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https://www.readbyqxmd.com/read/28332943/effects-of-different-models-of-dialysis-care-on-patient-important-outcomes-a-systematic-review-and-meta-analysis
#1
Priya Ramar, Ahmed T Ahmed, Zhen Wang, Sagar S Chawla, Maria Lourdes Gonzalez Suarez, LaTonya J Hickson, Ann Farrell, Amy W Williams, Nilay D Shah, M Hassan Murad, Bjorg Thorsteinsdottir
Ongoing payment reform in dialysis necessitates better patient outcomes and lower costs. Suggested improvements to processes of care for maintenance dialysis patients are abundant; however, their impact on patient-important outcomes is unclear. This systematic review included comparative randomized controlled trials or observational studies with no restriction on language, published from 2000 to 2014, involving at least 5 adult dialysis patients who received a minimum of 6 months of follow-up. The effect size was pooled and stratified by intervention strategy (multidisciplinary care [MDC], home dialysis, alternate dialysis settings, and electronic health record implementation)...
March 23, 2017: Population Health Management
https://www.readbyqxmd.com/read/28332223/change-management-in-an-environment-of-ongoing-primary-health-care-system-reform-a-case-study-of-australian-primary-health-care-services
#2
Sara Javanparast, Janny Maddern, Fran Baum, Toby Freeman, Angela Lawless, Ronald Labonté, David Sanders
INTRODUCTION/BACKGROUND: Globally, health reforms continue to be high on the health policy agenda to respond to the increasing health care costs and managing the emerging complex health conditions. Many countries have emphasised PHC to prevent high cost of hospital care and improve population health and equity. The existing tension in PHC philosophies and complexity of PHC setting make the implementation and management of these changes more difficult. This paper presents an Australian case study of PHC restructuring and how these changes have been managed from the viewpoint of practitioners and middle managers...
March 22, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28321291/re-thinking-barriers-to-organizational-change-in-public-hospitals
#3
Nigel Edwards, Richard B Saltman
Public hospitals are well known to be difficult to reform. This paper provides a comprehensive six-part analytic framework that can help policymakers and managers better shape their organizational and institutional behavior. The paper first describes three separate structural characteristics which, together, inhibit effective problem description and policy design for public hospitals. These three structural constraints are i) the dysfunctional characteristics found in most organizations, ii) the particular dysfunctions of professional health sector organizations, and iii) the additional dysfunctional dimensions of politically managed organizations...
2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28317168/the-health-policy-pendulum-cost-control-vs-activity-growth
#4
Trond Tjerbo, Terje P Hagen
BACKGROUND: Cost containment is a major policy challenge and one of the key drivers of health care reform. In this article, we focus on the role cost control has played as a reform driver in the Norwegian hospital sector between 1980 and 2014. METHODS: We use data on aggregate expenditure as well as on activity changes from year to year. We also use qualitative data for illustrative purposes. RESULTS: We identify 4 phases in the period 1980 to 2014: two where activity increases have dominated the agenda and 2 where cost control has been emphasized...
March 20, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28316305/the-statesmanship-of-william-crawford-gorgas-m-d-surgeon-general-medical-corps-united-states-army
#5
Roy E Gandy, Raven M Christopher, Charles B Rodning
If statesmanship can be characterized as a bed rock of principles, a strong moral compass, a vision, and an ability to articulate and effect that vision, then the fortitude, tenacity, imperturbability, and resilience of William Crawford Gorgas cannot be overestimated. As Chief Sanitary Officer in Cuba and as Chief Medical Officer in Panama, he actualized strategies to eradicate the vectors of yellow fever and malaria. His superiors initially pigeonholed his requisitions, refused to provide him with any authority, and clamored for his dismissal...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28316039/public-health-data-in-action-an-analysis-of-using-louisiana-vital-statistics-for-quality-improvement-and-payment-reform
#6
Valery A Danilack, Rebekah E Gee, Danielle P Berthelot, Rebecca Gurvich, Janet H Muri
Introduction In 2012, the Louisiana (LA) Department of Health and Hospitals revised the LA birth certificate to include medical reasons for births before 39 completed weeks' gestation. We compared the completeness and validity of these data with hospital discharge records. Methods For births occurring 4/1/2012-9/30/2012 at Woman's Hospital of Baton Rouge, we linked maternal delivery and newborn birth data collected through the National Perinatal Information Center with LA birth certificates. Among early term births (37-38 completed weeks' gestation), we quantified the reasons for early delivery listed on the birth certificate and compared them with ICD-9-CM codes from Woman's discharge data...
March 18, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28299244/large-scale-health-information-database-and-privacy-protection
#7
Ryuichi Yamamoto
Japan was once progressive in the digitalization of healthcare fields but unfortunately has fallen behind in terms of the secondary use of data for public interest. There has recently been a trend to establish large-scale health databases in the nation, and a conflict between data use for public interest and privacy protection has surfaced as this trend has progressed. Databases for health insurance claims or for specific health checkups and guidance services were created according to the law that aims to ensure healthcare for the elderly; however, there is no mention in the act about using these databases for public interest in general...
September 2016: Japan Medical Association Journal: JMAJ
https://www.readbyqxmd.com/read/28292629/the-5-clinical-pillars-of-value-for-total-joint-arthroplasty-in-a-bundled-payment-paradigm
#8
Kelvin Kim, Richard Iorio
BACKGROUND: Our large, urban, tertiary, university-based institution reflects on its 4-year experience with Bundled Payments for Care Improvement. We will describe the importance of 5 clinical pillars that have contributed to the early success of our bundled payment initiative. We are convinced that value-based care delivered through bundled payment initiatives is the best method to optimize patient outcomes while rewarding surgeons and hospitals for adapting to the evolving healthcare reforms...
February 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28291130/making-the-pediatric-perioperative-surgical-home-come-to-life-by-leveraging-existing-health-information-technology
#9
Izabela C Leahy, Rachel Borczuk, Lynne R Ferrari
PURPOSE OF REVIEW: To design a patient data dashboard for the Department of Anesthesiology, Perioperative and Pain Medicine at Boston Children's Hospital that supports care integration across the healthcare system as described by the pediatric perioperative surgical home (PPSH) initiative. RECENT FINDINGS: By using 360 Technology, patient data was automatically pulled from all available Electronic Health Record sources from 2005 to the present. The PPSH dashboard described in this report provides a guide for implementation of PPSH Clinical Care Pathways...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28290254/primary-health-care-in-china-is-china-s-health-reform-reform-for-the-whole-nation
#10
Jing-Min Cheng, Yong-Xu Yuan, Wei Lu, Le Yang
BACKGROUND: Good primary health care can enhance national health status at relatively low cost. The barefoot doctor model in China was once considered to have been a successful health care policy. It was a model which was followed by other low-developed or developing countries. In recent decades, the Chinese government promulgated a number of new policies and health reforms to improve its health care system. AIM: This paper aimed to highlight the great significance of primary health care and appeal to the policymakers to change the priority to primary health care in order to be able to guarantee universal health care for the whole nation at least at primary care level...
March 14, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28289779/-does-the-healthcare-for-rare-diseases-benefit-from-the-legislative-reforms
#11
Ralf Heyder
BACKGROUND: The founding of the National Action League for People with Rare Diseases (NAMSE) in 2010 represents the creation of a significant political platform. In addition, recent years had seen Germany and the EU adopt specific legislative measures aimed at improving healthcare for people with rare diseases. OBJECTIVE: In this article we will give an overview of the legislative reforms adopted between 2013 and 2016 and evaluate how the specific healthcare situation of people with rare diseases has been improved...
March 13, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/28284366/-state-of-development-of-the-role-of-academic-nursing-staff-at-german-university-hospitals-in-2015
#12
Antje Tannen, Johanna Feuchtinger, Barbara Strohbücker, Andreas Kocks
INTRODUCTION: In order to meet the requirements of the increasing complexity of patient care it is recommended to promote more differentiated nursing staff structures and to integrate academic nurses, which is international standard and recommended by the German Science Council. The implementation level is unclear. What is the percentage of nurses with an academic degree at German university hospitals, and what are their task profiles? METHOD: Standardised written survey by nursing directors of all 32 German university hospitals and medical universities in 2015...
February 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28268164/funds-flow-in-the-era-of-value-based-health-care
#13
Jason N Itri, Ayman Mithqal, Arun Krishnaraj
Health care reform is creating significant challenges for hospital systems and academic medical centers (AMCs), requiring a new operating model to adapt to declining reimbursement, diminishing research funding, market consolidation, payers' focus on higher quality and lower cost, and greater cost sharing by patients. Maintaining and promoting the triple mission of clinical care, research, and education will require AMCs to be system-based with strong alignment around governance, operations, clinical care, and finances...
March 3, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28266025/impact-of-the-local-public-hospital-reform-on-the-efficiency-of-medium-sized-hospitals-in-japan-an-improved-slacks-based-measure-data-envelopment-analysis-approach
#14
Xing Zhang, Kaoru Tone, Yingzhe Lu
OBJECTIVE: To assess the change in efficiency and total factor productivity (TFP) of the local public hospitals in Japan after the local public hospital reform launched in late 2007, which was aimed at improving the financial capability and operational efficiency of hospitals. DATA SOURCES AND DATA COLLECTION: Secondary data were collected from the Ministry of Internal Affairs and Communications on 213 eligible medium-sized hospitals, each operating 100-400 beds from FY2006 to FY2011...
March 6, 2017: Health Services Research
https://www.readbyqxmd.com/read/28262631/-surgical-treatment-for-endocarditis-in-iceland-1997-2003
#15
Hedinn Sigurdsson, Sunna Gestsdottir, Kristjan G Gudmundsson, Sigridur Halldorsdottir
INTRODUCTION: Most GPs in Iceland are public employees on fixed salaries which is very different from their Norwegian colleagues. The aim of this study was to explore the experience of Icelandic GPs who have also worked as GPs in Norway and compare their experience of working in these two neighboring countries. MATERIAL AND METHODS: Data were collected through interviews with 16 GPs that during the study period 2009-2010 were all working in Iceland. Two to ten years had passed since their return from Norway...
2017: Læknablađiđ
https://www.readbyqxmd.com/read/28259213/movement-advocacy-personal-relationships-and-ending-health-care-disparities
#16
Marshall H Chin
Deep-rooted structural problems drive health care disparities. Compounding the difficulty of attaining health equity, solutions in clinics and hospitals require the cooperation of clinicians, administrators, patients, and the community. Recent protests over police brutality and racism on campuses across America have opened fresh wounds over how best to end racism, with lessons for achieving health equity. Movement advocacy, the mobilizing of the people to raise awareness of an injustice and to advocate for reform, can break down ingrained structural barriers and policies that impede health equity...
April 2017: Journal of the National Medical Association
https://www.readbyqxmd.com/read/28253876/inequality-in-the-distribution-of-health-resources-and-health-services-in-china-hospitals-versus-primary-care-institutions
#17
Tao Zhang, Yongjian Xu, Jianping Ren, Liqi Sun, Chaojie Liu
BACKGROUND: Equity is one of the major goals of China's recent health system reform. This study aimed to evaluate the equality of the distribution of health resources and health services between hospitals and primary care institutions. METHODS: Data of this study were drawn from the China Health Statistical Year Books. We calculated Gini coefficients based on population size and geographic size, respectively, for the indicators: number of institutions, number of health workers and number of beds; and the concentration index (CI) for the indicators: per capita outpatient visits and annual hospitalization rates...
March 3, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28240728/%C3%AF-%C3%AF-occupational-medicine-in-italian-academy-what-future
#18
Pietro Apostoli
The entire Italian University system, including the whole field of medical teaching and research, is currently passing through a period of cumbersome changes due to the many difficulties encountered in its reform process. Academic occupational medicine is deeply involved in this process that resembles a real crisis. Given this background, this contribution - written as President of the Italian College of Occupational Medicine Full Professors - has the main objective to open a debate about the current generalized crisis of our Academic Discipline and about its possible future developments...
February 15, 2017: La Medicina del Lavoro
https://www.readbyqxmd.com/read/28237353/-evolution-of-reimbursement-of-high-cost-anticancer-drugs-financial-impact-within-a-university-hospital
#19
Amandine Baudouin, Emilie Fargier, Ariane Cerruti, Amélie Dubromel, Nicolas Vantard, Florence Ranchon, Vérane Schwiertz, Gilles Salles, Pierre-Jean Souquet, Luc Thomas, Frédéric Bérard, Stéphane Nancey, Gilles Freyer, Véronique Trillet-Lenoir, Catherine Rioufol
INTRODUCTION: In the context of health expenses control, reimbursement of high-cost medicines with a 'minor' or 'nonexistent' improvement in actual health benefit evaluated by the Haute Autorité de santé is revised by the decree of March 24, 2016 related to the procedure and terms of registration of high-cost pharmaceutical drugs. This study aims to set up the economic impact of this measure. METHOD: A six months retrospective study was conducted within a French university hospital from July 1, 2015 to December 31, 2015...
February 22, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28222904/the-2016-proposal-for-the-reorganisation-of-urgent-care-provision-in-belgium-a-political-struggle-to-co-locate-primary-care-providers-and-emergency-departments
#20
Koen Van den Heede, Wilm Quentin, Cécile Dubois, Stephan Devriese, Carine Van de Voorde
Internationally the number of emergency department (ED) visits is on the rise while evidence suggests that a substantial proportion of these patients do not require emergency care but primary care. This paper presents the Belgian 2016 proposal for the reorganisation of urgent care provision and places it into its political context. The proposal focused on re-designing patient flow aiming to reduce inappropriate ED visits by improving guidance of patients through the system. Initially policymakers envisaged, as cornerstone of the reform, to roll-out as standard model the co-location of primary care centres and EDs...
February 17, 2017: Health Policy
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