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https://www.readbyqxmd.com/read/28334973/analysis-of-dropout-across-the-continuum-of-maternal-health-care-in-tanzania-findings-from-a-cross-sectional-household-survey
#1
Diwakar Mohan, Amnesty E LeFevre, Asha George, Rose Mpembeni, Eva Bazant, Neema Rusibamayila, Japhet Killewo, Peter J Winch, Abdullah H Baqui
The 'continuum of care' is proposed as a key framework for the delivery of maternal, neonatal and child health services. This study examined the extent of dropout as well as factors associated with retention across the MNCH continuum from antenatal care (ANC), through skilled birth attendance (SBA), to postnatal care (PNC).We analyzed data from 1931 women who delivered in the preceding 2-14 months, from a two-stage cluster sampling household survey in four districts of Tanzania's Morogoro region. The survey was conducted in 2011 as a part of a baseline for an independent evaluation of a maternal health program...
March 16, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28334910/evaluating-pharmacist-input-into-the-pharmaceutical-care-of-patients-in-dispensing-medical-practices-in-remote-and-rural-areas-of-scotland
#2
Derek Stewart, Breda Anthony, Clare Morrison, Yvonne MacRae, Lucy Dixon, Emer Friel, Evelyn Yoong, Scott Cunningham, Katie MacLure
Background.: The Highlands and the Western Isles are the two most remote and rural areas of Scotland, with many medical practices in areas where pharmacies would not be viable. Recent regulations state that that dispensing medical practices in these areas must receive pharmacist support for patients who would benefit. Objective.: This study aimed to evaluate pilot services, which centred on the provision of patient centred pharmaceutical care. Methods...
March 8, 2017: Family Practice
https://www.readbyqxmd.com/read/28334740/patient-experience-of-primary-care-and-advance-care-planning-a-multicentre-cross-sectional-study-in-japan
#3
Takuya Aoki, Jun Miyashita, Yosuke Yamamoto, Tatsuyoshi Ikenoue, Morito Kise, Yasuki Fujinuma, Shingo Fukuma, Miho Kimachi, Sayaka Shimizu, Shunichi Fukuhara
Background.: Advance care planning (ACP) is becoming increasingly important in the primary care setting because of its positive impact on the end-of-life care. Objective.: We aimed to investigate the relationship between patient experience of primary care and ACP. Methods.: This cross-sectional study was conducted in 28 primary care clinics in Japan. We assessed patient experience of primary care using a Japanese version of Primary Care Assessment Tool (JPCAT), which comprises six domains: first contact, longitudinality, coordination, comprehensiveness (services available), comprehensiveness (services provided) and community orientation...
January 30, 2017: Family Practice
https://www.readbyqxmd.com/read/28334592/using-an-electronic-perioperative-documentation-tool-to-identify-returns-to-operating-room-ror-in-a-tertiary-care-academic-medical-center
#4
Robert R Cima, Sarah R Dhanorker, Christopher L Ostendorf, Mfonabasi Ntekpe, Raghu V Mudundi, Elizabeth B Habermann, Claude Deschamps
BACKGROUND: The metric "Unplanned returns to operating room (ROR)" is being tracked in surgical quality dashboards; 70% of unplanned RORs may be related to surgical complications. With increasing regionalization of trauma and complex surgical care at tertiary care academic centers, it is unclear if a simple ROR metric is a valid assessment of surgical quality at such centers. METHOD: A real-time electronic tool was used to identify all RORs-planned and unplanned-in a high-volume, high-complexity academic surgical practice at Mayo Clinic-Rochester within 45 days of the index operation...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334591/crossing-the-communication-chasm-challenges-and-opportunities-in-transitions-of-care-from-the-hospital-to-the-primary-care-clinic
#5
Nicholas A Rattray, Jason J Sico, LeeAnn M Cox, Alissa L Russ, Marianne S Matthias, Richard M Frankel
BACKGROUND: Transitions of care from specialty and acute settings to primary care abound. Compared to the continuity in end-of-shift handoffs, care transitions involve provider communication between practices and facilities with their own cultures and bureaucracies. Using the transition from acute care to outpatient primary care for stroke/transient ischemic attack (TIA) patients as a case study, this qualitative research explored communication practices and institutional arrangements among clinical providers responsible for longitudinal management of hypertension...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334588/applying-the-chronic-care-model-to-improve-care-and-outcomes-at-a-pediatric-medical-center
#6
Jennifer Lail, Pamela J Schoettker, Denise L White, Bhavna Mehta, Uma R Kotagal
BACKGROUND: Cincinnati Children's Hospital Medical Center launched the Condition Outcomes Improvement Initiative in 2012 to help disease-based teams use the principles of improvement science to implement components of the Chronic Care Model and improve outpatient care delivery for populations of children with chronic and complex conditions. The goal was to improve outcomes by 20% from baseline. METHODS: Initiative activities included review of the evidence to choose and measure outcomes, development of condition-specific patient registries and tools for data collection, patient stratification, planning and coordinating care before and after visits, and self-management support...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334584/delayed-workup-of-rectal-bleeding-in-adult-primary-care-examining-process-of-care-failures
#7
Saul N Weingart, Elena M Stoffel, Daniel C Chung, Thomas D Sequist, Ruth I Lederman, Stephen R Pelletier, Helen M Shields
BACKGROUND: Although delayed colorectal cancer diagnoses figure prominently in medical malpractice claims, little is known about the quality of primary care clinicians' workup of rectal bleeding. METHODS: In this study, 438 patients were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for rectal bleeding, hemorrhoids, and blood in the stool at 10 Boston adult primary care practices. Following nurse chart abstraction, physician reviewers assessed the overall quality of care and key care processes...
January 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334559/design-and-hospitalwide-implementation-of-a-standardized-discharge-summary-in-an-electronic-health-record
#8
Shannon M Dean, Andrea Gilmore-Bykovskyi, Joel Buchanan, Brad Ehlenfeldt, Amy J H Kind
BACKGROUND: The hospital discharge summary is the primary method used to communicate a patient's plan of care to the next provider(s). Despite the existence of regulations and guidelines outlining the optimal content for the discharge summary and its importance in facilitating an effective transition to posthospital care, incomplete discharge summaries remain a common problem that may contribute to poor posthospital outcomes. Electronic health records (EHRs) are regularly used as a platform on which standardization of content and format can be implemented...
December 2016: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334438/insurance-denials-for-cancer-clinical-trial-participation-after-the-affordable-care-act-mandate
#9
Christine B Mackay, Kaitlyn R Antonelli, Suanna S Bruinooge, Jarron M Saint Onge, Shellie D Ellis
BACKGROUND: The Affordable Care Act (ACA) includes a mandate requiring most private health insurers to cover routine patient care costs for cancer clinical trial participation; however, the impact of this provision on cancer centers' efforts to accrue patients to clinical trials has not been well described. METHODS: First, members of cancer research centers and community-based institutions (n = 252) were surveyed to assess the status of insurance denials, and then, a focused survey (n = 77) collected denial details...
March 23, 2017: Cancer
https://www.readbyqxmd.com/read/28333847/management-of-children-with-autism-spectrum-disorder-in-the-anesthesia-and-radiographic-context
#10
Ingalill G Berglund, Berit Björkman, Karing Enskär, Maria Faresjö, Karina Huus
OBJECTIVE: As a primary objective, this study purports to develop guidelines to better care for children with autism spectrum disorder (ASD), particularly regarding these children's preparation for anesthesia and radiologic procedures. METHODS: Using a Delphi method with an online distribution of questionnaire, guidelines for caring for children with ASD were created. Twenty-one participants were included in the expert panel. These participants were working with children with ASD in several anesthesia and radiology departments in Sweden...
March 21, 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28333822/committee-opinion-no-694-management-of-mesh-and-graft-complications-in-gynecologic-surgery
#11
(no author information available yet)
This document focuses on the management of complications related to mesh used to correct stress urinary incontinence or pelvic organ prolapse. Persistent vaginal bleeding, vaginal discharge, or recurrent urinary tract infections after mesh placement should prompt an examination and possible further evaluation for exposure or erosion. A careful history and physical examination is essential in the diagnosis of mesh and graft complications. A clear understanding of the location and extent of mesh placement, as well as the patient's symptoms and therapy goals, are necessary to plan treatment approaches...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28333814/committee-opinion-no-694-summary-management-of-mesh-and-graft-complications-in-gynecologic-surgery
#12
(no author information available yet)
This document focuses on the management of complications related to mesh used to correct stress urinary incontinence or pelvic organ prolapse. Persistent vaginal bleeding, vaginal discharge, or recurrent urinary tract infections after mesh placement should prompt an examination and possible further evaluation for exposure or erosion. A careful history and physical examination is essential in the diagnosis of mesh and graft complications. A clear understanding of the location and extent of mesh placement, as well as the patient's symptoms and therapy goals, are necessary to plan treatment approaches...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28333606/patterns-of-multiple-emergency-department-visits-do-primary-care-physicians-matter
#13
Daniel D Maeng, Jing Hao, John B Bulger
CONTEXT: Overutilization and overreliance on Emergency Departments (EDs) as a usual source of care can lead to unnecessarily high costs and undesirable consequences, such as a gap in care coordination and inadequate provision of preventive care. OBJECTIVE: To identify factors associated with multiple ED visits by patients, in particular, the impact of primary care physicians (PCPs) on their patients' multiple ED visit rates. DESIGN: Geisinger Health Plan claims data among adult patients who averaged more than 1 ED visit within a 12-month period between 2013 and 2014 were obtained (N = 20,351)...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28333598/achieving-health-equity-through-community-engagement-in-translating-evidence-to-policy-the-san-francisco-health-improvement-partnership-2010-2016
#14
Kevin Grumbach, Roberto A Vargas, Paula Fleisher, Tomás J Aragón, Lisa Chung, Colleen Chawla, Abbie Yant, Estela R Garcia, Amor Santiago, Perry L Lang, Paula Jones, Wylie Liu, Laura A Schmidt
BACKGROUND: The San Francisco Health Improvement Partnership (SFHIP) promotes health equity by using a novel collective impact model that blends community engagement with evidence-to-policy translational science. The model involves diverse stakeholders, including ethnic-based community health equity coalitions, the local public health department, hospitals and health systems, a health sciences university, a school district, the faith community, and others sectors. COMMUNITY CONTEXT: We report on 3 SFHIP prevention initiatives: reducing consumption of sugar sweetened beverages (SSBs), regulating retail alcohol sales, and eliminating disparities in children's oral health...
March 23, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28333581/the-social-construction-of-fibromyalgia-as-a-health-problem-from-the-perspective-of-policies-professionals-and-patients
#15
Erica Briones-Vozmediano
BACKGROUND: Fibromyalgia is a painful chronic disease, suffered mainly by women, that consolidates a number of symptoms and skeletal muscle issues which are little understood. OBJECTIVES: To explore the social construction of FM from the perspective of health policies, patients, and health professionals involved in their medical attention. METHODS: I) Policy review of national and regional health plans in a national and international context, the clinical protocols for fibromyalgia in Spain, and the Parliamentary initials in the European and Spanish context; and ii) Qualitative study involving 28 personal interviews with 16 fibromyalgia patients and 12 interviews with health care professionals in Spain...
2017: Global Health Action
https://www.readbyqxmd.com/read/28333516/collaborative-mental-health-care-for-pediatric-behavior-disorders-in-primary-care-does-it-reduce-mental-health-care-costs
#16
Hao Yu, David J Kolko, Eunice Torres
OVERVIEW: One recently completed randomized controlled trial (RCT) demonstrated the effectiveness of a doctor-office collaborative care (DOCC), relative to enhanced usual care (EUC), for pediatric behavior problems and attention-deficit/hyperactivity disorder. In this study, we sought to extend the literature by incorporating a cost-analysis component at the conclusion of the aforementioned trial. To our knowledge, it was the first study to examine whether the DOCC model leads to lower costs of mental health services for children...
March 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28333318/a-phase-iii-randomized-controlled-trial-comparing-the-efficacy-safety-and-tolerability-of-oral-dydrogesterone-versus-micronized-vaginal-progesterone-for-luteal-support-in-in-vitro-fertilization
#17
Herman Tournaye, Gennady T Sukhikh, Elke Kahler, Georg Griesinger
STUDY QUESTION: Is oral dydrogesterone 30 mg daily (10 mg three times daily [TID]) non-inferior to micronized vaginal progesterone (MVP) 600 mg daily (200 mg TID) for luteal support in in vitro fertilization (IVF), assessed by the presence of fetal heartbeats determined by transvaginal ultrasound at 12 weeks of gestation? SUMMARY ANSWER: Non-inferiority of oral dydrogesterone versus MVP was demonstrated at 12 weeks of gestation, with a difference in pregnancy rate and an associated confidence interval (CI) that were both within the non-inferiority margin...
March 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28332940/longitudinal-cancer-risk-management-trajectories-of-brca1-2-mutation-positive-reproductive-age-women
#18
Jennifer Louise Young, Allison Werner-Lin, Rebecca Mueller, Lindsey Hoskins, Norman Epstein, Mark H Greene
Young women with BRCA1/2 mutations face difficult health-care decisions regarding family formation, fertility, breastfeeding, and whether/when to undergo cancer risk-reducing surgery. This longitudinal qualitative study investigated these life choices during the reproductive years. We conducted two semistructured interviews over three years with 12 reproductive-age BRCA1/2-positive women. Researchers coded transcripts to examine the evolution of risk perceptions, risk management, and family planning decisions...
February 14, 2017: Journal of Psychosocial Oncology
https://www.readbyqxmd.com/read/28332939/pediatric-asthma-hospitalizations-among-urban-minority-children-and-the-continuity-of-primary-care
#19
Levon H Utidjian, Alexander G Fiks, A Russell Localio, Lihai Song, Mark J Ramos, Ron Keren, Louis M Bell, Robert W Grundmeier
OBJECTIVE: To examine the effect of ambulatory health care processes on asthma hospitalizations. METHODS: A retrospective cohort study using electronic health records was completed. Patients aged 2-18 years receiving health care from 1 of 5 urban practices between Jan 1, 2004 and Dec 31, 2008 with asthma documented on their problem list were included. Independent variables were modifiable health care processes in the primary care setting: (1) use of asthma controller medications; (2) regular assessment of asthma symptoms; (3) use of spirometry; (4) provision of individualized asthma care plans; (5) timely influenza vaccination; (6) access to primary healthcare; and (7) use of pay for performance physician incentives...
February 25, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28332892/outcomes-in-continuing-pregnancies-diagnosed-with-a-severe-fetal-abnormality-and-implication-of-antenatal-neonatology-consultation-a-10-year-retrospective-study
#20
Laura Hostalery, Barthélémy Tosello
PURPOSE: To describe a population choosing to continue their pregnancy despite a severe fetal abnormality and to evaluate the role of antenatal neonatology consultation in perinatal decision-making. METHODS: A 10-year (2005-2015) retrospective descriptive study in a single Multidisciplinary Prenatal Diagnosis Center in South France. A series of pregnancies with severe fetal abnormalities were collected by a person outside the decision making process and/or the child's care...
March 23, 2017: Fetal and Pediatric Pathology
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