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https://www.readbyqxmd.com/read/28655169/hospital-at-home-integrated-care-programme-for-the-management-of-disabling-health-crises-in-older-patients-comparison-with-bed-based-intermediate-care
#1
Miquel À Mas, Marco Inzitari, Sergi Sabaté, Sebastià J Santaeugènia, Ramón Miralles
Objective: to analyse the clinical impact of a home-based Intermediate Care model in the Catalan health system, comparing it with usual bed-based care. Design: quasi-experimental longitudinal study. Setting: hospital Municipal de Badalona and El Carme Intermediate Care Hospital, Badalona, Catalonia, Spain. Participants: we included older patients with medical and orthopaedic disabling health crises in need of Comprehensive Geriatric Assessment (CGA) and rehabilitation...
June 24, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28648218/innovative-information-technology-powered-population-health-care-management-improves-outcomes-and-reduces-hospital-readmissions-and-emergency-department-visits
#2
Sharon Anderson, Michele Campbell, Donna Mahoney, Ann Kathryn Muther, Janice Nevin, Patricia Resnik, Tabassum Salam, Terri Steinberg
BACKGROUND: Patients with chronic conditions are often the most frequent users of health care. Moreover, adapting to developments in one's illness, understanding how to self-manage a chronic illness, and sharing information between primary care and specialty providers, can be a full-time job for someone with a chronic illness. In response to these challenges, Christiana Care Health System (Wilmington, Delaware) developed Care Link, an information technology (IT)-enhanced care management support to enable populations of patients to achieve better clinical outcomes at lower cost...
July 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28645127/-high-prevalence-of-antipsychotic-medication-use-in-dementia-patients-in-german-neuropsychiatric-practices
#3
Jens Bohlken, Anke Booker, Karel Kostev
Background The aim of the present study was to examine inpatients as well as patients living at home with respect to the frequency of antipsychotic medication use and to determine the factors leading to initial use of antipsychotics following dementia diagnosis. Methods This study included patients aged 60 years and over with an initial diagnosis of all-cause dementia (index date) by German psychiatrists in Disease Analyzer database (IMS Health). The main outcome measure was the proportion of patients who initially received an antipsychotic prescription after the index date...
June 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28642372/the-highland-health-advocates-a-preliminary-evaluation-of-a-novel-programme-addressing-the-social-needs-of-emergency-department-patients
#4
Lia Ilona Losonczy, Dennis Hsieh, Michael Wang, Christopher Hahn, Tarak Trivedi, Marcela Rodriguez, Jahan Fahimi, Harrison Alter
OBJECTIVES: Patients commonly come to the emergency department (ED) with social needs. To address this, we created the Highland Health Advocates (HHA), an ED-based help desk and medical-legal partnership using undergraduate volunteers to help patients navigate public resources and provide onsite legal and social work referrals. We were able to provide these services in English and Spanish. We aimed to determine the social needs of the patients who presented to our ED and the potential impact of the programme in resolving those needs and connecting them to a 'medical home' (defined as a consistent, primary source of medical care such as a primary care doctor or clinic)...
June 22, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28639869/economic-burden-of-inpatient-admission-of-ankle-fractures
#5
Justin D Stull, Suneel B Bhat, Justin M Kane, Steven M Raikin
BACKGROUND: Ankle fractures are among the most prevalent traumatic orthopaedic injuries. A large proportion of patients sustaining operative ankle fractures are admitted directly from the emergency department prior to operative management. In the authors' experience, however, many closed ankle injuries may be safely and effectively managed on an outpatient basis. The aim of this study was to characterize the economic impact of routine inpatient admission of ankle fractures. METHODS: A retrospective review of all outpatient ankle fracture surgery performed by a single foot and ankle fellowship-trained surgeon at a tertiary level academic center in 2012 was conducted to identify any patients requiring postoperative inpatient admission...
June 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28635169/potential-drug-drug-interactions-in-older-adults-a-population-based-study
#6
Thalyta Renata Araújo Santos, Erika Aparecida Silveira, Lílian Varanda Pereira, Mércia Pandolfo Provin, Dione Marçal Lima, Rita Goreti Amaral
AIM: To evaluate the potential drug-drug interactions (PDDI) between drugs used by older adults, any associated factors and recommended clinical management. METHODS: A cross-sectional, population-based study was carried out through a home survey of 934 older adults (from December 2009 to April 2010). A questionnaire was applied, and the participants were asked to show all the drugs used and their respective prescriptions, thus providing data to identify polypharmacy, self-medication and PDDI...
June 21, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28632542/creation-and-execution-of-a-novel-anesthesia-perioperative-care-service-at-a-veterans-affairs-hospital
#7
Bret D Alvis, Adam B King, Pratik P Pandharipande, Liza M Weavind, Katelin Avila, Philip J Leisy, Muhammad Ajmal, Michael McHugh, Kirk A Keegan, David A Baker, Ann Walia, Christopher G Hughes
Physician-led perioperative surgical home models are developing as a method for improving the American health care system. These models are novel, team-based approaches that help to provide continuity of care throughout the perioperative period. Another avenue for improving care for surgical patients is the use of enhanced recovery after surgery pathways. These are well-described methods that have shown to improve perioperative outcomes. An established perioperative surgical home model can help implementation, efficiency, and adherence to enhanced recovery after surgery pathways...
June 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28632535/perioperative-surgical-home-evaluation-of-a-new-protocol-focused-on-a-multidisciplinary-approach-to-manage-children-undergoing-posterior-spinal-fusion-operation
#8
Eugene Kim, Brian Lee, Giovanni Cucchiaro
BACKGROUND: The concept of Perioperative Surgical Home has been gaining significant attention in surgical centers. This model is delivering and improving coordinated care in a cost-effective manner to patients undergoing surgical procedures. It starts with the decision for surgical intervention, continues to the intraoperative and postoperative periods, and follows into long-term recovery. Constant re-evaluation of outcomes and modifications of delivery provides a feedback loop for improvement...
June 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28629279/understanding-determinants-of-cardiovascular-health-in-a-mexican-american-community
#9
Karen A Larimer, Meg Gulanick, Sue Penckofer
Cardiovascular disease (CVD) is the leading cause of death in Hispanic Americans. Social and physical determinants of health unique to this community must be understood before interventions can be designed and implemented. This article describes a CVD risk assessment conducted in a primarily Mexican American community, using Healthy People 2020 as a model. Social (language, culture, awareness of CVD, and socio-economic status) and physical (presence and use of recreation areas, presence of grocery stores, public transportation, and environmental pollution) determinants of health as well as access to health services were assessed...
July 2017: Health Promotion Practice
https://www.readbyqxmd.com/read/28626877/factors-associated-with-the-difficulty-in-hospital-acceptance-among-elderly-emergency-patients-a-population-based-study-in-osaka-city-japan
#10
Tasuku Matsuyama, Tetsuhisa Kitamura, Yusuke Katayama, Kosuke Kiyohara, Sumito Hayashida, Takashi Kawamura, Taku Iwami, Bon Ohta
AIM: We aimed to investigate prehospital factors associated with difficulty in hospital acceptance among elderly emergency patients. METHODS: We reviewed ambulance records in Osaka City from January 2013 through December 2014, and enrolled all elderly emergency patients aged ≥65 years who were transported by on-scene emergency medical service personnel to a hospital that the personnel had selected. The definition of difficulty in hospital acceptance was to the requirement for ≥4 phone calls to hospitals by emergency medical service personnel before receiving a decision from the destination hospitals...
June 18, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28625207/use-of-psychotropic-medications-in-relation-to-neuropsychiatric-symptoms-cognition-and-functional-performance-in-alzheimer-s-disease-over-a-three-year-period-kuopio-alsova-study
#11
Soili Törmälehto, Janne Martikainen, J Simon Bell, Ilona Hallikainen, Anne M Koivisto
BACKGROUND: Psychotropic medications are widely prescribed to manage neuropsychiatric symptoms (NPS) of Alzheimer's disease (AD). Our objective was to investigate the longitudinal associations between psychotropic medication use and NPS, cognition, and functional performance in persons with very mild or mild AD at baseline. METHODS: Data were collected as part of the prospective three-year study of home-dwelling persons with AD and their caregivers (n = 236 dyads)...
June 19, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28622983/the-effect-of-a-comprehensive-care-transition-model-on-cost-and-utilization-for-medically-complex-children-with-cerebral-palsy
#12
Steven W Howard, Zidong Zhang, Paula Buchanan, Eric Armbrecht, Christine Williams, Geneva Wilson, Janna Hutchinson, Lindsey Pearson, Samantha Ellsworth, Caitlin M Byler, Travis Loux, Jing Wang, Steph Bernell, Nicholas Holekamp
INTRODUCTION: Our aim was to evaluate cost and acute care utilization related to an organized approach to care coordination and transitional care after major acute care hospitalization for children with medical complexities, including cerebral palsy. METHODS: A retrospective cohort of 32 patients from Ranken Jordan Pediatric Bridge Hospital (RJPBH) who received the Care Beyond the Bedside model was compared with 151 patients receiving standard care elsewhere across Missouri...
June 13, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28622004/six-month-morbidity-and-mortality-among-icu-patients-receiving-life-sustaining-therapy-a-prospective-cohort-study
#13
Michael E Detsky, Michael O Harhay, Dominique F Bayard, Aaron M Delman, Anna E Buehler, Saida A Kent, Isabella V Ciuffetelli, Elizabeth Cooney, Nicole B Gabler, Sarah J Ratcliffe, Mark E Mikkelsen, Scott D Halpern
RATIONALE: Understanding long-term outcomes of critically ill patients may inform shared decision making in the ICU. OBJECTIVE: To quantify six-month functional outcomes of general ICU patients, and develop a multivariable model comprising factors present during the first ICU day to predict which patients will return to their baseline function 6 months later. METHODS: We conducted a prospective cohort study in three medical ICUs and two surgical ICUs in three hospitals...
June 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28620725/understanding-adaptations-to-patient-centered-medical-home-activities-the-pcmh-adaptations-model
#14
Tristen L Hall, Jodi Summers Holtrop, L Miriam Dickinson, Russell E Glasgow
Primary care practices have increasingly adopted the patient-centered medical home (PCMH) model and often adapted quality improvement efforts to fit local context. This paper implemented a modified framework for understanding adaptations in the context of primary care PCMH transformation efforts. We combined an adaptations model by Stirman et al. that categorized adaptations to evidence-based interventions in research studies with dimensions from the RE-AIM framework, as well as items specific to PCMH. The resulting constructs were translated into a "plain English" adaptations interview...
June 15, 2017: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/28617244/continuity-of-care-in-infancy-and-early-childhood-health-outcomes
#15
Elizabeth Enlow, Molly Passarella, Scott A Lorch
BACKGROUND AND OBJECTIVES: Continuity of care is a key aspect of the patient-centered medical home and improves pediatric outcomes. Health care reform requires high-quality data to demonstrate its continued value. We hypothesized that increased provider continuity in infancy will reduce urgent health care use and increase receipt of preventive services in early childhood. METHODS: Continuity, using the Usual Provider of Care measure, was calculated across all primary care encounters during the first year of life in a prospectively-constructed cohort of 17 773 infants receiving primary care from birth through 3 years at 30 clinics...
June 15, 2017: Pediatrics
https://www.readbyqxmd.com/read/28616815/-prevention-of-nosocomial-infections-and-antibiotic-resistance-in-nursing-homes
#16
REVIEW
Markus Bleckwenn, Judith Hammerschmidt, Claudia Rösing, Manuela Klaschik
BACKGROUND: Nosocomial infections and multidrug-resistant organisms are an increasing problem in nursing homes worldwide; therefore, new approaches for infection control need to be developed. OBJECTIVES: This article gives an overview of infections in nursing homes, their medical treatment and previous measures for infection prevention. MATERIALS AND METHODS: The article is based on a selective literature search including the literature database PubMed...
June 14, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28609248/using-statewide-data-on-health-care-quality-to-assess-the-effect-of-a-patient-centered-medical-home-initiative-on-quality-of-care
#17
Nathan D Shippee, Michael Finch, Douglas Wholey
Patient-centered medical homes comprise a large portion of modern health care redesign. However, most efforts have reflected rigid, limited models of transformation. In addition, evaluations of their impact on quality of care have relied on data designed for other purposes. Minnesota's Health Care Home (HCH) initiative is a statewide medical home model relying on state-run, adaptive certification and supportive data infrastructure. This longitudinal study leverages a unique statewide system of clinic-reported, patient-level quality data (2010-2013) to assess the effect of being in a HCH clinic on health care quality...
June 13, 2017: Population Health Management
https://www.readbyqxmd.com/read/28604260/developing-high-functioning-teams-factors-associated-with-operating-as-a-real-team-and-implications-for-patient-centered-medical-home-development
#18
Somava Stout, Leah Zallman, Lisa Arsenault, Assaad Sayah, Karen Hacker
Team-based care is a foundation of health care redesign models like the patient-centered medical home (PCMH). Yet few practices rigorously examine how the implementation of PCMH relates to teamwork. We identified factors associated with the perception of a practice operating as a real team. An online workforce survey was conducted with all staff of 12 primary care sites of Cambridge Health Alliance at different stages of PCMH transformation. Bivariate and multivariate analyses of factors associated with teamwork perceptions were conducted...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28601691/effects-of-a-nurse-led-transitional-care-program-on-clinical-outcomes-health-related-knowledge-physical-and-mental-health-status-among-chinese-patients-with-coronary-artery-disease-a-randomized-controlled-trial
#19
Pan Zhang, Yu-Ding Hu, Feng-Mei Xing, Chang-Zai Li, Wang-Feng Lan, Xiao-Li Zhang
BACKGROUND: Coronary artery disease is a major cause of morbidity and mortality among adults worldwide, including China. After a hospital stay, transitional care could help to ensure improved patient care and outcomes, and reduce Medicare costs. Nevertheless, the results of the existing transitional care are not always satisfactory and our knowledge of how to perform effective transitional care for patients with coronary artery disease is limited in mainland China. OBJECTIVES: To examine the effectiveness of a nurse-led transitional care program on clinical outcomes, health-related knowledge, and physical and mental health status among Chinese patients with coronary artery disease...
April 14, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28601683/prenatal-intrapartum-and-postnatal-factors-are-associated-with-pediatric-eosinophilic-esophagitis
#20
Elizabeth T Jensen, Jonathan T Kuhl, Lisa J Martin, Marc E Rothenberg, Evan S Dellon
BACKGROUND: Multiple lines of evidence point to the potential importance of early-life environmental factors in the rapid rise in incidence of eosinophilic esophagitis (EoE), but potential exposures have not been extensively studied. OBJECTIVE: To assess the association between prenatal, intrapartum, and postnatal factors and the development of pediatric EoE using a case-control study. METHODS: Cases of EoE were recruited from an existing registry at Cincinnati Children's Hospital Medical Center (CCHMC)...
June 7, 2017: Journal of Allergy and Clinical Immunology
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