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https://www.readbyqxmd.com/read/28535101/design-challenges-of-an-episode-based-payment-model-in-oncology-the-centers-for-medicare-medicaid-services-oncology-care-model
#1
Ronald M Kline, L Daniel Muldoon, Heidi K Schumacher, Larisa M Strawbridge, Andrew W York, Laura K Mortimer, Alison F Falb, Katherine J Cox, Carol Bazell, Ellen W Lukens, Mary C Kapp, Rahul Rajkumar, Amy Bassano, Patrick H Conway
The Centers for Medicare & Medicaid Services developed the Oncology Care Model as an episode-based payment model to encourage participating practitioners to provide higher-quality, better-coordinated care at a lower cost to the nearly three-quarter million fee-for-service Medicare beneficiaries with cancer who receive chemotherapy each year. Episode payment models can be complex. They combine into a single benchmark price all payments for services during an episode of illness, many of which may be delivered at different times by different providers in different locations...
May 23, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28485359/spectrum-of-bacteremia-in-posthematopoietic-stem-cell-transplant-patients-from-an-indian-center
#2
A Ghafur, V Devarajan, R Raj, J Easow, T Raja
BACKGROUND: Despite the relatively low prevalence of Gram-positive bacteremic infections in Indian oncology patients, glycopeptides are extensively used for empirical management of febrile neutropenia. Our aim was to analyze the spectrum of bacteremia in posthematopoietic stem cell transplant (HSCT) recipients in our center and make a recommendation on glycopeptide use in this patient population. MATERIALS AND METHODS: Retrospective analysis of bacteremic data from HSCT recipients in a tertiary care oncology and transplant center from South India, between 2011 and 2013...
October 2016: Indian Journal of Cancer
https://www.readbyqxmd.com/read/28401138/prevalence-of-symptoms-at-the-end-of-life-in-an-acute-care-hospital-a-retrospective-cohort-study
#3
Daniel Kobewka, Paul Ronksley, Dan McIsaac, Sunita Mulpuru, Alan Forster
BACKGROUND: There is currently debate over the benefits and harms of physician-assisted death. One of the factors influencing this debate is concern about symptoms in the days before death. The objective of this study was to describe the frequency of symptoms before death and determine patient characteristics associated with these symptoms. METHODS: We reviewed the medical record of every patient who died at a multisite academic teaching hospital over a 3-month period...
January 2017: CMAJ Open
https://www.readbyqxmd.com/read/28318493/-bipolar-disorders-in-oncology-characteristics-and-management
#4
Michel Reich, Nuria Kotecki
Bipolar disorders belong to the spectrum of mood disorders and represent a serious psychiatric comorbidity. Behaviors adopted by bipolar patients can foster cancer occurrence but also impact its management, especially during acute depressive or manic episode. Oncologists must adapt their protocols in order to obtain the best compliance for treatment and avoid any possible mood destabilization, with the inherent risk of suicidal attempt. Potential interactions between mood-stabilizing agents (lithium, divalproate, atypical antipsychotics, and anticonvulsivants) and oncologic treatment (chemotherapy, targeted therapy, immunotherapy, corticotherapy) will be particularly watched...
March 15, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28291598/identifying-radiology-s-place-in-the-expanding-landscape-of-episode-payment%C3%A2-models
#5
Andrew B Rosenkrantz, Joshua A Hirsch, Bibb Allen, H Benjamin Harvey, Gregory N Nicola
The current fee-for-service system for health care reimbursement in the United Stated is argued to encourage fragmented care delivery and a lack of accountability that predisposes to insufficient focus on quality as well as unnecessary or duplicative resource utilization. Episode payment models (EPMs) seek to improve coordination by linking payments for all services related to a patient's condition or procedure, thereby improving quality and efficiency of care. The CMS Innovation Center has implemented a broadening array of EPMs...
March 10, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28242237/transarterial-embolization-in-maxillofacial-intractable-potentially-life-threatening-hemorrhage
#6
Dani Noy, Adi Rachmiel, Omri Emodi, Yaakov Amsalem, Yair Israel, Rafael M Nagler
PURPOSE: Although transarterial embolization (TAE) of vascular lesions with embolizing agents through angiographic catheters has been used for more than 45 years, reports of life-threatening maxillofacial bleeding are relatively rare and have not been updated. The authors review treatment modalities, present their experience of the past 21 years, and suggest a comprehensive algorithm and guidelines for the use of TAE in the treatment of intractable life-threatening maxillofacial hemorrhage...
June 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28152838/a-schematic-case-episode-format-to-aid-in-choosing-wisely
#7
B Brooke Mann, Jad Hayes, Lalan S Wilfong, Marcus A Neubauer
181 Background: The recommendations of the Choosing Wisely campaign are evidence -based strategies to reduce cost without sacrificing outcomes. Yet tying the recommendations to indicators of use at the physician and case level has been challenging. As practices become responsible for total cost of care, an easy to use analytic method to determine appropriate use will be critical. We here describe a tool for rapid assessment of individual cases to achieve that objective. METHODS: The population was a payer defined cohort of lung cancer patients treated at Texas Oncology (TxO)...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152738/designing-and-implementing-a-payment-system-to-support-cancer-care-coordination-a-literature-review
#8
Chloe Gerves-Pinquie, Etienne Minvielle
40 Background: Demands for new payment systems to better coordinate services along the care continuum are emerging in oncology. Among them, bundling payments for defined episodes of care are considered as a promising payment option. The study objective was to understand how to develop an optimal payment system in order to foster coordination between hospitals and post-acute providers, and to identify potential pitfalls associated with its implementation. METHODS: We conducted a literature review, exploring articles published between 2010 and 2015 in Medline...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152727/a-prospective-study-of-an-inpatient-febrile-neutropenia-clinical-practice-guideline-in-oncology-patients
#9
Tanya Thomas, Joshua Reuss, Gina Degennaro, Elizabeth Daniels, Jin Li, Mark Smolkin, Michael Kenneth Keng
114 Background: Febrile neutropenia (FN) is a common complication in oncology patients and is associated with significant morbidity and mortality if untreated. Because of this, it is regarded as a medical emergency. FN treatment guidelines universally recommend the prompt initiation ( < 60 minutes) of intravenous antibiotic therapy. We hypothesized that a quality initiative project creating a new FN clinical practice guideline (CPG) would reduce the time to antibiotic administration (TTA) for inpatient oncology patients with FN...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28095701/malignant-bowel-obstruction-in-advanced-ovarian-cancer
#10
Emma Dean, Leila Khoja, Andrew Clamp, Gordon C Jayson, Dilly Goonetilleke, Alicia M Conway, Jurjees Hasan
AIM: Malignant bowel obstruction (MBO) in ovarian cancer is poorly understood. METHODS: This retrospective cohort study analyzed 129 patients with ovarian cancer and MBO. RESULTS: At presentation, 69 (53%) had platinum-resistant, 37 (29%) platinum-sensitive and 23 (18%) chemotherapy-naive disease. In patients receiving chemotherapy following the MBO episode, median overall survival (OS) was 107 days for chemotherapy-naive patients compared with 83 and 86 for platinum-sensitive or platinum-resistant patients (p = 0...
March 2017: Future Oncology
https://www.readbyqxmd.com/read/28089143/long-term-mortality-following-pseudomonas-aeruginosa-bloodstream-infection
#11
K L McCarthy, D L Paterson
BACKGROUND: Pseudomonas aeruginosa bloodstream infections (BSI) are associated with substantial short-term mortality. There is little data on long-term mortality associated with this BSI. AIM: To describe mortality rates up to one year post infection and the significant factors associated with death. METHODS: Positive blood cultures for P. aeruginosa were identified retrospectively from January 2008 to January 2011 at seven tertiary care hospitals...
March 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/27889413/molecular-diagnosis-of-bloodstream-infections-in-onco-haematology-patients-with-pcr-esi-ms-technology
#12
Elena Jordana-Lluch, Belén Rivaya, Clara Marcó, Montserrat Giménez, Mª Dolores Quesada, Agustín Escobedo, Montserrat Batlle, Elisa Martró, Vicente Ausina
OBJECTIVES: Onco-haematological patients are prone to develop infections, and antibiotic prophylaxis may lead to negative blood cultures. Thus, the microbiological diagnosis and subsequent administration of a targeted antimicrobial therapy is often difficult. The goal of this study was to evaluate the usefulness of IRIDICA (PCR/ESI-MS technology) for the molecular diagnosis of bloodstream infections in this patient group. METHODS: A total of 463 whole blood specimens from different sepsis episodes in 429 patients were analysed using the PCR/ESI-MS platform, comparing the results with those of blood culture and other clinically relevant information...
November 23, 2016: Journal of Infection
https://www.readbyqxmd.com/read/27862499/pain-assessment-and-management-in-paediatric-oncology-a-cross-sectional-audit
#13
Karin Plummer, Maria McCarthy, Ian McKenzie, Fiona Newall, Elizabeth Manias
AIMS AND OBJECTIVES: To describe the pain assessment and management practices documented by health professionals within a tertiary-level Children's Cancer Centre and to evaluate how these practices were compared with international recommendations. BACKGROUND: Children with cancer are vulnerable to pain due to the intensity of antineoplastic therapy. Therefore, it is imperative to ensure that current pain management practices provided to paediatric oncology inpatients are of a high quality...
November 10, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27854183/prognostic-factors-in-the-survival-of-patients-with-blood-disorders-recovering-from-septic-shock
#14
Anna Waszczuk-Gajda, Wieslaw Wiktor Jedrzejczak
BACKGROUND: Septic shock is one of the major direct causes of death in patients in hematology departments. OBJECTIVES: The knowledge about clinical outcomes and factors associated with negative outcome in these patients can be important and useful for physicians to identify the patients who are most likely to benefit from ICU therapy. METHODS: We retrospectively analyzed records of 214 episodes of septic shock in patients with different blood diseases hospitalized between 1998 and 2011 in the Department of Hematology, Oncology and Internal Medicine, the Medical University of Warsaw, Poland...
June 2017: Hematology (Amsterdam, Netherlands)
https://www.readbyqxmd.com/read/27814324/outcome-of-pediatric-gastroenterology-outpatients-with-fever-and-central-line
#15
Thomas Alexander, Julie Blatt, Asheley Cockrell Skinner, Ravi Jhaveri, Meghan Jobson, Katherine Freeman
OBJECTIVE: Although management algorithms for fever and central venous catheters (CVCs) have been implemented for pediatric oncology (PO) patients, management of pediatric outpatients with noncancer diagnoses and CVCs lacks clear protocols. The aim of the study was to assess outcomes for pediatric outpatients with gastrointestinal disorders presenting with fever and CVC. METHODS: Using a microbiology database and emergency department records, we created a database of pediatric gastroenterology (PGI) and PO outpatients with fever and a CVC who presented to our emergency department or clinics from January 2010 through December 2012...
November 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27804875/clostridium-difficile-infection-associations-with-chemotherapy-radiation-therapy-and-targeting-therapy-treatments
#16
REVIEW
Avi Peretz, Izhar Ben Shlomo, Orna Nitzan, Luigi Bonavina, Pmela M Schaffer, Moshe Schaffer
BACKGROUND: Although mucositis, diarrhea, and constipation as well as immunosuppression are well recognized side-effects of cancer treatment, the underlying mechanisms including changes in the composition of gut microbiota and Clostridium difficile infection have not yet been thoroughly reviewed. OBJECTIVE: We herein set out to review the literature regarding the relations between cancer chemotherapy, radiation treatment, and Clostridium difficile-associated colitis...
2016: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/27698881/impact-of-intense-systemic-therapy-and-improved-survival-on-the-use-of-palliative-radiotherapy-in-patients-with-bone-metastases-from-prostate-cancer
#17
Carsten Nieder, Ellinor Haukland, Bård Mannsåker, Jan Norum
More effective drugs may reduce the requirement for palliative external beam radiotherapy for bony target volumes; however, living with metastases for prolonged periods of time may result in more frequent episodes of bone pain or serious skeletal-related events. The purpose of the present study was to evaluate how recent advances in systemic therapy impact radiotherapy utilization. A retrospective analysis of a comprehensive regional database was performed. All oncology care in this region was provided by only one center, assuring complete data...
October 2016: Oncology Letters
https://www.readbyqxmd.com/read/27688611/bloodstream-infections-in-febrile-neutropenic-patients-at-a-tertiary-cancer-institute-in-south-india-a-timeline-of-clinical-and-microbial-trends-through-the-years
#18
K Govind Babu, D Lokanatha, K C Lakshmaiah, M C Suresh Babu, Linu A Jacob, Gita R Bhat, Harsha Vardhana, Mahua Sinha, B R Vijaykumar, B G Sumati, R S Jayshree
INTRODUCTION: Febrile neutropenia (FN) is an oncological emergency. The choice of empiric therapy depends on the locally prevalent pathogens and their sensitivities, the sites of infection, and cost. The Infectious Diseases Society of America guidelines are being followed for the management of FN in India. METHODS: This is a prospective observational study conducted at a tertiary care cancer centre from September 2012 to September 2014. OBJECTIVES: The objectives of this study were as follows: (1) To review the pattern of microbial flora, susceptibility pattern, and important clinical variables among bloodstream infections in febrile neutropenic patients with solid tumors and hematological malignancies...
July 2016: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/27637823/value-based-care-and-bundled-payments-anesthesia-care-costs-for-outpatient-oncology-surgery-using-time-driven-activity-based-costing
#19
Katy E French, Alexis B Guzman, Augustin C Rubio, John C Frenzel, Thomas W Feeley
BACKGROUND: With the movement towards bundled payments, stakeholders should know the true cost of the care they deliver. Time-driven activity-based costing (TDABC) can be used to estimate costs for each episode of care. In this analysis, TDABC is used to both estimate the costs of anesthesia care and identify the primary drivers of those costs of 11 common oncologic outpatient surgical procedures. METHODS: Personnel cost were calculated by determining the hourly cost of each provider and the associated process time of the 11 surgical procedures...
September 2016: Healthcare
https://www.readbyqxmd.com/read/27602414/use-of-procalcitonin-in-clinical-oncology-a-literature-review
#20
Andrea Sbrana, Martina Torchio, Giuditta Comolli, Andrea Antonuzzo, Marco Danova
The use of procalcitonin (PCT) as an early marker of infectious episodes in cancer patients is still controversial. We performed a MEDLINE search of peer-reviewed articles published between January 1990 and December 2015, and finally we analysed 15 articles. PCT seems to have a good diagnostic value of infectious episodes in cancer patients and its accuracy seems greater if we consider major events, such as bloodstream infections and sepsis. Serial evaluations of this protein seem to be more accurate in the diagnostic phase and useful to predict outcome and response to antibacterial treatment...
September 2016: New Microbiologica
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