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Healthcare predictive modeling

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https://www.readbyqxmd.com/read/29161521/lessons-from-the-camden-coalition-of-healthcare-providers-first-medicaid-shared-savings-performance-evaluation
#1
Aaron Truchil, Natasha Dravid, Stephen Singer, Zachary Martinez, Teagan Kuruna, Scott Waulters
Accountable Care Organizations (ACOs) aim to reduce health care costs while improving patient outcomes. Camden Coalition of Healthcare Providers' (Camden Coalition) work already aligned with this aim before receiving state approval to operate a certified Medicaid ACO in New Jersey. Upon its formation, the Camden Coalition ACO partnered with UnitedHealthcare and, through state legislation, Rutgers Center for State Health Policy (CSHP) was established as its external evaluator. In evaluating the Camden Coalition ACO, Rutgers CSHP built on the Medicare Shared Savings model, but modified it based on the understanding that the Medicaid population differs from the Medicare population...
November 21, 2017: Population Health Management
https://www.readbyqxmd.com/read/29159785/improving-the-hospital-quality-of-care-during-winter-periods-by-optimizing-budget-allocation-between-rotavirus-vaccination-and-bed-expansion
#2
Thibaut Dort, Nadia Schecroun, Baudouin Standaert
BACKGROUND: During each winter the hospital quality of care (QoC) in pediatric wards decreases due to a surge in pediatric infectious diseases leading to overcrowded units. Bed occupancy rates often surpass the good hospital bed management threshold of 85%, which can result in poor conditions in the workplace. This study explores how QoC-scores could be improved by investing in additional beds and/or better vaccination programs against vaccine-preventable infectious diseases. METHODS: The Cobb-Douglas model was selected to define the improvement in QoC (%) as a function of two strategies (rotavirus vaccination coverage [%] and addition of extra hospital beds [% of existing beds]), allowing improvement-isocurves to be produced...
November 20, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/29159270/the-circular-rna-micra-for-risk-stratification-after-myocardial-infarction
#3
Antonio Salgado-Somoza, Lu Zhang, Melanie Vausort, Yvan Devaux
Background: A significant proportion of patients develop heart failure (HF) after acute myocardial infarction (MI). Predicting this development with novel biomarkers would allow tailoring healthcare to each individual. We recently identified a circular RNA called MICRA which was associated with HF development after MI. Here, we tested whether MICRA was able to risk stratify MI patients. Methods: MICRA was assessed in whole blood samples collected at reperfusion in 472 patients with acute MI...
December 2017: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/29158647/performance-of-physiology-scoring-systems-in-prediction-of-in-hospital-mortality-of-traumatic-children-a-prospective-observational-study
#4
Babak Nakhjavan-Shahraki, Mahmoud Yousefifard, Gholamreza Faridaalaee, Kavous Shahsavari, Alireza Oraii, Mohammad Javad Hajighanbari, Parviz Karimi, Fatemeh Mahdizadeh, Samaneh Abiri, Mostafa Hosseini
Background: This study is designed to compare the value of four physiologic scoring systems of rapid acute physiology score (RAPS), rapid emergency medicine score (REMS), Worthing physiology scoring system (WPSS) and revised trauma score (RTS) in predicting the in-hospital mortality of traumatic children brought to the emergency department. Method: We used the data gathered from six healthcare centers across Iran between the April-October 2016. Included patients were all children with trauma...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29158247/predictive-values-of-referrals-for-transient-ischaemic-attack-from-first-contact-health-care-a-systematic-review
#5
Rebecca Kandiyali, Daniel S Lasserson, Penny Whiting, Alison Richards, Jonathan Mant
BACKGROUND: Over 150 000 cases of suspected transient ischaemic attack (TIA) are referred to outpatient clinics in England each year. The majority of referrals are made by GPs. AIM: This study aimed to identify how many patients referred to a TIA clinic actually have TIA (that is, calculate the positive predictive value [PPV] of first-contact healthcare referral) and to record the alternative diagnoses in patients without TIA, in order to determine the optimal service model for patients with suspected TIA...
November 20, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29152921/proximity-to-pediatric-cardiac-surgical-care-among-adolescents-with-congenital-heart-defects-in-11-new-york-counties
#6
Kristin M Sommerhalter, Tabassum Z Insaf, Tugba Akkaya-Hocagil, Claire E McGarry, Sherry L Farr, Karrie F Downing, George K Lui, Ali N Zaidi, Alissa R Van Zutphen
BACKGROUND: Many individuals with congenital heart defects (CHDs) discontinue cardiac care in adolescence, putting them at risk of adverse health outcomes. Because geographic barriers may contribute to cessation of care, we sought to characterize geographic access to comprehensive cardiac care among adolescents with CHDs. METHODS: Using a population-based, 11-county surveillance system of CHDs in New York, we characterized proximity to the nearest pediatric cardiac surgical care center among adolescents aged 11 to 19 years with CHDs...
November 1, 2017: Birth defects research
https://www.readbyqxmd.com/read/29152814/depression-young-age-chronic-marijuana-use-and-interepisodic-symptoms-predict-psychological-distress-in-patients-with-cyclic-vomiting-syndrome
#7
Tatyana Taranukha, Vishnu Charan Suresh Kumar, Alex Seamon, Natasha Sahr, Aniko Szabo, Thangam Venkatesan
BACKGROUND: Cyclic vomiting syndrome (CVS) is often triggered by stress. Patients report high degrees of psychological distress due to CVS, but there is limited data on factors associated with psychological distress. We sought to determine the degree of psychological distress and its correlation with clinical characteristics in CVS. METHODS: The Brief Symptom Inventory (BSI), a validated tool to determine psychological distress, was administered prospectively to patients...
November 20, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29148021/routine-adoption-of-timp2-and-igfbp7-biomarkers-in-cardiac-surgery-for-early-identification-of-acute-kidney-injury
#8
Chiara Levante, Fiorenza Ferrari, Chiara Manenti, Faeq Husain-Syed, Marta Scarpa, Tommaso Hinna Danesi, Massimo De Cal, Valentina Corradi, Grazia M Virzì, Alessandra Brendolan, Federico Nalesso, Pércia Bezerra, Salvador Lopez-Giacoman, Sara Samoni, Mara Senzolo, Davide Giavarina, Loris Salvador, Raffaele Bonato, Silvia De Rosa, Enrico Rettore, Claudio Ronco
BACKGROUND AND PURPOSE: Acute Kidney Injury (AKI) is a severe complication affecting many hospitalized patients after cardiac surgery, with negative impacts on short- and long-term clinical outcomes and on healthcare costs. Recently, clinical interest has been aimed at defining and classifying AKI, identifying risk factors and developing diagnostic strategies to identify patients at risk early on. Achieving an early and accurate diagnosis of AKI is a crucial issue, because prevention and timely detection may help to prevent negative clinical outcomes and avoid AKI-associated costs...
November 16, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29147853/biospecimen-donation-among-black-and-white-breast-cancer-survivors-opportunities-to-promote-precision-medicine
#9
Vanessa B Sheppard, Alejandra Hurtado-de-Mendoza, Yun-Ling Zheng, Ying Wang, Kristi D Graves, Tania Lobo, Hanfei Xu, Yvonne Jennings, Dennis Tolsma, Martha Trout, Brandi E Robinson, Brittany McKinnon, Mahlet Tadesse
PURPOSE: Advances in precision medicine (PM) have potential to reduce and/or eliminate breast cancer disparities in both treatment and survivorship. However, compared to white Americans, black Americans are often underrepresented in genetic research. This report assessed factors that influence receipt of buccal cells via saliva kits. METHODS: This prospective study recruited women with confirmed hormonal-positive (HR+) breast cancer (BC). A standardized telephone survey collected sociodemographic, socio-cultural (e...
November 16, 2017: Journal of Cancer Survivorship: Research and Practice
https://www.readbyqxmd.com/read/29146680/the-association-between-patient-experience-factors-and-likelihood-of-30-day-readmission-a-prospective-cohort-study
#10
Jocelyn Carter, Charlotte Ward, Deborah Wexler, Karen Donelan
OBJECTIVE: Hospital readmissions comprise nearly a third of US healthcare expenditures. Fifteen to 20 per cent of this spending is considered to be potentially preventable. Risk prediction models have suboptimal accuracy and typically exclude patient experience data. No studies have explored patient perceptions of the likelihood of readmission during index admission. Our objective was to examine associations between patient perceptions of care during index hospital admission and 30-day readmission...
November 16, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29143624/randomized-controlled-pilot-of-a-group-antenatal-care-model-and-the-sociodemographic-factors-associated-with-pregnancy-related-empowerment-in-sub-saharan-africa
#11
Crystal L Patil, Carrie S Klima, Sebalda C Leshabari, Alana D Steffen, Heather Pauls, Molly McGown, Kathleen F Norr
BACKGROUND: The links between empowerment and a number of health-related outcomes in sub-Saharan Africa have been documented, but empowerment related to pregnancy is under-investigated. Antenatal care (ANC) is the entry point into the healthcare system for most women, so it is important to understand how ANC affects aspects of women's sense of control over their pregnancy. We compare pregnancy-related empowerment for women randomly assigned to the standard of care versus CenteringPregnancy-based group ANC (intervention) in two sub-Saharan countries, Malawi and Tanzania...
November 8, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29142531/factors-associated-with-implementation-of-the-5a-s-smoking-cessation-model
#12
C Martínez, Y Castellano, A Andrés, M Fu, L Antón, M Ballbè, P Fernández, S Cabrera, A Riccobene, E Gavilan, A Feliu, A Baena, M Margalef, E Fernández
Background: Several health organizations have adopted the 5A's brief intervention model (Ask, Advise, Assess, Assist, Arrange), based on evidence-based guidelines for smoking cessation. We examine individual, cognitive, behavioral, and organizational factors associated with the 5A's performance among clinical healthcare workers in Catalonia. We also investigate how these factors interact and potentially predict the implementation of each component of the 5A's. Methods: A cross-sectional survey was conducted among clinical health workers enrolled in an online smoking cessation training course (n = 580)...
2017: Tobacco Induced Diseases
https://www.readbyqxmd.com/read/29138431/modelling-the-effect-of-beliefs-about-asthma-medication-and-treatment-intrusiveness-on-adherence-and-preference-for-once-daily-vs-twice-daily-medication
#13
Sarah Chapman, Peter Dale, Henrik Svedsater, Gillian Stynes, Nicola Vyas, David Price, Rob Horne
People with asthma who do not adhere to their maintenance medication may experience poorer asthma control and need more healthcare support than those who adhere. People (N = 1010) aged 18-55 years with self-reported asthma, taking one or more asthma maintenance medication(s), from five European countries, participated in a survey using validated scales (Medication Adherence Report Scale [MARS], Asthma Control Test™ [ACT], Beliefs about Medicine Questionnaire [BMQ] and the Asthma Treatment Intrusiveness Questionnaire [ATIQ])...
November 14, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/29132146/identification-of-unique-neoantigen-qualities-in-long-term-survivors-of-pancreatic-cancer
#14
Vinod P Balachandran, Marta Łuksza, Julia N Zhao, Vladimir Makarov, John Alec Moral, Romain Remark, Brian Herbst, Gokce Askan, Umesh Bhanot, Yasin Senbabaoglu, Daniel K Wells, Charles Ian Ormsby Cary, Olivera Grbovic-Huezo, Marc Attiyeh, Benjamin Medina, Jennifer Zhang, Jennifer Loo, Joseph Saglimbeni, Mohsen Abu-Akeel, Roberta Zappasodi, Nadeem Riaz, Martin Smoragiewicz, Z Larkin Kelley, Olca Basturk, Mithat Gönen, Arnold J Levine, Peter J Allen, Douglas T Fearon, Miriam Merad, Sacha Gnjatic, Christine A Iacobuzio-Donahue, Jedd D Wolchok, Ronald P DeMatteo, Timothy A Chan, Benjamin D Greenbaum, Taha Merghoub, Steven D Leach
Pancreatic ductal adenocarcinoma is a lethal cancer with fewer than 7% of patients surviving past 5 years. T-cell immunity has been linked to the exceptional outcome of the few long-term survivors, yet the relevant antigens remain unknown. Here we use genetic, immunohistochemical and transcriptional immunoprofiling, computational biophysics, and functional assays to identify T-cell antigens in long-term survivors of pancreatic cancer. Using whole-exome sequencing and in silico neoantigen prediction, we found that tumours with both the highest neoantigen number and the most abundant CD8(+) T-cell infiltrates, but neither alone, stratified patients with the longest survival...
November 8, 2017: Nature
https://www.readbyqxmd.com/read/29128200/exploring-sociodemographic-and-economic-factors-that-promote-adverse-drug-reactions-reporting-by-patients
#15
Pedro Inácio, João José Gomes, Marja Airaksinen, Afonso Cavaco
BACKGROUND: Adverse drug reactions (ADRs) are recognized as a leading cause of morbidity and mortality, and an important cost factor to health systems. Patient reporting of ADRs has emerged as an important topic in recent years but reporting rates are still low in many countries. OBJECTIVE: To explore different countries' sociodemographic and economic features as explanatory factors for population ADRs reporting, including the propensity of patients' reporting to pharmacovigilance authorities...
November 8, 2017: Health Policy
https://www.readbyqxmd.com/read/29125585/estimation-and-evaluation-of-future-demand-and-supply-of-healthcare-services-based-on-a-patient-access-area-model
#16
Shunsuke Doi, Hiroo Ide, Koichi Takeuchi, Shinsuke Fujita, Katsuhiko Takabayashi
Accessibility to healthcare service providers, the quantity, and the quality of them are important for national health. In this study, we focused on geographic accessibility to estimate and evaluate future demand and supply of healthcare services. We constructed a simulation model called the patient access area model (PAAM), which simulates patients' access time to healthcare service institutions using a geographic information system (GIS). Using this model, to evaluate the balance of future healthcare services demand and supply in small areas, we estimated the number of inpatients every five years in each area and compared it with the number of hospital beds within a one-hour drive from each area...
November 10, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29121913/predicting-health-related-quality-of-life-in-cancer-patients-receiving-chemotherapy-a-structural-equation-approach-using-the-self-control-model
#17
Yu-Ri Park, Eun-Young Park, Jung-Hee Kim
BACKGROUND: According to the self-control model, self-control works as a protective factor and a psychological resource. Although an understanding of the effect(s) of peripheral neuropathy on quality of life is important to healthcare professionals, previous studies do not facilitate broad comprehension in this regard. The purpose of this cross-sectional study was to test the multidimensional assumptions of quality of life of patients with cancer, with focus on their self-control. METHODS: A structural equation model was tested on patients with cancer at the oncology clinic of a university hospital where patients received chemotherapy...
November 9, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29119339/the-prostate-cancer-screening-clinic-in-the-bahamas-a-model-for-low-and-middle-income-countries
#18
Robin Roberts, Corydon Mitchell, Ana Lourdes Tancawan, Mandi Pedican, Glenn Wayne Jones
PURPOSE: Grand Bahama (pop. 51,000) is an island within the Bahamas archipelago. A local chapter of International Us TOO Prostate Cancer Support Group (UTGB) has led an annual community-based prostate cancer screening clinic in Grand Bahama each September since 2009. Features of this initiative, characteristics of attendees, and a description of found cancers were summarized to determine the clinic's value and to guide improvements. METHOD: We analyzed the established clinic from 2012 to 2015, wherein UTGB attracted corporate funding, volunteers managed clinics, and health professionals provided healthcare services...
November 2017: Cancer Causes & Control: CCC
https://www.readbyqxmd.com/read/29118232/healthcare-utilization-and-costs-during-the-initial-phase-of-care-among-elderly-women-with-breast-cancer
#19
Ami Vyas, S Suresh Madhavan, Usha Sambamoorthi, Xiaoyun Lucy Pan, Michael Regier, Hannah Hazard, Sita Kalidindi
Background: Understanding the patterns of healthcare utilization and costs during the initial phase of care (12 months after breast cancer [BC] diagnosis) in older women (aged ≥65 years) is crucial in the allocation of Medicare resources. The objective of this study was to determine healthcare utilization and costs during the initial phase of care in older, female, Medicare fee-for-service beneficiaries diagnosed with BC, and to determine the factors associated with higher costs. Methods: A retrospective observational study using the SEER-Medicare linked database was conducted in 69,307 women aged ≥66 years diagnosed with primary incident BC in 2003-2009 to determine healthcare utilization, average costs, and costs for specific services during the initial phase of care...
November 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29116679/functional-status-healthcare-utilization-and-the-costs-of-liver-transplantation
#20
Marina Serper, Therese Bittermann, Michael Rossi, David S Goldberg, Arwin M Thomasson, Kim M Olthoff, Abraham Shaked
The Model for End-stage Liver Disease (MELD) score predicts higher transplant healthcare utilization and costs; however, the independent contribution of functional status towards costs is understudied. The study objective was to evaluate the association between functional status, as measured by Karnofsky Performance Status (KPS), and liver transplant (LT) costs in the first post-transplant year. In a cohort of 598 LT recipients from 7/1/2009-11/30/2014, multivariable models assessed associations between KPS and outcomes...
November 8, 2017: American Journal of Transplantation
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