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https://www.readbyqxmd.com/read/29146489/exploring-the-barriers-to-and-facilitators-of-using-evidence-based-drugs-in-the-secondary-prevention-of-cardiovascular-diseases-findings-from-a-multistakeholder-qualitative-analysis
#1
Victoria Miller, Lavanya Nambiar, Malvika Saxena, Darryl Leong, Amitava Banerjee, José Pablo Werba, Jose Rocha Faria Neto, Katherine Curi Quinto, Mohammed Moniruzzaman, Shweta Khandelwal
BACKGROUND: Health-system barriers and facilitators associated with cardiovascular medication adherence have seldom been studied, particularly in low- and middle-income countries where uptake rates are poorest. OBJECTIVES: This study sought to explore the major obstacles and facilitators to the use of evidence-supported medications for secondary prevention of cardiovascular disease using qualitative analysis in 2 diverse countries across multiple levels of their health care systems...
November 13, 2017: Global Heart
https://www.readbyqxmd.com/read/29144165/gene-therapy-evidence-value-and-affordability-in-the-us-health-care-system
#2
Grace Hampson, Adrian Towse, Steven D Pearson, William B Dreitlein, Chris Henshall
AIMS: To explore the challenges presented by gene therapies, discuss potential solutions, and present policy recommendations. METHODS: A review of the literature and series of expert interviews were conducted and discussed at a Policy Forum convened by The Institute for Clinical and Economic Review (ICER). The Policy Forum was attended by independent experts and senior representatives from 20 payer organizations and life sciences companies. RESULTS: Three categories of challenges are identified: evidence generation, assessing value and affordability...
November 16, 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/29143612/values-preferences-and-current-hepatitis-b-and-c-testing-practices-in-low-and-middle-income-countries-results-of-a-survey-of-end-users-and-implementers
#3
Elena Ivanova Reipold, Alessandra Trianni, Douglas Krakower, Stefano Ongarello, Teri Roberts, Philippa Easterbrook, Claudia Denkinger
BACKGROUND: Access to hepatitis B virus (HBV) and hepatitis C virus (HCV) diagnostics remains a key bottleneck in scale-up of access to HBV and HCV treatment, particularly in low- and middle-income countries (LMICs) that lack laboratory resources and skilled personnel. To inform the development of World Health Organization (WHO) testing guidelines on who to test and how to test, we performed a "values and preferences" survey of end users and implementers of hepatitis testing in LMICs on current hepatitis B and C testing practices and acceptability of diagnostic approaches, as well as preferences for the future...
November 1, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29142907/social-effects-of-health-care-reform-medicaid-expansion-under-the-affordable-care-act-and-changes-in-volunteering
#4
Heeju Sohn, Stefan Timmermans
Do public health policy interventions result in pro-social behaviors? The Affordable Care Act (ACA)'s Medicaid expansions were responsible for the largest gains in public insurance coverage since its inception in 1965. These gains were concentrated in states that opted to expand Medicaid eligibility and provide a unique opportunity to study not just medical but also social consequences of increased public health coverage. This article examines the association between Medicaid and volunteer work. Volunteerism is implicated in individuals' health and well-being yet it is highly correlated with a person's existing socioeconomic resources...
January 2017: Socius
https://www.readbyqxmd.com/read/29140263/access-to-guideline-recommended-pharmacogenomic-tests-for-cancer-treatments-experience-of-providers-and-patients
#5
Ann Chen Wu, Kathleen M Mazor, Rachel Ceccarelli, Stephanie Loomer, Christine Y Lu
Genomic tests are the fastest growing sector in medicine and medical science, yet there remains a dearth of research on access to pharmacogenomic tests and medications. The objective of this study is to explore providers' and patients' experiences and views on test access as well as strategies used for gaining access. We interviewed clinicians who prescribed medications that should be guided by pharmacogenomic testing and patients who received those prescriptions. We organized the themes into the four dimensions suggested by the World Health Organization framework on access to medications and health technologies...
November 15, 2017: Journal of Personalized Medicine
https://www.readbyqxmd.com/read/29137499/improving-care-and-lowering-costs-evidence-and-lessons-from-a-global-analysis-of-accountable-care-reforms
#6
Mark McClellan, Krishna Udayakumar, Andrea Thoumi, Jonathan Gonzalez-Smith, Kushal Kadakia, Natalia Kurek, Mariam Abdulmalik, Ara W Darzi
Policy makers and providers are under increasing pressure to find innovative approaches to achieving better health outcomes as efficiently as possible. Accountable care, which holds providers accountable for results rather than specific services, is emerging in many countries to support such care innovations. However, these reforms are challenging and complex to implement, requiring significant policy and delivery changes. Despite global interest, the evidence on how to implement accountable care successfully remains limited...
November 2017: Health Affairs
https://www.readbyqxmd.com/read/29136150/using-value-stream-mapping-to-improve-quality-of-care-in-low-resource-facility-settings
#7
Rohit Ramaswamy, Claire Rothschild, Funmi Alabi, Eric Wachira, Faith Muigai, Nick Pearson
Quality problem or issue: Jacaranda Health (JH) is a Kenya-based organization that attempts to provide affordable, high-quality maternal and newborn healthcare through a chain of private health facilities in Nairobi. Initial assessment: JH needed to adopted quality improvement as an organization-wide strategy to optimize effectiveness and efficiency. Choice of solution: Value Stream Mapping, a Lean Management tool, was used to engage staff in prioritizing opportunities to improve clinical outcomes and patient-centered quality of care...
November 9, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29133152/laparoscopic-assisted-uterus-retrieval-from-live-organ-donors-for-uterine-transplant
#8
Shailesh Puntambekar, Milind Telang, Pankaj Kulkarni, Sanjeev Jadhav, Ravindra Sathe, Neeta Warty, Seema Puntambekar, Sandesh Kade, Mangesh Panse, Nikhil Agarkhedkar, Giriraj Gandhi, Manoj Manchekar, Hirav Parekh, Kajal Parikh, Riddhi Desai, Mehul Mehta, Mihir Chitale, Sambit Nanda
OBJECTIVE: The authors present the first ever laparoscopic assisted uterus retrieval in live donor for uterus transplant. DESIGN: A step-by-step surgical demonstration SETTING: Galaxy CARE Laparoscopy Institute, Pune, India PATIENT(S): Two patients, ages 21 and 26 with Mayer Rokitansky Kuster Hauser (MRKH) syndrome and Ashermann's syndrome respectively, with their mothers as donors. INTERVENTION(S): A Twelve member team was formed. After review of available literature on uterine transplant a protocol was formulated and submitted to the IRB...
November 10, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29130265/the-economics-of-public-health-missing-pieces-to-the-puzzle-of-health-system-reform
#9
Glen P Mays, Adam J Atherly, Alan M Zaslavsky
The United States continues to experiment with health care delivery and financing innovations, but relatively little attention is given to the public health system and its capacity for improving health status in the U.S. population at large. The public health system operates as a multisector enterprise in which government agencies work in conjunction with private and voluntary organizations to identify health risks in the population and to mobilize community-wide actions that prevent and contain these risks...
December 2017: Health Services Research
https://www.readbyqxmd.com/read/29129193/experiences-of-three-states-implementing-the-medicaid-health-home-model-to-address-opioid-use-disorder-case-studies-in-maryland-rhode-island-and-vermont
#10
Lisa Clemans-Cope, Jane B Wishner, Eva H Allen, Nicole Lallemand, Marni Epstein, Brenda C Spillman
PURPOSE: The United States is facing an unprecedented opioid epidemic. The Affordable Care Act (ACA) included several provisions designed to increase care coordination in state Medicaid programs and improve outcomes for those with chronic conditions, including substance use disorders. Three states-Maryland, Rhode Island, and Vermont - adopted the ACA's optional Medicaid health home model for individuals with opioid use disorder. The model coordinates opioid use disorder treatment that features opioid agonist therapy provided at opioid treatment programs (OTPs) and Office-based Opioid Treatment (OBOT) with medical and behavioral health care and other services, including those addressing social determinants of health...
December 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/29101960/market-evaluation-finances-bundled-payments-and-accountable-care-organizations
#11
REVIEW
Shazia Mehmood Siddique, Shivan J Mehta
To control costs and improve quality, changes in health care delivery and financing have emerged, resulting in shifting of financial risk to providers for the quality and cost of care, including emergence of accountable care organizations and bundled payment models. This article discusses health care financing and delivery models in the context of procedures and surgeries that happen outside of the operating room. It describes the history of health insurance, trends in ambulatory surgery centers, and new payment models that have emerged from the Affordable Care Act and the Medicare Access and Children's Health Insurance Program Reauthorization Act...
December 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29093140/-you-get-beautiful-teeth-down-there-racial-ethnic-minority-older-adults-perspectives-on-care-at-dental-school-clinics
#12
Mary E Northridge, Andrew B Schenkel, Shirley Birenz, Ivette Estrada, Sara S Metcalf, Mark S Wolff
To help eliminate reported racial/ethnic and socioeconomic inequities in oral health care, listening to the perspectives of racial/ethnic minority older adults on their experiences with dental school clinics is needed. The aim of this study was to examine the experiences of African American, Puerto Rican, and Dominican older adults who attend senior centers in upper Manhattan, New York City, regarding the care received at dental school clinics. Focus groups were conducted from 2013 to 2015 with 194 racial/ethnic minority men and women aged 50 years and older living in upper Manhattan...
November 2017: Journal of Dental Education
https://www.readbyqxmd.com/read/29091449/aerogels-from-chloromethyltrimethoxysilane-and-their-functionalizations
#13
Tomoki Kimura, Taiyo Shimizu, Kazuyoshi Kanamori, Ayaka Maeno, Hironori Kaji, Kazuki Nakanishi
Reactions of chloromethyltrimethoxysilane (CMTMS) and its derived colloidal network polychloromethylsilsesquioxane (PCMSQ) have been investigated to extend the material design strategy toward mechanically reinforced aerogels. In a carefully designed sol-gel system, CMTMS has afforded transparent aerogels under the presence of cationic surfactant. The surface chloromethyl groups with polarity and reactivity are shown to be useful for supporting nanostructures, photoluminescent carbon dots (C-dots) prepared from polyethyleneimine and citric acid as an example...
November 1, 2017: Langmuir: the ACS Journal of Surfaces and Colloids
https://www.readbyqxmd.com/read/29083973/amcp-partnership-forum-advancing-value-based-contracting
#14
(no author information available yet)
During the past decade, payment models for the delivery of health care have undergone a dramatic shift from focusing on volume to focusing on value. This shift began with the Affordable Care Act and was reinforced by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which increased the emphasis on payment for delivery of quality care. Today, value-based care is a primary strategy for improving patient care while managing costs. This shift in payment models is expanding beyond the delivery of health care services to encompass models of compensation between payers and biopharmaceutical manufacturers...
November 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29073953/temporary-circulatory-support-in-u-s-children-awaiting-heart-transplantation
#15
Vamsi V Yarlagadda, Katsuhide Maeda, Yulin Zhang, Sharon Chen, John C Dykes, Mary Alice Gowen, Paul Shuttleworth, Jenna M Murray, Andrew Y Shin, Olaf Reinhartz, David N Rosenthal, Doff B McElhinney, Christopher S Almond
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has long served as the standard of care for short-term mechanical circulatory support in pediatrics. It is unknown whether newer-generation temporary circulatory support (TCS) devices afford children a meaningful survival advantage over ECMO. OBJECTIVES: This study sought to determine whether bridge-to-heart transplant survival with a TCS device is superior to ECMO after adjusting for patient differences. METHODS: All children ≤21 years of age listed for heart transplant from 2011 to 2015 who received a TCS device or ECMO as a bridge to transplant were identified using Organ Procurement and Transplantation Network data...
October 31, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29026968/clinical-outcome-social-impact-and-patient-expectation-a-purposive-sampling-pilot-evaluation-of-patients-in-benin-seven-years-after-surgery
#16
Michelle C White, Kirsten Randall, Esther Avara, Jenny Mullis, Gary Parker, Mark G Shrime
BACKGROUND: Access to affordable and timely surgery is not equitable around the world. Five billion people lack access, and while non-governmental organizations (NGOs) help to meet this need, long-term surgical outcomes, social impact or patient experience is rarely reported. METHOD: In 2016, Mercy Ships, a surgical NGO, undertook an evaluation of patients who had received surgery seven years earlier with Mercy Ships in 2009 in Benin. Using purposive sampling, patients who had received maxillofacial, plastics or orthopedic surgery were invited to attend a surgical evaluation day...
October 12, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29025697/predicting-consumer-effort-in-finding-and-paying-for-health-care-expert-interviews-and-claims-data-analysis
#17
Sandra Long, Karen A Monsen, David Pieczkiewicz, Julian Wolfson, Saif Khairat
BACKGROUND: For consumers to accept and use a health care information system, it must be easy to use, and the consumer must perceive it as being free from effort. Finding health care providers and paying for care are tasks that must be done to access treatment. These tasks require effort on the part of the consumer and can be frustrating when the goal of the consumer is primarily to receive treatments for better health. OBJECTIVE: The aim of this study was to determine the factors that result in consumer effort when finding accessible health care...
October 12, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28981350/whole-body-high-pitch-ct-angiography-strategies-to-reduce-radiation-dose-and-contrast-volume
#18
Sebastian Manneck, Lynne M Hurwitz, Danielle M Seaman, Tobias Heye, Daniel T Boll
OBJECTIVE: The purpose of this study was to assess the noninferiority of dual-source high-pitch CT angiography (CTA) performed with high-concentration (iopamidol 370) low-volume (60 mL) iodinated contrast material at low voltage (100 kVp) in comparison with dual-source high-pitch CTA with standard-of-care low-concentration (iopamidol 300) standard-volume (75 mL) iodinated contrast material at high voltage (120 kVp) to determine whether use of the high-concentration low-volume method would afford a reduction in radiation dose and contrast volume without negatively affecting vascular opacification...
October 5, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28978500/twitter-and-public-health-part-2-qualitative-analysis-of-how-individual-health-professionals-outside-organizations-use-microblogging-to-promote-and-disseminate-health-related-information
#19
Mark Hart, Nichole Stetten, Sabrina Islam, Katherine Pizarro
BACKGROUND: Twitter is the most popular form of microblogging that is being utilized in public health to engage audiences and to communicate health-related information. Although there is some research showing the various forms of Twitter use in public health, little is known about how individual public health professionals are using their personal Twitter accounts to disseminate health information. OBJECTIVE: The purpose of this research was to categorize public health professionals' tweets to evaluate how individual public health professionals are furthering the mission of public health...
October 4, 2017: JMIR Public Health and Surveillance
https://www.readbyqxmd.com/read/28904910/complications-acknowledging-managing-and-coping-with-human-error
#20
REVIEW
Sevann Helo, Carol-Anne E Moulton
Errors are inherent in medicine due to the imperfectness of human nature. Health care providers may have a difficult time accepting their fallibility, acknowledging mistakes, and disclosing errors. Fear of litigation, shame, blame, and concern about reputation are just some of the barriers preventing physicians from being more candid with their patients, despite the supporting body of evidence that patients cite poor communication and lack of transparency as primary drivers to file a lawsuit in the wake of a medical complication...
August 2017: Translational Andrology and Urology
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