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https://www.readbyqxmd.com/read/28655014/association-between-health-plan-exit-from-medicaid-managed-care-and-quality-of-care-2006-2014
#1
Chima D Ndumele, William L Schpero, Mark J Schlesinger, Amal N Trivedi
Importance: State Medicaid programs have increasingly contracted with insurers to provide medical care services for enrollees (Medicaid managed care plans). Insurers that provide these plans can exit Medicaid programs each year, with unclear effects on quality of care and health care experiences. Objective: To determine the frequency and interstate variation of health plan exit from Medicaid managed care and evaluate the relationship between health plan exit and market-level quality...
June 27, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28653549/sociodemographic-and-clinical-profiles-of-homeless-mentally-ill-admitted-in-mental-health-institute-of-south-india-know-the-unknown-project
#2
Guru S Gowda, G Gopika, Narayana Manjunatha, Channaveerachari Naveen Kumar, Ravi Yadav, Dwarakanath Srinivas, Bharath Rose Dawn, Suresh Bada Math
OBJECTIVES: A significant number of homeless mentally ill (HMI) patients without any personal, family or other identification details represent a unique problem in the psychiatric services of developing countries like India in the context of legal, humanitarian and treatment issues. These patients pose challenge to the mental health professional in diagnosis and management. AIMS: To study the sociodemographic and clinical profiles of HMI patients admitted under psychiatry...
June 1, 2017: International Journal of Social Psychiatry
https://www.readbyqxmd.com/read/28653544/operative-management-of-unstable-radial-head-fractures-in-a-young-active-population
#3
Nicholas Kusnezov, Emmanuel Eisenstein, John C Dunn, Austin Fares, Justin Mitchell, Kelly Kilcoyne, Brian R Waterman
BACKGROUND: Radial head and neck fractures are the most common elbow fracture in the general adult population; however, the optimal treatment for radial head fractures remains a topic of ongoing clinical controversy. The purpose of this study was to determine the rate of return to function, complications, and reoperation following operative management of unstable radial head fractures in a young, active patient population with intense upper extremity demands. METHODS: A military health care database was queried for all US military servicemembers undergoing open reduction with internal fixation (ORIF; Current Procedural Terminology [CPT] code: 24665) and radial head arthroplasty (RHA; CPT code: 24666) between 2010 and 2015...
June 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28653221/effect-of-an-obesity-best-practice-alert-on-physician-documentation-and-referral-practices
#4
Stephanie L Fitzpatrick, Kirsten Dickins, Elizabeth Avery, Jennifer Ventrelle, Aaron Shultz, Ekta Kishen, Steven Rothschild
The Centers for Medicare & Medicaid Services Electronic Health Record Meaningful Use Incentive Program requires physicians to document body mass index (BMI) and a follow-up treatment plan for adult patients with BMI ≥ 25. To examine the effect of a best practice alert on physician documentation of obesity-related care and referrals to weight management treatment, in a cluster-randomized design, 14 primary care clinics at an academic medical center were randomized to best practice alert intervention (n = 7) or comparator (n = 7)...
June 26, 2017: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/28652760/worksite-based-cardiovascular-risk-screening-and-management-a-feasibility-study
#5
Raj Padwal, Mohammad Rashead, Jonathan Snider, Louise Morrin, Agnes Lehman, Norm Rc Campbell
BACKGROUND: Established cardiovascular risk factors are highly prevalent and contribute substantially to cardiovascular morbidity and mortality because they remain uncontrolled in many Canadians. Worksite-based cardiovascular risk factor screening and management represent a largely untapped strategy for optimizing risk factor control. METHODS: In a 2-phase collaborative demonstration project between Alberta Health Services (AHS) and the Alberta Newsprint Company (ANC), ANC employees were offered cardiovascular risk factor screening and management...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28652720/development-of-a-training-program-to-support-health-care-professionals-to-deliver-the-space-for-copd-self-management-program
#6
Claire Blackmore, Vicki L Johnson-Warrington, Johanna Ea Williams, Lindsay D Apps, Hannah Ml Young, Claire LA Bourne, Sally J Singh
BACKGROUND: With the growing burden of COPD and associated morbidity and mortality, a need for self-management has been identified. The Self-management Programme of Activity, Coping and Education for Chronic Obstructive Pulmonary Disease (SPACE for COPD) manual was developed to support self-management in COPD patients. Currently, there is no literature available regarding health care professionals' training needs when supporting patients with COPD on self-management. AIM: This study sought to identify these needs to inform, design and develop a training program for health care professionals being trained to deliver a self-management program in COPD...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28652717/elder-self-neglect-research-and-practice
#7
REVIEW
XinQi Dong
Elder self-neglect is a global public health and human rights issue that threatens older people's health and safety. It commonly refers to refusal or failure to provide oneself with care and protection in areas of food, water, clothing, hygiene, medication, living environments, and safety precautions. While prevalent, the status of self-neglecting individuals remains largely unclear, in particular within community-dwelling populations. By reviewing the epidemiology of elder self-neglect (definition, prevalence, risk factors, and consequences) to date, the present paper identifies key research gaps such as methodological inconsistency in case identification and measurement, and study designs that are inadequate to determine risk factors of self-neglect...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28652227/reducing-parental-uncertainty-around-childhood-cancer-implementation-decisions-and-design-trade-offs-in-developing-an-electronic-health-record-linked-mobile-app
#8
Keith Marsolo, William Shuman, Jeremy Nix, Caroline F Morrison, Larry L Mullins, Ahna Lh Pai
BACKGROUND: Parents of children newly diagnosed with cancer are confronted with multiple stressors that place them at risk for significant psychological distress. One strategy that has been shown to help reduce uncertainty is the provision of basic information; however, families of newly diagnosed cancer patients are often bombarded with educational material. Technology has the potential to help families manage their informational needs and move towards normalization. OBJECTIVE: The aim of this study was to create a mobile app that pulls together data from both the electronic health record (EHR) and vetted external information resources to provide tailored information to parents of newly diagnosed children as one method to reduce the uncertainty around their child's illness...
June 26, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28652226/a-hybrid-web-based-and-in-person-self-management-intervention-to-prevent-acute-to-chronic-pain-transition-after-major-lower-extremity-trauma-ipact-e-trauma-protocol-for-a-pilot-single-blind-randomized-controlled-trial
#9
Mélanie Bérubé, Céline Gélinas, Géraldine Martorella, José Côté, Nancy Feeley, George-Yves Laflamme, Dominique Rouleau, Manon Choinière
BACKGROUND: Acute pain frequently transitions to chronic pain after major lower extremity trauma (ET). Several modifiable psychological risk and protective factors have been found to contribute to, or prevent, chronic pain development. Some empirical evidence has shown that interventions, including cognitive and behavioral strategies that promote pain self-management, could prevent chronic pain. However, the efficacy of such interventions has never been demonstrated in ET patients. We have designed a self-management intervention to prevent acute to chronic pain transition after major lower extremity trauma (iPACT-E-Trauma)...
June 26, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28651935/derivation-and-validation-of-a-novel-risk-score-for-safe-discharge-after-acute-lower-gastrointestinal-bleeding-a-modelling-study
#10
Kathryn Oakland, Vipul Jairath, Raman Uberoi, Richard Guy, Lakshmana Ayaru, Neil Mortensen, Mike F Murphy, Gary S Collins
BACKGROUND: Acute lower gastrointestinal bleeding is a common reason for emergency hospital admission, and identification of patients at low risk of harm, who are therefore suitable for outpatient investigation, is a clinical and research priority. We aimed to develop and externally validate a simple risk score to identify patients with lower gastrointestinal bleeding who could safely avoid hospital admission. METHODS: We undertook model development with data from the National Comparative Audit of Lower Gastrointestinal Bleeding from 143 hospitals in the UK in 2015...
June 23, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28651618/relationships-between-received-and-perceived-social-support-and-health-related-quality-of-life-among-patients-receiving-methadone-maintenance-treatment-in-mainland-china
#11
Kaina Zhou, Hengxin Li, Xiaoli Wei, Juan Yin, Peifeng Liang, Hongmei Zhang, Lingling Kou, Mengmeng Hao, Lijuan You, Xiaomei Li, Guihua Zhuang
BACKGROUND: Social support has been considered one of the most important factors of health-related quality of life (HRQoL) evaluations among different populations; however, few studies have explored the relationships of both received and perceived social support to HRQoL among patients undergoing methadone maintenance treatment (MMT). Thus, the purpose of this cross-sectional study was to clarify these relationships. METHODS: Participants were patients admitted at the two largest privately and publicly funded MMT clinics in Xi'an...
June 26, 2017: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/28651588/perceptions-on-use-of-home-telemonitoring-in-patients-with-long-term-conditions-concordance-with-the-health-information-technology-acceptance-model-a-qualitative-collective-case-study
#12
Jo B Middlemass, Jolien Vos, A Niroshan Siriwardena
BACKGROUND: Health information technology (HIT) may be used to improve care for increasing numbers of older people with long term conditions (LTCs) who make high demands on health and social care services. Despite its potential benefits for reducing disease exacerbations and hospitalisations, HIT home monitoring is not always accepted by patients. Using the Health Information Technology Acceptance Model (HITAM) this qualitative study examined the usefulness of the model for understanding acceptance of HIT in older people (≥60 years) participating in a RCT for older people with Chronic Obstructive Pulmonary Disease (COPD) and associated heart diseases (CHROMED)...
June 26, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28651583/challenges-and-potential-improvements-in-the-admission-process-of-patients-with-spinal-cord-injury-in-a-specialized-rehabilitation-clinic-an-interview-based-qualitative-study-of-an-interdisciplinary-team
#13
Fabian Röthlisberger, Stefan Boes, Sara Rubinelli, Klaus Schmitt, Anke Scheel-Sailer
BACKGROUND: The admission process of patients to a hospital is the starting point for inpatient services. In order to optimize the quality of the health services provision, one needs a good understanding of the patient admission workflow in a clinic. The aim of this study was to identify challenges and potential improvements in the admission process of spinal cord injury patients at a specialized rehabilitation clinic from the perspective of an interdisciplinary team of health professionals...
June 26, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28651296/early-discharge-hospital-at-home
#14
REVIEW
Daniela C Gonçalves-Bradley, Steve Iliffe, Helen A Doll, Joanna Broad, John Gladman, Peter Langhorne, Suzanne H Richards, Sasha Shepperd
BACKGROUND: Early discharge hospital at home is a service that provides active treatment by healthcare professionals in the patient's home for a condition that otherwise would require acute hospital inpatient care. This is an update of a Cochrane review. OBJECTIVES: To determine the effectiveness and cost of managing patients with early discharge hospital at home compared with inpatient hospital care. SEARCH METHODS: We searched the following databases to 9 January 2017: the Cochrane Effective Practice and Organisation of Care Group (EPOC) register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and EconLit...
June 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28650884/can-surgeon-demographic-factors-predict-postoperative-complication-rates-after-elective-spinal-fusion
#15
Danielle S Chun, Ralph W Cook, Joseph A Weiner, Michael S Schallmo, Kathryn A Barth, Sameer K Singh, Ryan D Freshman, Alpesh A Patel, Wellington K Hsu
STUDY DESIGN: Retrospective cohort. OBJECTIVE: Determine whether surgeon demographic factors influence postoperative complication rates after elective spine fusion procedures. BACKGROUND: Surgeon demographic factors have been shown to impact decision making in the management of degenerative disease of the lumbar spine. Complication rates are frequently reported outcome measurements used to evaluate surgical treatments, quality-of-care, and determine health care reimbursements...
June 23, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28650347/electronic-health-telemedicine-and-new-paradigms-for-training-and-care
#16
Catherine S Todd, Stephen J Mills, Anh L Innes
PURPOSE OF REVIEW: HIV prevention and care is changing rapidly; guideline revisions and programmatic scale-up require innovative approaches to in-service training and care extension to improve provider practice and care access. We assessed recent (≤12 months) peer-reviewed publications on electronic health (eHealth), telemedicine, and other innovative provider-targeted interventions for HIV-related care. RECENT FINDINGS: Key developments included systems merging electronic medical records (EMR) with provider clinical decision aids to prompt action, demonstration eHealth, and telemedicine projects, reviews or descriptions of technology to improve connectivity in lower resource settings, and a few trials on provider-centered interventions...
June 23, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28649928/beyond-the-medical-model
#17
Scott J Fitzpatrick, Jo River
The medical model continues to dominate research and shape policy and service responses to suicide. In this work we challenge the assumption that the medical model always provides the most effective and appropriate care for persons who are suicidal. In particular, we point to service user perspectives of health services which show that interventions are often experienced as discriminatory, culturally inappropriate, and incongruent with the needs and values of persons who are suicidal. We then examine "humanistic" approaches to care that have been proposed as a corrective to an overly medical model...
January 1, 2017: International Journal of Health Services: Planning, Administration, Evaluation
https://www.readbyqxmd.com/read/28649884/the-long-term-occupational-fitness-of-uk-military-personnel-following-community-mental-health-care
#18
Norman Jones, Nicola T Fear, Simon Wessely, Gursimran Thandi, Neil Greenberg
BACKGROUND: Fitness to undertake operational deployment is a key requirement of military service. AIM: To assess individual deployment fitness at a single point from one month to eight years following discharge from mental healthcare. METHOD: Survival analyses assessed levels of deployability; the predictive effects of key covariates upon time to being classified as non-deployable were examined using univariate and multivariate Cox proportional hazards regression procedures...
June 24, 2017: Journal of Mental Health
https://www.readbyqxmd.com/read/28648090/effectiveness-of-a-10-week-group-program-based-on-dialectical-behaviour-therapy-skills-among-patients-with-personality-and-mood-disorders-findings-from-a-pilot-study
#19
Agatha M Conrad, Anoop Sankaranarayanan, Terry J Lewin, Anna Dunbar
OBJECTIVES: Community mental health services are often required to manage people experiencing repeated crises. Personality disorders are not uncommon, accounting for up to one-third of such presentations. These patients are often difficult to treat, leading to a revolving-door phenomenon. This study evaluated the effectiveness of a pilot intervention in reducing psychological symptoms and distress, and examined the impact of the intervention on mental health service utilization. METHODS: A pre- versus post-treatment evaluation was conducted of the effectiveness of a 10-week group psychological intervention based on Dialectical Behaviour Therapy skills, conducted in a regional Australian community mental health service with patients diagnosed with either Cluster B personality disorder or a mood disorder...
June 1, 2017: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/28647951/complexities-of-care-in-klinefelter-syndrome-an-aprn-perspective
#20
Sharron Close, Amy Talboy, Ilene Fennoy
47,XXY (Klinefelter Syndrome) is associated with a spectrum of complex clinical needs that are associated with variable physical, neurocognitive and psychosocial aspects. For patients and families affected by this sex chromosome trisomy, navigation of health care services is difficult due to lack of 47,XXY awareness among many health care providers and little evidence to support endocrine and additional treatment plans. While endocrine management of androgen deficiency has been the mainstay of treatment for patients from puberty through adulthood, testosterone replacement, alone, fails to mitigate many symptoms and issues...
June 2017: Pediatric Endocrinology Reviews: PER
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