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https://www.readbyqxmd.com/read/28108639/prevalence-of-epilepsy-seizures-as-a-comorbidity-of-neurologic-disorders-in-nursing-homes
#1
Angela K Birnbaum, Ilo E Leppik, Kenneth Svensden, Lynn E Eberly
OBJECTIVE: To determine the prevalence of epilepsy/seizure (epi/sz) comorbid with other neurologic disorders in elderly nursing home residents and to examine demographic and regional variability and associations with clinical characteristics. METHODS: We studied 5 cross-sectional cohorts of all residents in any Medicare/Medicaid-certified nursing home in the United States on July 15 of each year from 2003 to 2007. Epi/sz was identified by ICD-9 codes (345.xx or 780...
January 20, 2017: Neurology
https://www.readbyqxmd.com/read/28108374/strategies-to-reduce-hospitalizations-of-children-with-medical-complexity-through-complex-care-expert-perspectives
#2
Ryan J Coller, Bergen B Nelson, Thomas S Klitzner, Adrianna A Saenz, Paul G Shekelle, Carlos F Lerner, Paul J Chung
OBJECTIVES: Interventions to reduce disproportionate hospital use among children with medical complexity (CMC) are needed. Our objective was to conduct a rigorous, structured process to develop intervention strategies aiming to reduce hospitalizations within a complex care program population. METHODS: A complex care medical home program used 1) semi-structured interviews of caregivers of CMC experiencing acute, unscheduled hospitalizations, and 2) literature review on preventing hospitalizations among CMC, to develop key drivers for lowering hospital utilization and link them with intervention strategies...
January 17, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28103923/risk-adjustment-methods-for-all-payer-comparative-performance-reporting-in-vermont
#3
Karl Finison, MaryKate Mohlman, Craig Jones, Melanie Pinette, David Jorgenson, Amy Kinner, Tim Tremblay, Daniel Gottlieb
BACKGROUND: As the emphasis in health reform shifts to value-based payments, especially through multi-payer initiatives supported by the U.S. Center for Medicare & Medicaid Innovation, and with the increasing availability of statewide all-payer claims databases, the need for an all-payer, "whole-population" approach to facilitate the reporting of utilization, cost, and quality measures has grown. However, given the disparities between the different populations served by Medicare, Medicaid, and commercial payers, risk-adjustment methods for addressing these differences in a single measure have been a challenge...
January 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28103856/relationship-between-the-presence-of-baccalaureate-educated-rns-and-quality-of-care-a-cross-sectional-study-in-dutch-long-term-care-facilities
#4
Ramona Backhaus, Erik van Rossum, Hilde Verbeek, Ruud J G Halfens, Frans E S Tan, Elizabeth Capezuti, Jan P H Hamers
BACKGROUND: Recent evidence suggests that an increase in baccalaureate-educated registered nurses (BRNs) leads to better quality of care in hospitals. For geriatric long-term care facilities such as nursing homes, this relationship is less clear. Most studies assessing the relationship between nurse staffing and quality of care in long-term care facilities are US-based, and only a few have focused on the unique contribution of registered nurses. In this study, we focus on BRNs, as they are expected to serve as role models and change agents, while little is known about their unique contribution to quality of care in long-term care facilities...
January 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28103562/a-decision-support-system-for-tele-monitoring-copd-related-worrisome-events
#5
Mario Merone, Claudio Pedone, Giuseppe Capasso, Raffaele Antonelli Incalzi, Paolo Soda
Chronic Obstructive Pulmonary Disease (COPD) is a preventable, treatable and slowly progressive disease, whose course is aggravated by a periodic worsening of symptoms and lung function lasting for several days. The development of home telemonitoring systems has made possible to collect symptoms and physiological data in electronic records, boosting the development of decision support systems (DSSs). Current DSSs work with physiological measurements collected by means of several measuring and communication devices as well as with symptoms gathered by questionnaires submitted to COPD subjects...
January 17, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28099065/exploring-variation-in-transformation-of-primary-care-practices-to-patient-centered-medical-homes-a-mixed-methods-approach
#6
Robert D Lieberthal, Tom Karagiannis, Evan Bilheimer, Manisha Verma, Colleen Payton, Mona Sarfaty, George Valko
The objective was to quantify the activities required for patient-centered medical home (PCMH) transformation in a sample of small to medium-sized National Committee for Quality Assurance (NCQA) recognized practices, and explore barriers and facilitators to transformation. Eleven small to medium-sized PCMH practices in Southeastern Pennsylvania completed a survey, which was adapted from the 2011 NCQA standards. Semistructured follow-up interviews were conducted, descriptive statistics were computed for the quantitative analysis, and a process of thematic coding was deployed for the qualitative analysis...
January 18, 2017: Population Health Management
https://www.readbyqxmd.com/read/28098085/experience-of-a-faculty-development-workshop-in-mentoring-at-an-indian-medical-college
#7
Jagdish R Varma, Anusha Prabhakaran, Suman Singh, Praveen Singh, Jaishree Ganjiwale, Himanshu Pandya
BACKGROUND: Our medical college is running a mentoring programme for undergraduate medical students since 2009. The academic leadership of the college identified the need to change the focus of the programme from mere problem- solving to professional and personal development of mentees. METHODS: A core group of faculty designed and implemented a workshop on mentoring for 28 mentors. The workshop included reflections on the participants' previous experiences about mentoring, discussion on perceptions of mentees about the existing mentoring programme, self-analysis of mentoring skills, overview of the Surrendering, Accepting, Gifting and Extending (SAGE) model and demonstration of effective mentoring skills using role plays and a film...
September 2016: National Medical Journal of India
https://www.readbyqxmd.com/read/28095906/cost-of-physician-led-home-visit-care-zaitaku-care-compared-with-hospital-care-at-the-end-of-life-in-japan
#8
Kentaro Kinjo, Tomoko Sairenji, Hidenobu Koga, Yasuhiro Osugi, Shin Yoshida, Hidefumi Ichinose, Yasunori Nagai, Hiroshi Imura, Jeannette E South-Paul, Mark Meyer, Yoshihisa Honda
BACKGROUND: Physician-led home visit care with medical teams (Zaitaku care) has been developed on a national scale to support those who wish to stay at home at the end of life, and promote a system of community-based integrated care in Japan. Medical care at the end of life can be expensive, and is an urgent socioeconomic issue for aging societies. However medical costs of physician-led home visits care have not been well studied. We compared the medical costs of Zaitaku care and hospital care at the end of life in a rapidly aging community in a rural area in Japan...
January 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28093640/polypharmacy-and-potentially-inappropriate-medications-a-cross-sectional-analysis-among-451-nursing-homes-in-france
#9
Marie Herr, Helene Grondin, Stéphane Sanchez, Didier Armaingaud, Caroline Blochet, Antoine Vial, Philippe Denormandie, Joël Ankri
PURPOSE: The quality of drug therapy is an important issue for nursing homes. This study aimed to assess the prevalence of polypharmacy and potentially inappropriate medications (PIMs) in a large sample of nursing home residents by using the data recorded during the preparation of pill dispensers. METHODS: This is a cross-sectional study that included 451 nursing homes across France. Information about the medications received by the 30,702 residents (73.8% women) living in these nursing homes was extracted from the system that assists in the preparation of pill dispensers in pharmacies...
January 16, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28092647/dietary-intake-mediates-the-relationship-of-body-fat-to-pain
#10
Charles F Emery, KayLoni L Olson, Andrew Bodine, Victoria Lee, Diane L Habash
Prior studies have documented an association of obesity with chronic pain, but the mechanism explaining the association remains unknown. This study evaluated the degree to which dietary intake of foods with anti-inflammatory effects mediates the relationship of body fat to body pain. Ninety-eight community-residing healthy adults (60% women; mean age = 43.2 ± 15.3 years; range: 20-78 years) participated in a home-based study of home environment, food-related behaviors, health, and adiposity. During a 3-hour home visit evaluation, 3 measures of body fat were collected, including height and weight for calculation of body mass index (BMI)...
February 2017: Pain
https://www.readbyqxmd.com/read/28092512/a-hidden-markov-model-for-seismocardiography
#11
Johan Wahlstrom, Isaac Skog, Peter Handel, Farzad Khosrow-Khavar, Kouhyar Tavakolian, Phyllis K Stein, Arye Nehorai
We propose a hidden Markov model approach for processing seismocardiograms. The seismocardiogram morphology is learned using the expectation-maximization algorithm, and the state of the heart at a given time instant is estimated by the Viterbi algorithm. From the obtained Viterbi sequence, it is then straightforward to estimate instantaneous heart rate, heart rate variability measures, and cardiac time intervals (the latter requiring a small number of manual annotations). As is shown in the conducted experimental study, the presented algorithm outperforms the state-of-the-art in seismocardiogrambased heart rate and heart rate variability estimation Moreover, the isovolumic contraction time and the left ventricular ejection time are estimated with mean absolute errors of about 5 [ms] and 9 [ms], respectively...
January 9, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28089817/patient-centered-specialty-practice-defining-the-role-of-specialists-in-value-based-healthcare
#12
REVIEW
Lawrence Ward, Rhea E Powell, Michael L Scharf, Andrew Chapman, Mani Kavuru
Healthcare is at a crossroads, under pressure to add value by improving patient experience and health outcomes and reducing costs to the system. Efforts to improve the care model in primary care, such as the patient-centered medical home, have enjoyed some success. Yet primary care accounts for only a small portion of total healthcare spending, and there is a need for policies and frameworks to support high quality, cost-efficient care in specialty practices of the "medical neighborhood". The Patient-Centered Specialty Practice (PCSP) model offers ambulatory-based specialty practices one such framework, supported by a formal recognition program through the National Committee for Quality Assurance...
January 13, 2017: Chest
https://www.readbyqxmd.com/read/28086869/evaluation-of-an-aged-care-nurse-practitioner-service-quality-of-care-within-a-residential-aged-care-facility-hospital-avoidance-service
#13
Trudy Dwyer, Alison Craswell, Dolene Rossi, Darren Holzberger
BACKGROUND: Reducing avoidable hospitialisation of aged care facility (ACF) residents can improve the resident experience and their health outcomes. Consequently many variations of hospital avoidance (HA) programs continue to evolve. Nurse practitioners (NP) with expertise in aged care have the potential to make a unique contribution to hospital avoidance programs. However, little attention has been dedicated to service evaluation of this model and the quality of care provided. The purpose of this study was to evaluate the quality of an aged care NP model of care situated within a HA service in a regional area of Australia...
January 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28086754/making-the-most-of-mealtimes-m3-protocol-of-a-multi-centre-cross-sectional-study-of-food-intake-and-its-determinants-in-older-adults-living-in-long-term-care-homes
#14
Heather H Keller, Natalie Carrier, Susan Slaughter, Christina Lengyel, Catriona M Steele, Lisa Duizer, K Steve Brown, Habib Chaudhury, Minn N Yoon, Alison M Duncan, Veronique M Boscart, George Heckman, Lita Villalon
BACKGROUND: Older adults living in long term care (LTC) homes are nutritionally vulnerable, often consuming insufficient energy, macro- and micronutrients to sustain their health and function. Multiple factors are proposed to influence food intake, yet our understanding of these diverse factors and their interactions are limited. The purpose of this paper is to fully describe the protocol used to examine determinants of food and fluid intake among older adults participating in the Making the Most of Mealtimes (M3) study...
January 13, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28079645/the-role-of-patient-navigators-in-building-a-medical-home-for-multiply-diagnosed-hiv-positive-homeless-populations
#15
Mariana Sarango, Alexander de Groot, Melissa Hirschi, Chukwuemeka Anthony Umeh, Serena Rajabiun
CONTEXT: People living with human immunodeficiency virus (HIV) (PLWH) who are most at risk for falling out of HIV primary care and detectable viral loads include homeless and unstably housed individuals and those codiagnosed with behavioral health disorders. The patient-centered medical home (PCMH) is a model that promotes provision of comprehensive, patient-centered, accessible, coordinated, and quality care for patients. This initiative provided patient navigation to HIV-positive homeless and unstably housed individuals codiagnosed with a mental health or substance use disorder as a means to create an adapted PCMH to meet the specific needs of this population...
January 11, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28077044/reducing-health-disparities-for-women-through-use-of-the-medical-home-model
#16
Patricia Moyle Wright
BACKGROUND: Healthcare services can be difficult to access, particularly for low-income or underinsured women. One way of overcoming the barriers to quality, patient-centered care is through the use of the Medical Home Model (MHM). The MHM is a cost-effective approach to care that improves patient outcomes and improves access. In this article, the benefits of extending the MHM into the area of women's health will be discussed. AIM: The purpose of this article is to discuss barriers to healthcare, with an emphasis on reducing healthcare disparities for women...
January 11, 2017: Contemporary Nurse
https://www.readbyqxmd.com/read/28075698/older-adults-and-management-of-medical-devices-in-the-home-five-requirements-for-appropriate-use
#17
Sara C Keller, Ayse P Gurses, Nicole Werner, Dawn Hohl, Ashley Hughes, Bruce Leff, Alicia I Arbaje
Medical devices, or instruments or tools to manage disease, are increasingly used in the home, yet there have been limited evaluations of how older adults and caregivers safely use these devices. This study concerns a qualitative evaluation of (1) barriers and facilitators of appropriate use, and (2) outcomes of inappropriate use, among older adults at the transition from hospital to home with skilled home health care (SHHC). Guided by a human factors engineering work system model, the authors (1) conducted direct observations with contextual inquiry of the start-of-care or resumption-of-care SHHC provider visit, and (2) semi-structured interviews with 24 older adults and their informal caregivers, and 39 SHHC providers and administrators...
January 11, 2017: Population Health Management
https://www.readbyqxmd.com/read/28075696/dual-eligibles-experience-of-care-with-north-carolina-s-patient-centered-medical-home
#18
Sarah Grantham, Debora Goetz Goldberg, Donna Lind Infeld
Although individuals enrolled in both Medicare and Medicaid (dual eligibles) are among those with the nation's greatest need, at $300 billion per year, their care is also expensive and beset by quality problems. Previous research found problems associated with inadequate coordination of benefits and services; however, these studies have largely used quantitative approaches and focused on providers-few studies have explored the perspective of dual eligible patients. In an effort to improve care and reduce costs, North Carolina (NC) developed a Patient-Centered Medical Home (PCMH) model centered on a continuous relationship with a primary care provider who is responsible for coordination of services and addressing patients' health care needs by providing direct services or arranging care with other qualified professionals...
January 11, 2017: Population Health Management
https://www.readbyqxmd.com/read/28075693/making-the-paradigm-shift-from-siloed-population-health-management-to-an-enterprise-wide-approach
#19
Marc R Matthews, Claudia Miller, Robert J Stroebel, Kari S Bunkers
Health systems across the United States have started their journeys toward population health management and the future of accountable care. Models of population health management include patient-centered medical homes and private sector accountable care organizations (ACOs). Other models include public sector efforts, such as Physician Group Practice Transition Demonstrations, Medicare Health Care Quality Demonstration Programs, Beacon Communities, Medicare Shared Savings Program, and Pioneer ACOs. As a result, health care organizations often have pockets of population health initiatives that lack an enterprise-wide strategy...
January 11, 2017: Population Health Management
https://www.readbyqxmd.com/read/28074757/advanced-practice-nurse-transitional-care-model-promotes-healing-in-wound-care
#20
Carole Mackavey
: Optimally, transition in health care should be seamless and incorporate a well-thought-out patient-centered discharge plan; yet, many hospitalized patients are unprepared for discharge, thereby compromising patient safety and quality of care. Transition of care should include a broad range of time-limited services designed to ensure health care continuity to avoid poor outcomes among at-risk populations. This case study demonstrates that advanced practice nurses (APNs) are in the perfect position to bridge the existing gap, reduce readmissions, and improve patient health...
September 1, 2016: Care Management Journals: Journal of Case Management ; the Journal of Long Term Home Health Care
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