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https://www.readbyqxmd.com/read/28646519/the-association-of-health-literacy-with-preventable-ed-visits-a-cross-sectional-study
#1
Meenakshi P Balakrishnan, Jill Boylston Herndon, Jingnan Zhang, Thomas Payton, Jonathan Shuster, Donna L Carden
BACKGROUND: Policy-makers argue that emergency department (ED) visits for conditions preventable with high-quality outpatient care contribute to waste in the healthcare system. However, access to ambulatory care is uneven, especially for vulnerable populations like minorities, the poor and those with limited health literacy. The impact of limited health literacy on ED visits that are preventable with timely, high-quality ambulatory care is unknown. OBJECTIVE: To determine the association of health literacy and preventable ED visits...
June 24, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28643577/an-assessment-of-advance-relatives-approach-for-brain-death-organ-donation
#2
Carine Michaut, Antoine Baumann, Hélène Gregoire, Corinne Laviale, Gérard Audibert, Xavier Ducrocq
BACKGROUND: Advance announcement of forthcoming brain death has developed to enable intensivists and organ procurement organisation coordinators to more appropriately, and separately from each other, explain to relatives brain death and the subsequent post-mortem organ donation opportunity. Research aim: The aim was to assess how potentially involved healthcare professionals perceived ethical issues surrounding the strategy of advance approach. RESEARCH DESIGN: A multi-centre opinion survey using an anonymous self-administered questionnaire was conducted in the six-member hospitals of the publicly funded East of France regional organ and tissue procurement network called 'Prélor'...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28643178/economic-evaluation-of-tobramycin-inhalation-powder-for-the-treatment-of-chronic-pulmonary-pseudomonas-aeruginosa-infection-in-patients-with-cystic-fibrosis
#3
Srilekha Panguluri, Praveen Gunda, Laurie Debonnett, Kamal Hamed
BACKGROUND: Chronic lung infection with Pseudomonas aeruginosa occurs in approximately 50% of patients with cystic fibrosis (CF). This infection further compromises lung function, and significantly contributes to the increased healthcare costs. OBJECTIVES: Inhaled tobramycin, used to manage P. aeruginosa infection in CF patients, is available as powder (tobramycin inhalation powder, TIP) and solution (tobramycin inhalation solution, TIS). Evidence suggests increased adherence with the use of TIP over TIS...
June 22, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28642108/investing-in-new-technology-in-pulmonary-medicine-navigating-the-tortuous-path-to-success
#4
REVIEW
Robert Kruklitis, Kim French, Michael Joseph Cangelosi, Kevin L Kovitz
The introduction of new technologies offer the promise to advance medicine. This occurs alongside improved efforts to control costs of healthcare by hospital administrators, Center for Medicare and Medicaid Services' (CMS) pivot to value programs, and commercial payers' efforts to reduce reimbursement. These trends present a challenge for the pulmonologist, among others, who must navigate increasingly complex and highly scrutinized evaluation processes used to secure new technologies. Healthcare providers are turning toward value assessments, while simultaneously tasked with a mission of offering state-of-the art technologies and services...
June 19, 2017: Chest
https://www.readbyqxmd.com/read/28641586/access-education-and-policy-awareness-predictors-of-influenza-vaccine-acceptance-among-vha-healthcare-workers
#5
Jennifer Lipkowitz Eaton, David C Mohr, Kathleen M McPhaul, Richard A Kaslow, Richard A Martinello
OBJECTIVE To identify predictors of influenza vaccine acceptance among VHA healthcare workers (HCWs), with emphasis on modifiable factors related to promotion campaigns. DESIGN Survey. SETTING National single-payer healthcare system with 140 hospitals and 321,000 HCWs. PARTICIPANTS National voluntary sample of HCWs in the Veterans Health Administration (VHA) system. METHODS We invited a random sample of 5% of all VHA HCWs to participate. An 18-item intranet-based survey inquired about occupation, vaccination status, employer policy, and local campaign efforts...
June 23, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28640845/is-self-assessment-of-medical-abortion-using-a-low-sensitivity-pregnancy-test-combined-with-a-checklist-and-phone-text-messages-feasible-in-south-african-primary-healthcare-settings-a-randomized-trial
#6
Deborah Constant, Jane Harries, Kristen Daskilewicz, Landon Myer, Kristina Gemzell-Danielsson
OBJECTIVE: To evaluate feasibility of self-assessment of medical abortion outcome using a low-sensitivity urine pregnancy test, checklist and text messages. The study assessed whether accurate self-assessment required a demonstration of the low-sensitivity urine pregnancy test or if verbal instructions suffice. METHODS: This non-inferiority trial enrolled 525 adult women from six public sector abortion clinics. Eligible women were undergoing medical abortion at gestations within 63 days...
2017: PloS One
https://www.readbyqxmd.com/read/28640023/preventing-harm-in-the-icu-building-a-culture-of-safety-and-engaging-patients-and-families
#7
Kevin C Thornton, Jennifer J Schwarz, A Kendall Gross, Wendy G Anderson, Kathleen D Liu, Mark C Romig, Hildy Schell-Chaple, Peter J Pronovost, Adam Sapirstein, Michael A Gropper, Angela K M Lipshutz
OBJECTIVE: Preventing harm remains a persistent challenge in the ICU despite evidence-based practices known to reduce the prevalence of adverse events. This review seeks to describe the critical role of safety culture and patient and family engagement in successful quality improvement initiatives in the ICU. We review the evidence supporting the impact of safety culture and provide practical guidance for those wishing to implement initiatives aimed at improving safety culture and more effectively integrate patients and families in such efforts...
June 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28637726/interventions-for-preventing-mother-to-child-hiv-transmission-protocol-of-an-overview-of-systematic-reviews
#8
Windy Mariane Virenia Wariki, Erika Ota, Rintaro Mori, Charles S Wiysonge, Hacsi Horvath, Jennifer S Read
INTRODUCTION: Various interventions to prevent mother-to-child-transmission (MTCT) of HIV have been investigated and implemented. A number of systematic reviews assessing the efficacy of interventions for the prevention of MTCT of HIV reported antiretroviral prophylaxis, caesarean section before labour and before ruptured membranes, and complete avoidance of breastfeeding were efficacious for preventing MTCT of HIV. Recent WHO guidelines recommend lifelong antiretroviral therapy for all pregnant women for treatment of the woman's own HIV infection and for prevention of MTCT of HIV...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28637725/filling-the-gaps-in-sards-research-collection-and-linkage-of-administrative-health-data-and-self-reported-survey-data-for-a-general-population-based-cohort-of-individuals-with-and-without-diagnoses-of-systemic-autoimmune-rheumatic-disease-sards-from-british
#9
Natalie McCormick, Kathryn Reimer, Ali Famouri, Carlo A Marra, J Antonio Aviña-Zubieta
PURPOSE: Systemic autoimmune rheumatic diseases (SARDs) are a group of debilitating autoimmune diseases, including systemic lupus erythematosus and related disorders. Assessing the healthcare and economic burden of SARDs has been challenging: while administrative databases can be used to determine healthcare utilisation and costs with minimal selection and recall bias, other health, sociodemographic and economic data have typically been sourced from highly selected, clinic-based cohorts...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28637723/impact-of-consumer-copayments-for-subsidised-medicines-on-health-services-use-and-outcomes-a-protocol-using-linked-administrative-data-from-western-australia
#10
Karla L Seaman, Frank M Sanfilippo, Elizabeth E Roughead, Max K Bulsara, Anna Kemp-Casey, Caroline Bulsara, Gerald F Watts, David Preen
INTRODUCTION: Across the world, health systems are adopting approaches to manage rising healthcare costs. One common strategy is a medication copayments scheme where consumers make a contribution (copayment) towards the cost of their dispensed medicines, with remaining costs subsidised by the health insurance service, which in Australia is the Federal Government.In Australia, copayments have tended to increase in proportion to inflation, but in January 2005, the copayment increased substantially more than inflation...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28637460/healthcare-utilization-and-costs-for-patients-initiating-dabigatran-or-warfarin
#11
Shannon L Reynolds, Sameer R Ghate, Richard Sheer, Pranav K Gandhi, Chad Moretz, Cheng Wang, Stephen Sander, Mary E Costantino, Srinivas Annavarapu, George Andrews
BACKGROUND: Novel oral anticoagulants (NOAC) such as dabigatran, when compared to warfarin, have been shown to potentially reduce the risk of stroke in patients with non-valvular atrial fibrillation (NVAF) together with lower healthcare resource utilization (HCRU) and similar total costs. This study expands on previous work by comparing HCRU and costs for patients newly diagnosed with NVAF and newly initiated on dabigatran or warfarin, and is the first study specifically in a Medicare population...
June 21, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28637407/oral-insulin-myth-or-reality
#12
Vikash Kumar, Ishwari Choudhry, Pooja Hurkat, Ashish Jain, Dharmendra Jain
BACKGROUND: Diabetes mellitus (DM) is a disorder of glucose metabolism marked by hyperglycemia, glycosuria, hyperlipidemia, negative nitrogen balance and ketonaemia. DM is a major healthcare problems today and its treatment costs billions of dollars worldwide annually. The cases of diabetes have increased rapidly in recent years throughout the world. Currently, for management of type-1 diabetes mellitus (TIDM), multiple daily insulin (MDI) injections is the most popular treatment. Oral administration of insulin is the most suitable and attractive as compared to subcutaneous route but unfortunately cannot be utilized for the administration of peptides and proteins due to poor epithelial permeability and enzymatic degradation within the gastrointestinal tract...
June 21, 2017: Current Diabetes Reviews
https://www.readbyqxmd.com/read/28635342/healthcare-costs-in-psoriasis-and-psoriasis-subgroups-over-time-following-psoriasis-diagnosis
#13
Sarah Al Sawah, Shonda A Foster, Orin M Goldblum, William N Malatestinic, Baojin Zhu, Nianwen Shi, Xue Song, Steven R Feldman
AIMS: To quantify healthcare costs in patients with psoriasis overall and, in psoriasis patient subgroups, by level of disease severity, presence or absence of psoriatic arthritis, or use of biologics. METHODS: Administrative data from Truven Health Analytics MarketScan Research Database were used to select adult patients with psoriasis from January 2009 to January 2014. The first psoriasis diagnosis was set as the index date. Patients were required to have ≥6 months of continuous enrollment with medical and pharmacy benefits pre-index and ≥12 months post-index...
June 21, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28634517/introduction-of-a-quality-improvement-curriculum-in-the-department-of-internal-medicine-lincoln-medical-center
#14
Usha Venugopal, Moiz Kasubhai, Vikram Paruchuri
Community hospitals with limited resources struggle to engage physicians in Quality improvement initiatives. We introduced Quality Improvement (QI) curriculum for residents in response to ACGME requirements and surveyed the residents understanding of QI and their involvement in QI projects before and after the introduction of the curriculum. The current article describes our experiences with the process, the challenges and possible solutions to have a successful resident led QI initiative in a community hospital...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28633782/factors-predicting-length-of-hospital-stay-and-extended-care-facility-admission-after-hindfoot-arthrodesis-procedures
#15
Jacob Deister, Brian G Cothern, Chad Williams, Andrew W Froehle, Richard T Laughlin
Delayed identification of patients requiring admission to extended care facilities (ECFs) can lead to greater healthcare costs through an increased length of hospital stay (LOHS). Previous studies of hip and knee arthroplasty identified factors associated with a likely discharge to an ECF. These issues have not been extensively studied for major hindfoot procedures. We conducted a retrospective review of 198 cases treated during a 3-year period to identify the risk factors for an extended LOHS and ECF admission after ankle arthrodesis, triple arthrodesis, pantalar arthrodesis, and subtalar arthrodesis...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28631497/cost-effectiveness-of-blinatumomab-versus-salvage-chemotherapy-in-relapsed-or-refractory-philadelphia-chromosome-negative-b-precursor-acute-lymphoblastic-leukemia-from-a-us-payer-perspective
#16
Thomas E Delea, Jordan Amdahl, Diana Boyko, May Hagiwara, Zachary F Zimmerman, Janet L Franklin, Ze Cong, Guy Hechmati, Anthony Stein
Objective To evaluate the cost-effectiveness of blinatumomab (Blincyto) versus standard of care (SOC) chemotherapy in adults with relapsed or refractory (R/R) Philadelphia-chromosome-negative (Ph-) B-precursor acute lymphoblastic leukemia (ALL) based on the results of the phase 3 TOWER study from a US healthcare payer perspective. Methods The Blincyto Global Economic Model (B-GEM), a partitioned survival model, was used to estimate the incremental cost-effectiveness ratio (ICER) of blinatumomab versus SOC. Response rates, event free survival (EFS), overall survival (OS), numbers of cycles of blinatumomab and SOC, and transplant rates were estimated from TOWER...
June 20, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28629753/active-identification-of-patients-who-are-methicillin-resistant-staphylococcus-aureus-colonized-is-not-associated-with-longer-duration-of-vancomycin-therapy
#17
Carlos Acuna-Villaorduna, Westyn Branch-Elliman, Judith Strymish, Kalpana Gupta
BACKGROUND: Excessive prescribing of vancomycin among patients admitted to inpatient wards is a challenge for antimicrobial stewardship programs, especially in the setting of expanded screening programs for methicillin-resistant Staphylococcus aureus (MRSA). Studies examining factors associated with longer duration of vancomycin use are limited. METHODS: We conducted a retrospective cohort study to assess the impact of universal MRSA admission screening on duration of vancomycin use at the VA Boston Healthcare System during the period from January 2013-November 2015...
June 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28629437/evaluation-of-a-low-cost-low-power-syringe-pump-to-deliver-magnesium-sulfate-intravenously-to-pre-eclamptic-women-in-a-malawian-referral-hospital
#18
Erica Skerrett, Edward Kommwa, Kelley Maynard, Alexa Juarez, Ronald Mataya, Rebecca Richards-Kortum, Z Maria Oden
BACKGROUND: Magnesium sulfate is an affordable and effective treatment for pre-eclampsia and eclampsia. In settings where infusion pumps are not available to regulate the flow rate of intravenous delivery, healthcare providers must administer magnesium sulfate (MgSO4) via time-consuming and painful, large-volume intramuscular injections. As an alternative to costly commercially available syringe pumps, we developed AutoSyp, an accurate, low-cost, and low-powered syringe pump designed to meet the needs and constraints these low-resource settings...
June 19, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28628484/battling-bacterial-infection-with-hexamethylene-diisocyanate-cross-linked-and-cefaclor-loaded-collagen-scaffolds
#19
E K Tsekoura, A L Helling, J G Wall, Y Bayon, D I Zeugolis
Implant infections remain a major healthcare problem due to the prolonged hospitalisation period required to disrupt and treat bacterial biofilm formation, and the need for additional surgery to remove/replace the infected implant, which if not removed in a timely manner may lead to sepsis. Although localised drug administration, via an implanted scaffold, has shown promise in a clinical setting, the ideal scaffold cross-linking (to initially withstand the aggressive infection environment) and drug (to be effective against infection) have yet to be identified...
June 19, 2017: Biomedical Materials
https://www.readbyqxmd.com/read/28627151/-assessment-of-an-algorithm-to-identify-paediatric-onset-celiac-disease-cases-through-administrative-healthcare-databases
#20
Gisella Pitter, Roberto Gnavi, Pierantonio Romor, Renzo Zanotti, Lorenzo Simonato, Cristina Canova
OBJECTIVES: to assess the role of four administrative healthcare databases (pathology reports, copayment exemptions, hospital discharge records, gluten-free food prescriptions) for the identification of possible paediatric cases of celiac disease. DESIGN: population-based observational study with record linkage of administrative healthcare databases. SETTING AND PARTICIPANT S: children born alive in the Friuli Venezia Giulia Region (Northern Italy) to resident mothers in the years 1989-2012, identified using the regional Medical Birth Register...
January 2017: Epidemiologia e Prevenzione
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