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medical home model

Ester Risco, Adelaida Zabalegui, Susana Miguel, Marta Farré, Carme Alvira, Esther Cabrera
OBJECTIVE: To describe the implementation of the Balance of Care model in decision-making regarding the best care for patients with dementia in Spain. METHODS: The Balance of Care model was used, which consists of (1) describing the profile of the typical cases of people with dementia and their caregivers, (2) identifying the most suitable care setting for each of the cases (home-care or long-term care institution), (3) designing specific care plans for each case, and (4) evaluating the cost of the proposed care plans...
October 14, 2016: Gaceta Sanitaria
Javier Jerez-Roig, Nayara Priscila Dantas de Oliveira, Bartolomeu Fagundes de Lima Filho, Maria Amanda de Farias Bezerra, Monayane Grazielly Leite Matias, Lidiane Macedo Ferreira, Fabienne Louise Juvêncio Dos Santos Amaral, Dyego Leandro Bezerra Souza, Kenio Costa Lima
: Background/Study Context: Depression is a common psychiatric disorder in the elderly that leads to a decrease in quality of life and functional impairment, among other health problems. The study of depressive symptoms in institutionalized elderly is scarce in Latin America and can contribute to plan prevention and treatment actions in order to improve health conditions for the residents as well as quality of life. Therefore, the aim of this study is to determine the prevalence of depressive symptoms and identify its associated factors in institutionalized elderly...
October 2016: Experimental Aging Research
Margaret Fry, Lesley Fitzpatrick, Julie Considine, Ramon Z Shaban, Kate Curtis
INTRODUCTION: Older persons aged over 65years represent up to 41% of Australian Emergency Department (ED) presentations. Older persons present with acute and/or chronic conditions, have more Emergency Department visits, hospital admissions and readmissions than other age groups. However, little is known about the characteristics and trends of acute illness and chronic presentations and whether frailty changes these dimensions within this cohort. METHODS: A 12-month retrospective medical record audit of persons over 65years presenting to four EDs...
October 12, 2016: International Emergency Nursing
J T Schousboe, M L Paudel, B C Taylor, A M Kats, B A Virnig, B E Dowd, L Langsetmo, K E Ensrud
: Older women with pre-fracture slow walk speed, high body mass index, and/or a high level of multimorbidity have significantly higher health care costs after hip fracture compared to those without those characteristics. Studies to investigate if targeted health care interventions for these individuals can reduce hip fracture costs are warranted. INTRODUCTION: The aim of this study is to estimate the associations of individual pre-fracture characteristics with total health care costs after hip fracture, using Study of Osteoporotic Fractures (SOF) cohort data linked to Medicare claims...
October 14, 2016: Osteoporosis International
Hung-Yu Huang, Pai-Chien Chou, Wen-Ching Joa, Li-Fei Chen, Te-Fang Sheng, Horng-Chyuan Lin, Lan-Yan Yang, Yu-Bin Pan, Fu-Tsai Chung, Chun-Hua Wang, Han-Pin Kuo
Pulmonary rehabilitation (PR) brings benefits to patients with chronic obstructive pulmonary disease (COPD). Negative pressure ventilation (NPV) increases ventilation and decreases hyperinflation as well as breathing work in COPD. We evaluated the long-term effects of a hospital-based PR program coupled with NPV support in patients with COPD on clinical outcomes.One hundred twenty-nine patients with COPD were followed up for more than 5 years, with the NPV group (n = 63) receiving the support of NPV (20-30 cm H2O delivery pressure for 60 min) and unsupervised home exercise program of 20 to 30 min daily walk, while the control group (n = 6) only received unsupervised home exercise program...
October 2016: Medicine (Baltimore)
Gerald Kayingo, Owais Gilani, Vasco Deon Kidd, Mary L Warner
BACKGROUND AND OBJECTIVES: The transformation of primary care (PC) training sites into patient-centered medical homes (PCMH) has implications for the education of health professionals. This study investigates the extent to which physician assistant (PA) students report learning about the PCMH model and how clinical exposure to PCMH might impact their interest in a primary care career. METHODS: An electronic survey was distributed to second-year PA students who had recently completed their PC rotation from 12 PA programs...
October 2016: Family Medicine
Jason M Davies, Michael T Lawton
OBJECTIVE Treatment of cerebrovascular malformations has grown in complexity with the development of multimodal approaches, including microsurgery, endovascular treatments, and radiosurgery. In spite of this changing standard of care, the provision of care continues across a variety of settings. The authors sought to determine the risk of adverse outcome after treatment of patients with vascular malformations in the US. Patient, surgeon, and hospital characteristics, including volume, were tested as potential outcome predictors...
October 14, 2016: Journal of Neurosurgery
Cari Levy, Emily A Whitfield
OBJECTIVE: To compare characteristics, healthcare use, and costs of care of veterans in the rapidly expanding Veterans Health Administration (VHA) medical foster home (MFH) with those of three other VHA long-term care (LTC) programs. DESIGN: Descriptive, unmatched study. SETTING: VHA MFHs, home-based primary care (HBPC), community living centers (CLCs), and community nursing homes (CNHs). PARTICIPANTS: Veterans newly enrolled in one of the four LTC settings in calendar years 2010 or 2011...
October 14, 2016: Journal of the American Geriatrics Society
James M Shultz, Janice L Cooper, Florence Baingana, Maria A Oquendo, Zelde Espinel, Benjamin M Althouse, Louis Herns Marcelin, Sherry Towers, Maria Espinola, Clyde B McCoy, Laurie Mazurik, Milton L Wainberg, Yuval Neria, Andreas Rechkemmer
The 2013-2016 West Africa Ebola virus disease pandemic was the largest, longest, deadliest, and most geographically expansive outbreak in the 40-year interval since Ebola was first identified. Fear-related behaviors played an important role in shaping the outbreak. Fear-related behaviors are defined as "individual or collective behaviors and actions initiated in response to fear reactions that are triggered by a perceived threat or actual exposure to a potentially traumatizing event. FRBs modify the future risk of harm...
November 2016: Current Psychiatry Reports
Roque da Silva Araújo, Edna Apparecida Moura Arcuri, Victor Cauê Lopes
Objective: to verify causes of inactivity in the Home Delivery Medicament Program, as referred by users from a Primary Health Care Service in São Paulo, comparing them to the causes registered in the program and analyzing them in the theoretical model Concept of Access to Health. Methods: cross-sectional study, interviewing 111 inactive users; and documentary study in the program records. Results: half of the users did not know the condition of inactivity...
October 10, 2016: Revista Latino-americana de Enfermagem
Daniel Petras, Louis-Félix Nothias, Robert A Quinn, Theodore Alexandrov, Nuno Bandeira, Amina Bouslimani, Gabriel Castro-Falcón, Liangyu Chen, Tam Dang, Dimitrios J Floros, Vivian Y H Hook, Neha Garg, Nicole Hoffner, Yike Jiang, Clifford A Kapono, Irina Koester, Rob Knight, Christopher A Leber, Tiejun Ling, Tal Luzzatto-Knaan, Laura-Isobel McCall, Aaron Philip McGrath, Michael J Meehan, Jonathan K Merritt, Robert H Mills, Jamie Morton, Sonia Podvin, Ivan Protsyuk, Trevor Purdy, Kendall Satterfield, Stephen Searles, Sahil Shah, Sarah Shires, Dana Steffen, Margot White, Jelena Todoric, Robert Tuttle, Aneta Wojnicz, Valerie Sapp, Fernando Vargas, Jin Yang, Chao Zhang, Pieter C Dorrestein
The cars we drive, the homes we live in, the restaurants we visit, and the labs and offices we work in are all a part of the modern human habitat. Remarkably, little is known about the diversity of chemicals present in these environments and to what degree molecules from our bodies influence the built environment that surrounds us and vice versa. We therefore set out to visualize the chemical diversity of five built human habitats together with their occupants, to provide a snapshot of the various molecules to which humans are exposed on a daily basis...
October 12, 2016: Analytical Chemistry
Jennifer M Boggs, Jennifer Dickman Portz, Diane K King, Leslie A Wright, Kenneth Helander, Jessica H Retrum, Wendolyn S Gozansky
This qualitative study conducted by a community-research partnership used multiple types of data collection to examine variables relevant for LGBTQ older adults who wished to age in place in their urban Denver neighborhood. Focus groups, interviews, and a town hall meeting were used to identify barriers and supports to aging in place. Participants (N = 73) primarily identified as lesbian or gay, aged 50-69, and lived with a partner. Ageism, heterosexism, and/or cisgenderism emerged as cross-cutting themes that negatively impact access to healthcare, housing, social support, home assistance and legal services...
October 12, 2016: Journal of Homosexuality
İbrahim Ömer Barlas, Orhan Sezgin, Collet Dandara, Gözde Türköz, Emre Yengel, Zinhle Cindi, Handan Ankaralı, Semra Şardaş
Pharmacogenomics harnesses the utility of a patient's genome (n = 1) in decisions on which therapeutic drugs and in what amounts should be administered. Often, patients with shared ancestry present with comparable genetic profiles that predict drug response. However, populations are not static, thus, often, population mobility through migration, especially enmasse as is seen for refugees, changes the pharmacogenetic profiles of resultant populations and therefore observed responses to commonly used therapeutic drugs...
October 2016: Omics: a Journal of Integrative Biology
John Cawley, Chad Meyerhoefer, Leah G Gillingham, Penny Kris-Etherton, Peter J H Jones
AIMS: Diets high in saturated fat are associated with elevated risk of heart disease. This study estimates the savings in direct (medical care) costs and indirect (job absenteeism) costs in the US from reductions in heart disease associated with substituting monounsaturated fats (MUFA) for saturated fats. MATERIALS AND METHODS: A four-part model of the medical care cost savings from avoided heart disease was estimated using data on 247,700 adults from the 2000-2010 Medical Expenditure Panel Survey (MEPS)...
October 11, 2016: Journal of Medical Economics
Satya Surbhi, Kiraat D Munshi, Paula C Bell, James E Bailey
OBJECTIVES: First, to investigate the prevalence and types of drug therapy problems and medication discrepancies among super-utilizers, and associated patient characteristics. Second, to examine the outcomes of pharmacist recommendations and estimated cost avoidance through care transitions support focused on medication management. DESIGN: Retrospective analysis of the pharmacist-led interventions as part of the SafeMed Program. SETTING: A large nonprofit health care system serving the major medically underserved areas in Memphis, Tennessee...
October 6, 2016: Journal of the American Pharmacists Association: JAPhA
Sera Nia Manning
The health service is having to plan for an increasingly older population putting extra demand on services, with a greater emphasis on providing care at home. A health board in Wales brought in an Early Response Service, which assessed whether patients attending accident and emergency needed to be admitted to hospital or could receive care at home. This qualitative study looked at the experiences of both patients and staff members in both settings. A multiple case study was undertaken using semi-structured interviews...
October 2, 2016: British Journal of Community Nursing
Karen L Pellegrin, Les Krenk, Sheena Jolson Oakes, Anita Ciarleglio, Joanne Lynn, Terry McInnis, Alistair W Bairos, Lara Gomez, Mercedes Benitez McCrary, Alexandra L Hanlon, Jill Miyamura
OBJECTIVES: To evaluate the association between a system of medication management services provided by specially trained hospital and community pharmacists (Pharm2Pharm) and rates and costs of medication-related hospitalization in older adults. DESIGN: Quasi-experimental interrupted time series design comparing intervention and nonintervention hospitals using a mixed-effects analysis that modeled the intervention as a time-dependent variable. SETTING: Sequential implementation of Pharm2Pharm at six general nonfederal acute care hospitals in Hawaii with more than 50 beds in 2013 and 2014...
October 7, 2016: Journal of the American Geriatrics Society
Parag Goyal, Madeline R Sterling, Ashley N Beecy, John T Ruffino, Sonal S Mehta, Erica C Jones, Mark S Lachs, Evelyn M Horn
OBJECTIVES: Although postdischarge outpatient follow-up appointments after a hospitalization for heart failure represent a potentially effective strategy to prevent heart failure readmissions, patterns of scheduled follow-up appointments upon discharge are poorly described. We aimed to characterize real-world patterns of scheduled follow-up appointments among adult patients with heart failure upon hospital discharge. PATIENTS AND METHODS: This was a retrospective cohort study performed at a large urban academic center in the United States among adults hospitalized with a principal diagnosis of congestive heart failure between January 1, 2013, and December 31, 2014...
2016: Clinical Interventions in Aging
Mário J D S Santos
BACKGROUND: The option of a planned home birth defies medical and social normativity across countries. In Denmark, despite the dramatic decline in the home birth rates between 1960 and 1980, the right to choose the place of birth was preserved. Little has been produced documenting this process. AIM: To present and discuss Susanne Houd's reflection on the history and social dynamics of home birth in Denmark, based in an in-depth interview. METHODS: This paper is part of wider Short Term Scientific Mission (STSM), in which this interview was framed as oral history...
October 1, 2016: Women and Birth: Journal of the Australian College of Midwives
R L Goldenberg, J B Griffin, B D Kamath-Rayne, M Harrison, D J Rouse, K Moran, B Hepler, A H Jobe, E M McClure
OBJECTIVE: Stillbirths are among the most common adverse pregnancy outcomes, with 98% occurring in low-income countries. More than one-third occur in sub-Saharan Africa (SSA). However, the medical conditions causing stillbirths and interventions to reduce stillbirths from these conditions are not well documented. We estimated the reductions in stillbirths possible with combinations of interventions. DESIGN: We developed a computerised model to estimate the impact of various interventions on stillbirths caused by the most common conditions...
October 5, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
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