, Dominic M Blunt
The difficulties of producing useful, bespoke, and affordable information technology systems for large health care organizations are well publicized, following several high-profile endeavors in the UK. This article describes the experience of a small group of clinical radiologists and their collaborators in producing an information technology system - from conception to piloting. This system, called Trainee Tracker, enables automated target date recalculation of trainee milestones, depending on their work patterns and other individual circumstances...
2016: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/27853302/the-journey-to-meet-emerging-community-benefit-requirements-in-a-rural-hospital-a-case-study
#6
Allison V Sabin, Pamela F Levin
The Affordable Care Act requires nonprofit hospitals to collaborate with public health agencies and community stakeholders to identify and address community health needs. As a rural organization, Wabash County (Indiana) Hospital pursued new approaches to achieve these revised requirements of the community benefit mandate. Using a case study approach, the authors provide a historical review of governmental relationships with nonprofit community hospitals, offer a case study application for implementing legislative mandates and community benefit requirements, share the insights they garnered on their journey to meet the mandates, and conclude that drawing upon the existing resources in the community and using current community assets in novel ways can help conserve time, and also financial, material, and human resources in meeting legislative mandates...
October 22, 2015: Online Journal of Issues in Nursing
https://www.readbyqxmd.com/read/27845516/community-health-centers-play-a-critical-role-in-caring-for-the-remaining-uninsured-in-the-affordable-care-act-era
#7
Steven P Wallace, Marie-Elena Young, Michael A Rodriguez
Federally Qualified Health Centers--commonly referred to as Community Health Centers (CHCs)--serve as a safety net for people who did not gain health insurance under the Affordable Care Act (ACA), including those immigrants not eligible for Medicaid or health insurance exchange coverage. ACA-driven changes in health insurance coverage, funding, and related policy have created new challenges for these safety net organizations. This policy brief reports the findings from analyses of the U.S. HRSA Uniform Data System and interviews conducted in 2014-16 with the leadership of 31 CHCs...
October 2016: Policy Brief
https://www.readbyqxmd.com/read/27829289/experiences-of-attitudes-in-sierra-leone-from-the-perspective-of-people-with-poliomyelitis-and-amputations-using-orthotics-and-prosthetics
#8
Emmelie Andregård, Lina Magnusson
PURPOSE: The aim of this study was to describe experiences of attitudes in the society of Sierra Leone from the perspective of individuals with poliomyelitis and people with amputations using orthotic or prosthetic devices. METHODS: Individual interviews were conducted using open-ended questions. Twelve participants with amputations or polio were included. Content analysis was applied to the data. RESULTS: The following six themes emerged during data analysis: Experience of negative attitudes; Neglected and respected by family; Traditional beliefs; The importance of assistive devices; People with disability struggle with poverty; and The need for governmental and international support...
November 10, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27809918/assessing-demand-side-barriers-to-uptake-of-intermittent-preventive-treatment-for-malaria-in-pregnancy-a-qualitative-study-in-two-regions-of-uganda
#9
Christian Rassi, Kirstie Graham, Rebecca King, James Ssekitooleko, Patrobas Mufubenga, Sam Siduda Gudoi
BACKGROUND: To prevent malaria infection during pregnancy in endemic areas in Africa, the World Health Organization recommends the administration of intermittent preventive treatment in pregnancy (IPTp) as part of the focused antenatal care package. However, IPTp uptake in most countries remains low despite generally high antenatal care coverage and increased efforts by governments to address known bottlenecks such as drug stock-outs. The study explored factors that continue to impede uptake of IPTp among women who attend antenatal care...
November 4, 2016: Malaria Journal
https://www.readbyqxmd.com/read/27799747/reaching-women-in-the-peruvian-andes-through-cervical-cancer-screening-campaigns-assessing-attitudes-of-stakeholders-and-patients
#10
John S Luque, Jonathan N Maupin, Daron G Ferris, Wendy S Guevara Condorhuaman
BACKGROUND: Peru is characterized by high cervical cancer incidence and mortality rates. The country also experiences significant gaps in quality cervical cancer screening coverage for the population. OBJECTIVE: This descriptive mixed methods study conducted in Cusco, Peru, aimed to assess the attitudes and perceptions of medical staff, health care workers, and patients toward a cervical cancer screening program that included both clinic-based and community outreach services conducted by a nongovernmental organization clinic (CerviCusco)...
2016: Patient Preference and Adherence
https://www.readbyqxmd.com/read/27798780/knowing-your-limits-a-qualitative-study-of-physician-and-nurse-practitioner-perspectives-on-np-independence-in-primary-care
#11
Elena Kraus, James M DuBois
BACKGROUND: The shortage of primary care providers and the provisions of the Affordable Care Act (ACA) have spurred discussion about expanding the number, scope of practice (SOP), and independence of primary care nurse practitioners (NPs). Such discussions in the media and among professional organizations may insinuate that changes to the laws governing NP practice will engender acrimony between practicing physicians and NPs. However, we lack empirical, descriptive data on how practicing professionals view NP independence in primary care...
October 31, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27796676/microfluidic-advances-in-phenotypic-antibiotic-susceptibility-testing
#12
Jennifer Campbell, Christine McBeth, Maxim Kalashnikov, Anna K Boardman, Andre Sharon, Alexis F Sauer-Budge
A strong natural selection for microbial antibiotic resistance has resulted from the extensive use and misuse of antibiotics. Though multiple factors are responsible for this crisis, the most significant factor - widespread prescription of broad-spectrum antibiotics - is largely driven by the fact that the standard process for determining antibiotic susceptibility includes a 1-2-day culture period, resulting in 48-72 h from patient sample to final determination. Clearly, disruptive approaches, rather than small incremental gains, are needed to address this issue...
December 2016: Biomedical Microdevices
https://www.readbyqxmd.com/read/27789732/new-medicaid-enrollees-see-health-and-social-benefits-in-pennsylvania-s-expansion
#13
Jeffrey K Hom, Charlene Wong, Christian Stillson, Jessica Zha, Carolyn C Cannuscio, Rachel Cahill, David Grande
Understanding how new Medicaid enrollees are approaching their own health and health care in the shifting health care landscape of the Affordable Care Act has implications for future outreach and enrollment efforts, as well as service planning for this population. The objective of this study was to explore the health care experiences and expectations of new Medicaid expansion beneficiaries in the immediate post-enrollment period. We conducted semistructured, qualitative interviews with a random sample of 40 adults in Philadelphia who had completed an application for Medicaid through a comprehensive benefits organization after January 1, 2015, when the Medicaid expansion in Pennsylvania took effect...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27753718/under-reporting-of-risky-drug-use-among-primary-care-patients-in-federally-qualified-health-centers
#14
Curtis Bone, Lilian Gelberg, Mani Vahidi, Barbara Leake, Julia Yacenda-Murphy, Ronald M Andersen
OBJECTIVE: The Affordable Care Act encourages integration of behavioral health into primary care. We aim to estimate the level of under-reporting of drug use in federally qualified health centers (FQHCs) among self-reported risky drug users. METHODS: Adult patients in the waiting rooms of 4 FQHCs who self-reported risky drug use on the screening instrument World Health Organization's Alcohol, Smoking and Substance Involvement Screening Test (score 4-26), who participated in the "Quit Using Drugs Intervention Trial," submitted urine samples for drug testing...
October 6, 2016: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/27753492/theoretical-exploration-of-type-i-type-ii-dual-photoreactivity-of-promising-ru-ii-dyads-for-pdt-approach
#15
Marta Erminia Alberto, Jenny Pirillo, Nino Russo, Carlo Adamo
Ru(II) dyads are a class of bioactive molecules of interest as anticancer agents obtained incorporating an organic chromophore in the light-absorbing metallic scaffold. A careful DFT and TDDFT investigation of the photophysical properties of a series of Ru(II)-polypiridyl dyads containing polythiophene chains of different lengths bound to a coordinating imidazo[4,5-f][1,10]phenanthroline ligand is herein reported. The modulation of the crucial chemical and physical properties of the photosensitizer with increasing number of thiophene units has been accurately described by investigating the UV-vis spectra and type I and type II photoreactions, also including spin-orbit coupling values (SOC)...
October 18, 2016: Inorganic Chemistry
https://www.readbyqxmd.com/read/27742528/age-friendly-communities-initiative-public-health-approach-to-promoting-successful-aging
#16
REVIEW
Dilip V Jeste, Dan G Blazer, Kathleen C Buckwalter, Keri-Leigh K Cassidy, Len Fishman, Lisa P Gwyther, Saul M Levin, Christopher Phillipson, Ramesh R Rao, Ellen Schmeding, William A Vega, Julie A Avanzino, Danielle K Glorioso, John Feather
Older adults consistently prefer aging in place, which requires a high level of community support and services that are currently lacking. With a rapidly aging population, the present infrastructure for healthcare will prove even more inadequate to meet seniors' physical and mental health needs. A paradigm shift away from the sole focus on delivery of interventions at an individual level to more prevention-focused, community-based approaches will become essential. Recent initiatives have been proposed to promote healthy lifestyles and preventive care to enable older adults to age in place...
December 2016: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27737976/follow-up-after-treatment-for-breast-cancer-practical-guide-to-survivorship-care-for-family-physicians
#17
Jeffrey Sisler, Genevieve Chaput, Jonathan Sussman, Emmanuel Ozokwelu
OBJECTIVE: To offer FPs a summary of evidence-based recommendations to guide their follow-up survivorship care of women treated for breast cancer. QUALITY OF EVIDENCE: A literature search was conducted in MEDLINE from 2000 to 2016 using the search words breast cancer, survivorship, follow-up care, aftercare, guidelines, and survivorship care plans, with a focus on review of recent guidelines published by national cancer organizations. Evidence ranges from level I to level III...
October 2016: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/27724952/organizational-interventions-improving-access-to-community-based-primary-health-care-for-vulnerable-populations-a-scoping-review
#18
Vladimir Khanassov, Pierre Pluye, Sarah Descoteaux, Jeannie L Haggerty, Grant Russell, Jane Gunn, Jean-Frederic Levesque
: Access to community-based primary health care (hereafter, 'primary care') is a priority in many countries. Health care systems have emphasized policies that help the community 'get the right service in the right place at the right time'. However, little is known about organizational interventions in primary care that are aimed to improve access for populations in situations of vulnerability (e.g., socioeconomically disadvantaged) and how successful they are. The purpose of this scoping review was to map the existing evidence on organizational interventions that improve access to primary care services for vulnerable populations...
October 10, 2016: International Journal for Equity in Health
https://www.readbyqxmd.com/read/27718326/potential-use-of-metabolic-breath-tests-to-assess-liver-disease-and-prognosis-has-the-time-arrived-for-routine-use-in-the-clinic
#19
REVIEW
R Todd Stravitz, Yaron Ilan
The progression of liver disease may be unique among organ system diseases in that progressive fibrosis compromises not only the sufficiency of hepatocyte mass but also impairs blood flow to the liver, resulting in porto-systemic shunting. Although liver biopsy as an assessment of fibrosis has become the key biomarker of and target for new therapies, it is invasive and subject to sampling error, and cannot quantify metabolic function or porto-systemic shunting. Measurement of the hepatic venous pressure gradient accommodates some of the deficiencies of biopsy but requires expertise not widely available and misses minor changes in hepatocellular mass and thereby information about metabolic function...
October 8, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27712948/community-organizing-for-healthier-communities-environmental-and-policy-outcomes-of-a-national-initiative
#20
Andrew M Subica, Cheryl T Grills, Sandra Villanueva, Jason A Douglas
INTRODUCTION: Childhood obesity is disproportionately prevalent in communities of color, partially because of structural inequities in the social and built environment (e.g., poverty, food insecurity, pollution) that restrict healthy eating and active living. Community organizing is an underexamined, grassroots health promotion approach that empowers and mobilizes community residents to advocate for, and achieve, environmental and policy changes to rectify these structural inequities...
December 2016: American Journal of Preventive Medicine
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