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Healthcare risk adjustment

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https://www.readbyqxmd.com/read/29667759/incidence-predictors-and-clinical-management-of-hyperkalaemia-in-new-users-of-mineralocorticoid-receptor-antagonists
#1
Marco Trevisan, Pietro de Deco, Hairong Xu, Marie Evans, Bengt Lindholm, Rino Bellocco, Peter Barany, Tomas Jernberg, Lars H Lund, Juan J Carrero
BACKGROUND: Concerns for hyperkalaemia limit the use of mineralocorticoid receptor antagonists (MRAs). The frequency of MRA-associated hyperkalaemia in real-world settings and the extent of subsequent MRA discontinuation are poorly quantified. METHODS AND RESULTS: Observational study including all Stockholm citizens initiating MRA therapy during 2007-2010. Hyperkalaemias were identified from all potassium (K+ ) measurements in healthcare. MRA treatment lengths and dosages were obtained from complete collection of pharmacy dispensations...
April 18, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29667471/cost-effectiveness-analysis-of-suvorexant-for-the-treatment-of-japanese-elderly-patients-with-chronic-insnomnia-in-a-virtual-cohort
#2
Shinichi Nishimura, Mutsuhiro Nakao
AIMS: We assessed the cost effectiveness of the orexin receptor antagonist suvorexant against zolpidem, the most widely used hypnotic benzodiazepine receptor agonist in Japan. To this end, a model was used that factored in insomnia and the risk for hip fractures, which have devastating effects on the elderly. METHODS: Data were derived from published papers. The target population was a virtual cohort of elderly patients (≥65 years) with insomnia residing in Japan...
April 18, 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/29667216/nationwide-routine-data-analysis-of-sex-differences-in-outcome-of-acute-myocardial-infarction
#3
Eva Freisinger, Susanne Sehner, Nasser M Malyar, Anna Suling, Holger Reinecke, Karl Wegscheider
BACKGROUND: Women have been reported to suffer from impaired outcome after acute myocardial infarction (AMI). HYPOTHESIS: Aim of the study was to determine the impact of sex and age on the utilization of inpatient healthcare and outcome in patients with acute myocardial infarction (AMI; STEMI and NSTEMI) in a real-life setting. METHODS: We performed a Routine-data based analysis of 203,106 nationwide in-patient cases hospitalized with STEMI and NSTEMI, focusing on sex differences regarding risk constellation, treatments, and in-hospital outcome...
April 17, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29667178/cost-utility-analysis-of-bariatric-surgery
#4
O Borisenko, V Lukyanov, A R Ahmed
BACKGROUND: The objective of the study was to evaluate the cost-utility of bariatric surgery in England. METHODS: A state-transition Markov model was developed to compare the costs and outcomes of two treatment approaches for patients with morbid obesity: bariatric surgery, including gastric bypass, sleeve gastrectomy and adjustable gastric banding; and non-surgical usual care. Parameters of the effectiveness of surgery and complications were informed by data from the UK National Bariatric Surgery Registry, the Scandinavian Obesity Registry and the Swedish Obese Subjects study...
April 17, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29666685/identifying-risk-factors-for-healthcare-associated-infections-caused-by-carbapenem-resistant-acinetobacter-baumannii-in-a-neonatal-intensive-care-unit
#5
Amira M Sultan, Wael A Seliem
Objectives: Acinetobacter baumannii is a causative pathogen of various healthcare-associated infections (HAIs) and is particularly prevalent in high-risk hospital settings. This study aimed to determine risk factors associated with HAIs caused by carbapenem-resistant A. baumannii (CRAB) in a neonatal intensive care unit (NICU). Methods: This prospective study was performed between January 2013 and June 2014 among NICU patients at the Mansoura University Children's Hospital, Mansoura, Egypt...
February 2018: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/29665242/comparative-analysis-of-marketed-factor-viii-products-recombinant-products-are-not-alike-vis-a-vis-soluble-protein-aggregates-and-subvisible-particles
#6
J Anzengruber, C Lubich, T Prenninger, A Gringeri, F Scheiflinger, B M Reipert, M Malisauskas
BACKGROUND: Recombinant protein technologies have facilitated the development of novel FVIII therapeutics with improved production efficiency, potency, half-live, and low risk of viral transmission. The increasing number of recombinant Factor VIII (rFVIII) products and information on their efficacy, safety, and cost allow patients and healthcare professionals to adjust treatment to individual needs. Nonetheless, 20-32% of previously untreated patients with severe hemophilia A develop inhibitory antibodies to rFVIII following treatment...
April 17, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29665231/estrogen-returns-to-the-stage-in-melanoma
#7
Jennifer L McQuade, Michael A Davies
It has long been recognized that female sex is associated with a lower risk of and improved survival in melanoma (Joosse et al., 2012). However, the mechanism underlying this disparity in outcomes is not understood. One potential explanation is behavioral- i.e. differences by sex in UV exposure, screening and detection, and healthcare utilization. Observed differences between men and women in prognostic factors in primary melanomas would support this. For example, men are more likely to have thicker, ulcerated tumors, which could reflect diagnostic delays...
April 17, 2018: Pigment Cell & Melanoma Research
https://www.readbyqxmd.com/read/29663601/psychiatric-disorders-among-children-of-parents-with-cancer-a-swedish-register-based-matched-cohort-study
#8
Ruoqing Chen, Amanda Regodón Wallin, Eva Norén Selinus, Arvid Sjölander, Katja Fall, Unnur Valdimarsdóttir, Kamila Czene, Fang Fang
OBJECTIVE: To investigate the risk of psychiatric disorders among children of parents with cancer in a nationwide population-based setting. METHODS: Based on Swedish national registers, the study included 101,339 children with parental cancer diagnosed either during pregnancy (N=1,047) or after birth (N=100,292) that were born during 1983-2000. For each exposed child, we randomly selected 10 unexposed children from the general population after individual matching by year of birth and sex...
April 16, 2018: Psycho-oncology
https://www.readbyqxmd.com/read/29662688/distribution-and-determinants-of-pneumonia-diagnosis-using-integrated-management-of-childhood-illness-guidelines-a-nationally-representative-study-in-malawi
#9
Omolara T Uwemedimo, Todd P Lewis, Elsie A Essien, Grace J Chan, Humphreys Nsona, Margaret E Kruk, Hannah H Leslie
Background: Pneumonia remains the leading cause of child mortality in sub-Saharan Africa. The Integrated Management of Childhood Illness (IMCI) strategy was developed to standardise care in low-income and middle-income countries for major childhood illnesses and can effectively improve healthcare worker performance. Suboptimal clinical evaluation can result in missed diagnoses and excess morbidity and mortality. We estimate the sensitivity of pneumonia diagnosis and investigate its determinants among children in Malawi...
2018: BMJ Global Health
https://www.readbyqxmd.com/read/29661386/association-between-intraoperative-opioid-administration-and-30-day-readmission-a-pre-specified-analysis-of-registry-data-from-a-healthcare-network-in-new-england
#10
D R Long, A L Lihn, S Friedrich, F T Scheffenbichler, K C Safavi, S M Burns, J C Schneider, S D Grabitz, T T Houle, M Eikermann
BACKGROUND: The use of intraoperative opioids may influence the rate of postoperative complications. This study evaluated the association between intraoperative opioid dose and the risk of 30-day hospital readmission. METHODS: We conducted a pre-specified analysis of existing registry data for 153 902 surgical cases performed under general anaesthesia at Massachusetts General Hospital and two affiliated medical centres. We examined the association between total intraoperative opioid dose (categorised in quintiles) and 30-day hospital readmission, controlling for several patient-, anaesthetist-, and case-specific factors...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661218/endometrial-cancer-survivors-follow-up-care-ensure-less-is-more-evaluating-patient-satisfaction-and-cost-effectiveness-of-a-reduced-follow-up-schedule-study-protocol-of-a-randomized-controlled-trial
#11
Nicole P M Ezendam, Belle H de Rooij, Roy F P M Kruitwagen, Carien L Creutzberg, Ingrid van Loon, Dorry Boll, M Caroline Vos, Lonneke V van de Poll-Franse
BACKGROUND: It has often been hypothesized that the frequency of follow-up visits for patients with early-stage endometrial cancer could be decreased. However, studies evaluating effects of a reduced follow-up schedule among this patient group are lacking. The aim of this study is to assess patient satisfaction and cost-effectiveness of a less frequent follow-up schedule compared to the schedule according to the Dutch guideline. METHODS: In this multicenter randomized controlled trial, patients diagnosed in the Netherlands with stage 1A and 1B low-risk endometrial cancer, for whom adjuvant radiotherapy is not indicated (n = 282), are randomized...
April 16, 2018: Trials
https://www.readbyqxmd.com/read/29661199/adverse-pregnancy-outcomes-in-adolescents-and-young-women-with-systemic-lupus-erythematosus-a-national-estimate
#12
Nicole Ling, Erica Lawson, Emily von Scheven
BACKGROUND: Pregnant women with systemic lupus erythematosus (SLE) have increased risk of adverse outcomes including disease flare, spontaneous abortion, preeclampsia/eclampsia, premature birth and maternal death. However, pregnancy outcomes among adolescents and young women with SLE have not been well-explored. Our objective was to compare risk of adverse pregnancy outcomes in adolescents and young women with SLE to risk among peers without SLE. METHODS: We studied the 2000-2011 Nationwide Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP) to estimate the prevalence of adverse pregnancy outcomes in women with SLE aged ≤ 21 years at time of delivery...
April 16, 2018: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/29661143/dietary-habits-and-helicobacter-pylori-infection-a-cross-sectional-study-at-a-lebanese-hospital
#13
Shafika Assaad, Rawan Chaaban, Fida Tannous, Christy Costanian
BACKGROUND: To examine the association between dietary habits and Helicobacter pylori (H. pylori) infection among patients at a tertiary healthcare center in Lebanon. METHODS: This cross-sectional study was conducted on 294 patients in 2016, at a hospital in Northern Lebanon. Participants were interviewed using a structured questionnaire to collect information on socio-demographic and lifestyle characteristics; dietary habits were ascertained via a short food frequency questionnaire (FFQ)...
April 16, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29659753/patient-and-strain-characteristics-associated-with-clostridium-difficile-transmission-and-adverse-outcomes
#14
Jessica S H Martin, David W Eyre, Warren N Fawley, David Griffiths, Kerrie Davies, Damian P C Mawer, Timothy E A Peto, Derrick W Crook, A Sarah Walker, Mark H Wilcox
Background: No previous study has used whole-genome sequencing (WGS) to investigate risk factors for C. difficile(CD) transmission between symptomatic cases, or assessed the impact of recent acquisition on patient outcome. Methods: This retrospective cohort study included consecutive diarrhoeal samples positive by cytotoxin assay in Leeds, UK(Aug10-Apr12). All samples underwent culture, ribotyping and WGS(Illumina). Sequenced isolates were compared using single nucleotide variants(SNVs)...
April 12, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29656745/severe-adverse-events-impact-overall-survival-and-costs-in-elderly-patients-with-advanced-non-small-cell-lung-cancer-on-second-line-therapy
#15
Hossein Borghaei, Yeun Mi Yim, Annie Guerin, Irina Pivneva, Sherry Shi, Mayank Gandhi, Raluca Ionescu-Ittu
OBJECTIVES: Elderly patients with advanced non-small lung cancer (aNSCLC) represent a high-risk patient population due to disease burden, comorbidities, and performance status, particularly after progressing on first-line therapy. Among elderly patients who receive second-line therapy, treatment related toxicities can have substantial impact on both clinical and economic outcomes. This study assessed the impact of severe adverse events (AEs) during second-line therapy on overall survival (OS) and all-cause heathcare costs in elderly with aNSCLC...
May 2018: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
https://www.readbyqxmd.com/read/29656727/outcomes-in-hospitalized-ischemic-stroke-patients-with-dementia-on-admission-a-population-based-cohort-study
#16
Charlotte Zerna, Mary P Lindsay, Jiming Fang, Richard H Swartz, Eric E Smith
BACKGROUND: Dementia prevalence is rising, and it will double in the next 20 years. This study sought to understand the prevalence of dementia in hospitalized patients with ischemic stroke, and its impact on outcomes. METHODS: Using the Canadian Institute of Health Information's (CIHI) Discharge Abstract Database (DAD), all acute ischemic stroke admissions from April 2003 to March 2015 in Canada (excluding Quebec) were analyzed. Concurrent dementia at the time of admission was assessed based on hospital diagnostic codes...
April 16, 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/29656206/enhancing-first-time-parents-self-efficacy-a-systematic-review-and-meta-analysis-of-universal-parent-education-interventions-efficacy
#17
REVIEW
Nur Arina Liyana Amin, Wilson W S Tam, Shefaly Shorey
BACKGROUND: Poor adjustment during early parenthood often leads to low feelings of parental self-efficacy, which influences parents' behaviours towards their infants. The long-term consequences on infant development warrant the need for more attention on the efficacy of universal parent education interventions to empower parents and enhance their self-efficacy. OBJECTIVES: To synthesise available evidence and explore the efficacy of universal parent education interventions on the parental self-efficacy of first-time parents...
March 28, 2018: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29653218/comparing-ran-out-status-of-inhaled-short-acting-beta-agonists-in-emergency-department-patients-with-acute-asthma-1996-1998-versus-2015-2017
#18
Tadahiro Goto, Carlos A Camargo, Catalina Gimenez-Zapiola, Daniel J Pallin, Nathan I Shapiro, Thomas J Ferro, Carolyn Rainville, Stanislav Stoyanov, Kohei Hasegawa
BACKGROUND: Medication non-adherence including running out of inhaled asthma medications, is an important problem. OBJECTIVE: To examine the changes in the proportion of adults with acute asthma who ran out of their short-acting beta-agonist (SABA) inhalers before presenting to the emergency department (ED) between 1996-1998 and 2015-2017. METHODS: We analyzed data from prospective multicenter observational cohort studies of ED adult patients (aged 18-54 years) with acute asthma...
April 10, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29651640/characteristics-of-new-onset-and-chronic-sleep-medication-users-among-older-adults-a-retrospective-study-of-a-us-medigap-plan-population-using-propensity-score-matching
#19
Shirley Musich, Shaohung S Wang, Luke B Slindee, Lynn Saphire, Ellen Wicker
BACKGROUND: Prescription sleep medications are often utilized to manage sleep problems among older adults even though these drugs are associated with multiple risks. OBJECTIVE: The aim was to determine the prevalence and characteristics of new-onset compared to chronic sleep medication users and to examine factors associated with the conversion from new to chronic use. A secondary objective was to investigate the impact of sleep medications on health outcomes of injurious falls and patterns of healthcare utilization and expenditures...
April 12, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29649078/point-of-diagnosis-and-patient-retention-in-hiv-care-in-western-kenya
#20
Becky L Genberg, Hana Lee, Joseph W Hogan, Fatma Some, Juddy Wachira, Xiaotian K Wu, Paula Braitstein
BACKGROUND: Home-based counseling and testing (HBCT) achieves earlier HIV diagnosis than other testing modalities; however, retention in care for these healthier patients is unknown. The objective of this study was to determine the association between point of HIV testing and retention in care and mortality. SETTING: AMPATH (Academic Model Providing Access to Healthcare) has provided HIV care in western Kenya since 2001. METHODS: AMPATH initiated HBCT in 2007...
April 10, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
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