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Population Health Management

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https://www.readbyqxmd.com/read/28647442/the-impact-of-the-transition-from-volume-to-value-on-heart-failure-care-implications-of-novel-payment-models-and-quality-improvement-initiatives
#1
REVIEW
Dushyanth Srinivasan, Nihar R Desai
In response to wide variation in quality and outcomes as well as escalating health care costs, the U.S. health care system is transitioning away from a volume based payment system to a quality- and value-based system. Medicare, the largest insurer and payer of healthcare, has accelerated the movement towards value-based care with the development and implementation of myriad alternative payment models and pay for performance programs as part of the Affordable Care Act. Given that heart failure affects a significant number of Medicare patients and these patients account for a disproportionate amount of healthcare utilization and spending, heart failure has become a focal point for these initiatives...
June 21, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28647335/incidence-and-duration-of-increased-somatic-cell-count-in-swedish-dairy-cows-and-associations-with-milking-system-type
#2
J Frössling, A Ohlson, C Hallén-Sandgren
Mastitis is one of the most costly diseases in dairy cows worldwide. Increased somatic cell count (SCC) is an indication of mastitis, often subclinical, which implies bacterial infection without clinical signs of inflammation. The aim was to investigate the occurrence of elevated udder SCC (defined as ≥200,000 cells/mL) over the lactation period, and before and after the dry period, for cows of different parity. The aim was also to analyze the association between prevalence and incidence of increased udder SCC and information on cow and herd level, such as breed and milking system type...
June 21, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/28647254/quantifying-public-health-benefits-of-environmental-strategy-of-pm2-5-air-quality-management-in-beijing-tianjin-hebei-region-china
#3
Li Chen, Mengshuang Shi, Suhuan Li, Shuang Gao, Hui Zhang, Yanling Sun, Jian Mao, Zhipeng Bai, Zhongliang Wang, Jiang Zhou
In 2013, China issued "Air Pollution Prevention and Control Action Plan (Action Plan)" to improve air quality. To assess the benefits of this program in Beijing-Tianjin-Hebei (BTH) region, where the density of population and emissions vary greatly, we simulated the air quality benefit based on BenMAP to satisfy the Action Plan. In this study, we estimate PM2.5 concentration using Voronoi spatial interpolation method on a grid with a spatial resolution of 1×1km(2). Combined with the exposure-response function between PM2...
July 2017: Journal of Environmental Sciences (China)
https://www.readbyqxmd.com/read/28646993/improving-the-evidence-for-the-management-of-childhood-nephrotic-syndrome
#4
Brendan D Crawford, Debbie S Gipson
Management of idiopathic nephrotic syndrome in children is based on a series of clinical trials. The trial by Sinha and colleagues in this issue is 1 of many needed to improve the evidence base for induction and maintenance therapies in this population. While key questions remain about identifying the appropriate therapy for each patient, clinical trials provide an opportunity to extend evidence-based practice that minimizes toxicity and optimizes patient health.
July 2017: Kidney International
https://www.readbyqxmd.com/read/28646442/variability-of-adverse-events-in-the-public-health-care-service-of-the-tuscany-region
#5
Sara Albolino, Riccardo Tartaglia, Tommaso Bellandi, Elisa Bianchini, Giancarlo Fabbro, Silvia Forni, Giulia Cernuschi, Annibale Biggeri
The objective of the study is to analyze the variation of adverse events (AEs) according to the different structure of hospitals. The study is a multicenter, retrospective study. It involves 4 teaching hospitals (THs) and 32 community hospitals, distributed in 12 local trusts (LTs), of the Tuscany Regional Healthcare Service (RHS). A random sample of the clinical records of patients admitted in LTs and THs in 2008 was selected from the database of the hospital discharge records of the centers. Among 11,293 clinical records included, a total of 354 adverse events were identified...
June 23, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28646002/preparation-for-transition-to-adult-care-among-medicaid-insured-adolescents
#6
Gregory S Sawicki, Katharine C Garvey, Sara L Toomey, Kathryn A Williams, J Lee Hargraves, Thomas James, Jean L Raphael, Angelo P Giardino, Mark A Schuster, Jonathan A Finkelstein
BACKGROUND: Parents of children with chronic illness consistently report suboptimal preparation for transition from pediatric- to adult-focused health care. Little data are available on transition preparation for low-income youth in particular. METHODS: We conducted a mailed survey of youth with chronic illness enrolled in 2 large Medicaid health plans to determine the quality of transition preparation using the Adolescent Assessment of Preparation for Transition (ADAPT)...
June 23, 2017: Pediatrics
https://www.readbyqxmd.com/read/28644930/trends-in-open-and-endoscopic-cubital-tunnel-release-in-the-medicare-patient-population
#7
Tsun Yee Law, Zachary S Hubbard, Lee Onn Chieng, Harvey W Chim
BACKGROUND: Cubital tunnel syndrome (CUT) is the second most common peripheral neuropathy with an annual incidence of 24.7 per 100 000, affecting nearly twice as many men as women. With increasing focus on cost-effectiveness and cost-containment in medicine, a critical understanding of utilization of health care resources for open and endoscopic approaches for cubital tunnel release is of value. The purpose of this study was to evaluate the costs and utilization trends of open and endoscopic cubital tunnel release...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28644350/lack-of-knowledge-and-low-readiness-for-health-care-transition-in-eosinophilic-esophagitis-and-eosinophilic-gastroenteritis
#8
Swathi Eluri, Wendy M Book, Ellyn Kodroff, Mary Jo Strobel, Jessica H Gebhart, Patricia D Jones, Paul Menard-Katcher, Maria E Ferris, Evan S Dellon
OBJECTIVES: A growing population of adolescents/young adults with eosinophilic esophagitis (EoE) and eosinophilic gastroenteritis (EGE) will need to transition from pediatric to adult health providers. Measuring health care transition (HCT) readiness is critical, but no studies have evaluated this process in EoE/EGE. We determined the scope and predictors of HCT knowledge in patients and parents with EoE/EGE and measured HCT readiness in adolescents/young adults. METHODS: We conducted an online survey of patients 13 years or older and parents of patients with EoE/EGE who were diagnosed when 25 years or younger...
July 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28644300/breathlessness-in-the-primary-care-setting
#9
Noel Baxter
PURPOSE OF REVIEW: Breathlessness is a high-volume problem with 10% of adults experiencing the symptom daily placing a heavy burden on the health and wider economy. As it worsens, they enter the specialist and hospital-based symptom services where costs quickly escalate and people may find themselves in a place not of their choosing. For many, their care will be delivered by a disease or organ specialist and can find themselves passing between physicians without coordination for symptom support...
July 20, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28644115/evaluation-of-the-effectiveness-and-cost-effectiveness-of-lightweight-fibreglass-heel-casts-in-the-management-of-ulcers-of-the-heel-in-diabetes-a-randomised-controlled-trial
#10
William Jeffcoate, Frances Game, Vivienne Turtle-Savage, Alison Musgrove, Patricia Price, Wei Tan, Lucy Bradshaw, Alan Montgomery, Deborah Fitzsimmons, Angela Farr, Thomas Winfield, Ceri Phillips
BACKGROUND: Ulcers of the foot in people with diabetes mellitus are slow to heal and result in considerable cost and patient suffering. The prognosis is worst for ulcers of the heel. OBJECTIVE: To assess both the clinical effectiveness and the cost-effectiveness of lightweight fibreglass casts in the management of heel ulcers. DESIGN: A pragmatic, multicentre, parallel, observer-blinded randomised controlled trial. A central randomisation centre used a computer-generated random number sequence to allocate participants to groups...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28643820/does-wealth-make-health-cherchez-la-renal-replacement-therapy
#11
COMMENT
Maria D Sanchez-Niño, Alberto Ortiz
In this issue of CKJ, McQuarrie et al. have explored the relationship between socioeconomic status and outcomes among Scottish patients with a renal biopsy diagnosis of primary glomerulonephritis. Patients in the lower socioeconomic category had a twofold higher risk of death. No significant differences were observed on progression to end-stage renal disease (ESRD) requiring renal replacement therapy (RRT), suggesting that overall medical management was appropriate for all socioeconomic categories. The findings are significant since they come from an ethnically homogeneous population with free access to healthcare; they also relate to a specific aetiology of chronic kidney disease (CKD) expected to be less dependent on unhealthy lifestyles than other more frequent aetiologies that dominate studies of CKD in general, such as diabetic or hypertensive nephropathy...
February 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28643746/breast-cancer-screening-practices-amongst-female-tertiary-health-worker-in-nnewi
#12
Chimezie Innocent Madubogwu, Amobi Ochonma Egwuonwu, Ngozi Ukamaka Madubogwu, Ifeoma A Njelita
BACKGROUND: Breast cancer in Nigeria and other developing countries is characterized by late presentation and poor outcome due to ignorance, superstition, self-denial, fear of mastectomy, and unavailability of treatment facilities. The mortality of breast cancer in Western world is decreasing due to early detection and better management. OBJECTIVE: This study aims at accessing the knowledge, attitude, and practice of breast cancer screening among female tertiary health workers...
April 2017: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28643430/platinum-containing-regimens-for-metastatic-breast-cancer
#13
REVIEW
Sam J Egger, Melina L Willson, Jenna Morgan, Harriet S Walker, Sue Carrick, Davina Ghersi, Nicholas Wilcken
BACKGROUND: Studies have reported high tumour response rates for platinum-containing regimens in the treatment of women with metastatic breast cancer. Most of these studies were conducted prior to the 'intrinsic subtype' era, and did not specifically focus on metastatic triple-negative breast cancers (mTNBCs). OBJECTIVES: To identify and review the evidence from randomised trials comparing platinum-containing chemotherapy regimens with regimens not containing platinum in the management of women with metastatic breast cancer...
June 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28643212/the-role-of-primary-health-care-in-hepatitis-b-testing-and-management-a-case-study
#14
Jacqueline A Richmond, Joe Sasadeusz, Meredith Temple-Smith
Hepatitis B is a complex disease requiring lifelong management. Infection is linked to birth in high prevalence regions including Africa and Asia. Best practice guidelines identify who to test for hepatitis B, however, a significant proportion of Australians with hepatitis B have not been diagnosed, and are subsequently at risk of serious morbidity and mortality. This study sought to address the gap between current and optimal hepatitis B testing in a primary care clinic with a likely high population of undiagnosed hepatitis B...
June 22, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28643167/microbiome-probiotics-and-neurodegenerative-diseases-deciphering-the-gut-brain-axis
#15
REVIEW
Susan Westfall, Nikita Lomis, Imen Kahouli, Si Yuan Dia, Surya Pratap Singh, Satya Prakash
The gut microbiota is essential to health and has recently become a target for live bacterial cell biotherapies for various chronic diseases including metabolic syndrome, diabetes, obesity and neurodegenerative disease. Probiotic biotherapies are known to create a healthy gut environment by balancing bacterial populations and promoting their favorable metabolic action. The microbiota and its respective metabolites communicate to the host through a series of biochemical and functional links thereby affecting host homeostasis and health...
June 22, 2017: Cellular and Molecular Life Sciences: CMLS
https://www.readbyqxmd.com/read/28642531/evidence-summary-the-relationship-between-oral-diseases-and-diabetes
#16
F D'Aiuto, D Gable, Z Syed, Y Allen, K L Wanyonyi, S White, J E Gallagher
Introduction This paper is the third of four rapid reviews undertaken to explore the relationships between oral health and general medical conditions in order to support teams within Public Health England, health practitioners and policymakers.Aims This review aimed to explore the nature of the association between poor oral health and diabetes when found in the same individuals or populations, having reviewed the most contemporary evidence in the field.Methods The reviews were undertaken by four groups each comprising consultant clinicians from medicine and dentistry, trainees, public health and academics...
June 23, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28642211/the-integrating-depression-and-diabetes-treatment-independent-study-design-and-methods-to-address-mental-healthcare-gaps-in-india
#17
A J Kowalski, S Poongothai, L Chwastiak, M Hutcheson, N Tandon, R Khadgawat, G R Sridhar, S R Aravind, B Sosale, R M Anjana, D Rao, R Sagar, N Mehta, K M V Narayan, J Unutzer, W Katon, V Mohan, M K Ali
INTRODUCTION: Depression and diabetes are highly prevalent worldwide and often co-exist, worsening outcomes for each condition. Barriers to diagnosis and treatment are exacerbated in low and middle-income countries with limited health infrastructure and access to mental health treatment. The INtegrating DEPrEssioN and Diabetes treatmENT (INDEPENDENT) study tests the sustained effectiveness and cost-effectiveness of a multi-component care model for individuals with poorly-controlled diabetes and depression in diabetes clinics in India...
June 19, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28641912/a-2-year-holistic-health-and-stress-intervention-results-of-an-rct-in-clergy
#18
Rae Jean Proeschold-Bell, Elizabeth L Turner, Gary G Bennett, Jia Yao, Xiang-Fang Li, David E Eagle, Rachel A Meyer, Redford B Williams, Robin Y Swift, H Edgar Moore, Melanie A Kolkin, Carl C Weisner, Katherine M Rugani, Holly J Hough, Virginia P Williams, David C Toole
INTRODUCTION: This study sought to determine the effect of a 2-year, multicomponent health intervention (Spirited Life) targeting metabolic syndrome and stress simultaneously. DESIGN: An RCT using a three-cohort multiple baseline design was conducted in 2010-2014. SETTING/PARTICIPANTS: Participants were United Methodist clergy in North Carolina, U.S., in 2010, invited based on occupational status. Of invited 1,745 clergy, 1,114 consented, provided baseline data, and were randomly assigned to immediate intervention (n=395), 1-year waitlist (n=283), or 2-year waitlist (n=436) cohorts for a 48-month trial duration...
June 13, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28641357/-the-german-thorax-registry-implementation-of-an-established-tool-of-perioperative-health-care-research
#19
Jérôme Defosse, Mark Schieren, Torsten Loop, Cerstin Arndt, Rainer Röhrig, Erich Stoelben, Corinna Ludwig, Alexander Schleppers, Frank Wappler, Mark Gerbershagen, Alberto Lopez-Pastorini
The collection of clinical treatment data in registry databases is an important aspect of health services research. It allows for a critical evaluation of the safety, efficacy and cost-effectiveness of clinical treatment concepts in large patient populations. The findings of registry research represent real-world patients and treatment structures as they are not limited by strict inclusion criteria or unrealistic conditions as applied in prospective clinical trials. The implementation of the German Thorax Registry has enabled the collection and analysis of data on the interdisciplinary care (thoracic surgery, anaesthesiology, intensive care, pain management) of patients undergoing thoracic surgery...
June 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28640860/the-path-to-specialist-multidisciplinary-care-in-amyotrophic-lateral-sclerosis-a-population-based-study-of-consultations-interventions-and-costs
#20
Miriam Galvin, Padhraig Ryan, Sinead Maguire, Mark Heverin, Caoifa Madden, Alice Vajda, Charles Normand, Orla Hardiman
BACKGROUND: Amyotrophic Lateral Sclerosis (ALS) is a devastating neurological condition that requires coordinated, multidisciplinary clinical management. ALS is prone to misdiagnosis as its signs and symptoms may be non-specific, which may prolong patients' journey to multidisciplinary ALS care. METHODS: Using chart review and national register data, we have detailed the journey of a national cohort of ALS patients (n = 155) from the time of first symptom to presentation at a multidisciplinary clinic (MDC)...
2017: PloS One
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