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https://www.readbyqxmd.com/read/27927193/demographic-profile-of-physician-participants-in-short-term-medical-missions
#1
Paul H Caldron, Ann Impens, Milena Pavlova, Wim Groot
BACKGROUND: The US is the leading sending country for short term medical missions (STMMs), an unregulated and unsanctioned, grass roots form of direct medical service aid from richer countries to low and middle income countries. The objective of this study is to profile US physicians who go on such missions by means of a survey sample of the US physician population. METHODS: An online survey solicited information on physician participation in STMMS as well as demographic and professional features...
December 7, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27926675/improvement-in-total-joint-replacement-quality-metrics-year-one-versus-year-three-of-the-bundled-payments-for-care-improvement-initiative
#2
John M Dundon, Joseph Bosco, James Slover, Stephen Yu, Yousuf Sayeed, Richard Iorio
BACKGROUND: In January 2013, a large, tertiary, urban academic medical center began participation in the Bundled Payments for Care Improvement (BPCI) initiative for total joint arthroplasty, a program implemented by the Centers for Medicare & Medicaid Services (CMS) in 2011. Medicare Severity-Diagnosis Related Groups (MS-DRGs) 469 and 470 were included. We participated in BPCI Model 2, by which an episode of care includes the inpatient and all post-acute care costs through 90 days following discharge...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27920510/the-clock-in-the-box-a-brief-cognitive-screen-is-associated-with-failure-to-return-home-in-an-elderly-hospitalized-sample
#3
Colleen E Jackson, Laura J Grande, Kelly Doherty, Elizabeth Archambault, Brittany Kelly, Jane A Driver, William P Milberg, Regina McGlinchey, James L Rudolph
PURPOSE: Cognitive screening upon hospital admission can provide important information about the patient's ability to process information during the inpatient stay. The Clock-in-the-Box (CIB) is a rapidly administered cognitive screening measure which has been previously validated with cognitive screening and neuropsychological assessments. The purpose of this study is to demonstrate the predictive validity of the CIB for discharge location among a sample of older medical inpatients. PATIENTS AND METHODS: Hospitalized Veterans (N=218), aged 55 years and older, were recruited on the day after admission after they gave their consent...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27918840/resilience-and-risk-for-alcohol-use-disorders-a-swedish-twin-study
#4
Elizabeth C Long, Sara L Lönn, Jianguang Ji, Paul Lichtenstein, Jan Sundquist, Kristina Sundquist, Kenneth S Kendler
BACKGROUND: Resilience has been shown to be protective against alcohol use disorders (AUDs), but the magnitude and nature of the relationship between these 2 phenotypes are not clear. The aim of this study was to examine the strength of this relationship and the degree to which it results from common genetic or common environmental influences. METHODS: Resilience was assessed on a 9-point scale during a personal interview in 1,653,721 Swedish men aged 17 to 25 years...
December 5, 2016: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/27913873/impact-of-intensity-and-timing-of-integrated-home-palliative-cancer-care-on-end-of-life-hospitalization-in-northern-italy
#5
M Pellizzari, D Hui, E Pinato, M Lisiero, S Serpentini, L Gubian, F Figoli, M Cancian, C De Chirico, E Ferroni, F Avossa, M Saugo
PURPOSE: The Veneto Region implemented a novel integrated home-based palliative cancer care (HPCC) program embedded in primary care. We examined the impact of timing and intensity of this program on the quality of end-of-life (EOL) care. METHODS: We selected adult cancer patients died in the Veneto Region between March and December 2013, excluding those died from haematological malignancies as well as the very elderly (85+ years). We retrieved the claim-based data on hospitalization and homecare visits, and defined two observation windows: 90 to 16 days before death to examine intensity of HPCC exposure, and the last 15 days of life to examine EOL outcomes, including hospital death, any hospital stay for medical reasons and hospital stay ≥7 days for medical reasons...
December 2, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27909251/-in-principle-we-have-agreement-but-in-practice-it-is-a-bit-more-difficult-obtaining-organizational-buy-in-to-patient-centered-medical-home-transformation
#6
Janelle Applequist, Michelle Miller-Day, Peter F Cronholm, Robert A Gabbay, Deborah S Bowen
The patient-centered medical home (PCMH) is a model of care that emphasizes the coordination of patient treatment among health care providers. Practice transformation to this model, however, presents a number of challenges. One of these challenges is getting the buy-in of all personnel to commit to making organizational changes in the journey to becoming a nationally recognized medical home. This study investigated internal messages of buy-in as communicated by practices transitioning to this type of care. Grounding itself in stakeholder theory, this study analyzed interviews with staff, administration, and practitioners from 20 medical practices in a mid-Atlantic state...
November 30, 2016: Qualitative Health Research
https://www.readbyqxmd.com/read/27905896/the-impact-of-medical-tourism-on-colorectal-screening-among-korean-americans-a-community-based-cross-sectional-study
#7
Linda K Ko, Victoria M Taylor, Jihye Yoon, Wade K Copeland, Joo Ha Hwang, Eun Jeong Lee, John Inadomi
BACKGROUND: Colorectal cancer (CRC) remains the most commonly diagnosed cancer among Korean Americans (KAs) in part due to low screening rates. Recent studies suggest that some KA patients engage in medical tourism and receive medical care in their home country. The impact of medical tourism on CRC screening is unknown. The purpose of this paper was to 1) investigate the frequency of medical tourism, 2) examine the association between medical tourism and CRC screening, and 3) characterize KA patients who engage in medical tourism...
December 1, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27905814/medicare-and-medicaid-programs-cy-2017-home-health-prospective-payment-system-rate-update-home-health-value-based-purchasing-model-and-home-health-quality-reporting-requirements-final-rule
#8
(no author information available yet)
This final rule updates the Home Health Prospective Payment System (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor; effective for home health episodes of care ending on or after January 1, 2017. This rule also: Implements the last year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates; updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 2nd-year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between CY 2012 and CY 2014; finalizes changes to the methodology used to calculate payments made under the HH PPS for high-cost "outlier" episodes of care; implements changes in payment for furnishing Negative Pressure Wound Therapy (NPWT) using a disposable device for patients under a home health plan of care; discusses our efforts to monitor the potential impacts of the rebasing adjustments; includes an update on subsequent research and analysis as a result of the findings from the home health study; and finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model, which was implemented on January 1, 2016; and updates to the Home Health Quality Reporting Program (HH QRP)...
November 3, 2016: Federal Register
https://www.readbyqxmd.com/read/27902840/team-based-interprofessional-competency-training-for-dementia-screening-and-management
#9
Zaldy S Tan, JoAnn Damron-Rodriguez, Mary Cadogan, Daphna Gans, Rachel M Price, Sharon S Merkin, Lee Jennings, Heather Schickedanz, Sam Shimomura, Dan Osterweil, Joshua Chodosh
As many as 50% of people satisfying diagnostic criteria for dementia are undiagnosed. A team-based training program for dementia screening and management was developed targeting four professions (medicine, nursing, pharmacy, social work) whose scope of practice involves dementia care. An interprofessional group of 10 faculty members was trained to facilitate four interactive competency stations on dementia screening, differential diagnoses, dementia management and team care planning, and screening for and managing caregiver stress...
November 30, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27896873/identifying-fallacious-arguments-in-a-qualitative-study-of-antipsychotic-prescribing-in-dementia
#10
Parastou Donyai
BACKGROUND: Dementia can result in cognitive, noncognitive and behavioural symptoms which are difficult to manage. Formal guidelines for the care and management of dementia in the UK state that antipsychotics should only be prescribed where fully justified. This is because inappropriate use, particularly problematic in care-home settings, can produce severe side effects including death. The aim of this study was to explore the use of fallacious arguments in professionals' deliberations about antipsychotic prescribing in dementia in care-home settings...
November 29, 2016: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27893520/impact-of-a-patient-centered-medical-home-pilot-on-utilization-quality-and-costs-and-variation-in-medical-homeness
#11
Signe Peterson Flieger
This study evaluated the impact of a patient-centered medical home (PCMH) pilot on utilization, costs, and quality and assessed variation in PCMH components. Data included the New Hampshire Comprehensive Healthcare Information System and Medical Home Index (MHI) scores for 9 pilot sites. A quasi-experimental, difference-in-difference model with propensity score-matched comparison group was employed. MHI scores were collected in late 2011. There were no statistically significant findings for utilization, cost, or quality in the expected direction...
November 23, 2016: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27893518/patient-centered-medical-home-implementation-and-burnout-among-va-primary-care-employees
#12
Joseph A Simonetti, Philip W Sylling, Karin Nelson, Leslie Taylor, David C Mohr, Idamay Curtis, Gordon Schectman, Stephan D Fihn, Christian D Helfrich
Burnout is widespread throughout primary care and is associated with negative consequences for providers and patients. The relationship between the patient-centered medical home model and burnout remains unclear. Using survey data from 8135 and 7510 VA primary care employees in 2012 and 2013, respectively, we assessed whether clinic-level medical home implementation was independently associated with burnout prevalence and estimated whether burnout changed among this workforce from 2012 to 2013. Adjusting for differences in respondent and clinic characteristics, we found that burnout was common among primary care employees, increased by 3...
November 23, 2016: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27893500/the-effect-of-reported-sleep-perceived-fatigue-and-sleepiness-on-cognitive-performance-in-a-sample-of-emergency-nurses
#13
Lisa A Wolf, Cydne Perhats, Altair Delao, Zoran Martinovich
OBJECTIVE: The aim of this study is to explore the relationship between reported sleep, perceived fatigue and sleepiness, and cognitive performance. BACKGROUND: Although evidence suggests that fatigue and sleepiness affect the provision of care in inpatient units, there is a lack of research on the sleep patterns of emergency nurses and the effects of disturbed sleep and fatigue on their cognitive abilities and susceptibility to medical errors. METHODS: A quantitative correlational design was used in this study; in each of 7 different statistical models, zero-order relationships between predictors and the dependent variable were examined with appropriate inferential tests...
January 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/27891528/preparing-nursing-home-data-from-multiple-sites-for-clinical-research-a-case-study-using-observational-health-data-sciences-and-informatics
#14
Richard D Boyce, Steven M Handler, Jordan F Karp, Subashan Perera, Charles F Reynolds
INTRODUCTION: A potential barrier to nursing home research is the limited availability of research quality data in electronic form. We describe a case study of converting electronic health data from five skilled nursing facilities to a research quality longitudinal dataset by means of open-source tools produced by the Observational Health Data Sciences and Informatics (OHDSI) collaborative. METHODS: The Long-Term Care Minimum Data Set (MDS), drug dispensing, and fall incident data from five SNFs were extracted, translated, and loaded into version 4 of the OHDSI common data model...
2016: EGEMS
https://www.readbyqxmd.com/read/27890309/patterns-of-ninety-day-readmissions-following-total-joint-replacement-in-a-bundled-payment-initiative
#15
Omar A Behery, Benjamin S Kester, Jarrett Williams, Joseph A Bosco, James D Slover, Richard Iorio, Ran Schwarzkopf
BACKGROUND: Alternative payment models aim to improve quality and decrease costs associated with total joint replacement. Postoperative readmissions within 90 days are of interest to clinicians and administrators as there is no additional reimbursement beyond the episode bundled payment target price. The aim of this study is to improve the understanding of the patterns of readmission which would better guide perioperative patient management affecting readmissions. We hypothesize that readmissions have different timing, location, and patient health profile patterns based on whether the readmission is related to a medical or surgical diagnosis...
November 1, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27884053/disability-in-patients-with-end-stage-liver-disease-results-from-the-functional-assessment-in-liver-transplantation-frailt-study
#16
Mariya L Samoylova, Kenneth E Covinsky, Marta Haftek, Selena Kuo, John P Roberts, Jennifer C Lai
: Cirrhosis leads to sarcopenia and functional decline that can severely impact one's ability to function at home and in society. Self-reported disability scales to quantify disability - Activities of Daily Living (ADL) and Instrumental ADL (IADL) - are validated to predict mortality in older adults. To evaluate disability in liver transplant (LT) candidates and quantify its impact on outcomes, consecutive outpatients ≥18y listed for LT with laboratory Model for End-stage Liver Disease (MELD) score ≥12 at a single high-volume U...
November 24, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/27881425/relationship-between-language-preference-and-intravenous-thrombolysis-among-acute-ischemic-stroke-patients
#17
Betty Luan Erfe, Khawja Ahmeruddin Siddiqui, Lee H Schwamm, Nicte I Mejia
BACKGROUND: Approximately 20% of the US population primarily speaks a language other than English at home. Yet the effect of language preference on treatment of acute ischemic stroke (AIS) patients remains unknown. We aimed to evaluate the influence of language preference on AIS patients' receipt of intravenous (IV) thrombolysis. METHODS AND RESULTS: We analyzed data from 3894 AIS patients who participated in the American Heart Association "Get With The Guidelines(®)-Stroke" program at our hospital from January 1, 2003 to April 30, 2014...
November 23, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27875834/medical-social-and-supportive-services-for-older-adults-with-hiv
#18
Lisa E Cox, Mark Brennan-Ing
Older people living with HIV are increasingly requiring formal supportive community-based services. Supportive services are essential to medical care and treatment for older people living with HIV/AIDS. This chapter considers Andersen's behavioral model of health services, and explores the predisposing, enabling, and need factors that affect service utilization among the older HIV population. The Andersen model provides a lens to understand the need for supportive services to go beyond primary medical care...
2017: Interdisciplinary Topics in Gerontology and Geriatrics
https://www.readbyqxmd.com/read/27875601/association-between-patient-centered-medical-home-features-and-satisfaction-with-family-medicine-residency-training-in-the-us
#19
Patricia A Carney, Elaine Waller, Eve Dexter, Miguel Marino, Stephanie E Rosener, Larry A Green, Geoffrey Jones, J Drew M Keister, Julie A Dostal, Samuel M Jones, M Patrice Eiff
BACKGROUND AND OBJECTIVES: Primary care residencies are undergoing dramatic changes because of changing health care systems and evolving demands for updated training models. We examined the relationships between residents' exposures to patient-centered medical home (PCMH) features in their assigned continuity clinics and their satisfaction with training. METHODS: Longitudinal surveys were collected annually from residents evaluating satisfaction with training using a 5-point Likert-type scale (1=very unsatisfied to 5=very satisfied) from 2007 through 2011, and the presence or absence of PCMH features were collected from 24 continuity clinics during the same time period...
November 2016: Family Medicine
https://www.readbyqxmd.com/read/27872790/kansas-city-cardiomyopathy-questionnaire-utility-in-prediction-of-30-day-readmission-rate-in-patients-with-chronic-heart-failure
#20
Shengchuan Dai, Manoucher Manoucheri, Junhong Gui, Xiang Zhu, Divyanshu Malhotra, Shenjing Li, Jason D'souza, Fnu Virkram, Aditya Chada, Haibing Jiang
Background. Heart failure (HF) is one of the most common diagnoses associated with hospital readmission. We designed this prospective study to evaluate whether Kansas City Cardiomyopathy Questionnaire (KCCQ) score is associated with 30-day readmission in patients hospitalized with decompensated HF. Methods and Results. We enrolled 240 patients who met the study criteria. Forty-eight (20%) patients were readmitted for decompensated HF within thirty days of hospital discharge, and 192 (80%) patients were not readmitted...
2016: Cardiology Research and Practice
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