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https://www.readbyqxmd.com/read/28818869/clinical-risks-and-healthcare-utilization-of-haematopoietic-cell-transplantation-for-sickle-cell-disease-in-the-u-s-using-merged-databases
#1
Staci D Arnold, Ruta Brazauskas, Naya He, Yimei Li, Richard Aplenc, Zhezhen Jin, Matt Hall, Yoshiko Atsuta, Jignesh Dalal, Theresa Hahn, Nandita Khera, Carmem Bonfim, Navneet S Majhail, Miguel Angel Diaz, Cesar O Freytes, William A Wood, Bipin M Savani, Rammurti T Kamble, Susan Parsons, Ibrahim Ahmed, Keith Sullivan, Sara Beattie, Christopher Dandoy, Reinhold Munker, Susana Marino, Menachem Bitan, Hisham Abdel-Azim, Mahmoud Aljurf, Richard F Olsson, Sarita Joshi, Dave Buchbinder, Michael J Eckrich, Shahrukh Hashmi, Hillard Lazarus, David I Marks, Amir Steinberg, Ayman Saad, Usama Gergis, Lakshmanan Krishnamurti, Allistair Abraham, Hemalatha G Rangarajan, Mark Walters, Joseph Lipscomb, Wael Saber, Prakash Satwani
Allogeneic hematopoietic cell transplant advances for sickle cell disease improve outcomes, but limited healthcare utilization analysis exists. We hypothesized that early transplant (age < 10 years) improves outcomes and decreases healthcare utilization compared to late. We performed a retrospective study of US children transplanted for sickle cell during 2000-2013 using two large databases. Univariate and Cox models estimated associations between demographics, sickle cell severity, and transplant-related variables on mortality and chronic graft versus-host-disease; while, Wilcoxon, Kruskal-Wallis, or linear trend tests estimated against healthcare utilization...
August 17, 2017: Haematologica
https://www.readbyqxmd.com/read/28818277/economics-of-self-measured-blood-pressure-monitoring-a-community-guide-systematic-review
#2
REVIEW
Verughese Jacob, Sajal K Chattopadhyay, Krista K Proia, David P Hopkins, Jeffrey Reynolds, Anilkrishna B Thota, Christopher D Jones, Daniel T Lackland, Kimberly J Rask, Nicolaas P Pronk, John M Clymer, Ron Z Goetzel
CONTEXT: The health and economic burden of hypertension, a major risk factor for cardiovascular disease, is substantial. This systematic review evaluated the economic evidence of self-measured blood pressure (SMBP) monitoring interventions to control hypertension. EVIDENCE ACQUISITION: The literature search from database inception to March 2015 identified 22 studies for inclusion with three types of interventions: SMBP used alone, SMBP with additional support, and SMBP within team-based care (TBC)...
September 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28817299/how-do-medicare-advantage-beneficiary-payments-vary-with-tenure
#3
Paul D Jacobs, Eamon Molloy
OBJECTIVES: To compare how premiums and expected out-of-pocket medical costs (OOPC) vary with the length of time Medicare Advantage (MA) beneficiaries have been enrolled in their plans. STUDY DESIGN: Descriptive and fixed effects regression analyses. METHODS: Using linked administrative enrollment and plan data, we compared the costs of the MA plans that beneficiaries chose with the costs of other plans available to them. We show predicted values adjusted for age, gender, race/ethnicity, disability, individual health risk, presence of mental health diagnoses, health plan quality, relative size of the plan's provider network, and the number of years continuously enrolled in the same plan...
June 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28811074/management-of-multidrug-resistant-gram-negative-bacilli-infections-in-solid-organ-transplant-recipients-set-gesitra-seimc-reipi-recommendations
#4
REVIEW
J M Aguado, J T Silva, M Fernández-Ruiz, E Cordero, J Fortún, C Gudiol, L Martínez-Martínez, E Vidal, L Almenar, B Almirante, R Cantón, J Carratalá, J J Caston, E Cercenado, C Cervera, J M Cisneros, M G Crespo-Leiro, V Cuervas-Mons, J Elizalde-Fernández, M C Fariñas, J Gavaldà, M J Goyanes, B Gutiérrez-Gutiérrez, D Hernández, O Len, R López-Andujar, F López-Medrano, P Martín-Dávila, M Montejo, A Moreno, A Oliver, A Pascual, E Pérez-Nadales, A Román-Broto, R San-Juan, D Serón, A Solé-Jover, M Valerio, P Muñoz, J Torre-Cisneros
Solid organ transplant (SOT) recipients are especially at risk of developing infections by multidrug resistant (MDR) Gram-negative bacilli (GNB), as they are frequently exposed to antibiotics and the healthcare setting, and are regulary subject to invasive procedures. Nevertheless, no recommendations concerning prevention and treatment are available. A panel of experts revised the available evidence; this document summarizes their recommendations: (1) it is important to characterize the isolate's phenotypic and genotypic resistance profile; (2) overall, donor colonization should not constitute a contraindication to transplantation, although active infected kidney and lung grafts should be avoided; (3) recipient colonization is associated with an increased risk of infection, but is not a contraindication to transplantation; (4) different surgical prophylaxis regimens are not recommended for patients colonized with carbapenem-resistant GNB; (5) timely detection of carriers, contact isolation precautions, hand hygiene compliance and antibiotic control policies are important preventive measures; (6) there is not sufficient data to recommend intestinal decolonization; (7) colonized lung transplant recipients could benefit from prophylactic inhaled antibiotics, specially for Pseudomonas aeruginosa; (8) colonized SOT recipients should receive an empirical treatment which includes active antibiotics, and directed therapy should be adjusted according to susceptibility study results and the severity of the infection...
July 26, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28808852/patient-experience-with-the-patient-centered-medical-home-in-michigan-s-statewide-multi-payer-demonstration-a-cross-sectional-study
#5
Issidoros Sarinopoulos, Diane L Bechel-Marriott, Jean M Malouin, Shaohui Zhai, Jason C Forney, Clare L Tanner
BACKGROUND: The literature on patient-centered medical homes (PCMHs) and patient experience is somewhat mixed. Government and private payers are promoting multi-payer PCMH initiatives to align requirements and resources and to enhance practice transformation outcomes. To this end, the multipayer Michigan Primary Care Transformation (MiPCT) demonstration project was carried out. OBJECTIVE: To examine whether the PCMH is associated with a better patient experience, and whether a mature, multi-payer PCMH demonstration is associated with even further improvement in the patient experience...
August 14, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28804011/functional-outcomes-subsequent-healthcare-utilization-and-mortality-of-stroke-postacute-care-patients-in-taiwan-a-nationwide-propensity-score-matched-study
#6
Li-Ning Peng, Wan-Hsuan Lu, Chih-Kuang Liang, Ming-Yueh Chou, Chih-Ping Chung, Shu-Ling Tsai, Zhi-Jun Chen, Fei-Yuan Hsiao, Liang-Kung Chen
OBJECTIVE: To evaluate the benefits of the national stroke postacute care (PAC) program on clinical outcomes and subsequent healthcare utilization. DESIGN: Propensity score-matched case-control study using the National Health Insurance data. PARTICIPANTS: A total of 1480 stroke cases receiving PAC services and 3159 matched controls with similar stroke severity but without PAC services. MEASUREMENTS: Demographic characteristics, functional outcomes (modified Rankin Scale, Barthel Index, Lawton-Brody Instrumental Activities of Daily Living, Functional Oral Intake Scale, Mini-Nutritional Assessment, Berg Balance Test, Usual Gait Speed Test, 6-Minute Walk Test, Fugl-Meyer Assessment (modified sensation and motor), Mini-Mental State Examination, Motor Activity Log, and the Concise Chinese Aphasia Test), subsequent healthcare utilization (90-day stroke re-admission and emergency department visits), and 90-day mortality...
August 10, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28803265/measuring-the-end-of-life-premium-in-cancer-using-individual-ex-ante-willingness-to-pay
#7
S Olofsson, U-G Gerdtham, L Hultkrantz, U Persson
For the assessment of value of new therapies in healthcare, Health Technology Assessment (HTA) agencies often review the cost per quality-adjusted life-year (QALY) gained. Some HTA agencies accept a higher cost per QALY gained when treatment is aimed at prolonging survival for patients with a short expected remaining lifetime, a so-called end-of-life (EoL) premium. The objective of this study is to elicit the existence and size of an EoL premium in cancer. Data was collected from 509 individuals in the Swedish general population 20-80 years old using a web-based questionnaire...
August 12, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28803005/safety-and-feasibility-of-therapeutic-platelet-depletion-with-spectra-optia-in-a-pregnant-woman
#8
Roman Małachowski, Olga Grzybowska-Izydorczyk, Nelly Besson, Anna Szmigielska-Kapłon, Mateusz Nowicki, Agnieszka Wierzbowska
INTRODUCTION: Thrombocytapheresis is an alternative treatment beneficial in rare circumstances, when cytoreductive agents are contraindicated, drug therapy gave no response or the expected response would be too slow. Here we present a case of a pregnant woman who underwent 5 thrombocytaphereses using Spectra Optia device to reduce circulating platelets (PLT) count and prepare for Cesarian section. PATIENT CHARACTERISTICS AND PERFORMED TREATMENT: A 39-year-old woman with diagnosed chronic myeloid leukemia (CML) was treated with interferon because of too high PLT count...
July 27, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28801441/changes-in-prevalence-of-workplace-violence-against-doctors-in-all-medical-specialties-in-norway-between-1993-and-2014-a-repeated-cross-sectional-survey
#9
Ingrid Hjulstad Johansen, Valborg Baste, Judith Rosta, Olaf G Aasland, Tone Morken
OBJECTIVES: The aim of this study was to investigate whether reported prevalence of experienced threats, real acts of violence and debilitating fear of violence among Norwegian doctors have increased over the last two decades. DESIGN: Repeated cross-sectional survey. SETTING: All healthcare levels and medical specialties in Norway. PARTICIPANTS: Representative samples of Norwegian doctors in 1993 (n=2628) and 2014 (n=1158)...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28796851/association-of-maternal-preeclampsia-with-infant-risk-of-premature-birth-and-retinopathy-of-prematurity
#10
Julia P Shulman, Cindy Weng, Jacob Wilkes, Tom Greene, M Elizabeth Hartnett
Importance: Studies report conflicting associations between preeclampsia and retinopathy of prematurity (ROP). This study provides explanations for the discrepancies to clarify the relationship between preeclampsia and ROP. Objective: To evaluate the association of maternal preeclampsia and risk of ROP among infants in an unrestricted birth cohort and a restricted subcohort of preterm, very low birth weight (P-VLBW) infants. Design, Setting, and Participants: A retrospective review of 290 992 live births within the Intermountain Healthcare System in Utah from January 1, 2001, through December 31, 2010, was performed...
August 10, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28796569/cost-effectiveness-of-kinase-inhibitors-for-hematologic-malignancies-a-systematic-and-critical-review
#11
Monia Marchetti
Several genetic disruptions lead to constitutive activation of those kinases leukemic cells depend on for survival and proliferation. Kinase inhibitors (KI) are major therapeutic innovations for chronic myeloid leukemia (CML), chronic lymphoid leukemia (CLL) and myelofibrosis (MF) providing a relevant improvement of quality-adjusted survival in patients with high-risk or refractory disease. CML patients are being treated with first-generation KI imatinib since many years, achieving expected survivals longer than 10 years...
August 10, 2017: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/28795013/management-of-diabetes-mellitus-in-children-and-adolescents-engaging-in-physical-activity
#12
REVIEW
Silpa Nadella, Justin A Indyk, Manmohan K Kamboj
Regular physical activity is an important component in the management of both type 1 and type 2 diabetes mellitus (T1DM and T2DM), as it has the potential to improve glycemic control, delay cardiovascular complications, and increase overall well-being. Unfortunately, many children and adolescents with diabetes do not partake in regular exercise and physical activity for multiple reasons. This review identifies the barriers to participation from the aspect of the patient, caregiver, and the healthcare provider...
July 2017: Translational pediatrics
https://www.readbyqxmd.com/read/28793375/independent-predictors-of-medication-adherence-among-singaporean-patients-following-an-ischemic-stroke-or-transient-ischemic-attack
#13
Wenru Wang, Gerk Sin Chia, Il Fan Tan, Siew Noi Janis Tye, Xiaona Wang, Birong Zhu, Ying Jiang
OBJECTIVES: To investigate the independent predictors of medication adherence among Singaporean patients following an ischemic stroke or transient ischemic attack. BACKGROUND: Secondary prevention of stroke includes optimal control over modifiable risk factors, and medication adherence is important in controlling the effect of co-morbidities. However, there is a paucity of published literature on the topics of medication adherence among stroke patients, especially in the Asian population...
August 9, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28792195/can-hydrophilic-coated-catheters-be-beneficial-for-the-public-healthcare-system-in-brazil-a-cost-effectiveness-analysis-in-patients-with-spinal-cord-injuries
#14
José Carlos Truzzi, Vanessa Teich, Camila Pepe
INTRODUCTION: Detrusor sphincter dyssynergia affects 70% to 80% of all spinal cord injury patients, resulting in increased risk of urinary tract infections (UTIs) and potential exposure to antimicrobial resistance. In Brazil, local guidelines recommend intermittent catheterization as the best method for bladder emptying, and two catheter types are available: the conventional uncoated PVC and the hydrophilic coated catheters. OBJECTIVE: To evaluate the cost-effectiveness of two types of catheters for intermittent catheterization from the perspective of the Brazilian public healthcare system...
August 8, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28783533/predictive-factors-of-developing-type-2-diabetes-mellitus-acute-myocardial-infarction-and-stroke-in-a-cohort-with-impaired-fasting-glucose-in-singapore
#15
Dennis Bingzhu Chia, Lai Yin Wong, Daveon Yu Kai Liu, Matthias Paul Han Sim Toh
AIMS: This study describes the incidence and predictive factors for development of Type II Diabetes Mellitus (T2DM), Acute Myocardial Infarction (AMI) and stroke, among subjects with IFG over a five-year period. METHODS: This is a retrospective cohort study of subjects with newly diagnosed IFG from the Singapore National Healthcare Group hospitals and primary care clinics from 1 January 2008 to 31 December 2010. Clinical data were collected over a five-year period from the date of diagnosis...
July 20, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28774932/variation-in-the-echocardiographic-surveillance-of-primary-mitral-regurgitation
#16
Varsha K Tanguturi, Michael K Hidrue, Michael H Picard, Steven J Atlas, Jeffrey B Weilburg, Timothy G Ferris, Katrina Armstrong, Jason H Wasfy
BACKGROUND: Clinical outcomes after surgical treatment of mitral regurgitation are worse if intervention occurs after deterioration of left ventricular size and function. Transthoracic echocardiographic (TTE) surveillance of patients with mitral regurgitation is indicated to avoid adverse ventricular remodeling. Overly frequent TTEs can impair patient access and reduce value in care delivery. This balance between timely surveillance and overutilization of TTE in valvular disease provides a model to study variation in the delivery of healthcare services...
August 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28774549/combined-healthy-behaviors-and-healthcare-services-use-in-older-adults
#17
Ana Hernández-Aceituno, Raúl F Pérez-Tasigchana, Pilar Guallar-Castillón, Esther López-García, Fernando Rodríguez-Artalejo, José R Banegas
INTRODUCTION: Data on the combined impact of healthy behaviors on healthcare use in older adults are limited. METHODS: Study with community-dwelling individuals aged ≥60 years from the Spanish Seniors-ENRICA cohort, recruited in 2008-2010, followed through 2012-2013, and analyzed in 2016 (N=2,021). At baseline, the following healthy behaviors were self-reported: three traditional (never smoking, being physically active, having a healthy diet) and three emerging (sleeping 7-8 hours/day, sitting <8 hours/day, not living alone)...
July 31, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28771653/impact-of-polypharmacy-on-seniors-self-perceived-health-status
#18
Rafia Rasu, Walter Agbor-Bawa, Nahid Rianon
OBJECTIVES: Polypharmacy is common among older patients and is linked to increased risk of adverse health outcomes. This study aimed to explore the association of polypharmacy and self-perceived health status (SPHS) among geriatric patients. METHODS: This cross-sectional analysis of longitudinal observational research used national survey data from 2005-2008. Multivariate logistic regressions examined the likelihood of having a good/poor SPHS and polypharmacy. Medical Expenditure Panel Survey data provided by Agency for Healthcare Research and Quality were used in this study...
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28771394/screening-for-malnutrition-among-people-accessing-health-services-at-greek-public-hospitals-results-from-an-observational-multicenter-study
#19
Ioannis Doundoulakis, Kalliopi Anna Poulia, Christina Antza, Emmanouil Bouras, Eirini Kasapidou, Stanislaw Klek, Michael Chourdakis
BACKGROUND: Malnutrition is associated with increased hospital stay and subsequently higher healthcare costs. Early detection of malnutrition among people accessing health services at public hospitals is vital to identify and treat malnutrition effectively and in a timewise and cost-effective manner. The aim of this study was to evaluate the nutrition risk of this population. MATERIALS AND METHODS: Nutrition screening was performed for 2970 patients (52% male; 55...
August 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28767576/association-between-costs-and-quality-of-acute-myocardial-infarction-care-hospitals-under-the-korea-national-health-insurance-program
#20
Hee-Chung Kang, Jae-Seok Hong
If cost reductions produce a cost-quality trade-off, healthcare policy makers need to be more circumspect about the use of cost-effective initiatives. Additional empirical evidence about the relationship between cost and quality is needed to design a value-based payment system. We examined the association between cost and quality performances for acute myocardial infarction (AMI) care at the hospital level.In 2008, this cross-sectional study examined 69 hospitals with 6599 patients hospitalized under the Korea National Health Insurance (KNHI) program...
August 2017: Medicine (Baltimore)
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