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Transition, quality, outcomes

Zhijun Tan, Fuyan Shi, Haiyue Zhang, Ning Li, Yongyong Xu, Ying Liang
BACKGROUND: In advanced economies, economic factors have been found to be associated with many health outcomes, including health-related quality of life (HRQL), and people's health is affected more by income inequality than by absolute income. However, few studies have examined the association of income inequality and absolute income with HRQL in transitional economies using individual data. This paper focuses on the effects of county or district income inequality and absolute income on the HRQL measured by EQ-5D and the differences between rural and urban regions in Shaanxi province, China...
March 14, 2018: International Journal for Equity in Health
Marion Waite, Clare Martin, Rachel Franklin, David Duce, Rachel Harrison
BACKGROUND: People with type 1 diabetes (T1D) undertake self-management to prevent short and long-term complications. Advanced technology potentially supports such activities but requires consideration of psychological and behavioral constructs and usability issues. Economic factors and health care provider capacity influence access and uptake of advanced technology. Previous reviews have focused upon clinical outcomes or were descriptive or have synthesized studies on adults with those on children and young people where human factors are different...
March 15, 2018: JMIR Human Factors
Marta Trapero-Bertran, Celia Muñoz, Kathryn Coyle, Doug Coyle, Adam Lester-George, Reiner Leidl, Bertalan Németh, Kei-Long Cheung, Subhash Pokhrel, Ángel Lopez-Nicolás
AIMS: To assess the cost-effectiveness of alternative smoking cessation scenarios from the perspective of the Spanish National Health Service (NHS). DESIGN: We used the European study on Quantifying Utility of Investment in Protection from Tobacco model (EQUIPTMOD), a Markov-based state transition economic model, to estimate the return on investment (ROI) of: (a) the current provision of smoking cessation services (brief physician advice and printed self-helped material + smoking ban and tobacco duty at current levels); and (b) four alternative scenarios to complement the current provision: coverage of proactive telephone calls; nicotine replacement therapy (mono and combo) [prescription nicotine replacement therapy (Rx NRT)]; varenicline (standard duration); or bupropion...
March 13, 2018: Addiction
Tavis A Read, Aaron Smith, Janine Thomas, Michael David, Matthew Foote, Michael Wagels, Andrew Barbour, B Mark Smithers
BACKGROUND: Patients with in-transit melanoma metastases frequently experience high rates of recurrence, limited overall survival and reduced quality of life. After promising results within a Phase II, multi-center study, PV-10 treatment was continued at our institution for patients with in-transit disease. METHODOLOGY: An open-label, non-randomized, prospective study was performed at the Princess Alexandra Hospital, Queensland, Australia. Patients were treated with PV-10 in accordance with the treatment protocol established during a previous Phase II study...
March 12, 2018: Journal of Surgical Oncology
Timothy J H Lathlean, Paul B Gastin, Stuart Newstead, Caroline F Finch
Well-developed physical qualities such as high jumping ability, running endurance, acceleration and speed can help aspiring junior elite Australian football (AF) players transition to the Australian Football League competition. In order to do so, players need to experience sufficient load in order to enhance their physical resilience without increasing their risk of negative outcomes in terms of impaired wellness or injury. The aim of this study was to investigate the differences in load for different levels of competition and training modes across one competitive season...
March 6, 2018: Journal of Strength and Conditioning Research
Muhammad M Fareed, Rizwan Ishtiaq, Thomas J Galloway
Overall radiation treatment time has long been recognized as an important factor in head and neck tumor control. The concern of tumor growth in waiting time either before starting radiotherapy or during treatment is substantial given its negative impact on clinical outcome. There is an overwhelming evidence that increasing the time to initiate treatment increases the tumor burden and worsens the prognosis. This effect is more pronounced especially in patients with an early stage cancer disease. Delay in treatment initiation is contributed by both health care- and patient-related factors...
March 12, 2018: Current Treatment Options in Oncology
O Somasundaram, Ponnudurai Ratnaraj
Period of Custodial Care Only: The magnificent "Institute of Mental Health" has its history almost from 1795 when the East India company appointed Surgeon Valentine Conolly to be in charge of a "House for accommodating persons of unsound mind." After a few transitions, backed by a government order for the construction of a lunatic asylum in a 66 1/2 acre site, the asylum started functioning from 1871. The period of about six decades from its inception could be referred to as "the period of custodial care...
February 2018: Indian Journal of Psychiatry
Anne L Donovan, J Matthew Aldrich, A Kendall Gross, Denise M Barchas, Kevin C Thornton, Hildy M Schell-Chaple, Michael A Gropper, Angela K M Lipshutz
OBJECTIVES: We describe the importance of interprofessional care in modern critical care medicine. This review highlights the essential roles played by specific members of the interprofessional care team, including patients and family members, and discusses quality improvement initiatives that require interprofessional collaboration for success. DATA SOURCES: Studies were identified through MEDLINE search using a variety of search phrases related to interprofessional care, critical care provider types, and quality improvement initiatives...
March 7, 2018: Critical Care Medicine
Larry D Waldrop, Joseph J King, John Mayfield, Kevin W Farmer, Aimee M Struk, Thomas W Wright, Bradley S Schoch
BACKGROUND: Patient-reported outcomes (PROs) are becoming increasingly important to define successful outcomes. With the potential transition toward quality-based reimbursement, identifying risk factors for poor surgical outcomes becomes increasingly important. This study compared functional and PROs of primary shoulder arthroplasty in patients aged younger than 65 years with lower socioeconomic insurance compared with those with private insurance. METHODS: A retrospective review of all primary shoulder arthroplasties in patients aged younger than 65 was performed at a single institution...
March 6, 2018: Journal of Shoulder and Elbow Surgery
Jennifer O'Rourke, Joanna Abraham, Lee Ann Riesenberg, Jeff Matson, Karen Dunn Lopez
AIM: To identify the core components of nurse-nurse handoffs. BACKGROUND: Patient handoffs involve a process of passing information, responsibility and control from one caregiver to the next during care transitions. Around the globe, ineffective handoffs have serious consequences resulting in wrong treatments, delays in diagnosis, longer stays, medication errors, patient falls and patient deaths. To date, the core components of nurse-nurse handoff have not been identified...
March 8, 2018: Journal of Advanced Nursing
Lan Yang, Jing Wang, Juan Cheng, Yuan Wang, Wenli Lu
BACKGROUND: We aimed to clarify the feasibility of a community-based screening strategy for breast cancer in Tianjin, China; to identify the factors that most significantly influenced its feasibility; and to identify the reference range for quality control. METHODS: A state-transition Markov model simulated a hypothetical cohort of 100,000 healthy women, the start aged was set at 35 years and the time horizon was set to 50 years. The primary outcome for the model was the incremental cost-utility ratio (ICUR), defined as the program's cost per quality-adjusted life year (QALY) gained...
March 7, 2018: BMC Cancer
Jeanette R Little, Holly H Pavliscsak, Mabel R Cooper, Lois A Goldstein, Stephanie J Fonda
Introduction: Research has shown that mobile phones can help with management of numerous health problems. As an adjunct to care management provided to injured service members rehabilitating in their communities, particularly those with mild traumatic brain injury (mTBI), post-traumatic stress (PTS), and/or behavioral health problems, the Army developed a mobile phone application called "mCare." This study examined whether service members who received mCare had higher well-being, were more satisfied with their care, and viewed mCare as a valuable part of their care management as compared with their counterparts who received standard care management alone, and whether those with mTBI, PTS, and/or behavioral health problems benefited differently from mCare...
March 1, 2018: Military Medicine
Petra Rattay, Elena von der Lippe, Elvira Mauz, Felicitas Richter, Heike Hölling, Cornelia Lange, Thomas Lampert
OBJECTIVE: This study's aim was to investigate the association between family structure and different health-related outcomes in adolescence (self-rated health, emotional and behavioural problems, health-related quality of life, regular smoking, and heavy episodic drinking). Furthermore, we analysed the extent to which socio-economic status, family cohesion and the pre-transition health status explain family structure-related health disparities. METHODS: We used longitudinal data from the first two waves of the German KiGGS cohort study carried out by the Robert Koch Institute (baseline: 2003-2006, follow-up: 2009-2012)...
2018: PloS One
Brendan Bowman, Sijie Zheng, Alex Yang, Brigitte Schiller, José A Morfín, Melvin Seek, Robert S Lockridge
Dialysis care in the United States continues to move toward an emphasis on continuous quality improvement and performance benchmarking. Government- and industry-sponsored programs have evolved to assess and incentivize outcomes for many components of end-stage renal disease care. One aspect that remains largely unaddressed at a systemic level is the high-risk transition period from chronic kidney disease and acute kidney injury to permanent dialysis dependence. Incident dialysis patients experience disproportionately high mortality and hospitalization rates coupled with high costs...
March 3, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Matt Stevenson, Abdullah Pandor, Jean Hamilton, John Stevens, Clare Rowntree, Marrissa Martyn-St James, Andrew Rawdin, Ruth Wong
As part of its single technology appraisal (STA) process, the UK National Institute for Health and Care Excellence (NICE) invited the manufacturer (Incyte Corporation) of ponatinib (Inclusig® ) to submit evidence of its clinical and cost effectiveness for previously treated Philadelphia-chromosome-positive acute lymphoblastic leukaemia (Ph+ ALL) and chronic myeloid leukaemia. This paper focusses on Ph+ ALL. The School of Health and Related Research Technology Appraisal Group at the University of Sheffield was commissioned to act as the independent evidence review group (ERG)...
March 3, 2018: PharmacoEconomics
Jeanette Whitaker, John L Field, Carl J Bernacchi, Carlos E P Cerri, Reinhart Ceulemans, Christian A Davies, Evan H DeLucia, Iain S Donnison, Jon P McCalmont, Keith Paustian, Rebecca L Rowe, Pete Smith, Patricia Thornley, Niall P McNamara
Perennial bioenergy crops have significant potential to reduce greenhouse gas (GHG) emissions and contribute to climate change mitigation by substituting for fossil fuels; yet delivering significant GHG savings will require substantial land-use change, globally. Over the last decade, research has delivered improved understanding of the environmental benefits and risks of this transition to perennial bioenergy crops, addressing concerns that the impacts of land conversion to perennial bioenergy crops could result in increased rather than decreased GHG emissions...
March 2018: Global Change Biology. Bioenergy
Mike English, Paul Mwaniki, Thomas Julius, Mercy Chepkirui, David Gathara, Paul O Ouma, Peter Cherutich, Emelda A Okiro, Robert W Snow
BACKGROUND: There is increasing focus on the strength of primary health care systems in low and middle-income countries (LMIC). There are important roles for higher quality district hospital care within these systems. These hospitals are also sources of information of considerable importance to health systems, but this role, as with the wider roles of district hospitals, has been neglected. KEY MESSAGES: As we make efforts to develop higher quality health systems in LMIC we highlight the critical importance of district hospitals focusing here on how data on hospital mortality offers value: i) in understanding disease burden; ii) as part of surveillance and impact monitoring; iii) as an entry point to exploring system failures; and iv) as a lens to examine variability in health system performance and possibly as a measure of health system quality in its own right...
March 1, 2018: BMC Medicine
Nedra S Whitehead, Laurina Williams, Sreelatha Meleth, Sara Kennedy, Paul Epner, Hardeep Singh, Kathleene Wooldridge, Anuj K Dalal, Stacy E Walz, Tom Lorey, Mark L Graber
Failure to follow up test results pending at discharge (TPAD) from hospitals or emergency departments is a major patient safety concern. The purpose of this review is to systematically evaluate the effectiveness of interventions to improve follow-up of laboratory TPAD. We conducted literature searches in PubMed, CINAHL, Cochrane, and EMBASE using search terms for relevant health care settings, transition of patient care, laboratory tests, communication, and pending or missed tests. We solicited unpublished studies from the clinical laboratory community and excluded articles that did not address transitions between settings, did not include an intervention, or were not related to laboratory TPAD...
February 28, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Irma H J Everink, Jolanda C M van Haastregt, Silvia M A A Evers, Gertrudis I J M Kempen, Jos M G A Schols
BACKGROUND: Integrated care pathways which cover multiple care settings are increasingly used as a tool to structure care, enhance coordination and improve transitions between care settings. However, little is known about their economic impact. The objective of this study is to determine the cost-effectiveness and cost-utility of an integrated care pathway designed for patients with complex health problems transferring from the hospital, a geriatric rehabilitation facility and primary care...
2018: PloS One
Lixin Song, Kaitlyn L Dunlap, Xianming Tan, Ronald C Chen, Matthew E Nielsen, Rebecca L Rabenberg, Josephine K Asafu-Adjei, Bridget F Koontz, Sarah A Birken, Laurel L Northouse, Deborah K Mayer
BACKGROUND: This project explores a new model of care that enhances survivorship care planning and promotes health for men with localized prostate cancer transitioning to posttreatment self-management. Survivorship care planning is important for patients with prostate cancer because of its high incidence rate in the United States, the frequent occurrence of treatment-related side effects, and reduced quality of life (QOL) for both men and their partners. A key component of comprehensive survivorship care planning is survivorship care plans (SCPs), documents that summarize cancer diagnosis, treatment, and plans for follow-up care...
February 26, 2018: JMIR Research Protocols
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