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https://www.readbyqxmd.com/read/29137878/integration-of-medicare-and-medicaid-for-dually-eligible-beneficiaries-a-focus-group-study-examining-beneficiaries-early-experiences-in-california-s-dual-financial-alignment-demonstration
#1
Carrie L Graham, Holly C Stewart, Elaine Kurtovich, Pi-Ju Liu
BACKGROUND: In 2014 California implemented a federal dual alignment demonstration that used a capitated managed care health plans called Cal MediConnect (CMC) to integrate medical care and long term services and supports (LTSS) for beneficiaries with both Medicare and Medicaid. These beneficiaries often have complex care needs, including multiple chronic conditions and disabilities. By 2016, 120,000 eligible beneficiaries were enrolled in the program. OBJECTIVES: Focus groups with enrolled beneficiaries were conducted to gather rich data about their early experiences with quality of care, access to care, and coordination of care in CMC plans and to identify recommendations for program improvement...
July 21, 2017: Disability and Health Journal
https://www.readbyqxmd.com/read/29037222/the-efficacy-and-stability-of-an-information-and-communication-technology-based-centralized-monitoring-system-of-adherence-to-immunosuppressive-medication-in-kidney-transplant-recipients-study-protocol-for-a-randomized-controlled-trial
#2
Hee-Yeon Jung, Sook Jin Seong, Ji-Young Choi, Jang-Hee Cho, Sun-Hee Park, Chan-Duck Kim, Young-Ran Yoon, Hyung-Kee Kim, Seung Huh, Se-Hee Yoon, Jong Soo Lee, Yong-Lim Kim
BACKGROUND: Immunosuppression non-adherence in kidney transplant recipients (KTRs) not only increases the risk of medical intervention due to acute rejection and graft loss but burdens the socioeconomic system in the form of increased healthcare costs. An aggressive preemptive effort by healthcare professionals, geared to ensure adherence to immunosuppressants in KTRs, is significant and imperative. METHODS/DESIGN: This study was designed as a prospective, open-label, multicenter, randomized controlled study aimed at evaluating the efficacy and stability of an information and communication technology (ICT)-based centralized monitoring system in boosting medication adherence in KTRs...
October 16, 2017: Trials
https://www.readbyqxmd.com/read/29024613/remote-monitoring-of-automated-peritoneal-dialysis-patients-assessing-clinical-and-economic-value
#3
Dilip Makhija, Mark Dominik Alscher, Stefan Becker, Silvia D'Alonzo, Raj Mehrotra, Leslie Wong, Kim McLeod, Judy Danek, Mary Gellens, Todd Kudelka, James A Sloand, Suzanne Laplante
BACKGROUND: For chronic kidney disease patients who progress to end-stage renal disease, survival is dependent on renal replacement therapy in the form of kidney transplantation or chronic dialysis. Peritoneal dialysis (PD), which can be performed at home, is both more convenient and less costly than hemodialysis that requires three 4-h visits per week to the dialysis facility and complicated equipment. Remote therapy management (RTM), technologies that collect medical information and transmit it to healthcare providers for patient management, has the potential to improve the outcomes of patients receiving automated peritoneal dialysis (APD) at home...
October 12, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28992158/avoidable-emergency-department-visits-a-starting-point
#4
Renee Y Hsia, Matthew Niedzwiecki
Objective: To better characterize and understand the nature of a very conservative definition of 'avoidable' emergency department (ED) visits in the United States to provide policymakers insight into what interventions can target non-urgent ED visits. Design/setting: We performed a retrospective analysis of a very conservative definition of 'avoidable' ED visits using data from the National Hospital Ambulatory Medical Care Survey from 2005 to 2011. Participants: We examined a total of 115 081 records, representing 424 million ED visits made by patients aged 18-64 years who were seen in the ED and discharged home...
October 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28981766/overview-methods-and-results-of-multi-country-community-based-maternal-and-newborn-care-economic-analysis
#5
Emmanuelle Daviaud, Helen Owen, Catherine Pitt, Kate Kerber, Fiorella Bianchi Jassir, Diana Barger, Fatuma Manzi, Elizabeth Ekipara-Kiracho, Giulia Greco, Peter Waiswa, Joy E Lawn
Home visits for pregnancy and postnatal care were endorsed by the WHO and partners as a complementary strategy to facility-based care to reduce newborn and maternal mortality. This article aims to synthesise findings and implications from the economic analyses of community-based maternal and newborn care (CBMNC) evaluations in seven countries. The evaluations included five cluster randomized trials (Ethiopia, Ghana, South Africa, Tanzania, Uganda) and programmatic before/after assessments (Bolivia, Malawi)...
October 1, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28964193/design-implementation-and-application-of-150-degree-commutation-vsi-to-improve-speed-range-of-sensored-bldc-motor
#6
Mehmet Cihat Ozgenel
Permanent magnet brushless dc (BLDC) motors are very convenient for many applications such as industrial, medical, robotic, aerospace, small electric vehicles, and home applications because of their inherent satisfying dynamic characteristics. There are numerous studies about these motors and their control schemes such as sensorless control and different speed and torque control schemes. All electric motors need commutation in order to produce speed and torque. Commutation in brushed DC motors is performed by means of a brush and collector...
September 2017: Review of Scientific Instruments
https://www.readbyqxmd.com/read/28958032/fall-risk-supports-and-services-and-falls-following-a-nursing-home-discharge
#7
Marwa Noureldin, Zachary Hass, Kathleen Abrahamson, Greg Arling
Background and Objectives: Falls are a major source of morbidity and mortality among older adults; however, little is known regarding fall occurrence during a nursing home (NH) to community transition. This study sought to examine whether the presence of supports and services impacts the relationship between fall-related risk factors and fall occurrence post NH discharge. Research Design and Methods: Participants in the Minnesota Return to Community Initiative who were assisted in achieving a community discharge (N = 1459) comprised the study sample...
September 4, 2017: Gerontologist
https://www.readbyqxmd.com/read/28935129/environmental-design-for-end-of-life-care-an-integrative-review-on-improving-quality-of-life-and-managing-symptoms-for-patients-in-institutional-settings
#8
REVIEW
Rana Sagha Zadeh, Paul Eshelman, Judith Setla, Laura Kennedy, Emily Hon, Aleksa Basara
CONTEXT: The environment in which end-of-life care is delivered can support or detract from the physical, psychological, social, and spiritual needs of patients, their families, and their caretakers. OBJECTIVES: This review aims to organize and analyze the existing evidence related to environmental design factors that improve the quality of life and total well-being of people involved in end-of-life care and to clarify directions for future research. METHOD: This integrated literature review synthesized and summarized research evidence from the fields of medicine, environmental psychology, nursing, palliative care, architecture, interior design, and evidence-based design...
September 18, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28914227/a-system-analysis-of-delay-in-outpatient-respiratory-equipment-delivery
#9
Sheila Kun, Gregory Placencia, Sally Davidson Ward, Thomas Keens
OBJECTIVES: To systematically assess barriers delaying home respiratory equipment requisition and to evaluate for temporal correlation between delays and emergency room or hospitalization episodes. BACKGROUND: Initiation of home respiratory treatments is delayed because of delays in delivery of durable medical equipment (DME). This study assesses root causes of such delays from a system perspective. We also describe clinical consequences by measuring emergency room visits and hospitalization days for temporal correlations...
December 1, 2016: Care Management Journals: Journal of Case Management ; the Journal of Long Term Home Health Care
https://www.readbyqxmd.com/read/28751491/pediatric-chronic-critical-illness-reducing-excess-hospitalizations
#10
Renee D Boss, Erin P Williams, Carrie M Henderson, Rebecca R Seltzer, Miriam C Shapiro, Emily Hahn, Nancy Hutton
OBJECTIVES: The past 2 decades have seen an expanding pediatric population that is chronically critically ill: children with repeated and prolonged hospitalizations and ongoing dependence on technologies to sustain vital functions. Although illness complexity prompts many hospitalizations, our goal with this study was to explore modifiable patient, family, and health system contributions to excess hospital days for children with chronic critical illness (CCI). METHODS: Semistructured interviews were conducted with 51 stakeholders known for their CCI expertise...
July 27, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28698249/pd-vs-hd-in-post-economic-crisis-greece-differences-in-patient-characteristics-and-estimation-of-therapy-cost
#11
Marilena G Koukou, Vassilios E Smyrniotis, Nikolaos F Arkadopoulos, Eirini I Grapsa
OBJECTIVE: The aim of this study was to investigate patient characteristics and make an estimation of the cost of peritoneal dialysis (PD) and hemodialysis (HD) to Greek society during the economic crisis. METHODS: We recorded the characteristics and the total cost of dialysis treatment in 100 patients on PD and 100 on HD. Total costs included dialysis procedure, consumables, drugs, laboratory tests, food, and transportation fees (only HD), covered by patients' insurance...
September 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28648313/cost-of-osteoporotic-fractures-in-singapore
#12
Charmaine Shuyu Ng, Tang Ching Lau, Yu Ko
OBJECTIVES: To estimate the 3-month direct and indirect costs associated with osteoporotic fractures from both the hospital's and patient's perspectives in Singapore and to compare the cost between acute and prevalent osteoporotic fractures. METHODS: Resource use and expenditure data were collected using interviewer-administered questionnaires at baseline and at a 3-month follow-up between July 2013 and January 2014. Estimated osteoporotic fracture-related costs included hospitalizations, accident and emergency room visits, outpatient physician visits, laboratory tests, medications, transportation, health care and community services, special equipment and home/car modifications, and productivity loss...
May 2017: Value in Health Regional Issues
https://www.readbyqxmd.com/read/28562401/using-a-standardized-patient-to-improve-collaboration-and-problem-solving-skills-with-cpap-usage-in-the-home
#13
Margaret G Williams, Joan Ruhs
A review of literature revealed a lack of research pertaining to nurses' or student nurses' knowledge of continuous positive airway pressure (CPAP) and the ability to troubleshoot CPAP malfunction. This study sought to answer the following questions: What are associate degree nursing (ADN) students' knowledge, interdisciplinary communication, and problem-solving skills regarding patients' home use of CPAP? Is there a change after participation in a simulation with a patient on CPAP in home setting? Twenty-one ADN students enrolled in small Midwest college participated...
June 2017: Home Healthcare Now
https://www.readbyqxmd.com/read/28518009/aeromedical-evacuation-using-extra-corporeal-life-support-after-resuscitated-cardiac-arrest
#14
David Gerard, Hervé Raffin, Guillaume Lebreton
BACKGROUND: Extra corporeal life support (ECLS) is presently first line therapy for refractory cardiogenic shock. Mobile circulatory support teams implant ECLS or extra corporeal membrane oxygenation (ECMO) in patients in the hospital without circulatory support. These patients are then transported to specialized centers. Here we report a case of sending a mobile circulatory support team abroad, followed by air ambulance evacuation, which, to our knowledge, has never been used as part of medical assistance abroad...
April 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28508790/development-of-a-multidisciplinary-and-telemedicine-focused-system-database
#15
Richard Paštěka, Mathias Forjan, Stefan Sauermann
BACKGROUND: Tele-rehabilitation at home is one of the promising approaches in increasing rehabilitative success and simultaneously decreasing the financial burden on the healthcare system. OBJECTIVES: Novel and mostly mobile devices are already in use, but shall be used in the future to a higher extent for allowing at home rehabilitation processes at a high quality level. The combination of exercises, assessments and available equipment is the basic objective of the presented database...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28403367/discourses-of-healthcare-professionals-about-health-surveillance-actions-for-tuberculosis-control
#16
Fernando Mitano, Amélia Nunes Sicsú, Luciana de Oliveira Sousa, Laís Mara Caetano da Silva, Pedro Fredemir Palha
OBJECTIVE: To analyze the meanings produced in the Health Surveillance actions for tuberculosis control, carried out by healthcare professionals in Mozambique. METHOD: Qualitative study using the theoretical and methodological framework of the French Discourse Analysis. RESULTS: A total of 15 healthcare professionals with more than one year of experience in disease control actions participated in the study. Four discursive blocks have emerged from the analysis: tuberculosis diagnosis process; meeting, communication and discussion of treatment; local strategies for tuberculosis control; involvement of family and community leaders in the tuberculosis control...
April 6, 2017: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/28388324/ability-of-three-general-use-pesticides-to-suppress-nymphal-ixodes-scapularis-and-amblyomma-americanum-acari-ixodidae
#17
Robert A Jordan, Terry L Schulze, Lars Eisen, Marc C Dolan
We evaluated 3 over-the-counter pesticides for their ability to suppress host-seeking Ixodes scapularis and Amblyomma americanum nymphs. We applied liquid concentrate and granular formulations of Bayer Advanced Complete Insect Killer, Spectracide Triazicide Insect Killer, and Ortho Bug-B-Gon to forest plots using equipment available for purchase at retail home improvement outlets. All 3 liquid formulations provided rapid knockdown (≥98% control) of both species 1 day after application. Liquid Ortho Bug-B-Gone provided 100% suppression of I...
March 2017: Journal of the American Mosquito Control Association
https://www.readbyqxmd.com/read/28367749/improving-voluntary-medical-male-circumcision-standards-adherence-and-post-procedure-follow-up-in-uganda-a-mixed-methods-study
#18
Sarah Smith Lunsford, John Byabagambi, Zachariah Falconer-Stout, Esther Karamagi
Voluntary medical male circumcision (VMMC) has been demonstrated to reduce the transmission of HIV by 60%. Scaling up VMMC services requires that they be of high quality, socially accepted, and effective. We evaluated an intervention aimed at improving VMMC standards adherence and patient follow-up rates in nine facilities in Uganda. We also qualitatively explored why some men return for follow-up care and others do not. The completeness and quality of clinical documentation was poor at baseline, but significantly improved at endline...
March 2017: African Journal of AIDS Research: AJAR
https://www.readbyqxmd.com/read/28342694/nursing-led-home-visits-post-hospitalization-for-children-with-medical-complexity
#19
Sarah Wells, Margaret O'Neill, Jayne Rogers, Kevin Blaine, Amy Hoffman, Sarah McBride, Meghan M Tschudy, Igor Shumskiy, Sangeeta Mauskar, Jay G Berry
PURPOSE: Hospital discharge for children with medical complexity (CMC) can be challenging for families. Home visits could potentially benefit CMC and their families after leaving the hospital. We assessed the utility of post-discharge home visits to identify and address health problems for recently hospitalized CMC. DESIGN AND METHODS: A prospective study of 36 CMC admitted to a children's hospital from 4/15/2015 to 4/14/2016 identified with a possible high risk of hospital readmission and offered a post-discharge home visit within 72h of discharge...
March 23, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28252825/effective-pain-management-in-recently-discharged-adult-trauma-patients-identifying-patient-and-system-barriers-a-prospective-exploratory-study
#20
Helen Goldsmith, Kate Curtis, Andrea McCloughen
AIMS AND OBJECTIVES: To identify barriers to adherence with prescribed analgesic regimens in recently discharged trauma patients. BACKGROUND: Trauma pain severely interferes with the life of healthy and often working individuals with intense and enduring pain experienced at home following discharge. The reasons for this are unclear considering discharge information (including discharge referral letters and nursing discharge checklists) and analgesics (scripts and/or medication) are routinely provided to patients at hospital discharge...
March 2, 2017: Journal of Clinical Nursing
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