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"High value care"

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https://www.readbyqxmd.com/read/28930760/medical-education-and-health-care-delivery-a-call-to-better-align-goals-and-purposes
#1
David P Sklar, Paul A Hemmer, Steven J Durning
The transformation of the U.S. health care system is under way, driven by the needs of an aging population, rising health care spending, and the availability of health information. However, the speed and effectiveness of the transformation of health care delivery will depend, in large part, upon engagement of the health professions community and changes in clinicians' practice behaviors. Current efforts to influence practice behaviors emphasize changes in the health payment system with incentives to move from fee-for-service to alternative payment models...
September 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28857962/women-s-awareness-of-and-responses-to-messages-about-breast-cancer-overdiagnosis-and-overtreatment-results-from-a-2016-national-survey
#2
Rebekah H Nagler, Erika Franklin Fowler, Sarah E Gollust
BACKGROUND: Scientists, clinicians, and other experts aim to maximize the benefits of cancer screening while minimizing its harms. Chief among these harms are overdiagnosis and overtreatment. Although available data suggest that patient awareness of these harms is low, we know little about how patients respond to information about these phenomena. OBJECTIVES: Using the case of breast cancer screening, this study assesses women's awareness of and reactions to statements about overdiagnosis and overtreatment...
August 28, 2017: Medical Care
https://www.readbyqxmd.com/read/28857791/the-high-value-care-rounding-tool-development-and-validity-evidence
#3
Corrie E McDaniel, Andrew A White, Miranda C Bradford, Carolyn D Sy, Tiffany Chen, Doug Brock, Jeffrey Foti, Jimmy B Beck
Little is known about current practices in high-value care (HVC) bedside teaching. A lack of instruments for measuring bedside HVC behaviors confounds efforts to assess the impact of curricular interventions. The authors aimed to define observable HVC concepts by developing an instrument to measure the content and frequency of HVC discussions.The authors developed the HVC Rounding Tool in four iterative phases, using Messick's validity framework. Phases 1 and 2 were designed to collect evidence of content validity, Phases 3 and 4 to collect evidence of response process and internal structure...
August 29, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28841874/science-of-health-care-delivery-milestones-for-undergraduate-medical-education
#4
Rachel D Havyer, Suzanne M Norby, Andrea N Leep Hunderfund, Stephanie R Starr, Tara R Lang, Alexandra P Wolanskyj, Darcy A Reed
BACKGROUND: The changing healthcare landscape requires physicians to develop new knowledge and skills such as high-value care, systems improvement, population health, and team-based care, which together may be referred to as the Science of Health Care Delivery (SHCD). To engender public trust and confidence, educators must be able to meaningfully assess physicians' abilities in SHCD. We aimed to develop a novel set of SHCD milestones based on published Accreditation Council for Graduate Medical Education (ACGME) milestones that can be used by medical schools to assess medical students' competence in SHCD...
August 25, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28817463/delivering-high-value-inflammatory-bowel-disease-care-through-telemedicine-visits
#5
Shawn X Li, Kimberly D Thompson, Tracey Peterson, Shelley Huneven, Jamie Carmichael, Fredric J Glazer, Katelyn Darling, Corey A Siegel
BACKGROUND: Patients with inflammatory bowel disease (IBD) require regular follow-up to manage their care, which requires significant amount of time and out-of-pocket costs. Telemedicine in the form of video virtual visits could serve as an alternative to in-office visits. The aim of this project was to understand if telemedicine can provide high value care (defined as quality/cost) to outpatients with IBD. METHODS: Patients who participated in the IBD telemedicine clinic in the second half of 2015 were included...
August 16, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28765505/drug-shortage-leading-to-serendipitous-adoption-of-high-value-care-practice
#6
EDITORIAL
Arjun Gupta, Anita Rahman, Kristin S Alvarez, John W Gard, David H Johnson, Deepak Agrawal
No abstract text is available yet for this article.
August 1, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28753038/physician-experiences-with-high-value-care-in-internal-medicine-residency-mixed-methods-study-of-2003-2013-residency-graduates
#7
Kira L Ryskina, Eric S Holmboe, Judy A Shea, Esther Kim, Judith A Long
Phenomenon: High healthcare costs and relatively poor health outcomes in the United States have led to calls to improve the teaching of high value care (defined as care that balances potential benefits of interventions with their harms including costs) to physicians-in-training. Numerous interventions to increase high value care in graduate medical education were implemented at the national and local levels over the past decade. However, there has been little evaluation of their impact on physician experiences during training and perceived preparedness for practice...
July 28, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/28711688/aga-institute-series-focus-on-enhancing-high-value-care-cost-effective-therapy-for-sphincter-of-oddi-dysfunction
#8
Dennis Yang, Patrick Yachimski
No abstract text is available yet for this article.
July 12, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28694129/high-value-care-hepatocellular-carcinoma-surveillance
#9
Janice H Jou, Andrew J Muir
No abstract text is available yet for this article.
July 7, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28669660/aga-institute-series-focus-on-enhancing-high-value-care-when-does-assessment-for-bile-duct-stones-need-to-be-performed-prior-to-cholecystectomy-for-calculus-gallbladder-disease
#10
Dennis Yang, Patrick Yachimski
No abstract text is available yet for this article.
June 29, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28666673/diagnostic-testing-requested-before-surgical-evaluation%C3%A2-for-carpal-tunnel%C3%A2-syndrome
#11
Erika D Sears, Yu-Ting Lu, Shannon M Wood, Jacob S Nasser, Rodney A Hayward, Kevin C Chung, Eve A Kerr
PURPOSE: We sought to evaluate how often physicians who perform carpal tunnel release in the state of Michigan routinely request electrodiagnostic studies (EDS) or other diagnostic tests prior to an initial consultation and whether provider or practice characteristics had an influence on requirements for preconsultation diagnostic tests. METHODS: Through online data sources, we identified 356 providers in 261 practices throughout the state of Michigan with profiles confirming hand surgery practice or surgical treatment of carpal tunnel syndrome (CTS)...
August 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28663352/a-high-value-care-curriculum-for-interns-a-description-of-curricular-design-implementation-and-housestaff-feedback
#12
Jason Hom, Andre Kumar, Kambria H Evans, David Svec, Ilana Richman, Daniel Fang, Andrea Smeraglio, Marisa Holubar, Tyler Johnson, Neil Shah, Cybele Renault, Neera Ahuja, Ronald Witteles, Stephanie Harman, Lisa Shieh
PURPOSE: Most residency programmes do not have a formal high value care curriculum. Our goal was to design and implement a multidisciplinary high value care curriculum specifically targeted at interns. DESIGN: Our curriculum was designed with multidisciplinary input from attendings, fellows and residents at Stanford. Curricular topics were inspired by the American Board of Internal Medicine's Choosing Wisely campaign, Alliance for Academic Internal Medicine, American College of Physicians and Society of Hospital Medicine...
June 29, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28558604/hospitals-known-for-nursing-excellence-perform-better-on-value-based-purchasing-measures
#13
Karen B Lasater, Hayley D Germack, Dylan S Small, Matthew D McHugh
It is well-established that hospitals recognized for good nursing care - Magnet hospitals - are associated with better patient outcomes. Less is known about how Magnet hospitals compare to non-Magnets on quality measures linked to Medicare reimbursement. The purpose of this study was to determine how Magnet hospitals perform compared to matched non-Magnet hospitals on Hospital Value Based Purchasing (VBP) measures. A cross-sectional analysis of three linked data sources was performed. The sample included 3,021 non-federal acute care hospitals participating in the VBP program (323 Magnets; 2,698 non-Magnets)...
November 2016: Policy, Politics & Nursing Practice
https://www.readbyqxmd.com/read/28476514/the-impact-of-carperitide-usage-on-the-cost-of-hospitalization-and-outcome-in-patients-with-acute-heart-failure-high-value-care-vs-low-value-care-campaign-in-japan
#14
Atsushi Mizuno, Hayato Iguchi, Yuuka Sawada, Michael Hurley, Hiroshi Nomura, Kuniyoshi Hayashi, Yasuharu Tokuda, Sachiko Watanabe, Aki Yoshikawa
BACKGROUND: The usefulness of carperitide in patients with acute heart failure (AHF) has not been confirmed; carperitide is expensive, and thus, its routine use has not been shown to add much value in clinical settings. We analyzed the impact of carperitide usage on the outcome and cost of hospitalization in AHF patients. METHODS: Data obtained from the Diagnosis Procedure Combination (DPC) database from July 2014 until June 2015 from 371 hospitals were analyzed...
April 26, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28459900/association-between-radiologic-incidental-findings-and-resource-utilization-in-patients-admitted-with-chest-pain-in-an-urban-medical-center
#15
Venkat P Gundareddy, Nisa M Maruthur, Abednego Chibungu, Preetam Bollampally, Regina Landis, Shaker M Eid
BACKGROUND: Increasing use of testing among hospitalized patients has resulted in an increase in radiologic incidental findings (IFs), which challenge the provision of high-value care in the hospital setting. OBJECTIVE: To understand impact of radiologic incidental findings on resource utilization in patients hospitalized with chest pain. DESIGN: Retrospective observational cross sectional study. SETTING: Academic medical center...
May 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28441671/swimming-upstream-creating-a-culture-of-high-value-care
#16
Reshma Gupta, Christopher Moriates
As health system leaders strategize the best ways to encourage the transition toward value-based health care, the underlying culture-defined as a system of shared assumptions, values, beliefs, and norms existing within an environment-continues to shape clinician practice patterns. The current prevailing medical culture contributes to overtesting, overtreatment, and health care waste. Choosing Wisely lists, appropriateness criteria, and guidelines codify best practices, but academic medicine as a whole must recognize that faculty and trainees are all largely still operating within the same cultural climate...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441271/alternative-payment-models-and-urology
#17
Deborah R Kaye, David C Miller, Chad Ellimoottil
PURPOSE OF REVIEW: The Medicare Access and CHIP Reauthorization Act (MACRA) is a historic bill that was recently passed that establishes how quality measurement and practice patterns will affect physician reimbursement. Alternative payment models (APMs) are an essential component of MACRA and Medicare's vision of paying for high-value care. This review describes APMs in the context of MACRA and their impact on urology. RECENT FINDINGS: The majority of urologists will be affected by MACRA...
July 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28428096/developing-the-pedsvalue-modules-a-national-pediatric-high-value-care-curriculum
#18
Carolyn S Avery, Jimmy Beck, Ryan Padrez, Lauren LaRue Walker, Lisa E Herrmann, Suzanne Woods, Alan R Schroeder, Adam Schickedanz
No abstract text is available yet for this article.
July 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28419060/relationship-of-hospital-costs-with-mortality-in-pediatric-critical-care-a-multi-institutional-analysis
#19
Punkaj Gupta, Mallikarjuna Rettiganti
OBJECTIVE: With increasing emphasis on high "value" care, we designed this study to evaluate the relationship between hospital costs and patient outcomes in pediatric critical care. DESIGN: Post hoc analysis of data from an existing administrative national database, Pediatric Health Information Systems. Multivariable mixed effects logistic regression models were fitted to evaluate association of hospital cost tertiles with odds of mortality after adjusting for patient and center characteristics...
June 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28395014/low-value-medical-services-in-the-safety-net-population
#20
Michael L Barnett, Jeffrey A Linder, Cheryl R Clark, Benjamin D Sommers
Importance: National patterns of low-value and high-value care delivered to patients without insurance or with Medicaid could inform public policy but have not been previously examined. Objective: To measure rates of low-value care and high-value care received by patients without insurance or with Medicaid, compared with privately insured patients, and provided by safety-net physicians vs non-safety-net physicians. Design, Setting, and Participants: This multiyear cross-sectional observational study included all patients ages 18 to 64 years from the National Ambulatory Medical Care Survey (2005-2013) and the National Hospital Ambulatory Medical Care Survey (2005-2011) eligible for any of the 21 previously defined low-value or high-value care measures...
June 1, 2017: JAMA Internal Medicine
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