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Healthcare risk adjustment

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https://www.readbyqxmd.com/read/29036230/predictors-of-adverse-drug-reaction-related-hospitalisation-in-southwest-ethiopia-a-prospective-cross-sectional-study
#1
Mulugeta Tarekegn Angamo, Colin Michael Curtain, Leanne Chalmers, Daniel Yilma, Luke Bereznicki
BACKGROUND: Adverse drug reactions (ADRs) are important causes of morbidity and mortality in the healthcare system; however, there are no studies reporting on the magnitude and risk factors associated with ADR-related hospitalisation in Ethiopia. OBJECTIVES: To characterise the reaction types and the drugs implicated in admission to Jimma University Specialized Hospital, Southwest Ethiopia, and to identify risk factors associated with ADR-related hospitalisation...
2017: PloS One
https://www.readbyqxmd.com/read/29033158/revision-total-knee-arthroplasty-for-periprosthetic-joint-infection-is-associated-with-increased-postoperative-morbidity-and-mortality-relative-to-noninfectious-revisions
#2
Venkat Boddapati, Michael C Fu, David J Mayman, Edwin P Su, Peter K Sculco, Alexander S McLawhorn
BACKGROUND: Periprosthetic joint infection (PJI) after primary total knee arthroplasty (TKA) is a devastating complication. The short-term morbidity profile of revision TKA performed for PJI relative to non-PJI revisions is poorly characterized. The purpose of this study is to determine 30-day postoperative outcomes after revision TKA for PJI, relative to primary TKA and aseptic revision TKA. METHODS: The American College of Surgeons National Surgical Quality Improvement Program from 2005 to 2015 was queried for primary and revision TKA cases...
September 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29031827/development-of-a-surgical-site-infection-prediction-model-in-orthopaedic-trauma-the-denver-health-model
#3
Sara M Reese, Bryan Knepper, Heather L Young, Cyril Mauffrey
BACKGROUND: The CDC's National Healthcare Safety Network's (NHSN) current risk adjustment model for surgical site infections (SSI) following open reduction internal fixation (ORIF) of long bone fractures is a suboptimal predictor of risk. We hypothesized that by including variables known to be associated with SSI following ORIF, we would develop a model that would increase the accuracy and predictability of SSI risk. METHODS: Patients who underwent ORIF of a long bone between January 1, 2012 and December 31, 2014 were included in the study (n=1543)...
October 9, 2017: Injury
https://www.readbyqxmd.com/read/29028119/comparison-of-treatment-persistence-with-dabigatran-or-rivaroxaban-versus-vitamin-k-antagonist-oral-anticoagulants-in-atrial-fibrillation-patients-a-competing-risk-analysis-in-the-french-nationwide-healthcare-databases
#4
Géric Maura, Cécile Billionnet, François Alla, Joshua J Gagne, Antoine Pariente
BACKGROUND: Direct oral anticoagulants (DOACs) have been proposed as a more convenient alternative to vitamin K antagonists (VKAs), which are commonly associated with poor treatment persistence in nonvalvular atrial fibrillation (nv-AF). METHODS: Using data from the French National Healthcare databases (Régime Général, 50 million beneficiaries), a cohort study was conducted to compare the 1-year non-persistence rates in nv-AF patients initiating dabigatran (N=11,141) or rivaroxaban (N=11,126) versus VKA (N=11,998)...
October 13, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29021816/determinants-of-early-initiation-of-breastfeeding-in-rural-niger-cross-sectional-study-of-community-based-child-healthcare-promotion
#5
Naoko Horii, James Allman, Yves Martin-Prével, Dominique Waltisperger
BACKGROUND: Most child deaths are preventable and caused by behaviorally modifiable factors. By promoting optimal breastfeeding, we can reduce neonatal and child mortality risks by 45%. This paper provides new family and community based perspectives to identify factors interfering with the program impact on promoting early initiation of breastfeeding among the most vulnerable populations in rural Niger. METHODS: A secondary analysis of a retrospective cross-sectional study evaluated a UNICEF behavior change program on child healthcare...
2017: International Breastfeeding Journal
https://www.readbyqxmd.com/read/29019887/factors-predicting-a-home-death-among-home-palliative-care-recipients
#6
Ming-Chung Ko, Sheng-Jean Huang, Chu-Chieh Chen, Yu-Ping Chang, Hsin-Yi Lien, Jia-Yi Lin, Lin-Chung Woung, Shang-Yih Chan
Awareness of factors affecting the place of death could improve communication between healthcare providers and patients and their families regarding patient preferences and the feasibility of dying in the preferred place.This study aimed to evaluate factors predicting home death among home palliative care recipients.This is a population-based study using a national representative sample retrieved from the National Health Insurance Research Database. Subjects receiving home palliative care, from 2010 to 2012, were analyzed to evaluate the association between a home death and various characteristics related to illness, individual, and health care utilization...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29019095/cost-effectiveness-of-surveillance-and-prevention-strategies-in-brca1-2-mutation-carriers
#7
Hideko Yamauchi, Chizuko Nakagawa, Makoto Kobayashi, Yusuke Kobayashi, Toshiki Mano, Seigo Nakamura, Masami Arai
BACKGROUND: Cost-effectiveness analysis is an important aspect of healthcare, including in Japan, where preventive measures for BRCA1/2 mutation carriers are not covered by health insurance. METHODS: We developed Markov models in a simulated cohort of women aged 35-70 years, and compared outcomes of surveillance with risk-reducing mastectomy (RRM) at age 35, risk-reducing salpingo-oophorectomy (RRSO) at age 45, and both (RRM&RRSO). We used breast and ovarian cancer incidences and adverse event rates from the previous studies, adjuvant chemotherapy, and hormonal therapy rates from the Hereditary Breast and Ovarian Cancer Registration 2015 in Japan, mortality rates from the National Cancer Center Hospital, Japan Society of Clinical Oncology, and Ministry of Health, Labour and Welfare, and direct costs from St...
October 10, 2017: Breast Cancer: the Journal of the Japanese Breast Cancer Society
https://www.readbyqxmd.com/read/28994447/prevalence-of-clostridium-difficile-and-ribotype-027-infection-in-patients-with-nosocomial-diarrhoea-in-southern-italy
#8
Raffaele Del Prete, Luigi Ronga, Grazia Addati, Raffaella Magrone, Giuseppe Miragliotta
Clostridium difficile is an emerging cause of healthcare-associated infections. The increasing frequency and severity is attributed to highly virulent ribotypes such as 027. The aim of this study was to retrospectively analyze the prevalence of CDI and ribotype 027 in 481 clinical samples collected from hospitalized patients and sent to the laboratory of molecular biology, UOC Microbiology and Virology, Azienda Ospedaliera-Universitaria, Policlinico of Bari, Italy. Toxins A+B and DNA C. difficile detections were performed using immunochromatographic test and a multiplex real-time PCR assay, respectively...
October 10, 2017: New Microbiologica
https://www.readbyqxmd.com/read/28992160/physicians-and-pharmacists-perceptions-on-real-time-drug-utilization-review-system-a-nationwide-survey
#9
Seung-Mi Lee, Soo-Ok Lee, Dong-Sook Kim
Objective: To identify healthcare providers' experience and satisfaction for the drug utilization review (DUR) system, their impact on prescription changes following alerts, and difficulties experienced in the system by surveying primary healthcare centers and pharmacies. Design: A cross-sectional nationwide survey. Setting and participants: Approximately 2000 institutions were selected for the survey by a simple random sampling of nationwide primary healthcare centers and community pharmacy approximately practices, and 358 replied...
October 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28992151/a-comparison-of-in-hospital-acute-myocardial-infarction-management-between-portugal-and-the-united-states-2000-2010
#10
Mariana F Lobo, Vanessa Azzone, Luís Filipe Azevedo, Bruno Melica, Alberto Freitas, Leonor Bacelar-Nicolau, Francisco N Rocha-Gonçalves, Cláudia Nisa, Armando Teixeira-Pinto, José Pereira-Miguel, Frederic S Resnic, Altamiro Costa-Pereira, Sharon-Lise Normand
Objective: To compare healthcare in acute myocardial infarction (AMI) treatment between contrasting health systems using comparable representative data from Europe and USA. Design: Repeated cross-sectional retrospective cohort study. Setting: Acute care hospitals in Portugal and USA during 2000-2010. Participants: Adults discharged with AMI. Interventions: Coronary revascularizations procedures (percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG) surgery)...
October 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28988753/a-biopsy-based-17-gene-genomic-prostate-score-as-a-predictor-of-metastases-and-prostate-cancer-death-in-surgically-treated-men-with-clinically-localized-disease
#11
Stephen K Van Den Eeden, Ruixiao Lu, Nan Zhang, Charles P Quesenberry, Jun Shan, Jeong S Han, Athanasios C Tsiatis, Amethyst D Leimpeter, H Jeffrey Lawrence, Phillip G Febbo, Joseph C Presti
BACKGROUND: A 17-gene biopsy-based reverse transcription polymerase chain reaction assay, which provides a Genomic Prostate Score (GPS-scale 0-100), has been validated as an independent predictor of adverse pathology and biochemical recurrence after radical prostatectomy (RP) in men with low- and intermediate-risk prostate cancer (PCa). OBJECTIVE: To evaluate GPS as a predictor of PCa metastasis and PCa-specific death (PCD) in a large cohort of men with localized PCa and long-term follow-up...
October 5, 2017: European Urology
https://www.readbyqxmd.com/read/28985854/reduced-disparities-and-improved-surgical-outcomes-for-asian-americans-with-colorectal%C3%A2-cancer
#12
Kayln C Mulhern, Tyler S Wahl, Lauren E Goss, Katey Feng, Joshua S Richman, Melanie S Morris, Herbert Chen, Daniel I Chu
BACKGROUND: Studies suggest Asian Americans may have improved oncologic outcomes compared with other ethnicities. We hypothesized that Asian Americans with colorectal cancer would have improved surgical outcomes in mortality, postoperative complications (POCs), length of stay (LOS), and readmissions compared with other racial/ethnic groups. METHODS: We queried the 2011-2014 American College of Surgeons National Surgical Quality Improvement Program for patients who underwent surgery for colorectal cancer and stratified patients by race...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28985516/assessment-of-spatial-variation-in-breast-cancer-specific-mortality-using-louisiana-seer-data
#13
Rachel Carroll, Andrew B Lawson, Chandra L Jackson, Shanshan Zhao
BACKGROUND: Previous studies suggest spatial differences in mortality for many types of cancer, including breast cancer. Identifying explanations for these spatial differences results in a better understanding of what leads to longer survival time. METHODS: We used a Bayesian accelerated failure time model with spatial frailty terms to investigate potential spatial differences in breast cancer mortality following breast cancer diagnosis using 2000-2013 Louisiana SEER data...
September 28, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28983579/cost-effectiveness-of-two-dose-human-papillomavirus-vaccination-in-singapore
#14
Sun Kuie Tay, Bee-Wah Lee, Woo Yun Sohn, I-Heng Lee, Gaurav Mathur, Melvin Sanicas, Georges Van Kriekinge
INTRODUCTION: Cervical cancer is the tenth most common cancer and the eighth most frequent cause of death among women in Singapore. Human papillomavirus (HPV) infection is the necessary cause of cervical cancer and therefore the risk of cervical cancer can be substantially reduced through vaccination. This study was conducted to evaluate the cost-effectiveness of two-dose HPV vaccination, as part of a national vaccination programme for 12-year-old girls in Singapore, from the perspective of the healthcare payer...
October 6, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28982347/outcome-measures-for-oral-health-based-on-clinical-assessments-and-claims-data-feasibility-evaluation-in-practice
#15
Riët Hummel, Josef Bruers, Onno van der Galiën, Wil van der Sanden, Geert van der Heijden
BACKGROUND: It is well known that treatment variation exists in oral healthcare, but the consequences for oral health are unknown as the development of outcome measures is still in its infancy. The aim of this study was to identify and develop outcome measures for oral health and explore their performance using health insurance claims records and clinical data from general dental practices. METHODS: The Dutch healthcare insurance company Achmea collaborated with researchers, oral health experts, and general dental practitioners (GDPs) in a proof of practice study to test the feasibility of measures in general dental practices...
October 5, 2017: BMC Oral Health
https://www.readbyqxmd.com/read/28979518/a-consensus-to-determine-the-ideal-critical-care-transfer-bag
#16
Gezz Van Zwanenberg, Melissa Dransfield, Rohit Juneja
BACKGROUND: Familiarity with environment, processes and equipment reduces the risk inherently associated with critical care transfers. Therefore, the North West London Critical Care Network decided to create a standardised ideal transfer bag and contents to improve patient safety. METHODS: A four-round modified Delphi survey developed a condensed and clinically tested content list. An expert panel then designed an ideal transfer bag based on agreed important principles...
November 2016: J Intensive Care Soc
https://www.readbyqxmd.com/read/28977687/professional-structural-and-organisational-interventions-in-primary-care-for-reducing-medication-errors
#17
REVIEW
Hanan Khalil, Brian Bell, Helen Chambers, Aziz Sheikh, Anthony J Avery
BACKGROUND: Medication-related adverse events in primary care represent an important cause of hospital admissions and mortality. Adverse events could result from people experiencing adverse drug reactions (not usually preventable) or could be due to medication errors (usually preventable). OBJECTIVES: To determine the effectiveness of professional, organisational and structural interventions compared to standard care to reduce preventable medication errors by primary healthcare professionals that lead to hospital admissions, emergency department visits, and mortality in adults...
October 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28977344/associations-between-vitamin-d-levels-and-depressive-symptoms-in-later-life-evidence-from-the-english-longitudinal-study-of-ageing-elsa
#18
Cesar de Oliveira, Vasant Hirani, Jane P Biddulph
Background: A possible role of vitamin D in depression has received considerable attention, especially given the significant disability, mortality, and healthcare costs associated to depression and the high prevalence of vitamin D deficiency. Methods: We investigated the cross-sectional associations between serum 25-hydroxyvitamin D (25OHD) levels and depressive symptoms (CES-D) in 5,607 older adults from the English Longitudinal Study of Ageing (ELSA). Results: Overall, there was a significant association between low 25OHD levels and elevated depressive symptoms (odds ratio [OR] = 1...
June 22, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28975609/healthcare-associated-meningitis-or-ventriculitis-in-older-adults
#19
Chanunya Srihawan, Onaizah Habib, Lucrecia Salazar, Rodrigo Hasbun
BACKGROUND/OBJECTIVES: Healthcare-associated meningitis or ventriculitis (HCAMV) is a serious and life-threatening complication of invasive neurosurgical procedures or penetrating head trauma. Older adults are at higher risk of adverse outcomes in community-acquired meningitis but studies of HCAMV are lacking. Therefore, we perform the study to define the differences in clinical outcomes between older and younger adults with HCAMV. DESIGN: Retrospective study. SETTING: A large tertiary care hospital in Houston, Texas, from July 2003 to November 2014...
October 4, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28974377/persistent-opioid-use-following-total-knee-arthroplasty-a-signal-for-close-surveillance
#20
Robert S Namba, Maria C S Inacio, Nicole L Pratt, Stephen E Graves, Elizabeth E Roughead, Elizabeth W Paxton
BACKGROUND: Prolonged opioid use following total knee arthroplasty (TKA) has not been extensively studied. METHODS: A cohort study of primary TKA for osteoarthritis using an integrated healthcare system and Total Joint Replacement Registry (January 2008-December 2011) was conducted. Opioid use during the first year after TKA was the exposure of interest and cumulative daily oral morphine equivalent (OME) amounts were calculated. Total postsurgical OME per 90-day exposure periods were categorized into quartiles...
September 13, 2017: Journal of Arthroplasty
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