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"High value care"

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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
#1
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
#2
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
#3
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
#4
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...
April 22, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28428096/developing-the-pedsvalue-modules-a-national-pediatric-high-value-care-curriculum
#5
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.
April 18, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28419060/relationship-of-hospital-costs-with-mortality-in-pediatric-critical-care-a-multi-institutional-analysis
#6
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...
April 17, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28395014/low-value-medical-services-in-the-safety-net-population
#7
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...
April 10, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28373333/small-decline-in-low-value-back-imaging-associated-with-the-choosing-wisely-campaign-2012-14
#8
Arthur S Hong, Dennis Ross-Degnan, Fang Zhang, J Frank Wharam
Choosing Wisely was launched by the American Board of Internal Medicine in April 2012 as a patient- and clinician-targeted campaign to reduce potentially unnecessary "low-value" medical services. The campaign's impact on low- and high-value care beyond its first year is unknown; furthermore, it is unknown whether some patients such as members of consumer-directed health plans and people residing in different US regions have responded more than others. To evaluate the impact of Choosing Wisely, we used commercial insurance claims to track changes in the use of low-value imaging (x-ray, computed tomography, and magnetic resonance imaging) for back pain before and after the campaign began, a period running from 2010 to 2014...
April 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28340128/crossing-the-health-it-chasm-considerations-and-policy-recommendations-to-overcome-current-challenges-and-enable-value-based-care
#9
Julia Adler-Milstein, Peter J Embi, Blackford Middleton, Indra Neil Sarkar, Jeff Smith
While great progress has been made in digitizing the US health care system, today's health information technology (IT) infrastructure remains largely a collection of systems that are not designed to support a transition to value-based care. In addition, the pursuit of value-based care, in which we deliver better care with better outcomes at lower cost, places new demands on the health care system that our IT infrastructure needs to be able to support. Provider organizations pursuing new models of health care delivery and payment are finding that their electronic systems lack the capabilities needed to succeed...
March 15, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28322509/teaching-medical-students-about-cost-effectiveness
#10
Mark Iscoe, Robert Lord, John Schulz, David Lee, Danelle Cayea, Amit Pahwa
BACKGROUND: Rising and burdensome health care costs have driven interest in the practice of high-value care (HVC) and have inspired calls for increased HVC training across all levels of medical education, including among undergraduate medical students. CONTEXT: Classroom-based HVC curricula targeted to medical students have not been previously described in the medical literature. INNOVATION: We developed and evaluated a workshop comprising a lecture, a small-group exercise and a group discussion to instruct medical students on interpreting cost-effectiveness analyses (CEA), applying CEA to patient care and discussing the cost of care with patients...
March 21, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28291382/cost-implications-of-an-evidence-based-approach-to-radiation-treatment-after-lumpectomy-for-early-stage-breast-cancer
#11
Rachel A Greenup, Rachel C Blitzblau, Kevin L Houck, Julie Ann Sosa, Janet Horton, Jeffrey M Peppercorn, Alphonse G Taghian, Barbara L Smith, E Shelley Hwang
INTRODUCTION: Breast cancer treatment costs are rising, and identification of high-value oncology treatment strategies is increasingly needed. We sought to determine the potential cost savings associated with an evidence-based radiation treatment (RT) approach among women with early-stage breast cancer treated in the United States. PATIENTS AND METHODS: Using the National Cancer Database, we identified women with T1-T2 N0 invasive breast cancers treated with lumpectomy during 2011...
April 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28264949/outcomes-for-high-needs-patients-practices-with-a-higher-proportion-of-these-patients-have-an-edge
#12
Dori A Cross, Genna R Cohen, Christy Harris Lemak, Julia Adler-Milstein
High-value primary care for high-needs patients-those with multiple physical, mental, or behavioral health conditions-is critical to improving health system performance. However, little is known about what types of physician practices perform best for high-needs patients. We examined two scale-related characteristics that could predict how well physician practices delivered care to this population: the proportion of patients in the practice that were high-needs and practice size (number of physicians). Using four years of data on commercially insured, high-needs patients in Michigan primary care practices, we found lower spending and utilization among practices with a higher proportion of high-needs patients (more than 10 percent of the practice's panel) compared to practices with smaller proportions...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28248575/ten-principles-to-guide-health-reform
#13
Joe K Gerald
Americans face inevitable trade-offs between health care affordability, accessibility, and innovation. Although numerous reforms have been proposed, universal principles to guide decision-making are lacking. Solving the challenges that confront us will be difficult, owing to intense partisan divisions and a dysfunctional political process. Nevertheless, we must engage in reasoned debate that respects deeply held differences of opinion regarding our individual and collective obligations to promote healthy living and ensure affordable access to health care...
March 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28192792/management-of-low-back-pain-getting-from-evidence-based-recommendations-to-high-value-care
#14
Steven J Atlas
No abstract text is available yet for this article.
April 4, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28182806/student-perceptions-of-high-value-care-education-in-internal-medicine-clerkships
#15
Amit Pahwa, Danelle Cayea, Amanda Bertram, Ariella Apfel, Chad Miller, Nick Van Wagoner, James Willig, Reena Karani, Bimal Ashar
No abstract text is available yet for this article.
February 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28166559/should-we-prescribe-antibiotics-to-this-patient-with-persistent-upper-respiratory-symptoms-grand-rounds-discussion-from-beth-israel-deaconess-medical-center
#16
Howard Libman, Diane M Brockmeyer, Howard S Gold
The American College of Physicians (ACP) and the Centers for Disease Control and Prevention (CDC) recently published advice for high-value care on the appropriate use of antibiotics for acute respiratory tract infections. They conducted a narrative literature review of evidence for antibiotic use in this setting that included recent clinical guidelines from professional societies supplemented by randomized, controlled trials; meta-analyses; and systematic reviews. They concluded that clinicians should reserve antibiotic treatment for acute rhinosinusitis in patients with persistent symptoms for more than 10 days, high fever and purulent nasal discharge or facial pain lasting for at least 3 consecutive days, or worsening symptoms after a typical viral illness that lasted 5 days and had initially improved ("double-sickening")...
February 7, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28156503/health-care-utilization-and-costs-at-end-of-life-among-patients-with-leukemia-or-lymphoma-in-a-regional-cancer-registry-insurance-claims-linked-database
#17
Catherine R Fedorenko, Karma L Kreizenbeck, Ted Conklin, Bruce Smith, Gary H Lyman, Scott David Ramsey
184 Background: End-of-life (EOL) care for persons with hematologic malignancies is variable and often involves high-intensity services at death approaches, which may not reflect patient or family preferences. We characterized healthcare utilization and associated costs in the last 30 days of life among subjects with leukemia or lymphoma to better understand patterns of care in this population. METHODS: We linked enrollment and claims records from two regional commercial insurers to Surveillance, Epidemiology, and End Results (SEER) records for patients diagnosed with leukemia or lymphoma in Western Washington state between January 1, 2007 and December 31, 2015...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152888/the-benefits-of-clinical-pathways-cp-for-radiation-oncology-in-a-large-cancer-care-network
#18
Sushil Beriwal, Hans Benson, Zach Lorinc, Amanda Barry, Kathleen Lokay
148 Background: UPMC CancerCenter and the University of Pittsburgh Cancer Institute (UPMC) created a radiation oncology CP program (now incorporated separately as Via Pathways) in 2003 to standardize care at 19 radiation sites. The program exists to ensure consistency and rapid adoption of best evidence-based care in a large, integrated NCI-designated comprehensive cancer center. METHODS: The web-based CP portal integrates with electronic medical records to provide point-of-care patient-specific decision support...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28134553/using-organizational-and-clinical-performance-data-to-increase-the-value-of-mental-health-care
#19
Eric M Schmidt, Dean D Krahn, Marsden H McGuire, Sara Tavakoli, David M Wright, Hugo E Solares, Sonne Lemke, Jodie Trafton
U.S. health systems, policy makers, and patients increasingly demand high-value care that improves health outcomes at lower cost. This study describes the initial design and analysis of the Mental Health Management System (MHMS), a performance data and quality improvement tool used by the Veterans Health Administration (VHA) to increase the value of its mental health care. The MHMS evaluates access to and quality of mental health care, organizational structure and efficiency, implementation of innovative treatment options, and, in collaboration with management, resource needs for delivering care...
February 2017: Psychological Services
https://www.readbyqxmd.com/read/28130386/ethics-and-high-value-care
#20
Matthew DeCamp, Jon C Tilburt
High-value care (HVC) is en vogue, but the ethics of physicians' roles in the growing number of HVC recommendations demands further attention. In this brief report, we argue that, from the standpoint of individual physicians' primary commitments and duties to individual patients, not all HVC is ethically equal. Our analysis suggests that the ethical case for HVC may be both stronger and weaker than is ordinarily supposed. In some cases, HVC is not merely a 'good thing to do' but is actually ethically obligatory...
January 26, 2017: Journal of Medical Ethics
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