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https://www.readbyqxmd.com/read/28811123/emergency-department-involvement-in-accountable-care-organizations-in-massachusetts-a-survey-study
#1
Nissa J Ali, J Michael McWilliams, Stephen K Epstein, Peter B Smulowitz
STUDY OBJECTIVE: We assess Massachusetts emergency department (ED) involvement and internal ED constructs within accountable care organization contracts. METHODS: An online survey was distributed to 70 Massachusetts ED directors. Questions attempted to assess involvement of EDs in accountable care organizations and the structures in place in EDs-from departmental resources to physician incentives-to help achieve accountable care organization goals of decreasing spending and improving quality...
August 12, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28806586/the-new-frontier-of-strategic-alliances-in-health-care-new-partnerships-under-accountable-care-organizations
#2
Valerie A Lewis, Katherine I Tierney, Carrie H Colla, Stephen M Shortell
Accountable care organizations (ACOs) and similar reforms aim to improve coordination between health care providers; however, due to the fragmented nature of the US health care system, successful coordination will hinge in large part on the ability of health care organizations to successfully partner across organizational boundaries. Little is known about new partnerships formed under the ACO model. We use mixed methods data from the National Survey of ACOs, Medicare ACO performance data and interviews with executive leaders across 31 ACOs to examine the prevalence, characteristics, and capabilities of partnership ACOs and why and how ACO partnerships form...
May 2, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28803487/a-mechanism-based-approach-to-management-of-children-with-end-stage-liver-disease
#3
Allah B Haafiz
Due to parallel advances in surgical and acute care disciplines, liver transplantation (LT) has revolutionized the outlook for children with end-stage liver disease (ESLD). Contrary to advances in technical aspects of LT and the peri-operative care, pre-transplant management of ESLD remains quite a formidable challenge. Areas covered: This review provides mechanisms based management strategies to address common complications of ESLD including malnutrition, amended metabolic pathways, gastrointestinal dysfunction, and development of ascites...
August 14, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28802877/declining-mortality-in-critically-ill-patients-with-cirrhosis-in-australia-and-new-zealand-between-2000-and-2015
#4
Avik Majumdar, Michael Bailey, William M Kemp, Rinaldo Bellomo, Stuart K Roberts, David Pilcher
BACKGROUND AND AIMS: Few studies have described the outcomes of patients with cirrhosis receiving intensive care unit (ICU) admission at a population level. We aimed to describe trends in the mortality of such patients in Australia and New Zealand (ANZ), and to investigate the relationship with associated organ failures. METHODS: We studied patients admitted to 172 ICUs on a non-elective basis, with and without cirrhosis between January 1(st) 2000 and December 31(st) 2015 as recorded by the ANZ Intensive Care Society Centre for Outcome and Resource Evaluation Adult Patient Database...
August 9, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28802182/inflammatory-markers-as-risk-factors-for-infection-with-multidrug-resistant-microbes-in-diabetic-foot-subjects
#5
Saba Noor, Abhijit Girish Borse, Maaz Ozair, Alok Raghav, Iqbal Parwez, Jamal Ahmad
BACKGROUND: Diabetic foot ulcers (DFUs), a dreadful microvascular complication of diabetes is responsible for substantial increase in morbidity and mortality. Infection, not a cause, but a consequence in DFUs that accounts for minor or major limb loss. The current study aimed to evaluate the microbial etiology of infected diabetic foot ulcers in northern tertiary care hospital, assessment of risk factors and role of inflammatory markers involved in colonization of multidrug-resistant organisms (MDROs) and their impact on the outcome...
May 3, 2017: Foot
https://www.readbyqxmd.com/read/28801468/minnesota-integrated-health-partnership-demonstration-implementation-of-a-medicaid-aco-model
#6
Lynn A Blewett, Donna Spencer, Peter Huckfeldt
In recent years, accountable care organizations (ACOs) have become more prevalent in the United States, as a means to provide coordinated care by local providers. This study describes the origins, implementation, and early results of Minnesota's Medicaid ACO payment model, the Integrated Health Partnership (IHP) demonstration project. We describe the structure of the program and present preliminary evaluation results to document the state's important work and to provide lessons for other states interested in implementing Medicaid ACOs...
August 11, 2017: Journal of Health Politics, Policy and Law
https://www.readbyqxmd.com/read/28801217/evaluation-of-unplanned-hospital-readmissions-after-major-urologic-inpatient-surgery-in-the-era-of-accountable-care
#7
Benjamin V Stone, Matthew R Cohn, Nicholas M Donin, Michael Schulster, James S Wysock, Danil V Makarov, Marc A Bjurlin
OBJECTIVE: To provide a multi-institutional analysis of clinical factors predicting unplanned hospital readmission after major inpatient urologic surgery. MATERIALS AND METHODS: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) is a risk-adjusted data collection mechanism for analyzing clinical outcomes data including 30-day perioperative readmissions and complications. We identified 23,108 patients who underwent major inpatient urologic surgery from 2011 to 2012...
August 8, 2017: Urology
https://www.readbyqxmd.com/read/28798922/practical-approach-to-the-patient-with-acute-neuromuscular-weakness
#8
REVIEW
Rajeev Nayak
Acute neuromuscular paralysis (ANMP) is a clinical syndrome characterized by rapid onset muscle weakness progressing to maximum severity within several days to weeks (less than 4 wk). Bulbar and respiratory muscle weakness may or may not be present. It is a common neurological emergency which requires immediate and careful investigations to determine the etiology because accurate diagnosis has significant impact on therapy and prognosis. Respiratory failure caused by neuromuscular weakness is considered as more critical than lung disease because its development may be insidious or subtle until sudden decompensation leads to life threatening hypoxia...
July 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28797017/how-do-social-capital-and-hiv-aids-outcomes-geographically-cluster-and-which-sociocontextual-mechanisms-predict-differences-across-clusters
#9
Yusuf Ransome, Lorraine T Dean, Natalie D Crawford, David S Metzger, Michael B Blank, Amy S Nunn
BACKGROUND: Place of residence has been associated with HIV transmission risks. Social capital, defined as features of social organization that improve efficiency of society by facilitating coordinated actions, often varies by neighborhood, and hypothesized to have protective effects on HIV care continuum outcomes. We examined whether the association between social capital and 2 HIV care continuum outcomes clustered geographically and whether sociocontextual mechanisms predict differences across clusters...
September 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28795413/nursing-lives-in-the-blogosphere-a-thematic-analysis-of-anonymous-online-nursing-narratives
#10
Aimee Castro, Gavin Andrews
AIM: To explore the work-life narratives of nurses through a thematic analysis of the nursing accounts they post in their publicly accessible, anonymous blogs. BACKGROUND: Many nurses participate on social media. Blogs have been advocated as a self-reflective tool in nursing practice, yet as far as the authors are aware, no previous studies have explored nurses' individual blogs for their potential to reveal nurses' perceptions of nursing work. DESIGN: The research design was qualitative description...
August 10, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28793967/type-2-diabetes-specialty-clinic-model-for-the-accountable-care-organization-era
#11
Heather Klingeman, Martha Funnell, Amolak Jhand, Sangeeta Lathkar-Pradhan, Israel Hodish
AIMS: A third of the patients with Type 2 diabetes have an advance disease that requires complex pharmacotherapies and advanced expertise, dependent on multiple clinical interactions. Unfortunately, limited providers availability enables only sporadic interactions. Additionally, the expanding Accountable Care Organization (ACO) concept enhances providers' compensation when clinical performance is improving while limiting face-to-face clinic visits. METHODS: We developed an advanced type 2 specialty clinic model, geared toward frequent remote clinical interventions while limiting face-to-face clinic visits...
May 25, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28791771/public-strategies-for-improving-ehealth-integration-and-long-term-sustainability-in-public-health-care-systems-findings-from-an-italian-case-study
#12
Sabina De Rosis, Sabina Nuti
eHealth is expected to contribute in tackling challenges for health care systems. However, it also imposes challenges. Financing strategies adopted at national as well regional levels widely affect eHealth long-term sustainability. In a public health care system, the public actor is among the main "buyers" eHealth. However, public interventions have been increasingly focused on cost containment. How to match these 2 aspects? This article explores some central issues, mainly related to financial aspects, in the development of effective and valuable eHealth strategies in a public health care system: How can the public health care system (as a "buyer") improve long-term success and sustainability of eHealth solutions? What levers are available to match in the long period different interests of different stakeholders in the eHealth field? A case study was performed in the Region of Tuscany, Italy...
August 8, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28783811/social-determinants-of-health-in-managed-care-payment-formulas
#13
Arlene S Ash, Eric O Mick, Randall P Ellis, Catarina I Kiefe, Jeroan J Allison, Melissa A Clark
Importance: Managed care payment formulas commonly allocate more money for medically complex populations, but ignore most social determinants of health (SDH). Objective: To add SDH variables to a diagnosis-based payment formula that allocates funds to managed care plans and accountable care organizations. Design, Setting, and Participants: Using data from MassHealth, the Massachusetts Medicaid and Children's Health Insurance Program, we estimated regression models predicting Medicaid spending using a diagnosis-based and SDH-expanded model, and compared the accuracy of their cost predictions overall and for vulnerable populations...
August 7, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28780148/intra-abdominal-hypertension-abdominal-compartment-syndrome-and-the-open-abdomen
#14
REVIEW
William Kirke Rogers, Luis Garcia
Abdominal Compartment Syndrome (ACS) is the endpoint of a process whereby massive interstitial swelling in the abdomen or rapid development of a space-filling lesion within the abdomen (such as ascites or a hematoma) leads to a pathologically increased pressure. This results in so-called Intra-Abdominal Hypertension (IAH), causing decreased perfusion of the kidneys and abdominal viscera and possible difficulties with ventilation and maintenance of cardiac output. These effects contribute to a cascade of ischemia and multiple organ dysfunction with high mortality...
August 2, 2017: Chest
https://www.readbyqxmd.com/read/28777548/generation-and-detection-of-reactive-oxygen-species-in-photocatalysis
#15
Yoshio Nosaka, Atsuko Y Nosaka
The detection methods and generation mechanisms of the intrinsic reactive oxygen species (ROS), i.e., superoxide anion radical ((•)O2(-)), hydrogen peroxide (H2O2), singlet oxygen ((1)O2), and hydroxyl radical ((•)OH) in photocatalysis, were surveyed comprehensively. Consequently, the major photocatalyst used in heterogeneous photocatalytic systems was found to be TiO2. However, besides TiO2 some representative photocatalysts were also involved in the discussion. Among the various issues we focused on the detection methods and generation reactions of ROS in the aqueous suspensions of photocatalysts...
August 4, 2017: Chemical Reviews
https://www.readbyqxmd.com/read/28774295/balanced-performance-measurement-in-research-hospitals-the-participative-case-study-of-a-haematology-department
#16
Simona Catuogno, Claudia Arena, Sara Saggese, Fabrizia Sarto
BACKGROUND: The paper aims to review, design and implement a multidimensional performance measurement system for a public research hospital in order to address the complexity of its multifaceted stakeholder requirements and its double institutional aim of care and research. METHOD: The methodology relies on a participative case study performed by external researchers in close collaboration with the staff of an Italian research hospital. RESULTS: The paper develops and applies a customized version of balanced scorecard based on a new set of performance measures...
August 3, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28774225/the-anterior-temporal-lobes-new-frontiers-opened-to-neuropsychological-research-by-changes-in-health-care-and-disease-epidemiology
#17
Guido Gainotti
Changes in health care and disease epidemiology have shifted the attention of neuropsychologists and cognitive neuroscientists from vascular lesions to degenerative diseases or other bilateral brain lesions. This displacement of attention from vascular patients to patients with degenerative brain diseases allowed the discovery of hitherto unexplored and unheralded aspects of the neural substrates of human cognition. Three aspects of research on the anterior parts of the temporal lobes (ATLs) are the focus of the present review...
August 4, 2017: Journal of Neuropsychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/28767410/orellanine-specifically-targets-renal-clear-cell-carcinoma
#18
Lisa Buvall, Heidi Hedman, Alina Khramova, Deman Najar, Lovisa Bergwall, Kerstin Ebefors, Carina Sihlbom, Sven Lundstam, Anders Herrmann, Hanna Wallentin, Emelie Roos, Ulf A Nilsson, Martin Johansson, Jan Törnell, Börje Haraldsson, Jenny Nyström
Renal cell carcinoma (RCC), arising from the proximal tubule in the kidney, accounts for approximately 85% of kidney cancers and causes over 140,000 annual deaths worldwide. In the last decade, several new therapies have been identified for treatment of metastatic RCC. Although these therapies increase survival time compared to standard care, none of them has curative properties. The nephrotoxin orellanine specifically targets proximal tubular epithelial cells, leaving other organs unaffected. We therefore hypothesized that the selective toxicity of orellanine extends to clear cell RCC (ccRCC) cells since they emanate from proximal tubular cells...
July 25, 2017: Oncotarget
https://www.readbyqxmd.com/read/28766004/-psychosocial-stress-in-patients-with-prostate-cancer-experiences-by-using-psychooncological-screening-questionnaires
#19
D L Dräger, N N Harke, K-D Sievert, C Protzel, O W Hakenberg
BACKGROUND: Prostate cancer is the most common malignancy in men and accounts for most surgical procedures in uro-oncology. Stressful sequelae of radical prostatectomy are incontinence and erectile dysfunction. Hormone ablation and radiation therapy are also known stressors. Mental stress has a low prevalence compared to other tumor entities. It is highly probable that there is an underexpression of verbally reported emotional experiences. Therefore, a low-threshold access to psycho-oncological services and accurate identification of patients with mental comorbidities is important...
August 1, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28761333/patient-satisfaction-with-clinical-laboratory-services-at-tikur-anbessa-specialized-hospital-addis-ababa-ethiopia
#20
Rodas Getachew Abera, Boaz Arka Abota, Melese Hailu Legese, Abebe Edao Negesso
BACKGROUND: Monitoring patient satisfaction is an important and useful quality improvement tool for clinical laboratories in particular and health care organizations in general. Thus, this study aimed to assess patient satisfaction toward clinical laboratory services at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia. METHODS: A hospital-based cross-sectional study was conducted and a convenient sampling technique was applied to recruit study participants...
2017: Patient Preference and Adherence
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