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https://www.readbyqxmd.com/read/28107297/nursing-care-management-influence-on-bundled-payments
#1
Shaynie Lentz, Brenda Luther
Fragmented and uncoordinated care is the third highest driver of U.S. healthcare costs. Although less than 10% of patients experience uncoordinated care, these patients represent 36% of total healthcare costs; care management interaction makes a significant impact on the utilization of healthcare dollars. A literature search was conducted to construct a model of care coordination for elective surgical procedures by collecting best practices for acute, transitions, and post-acute care periods. A case study was used to demonstrate the model developed...
January 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28104426/survival-expenditure-and-disposition-in-patients-following-out-of-hospital-cardiac-arrest-1995-2013
#2
Shaker M Eid, Marwan S Abougergi, Aiham Albaeni, Nisha Chandra-Strobos
AIMS: To investigate trends in survival to hospital discharge, in-hospital expenditures, and post-acute-care disposition following out-of-hospital cardiac arrest (OHCA) in the United States. METHODS: We performed this nationwide serial cross-sectional study using data from the National Inpatient Sample on all patients (age >18years) hospitalized with OHCA between January 1, 1995, and December 31, 2013. Our main outcome measure was survival to hospital discharge...
January 16, 2017: Resuscitation
https://www.readbyqxmd.com/read/28094021/neuropsychological-characteristics-of-encephalopathy-in-susac-s-syndrome-case-report
#3
Magdalena Roessler-Górecka, Tadeusz Mendel, Justyna Wiśniowska, Joanna Seniów
Susac's Syndrome (SS) is a rare, autoimmune angiopathy characterized by hearing loss, retinal artery occlusions and encephalopathy, which is usually expressed in multifocal neurological signs and symptoms, confusion state and cognitive impairment. There have been few descriptions of neuropsychological assessment of SS. We present a case study of 29-year-old woman who developed full SS. During the post-acute stage of disease, she was admitted to neurorehabilitation ward to improve her cognitive-behavioral and motor functioning...
January 10, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28092022/relevance-of-neuroimaging-for-neurocognitive-and-behavioral-outcome-after-pediatric-traumatic-brain-injury
#4
Marsh Königs, Petra Jw Pouwels, L W Ernest van Heurn, Roel Bakx, R Jeroen Vermeulen, J Carel Goslings, Bwee Tien Poll-The, Marleen van der Wees, Coriene E Catsman-Berrevoets, Jaap Oosterlaan
This study aims to (1) investigate the neuropathology of mild to severe pediatric TBI and (2) elucidate the predictive value of conventional and innovative neuroimaging for functional outcome. Children aged 8-14 years with trauma control (TC) injury (n = 27) were compared to children with mild TBI and risk factors for complicated TBI (mild(RF+), n = 20) or moderate/severe TBI (n = 17) at 2.8 years post-injury. Neuroimaging measures included: acute computed tomography (CT), volumetric analysis on post-acute conventional T1-weighted magnetic resonance imaging (MRI) and post-acute diffusion tensor imaging (DTI, analyzed using tract-based spatial statistics and voxel-wise regression)...
January 14, 2017: Brain Imaging and Behavior
https://www.readbyqxmd.com/read/28089214/prevalence-of-chronic-pancreatitis-results-of-a-primary-care-physician-based-population-study
#5
Gabriele Capurso, Livia Archibugi, Piera Pasquali, Alessandro Aceti, Paolo Balducci, Patrizia Bianchi, Francesco Buono, Stefano Camerucci, Rosanna Cantarini, Sergio Centofanti, Patrizia Colantonio, Riccarda Cremaschi, Sergio Crescenzi, Caterina Di Mauro, Davide Di Renzi, Andrea Filabozzi, Alfonso Fiorillo, Giuseppe Giancaspro, Paola Giovannetti, Giuseppe Lanna, Claudio Medori, Emilio Merletti, Enzo Nunnari, Francesca Paris, Marco Pavone, Angela Piacenti, Almerindo Rossi, Maria Cristina Scamuffa, Giovanni Spinelli, Marco Taborchi, Biagio Valente, Antonella Villanova, Alberto Chiriatti, Gianfranco Delle Fave
BACKGROUND: Data on chronic pancreatitis prevalence are scanty and usually limited to hospital-based studies. AIM: Investigating chronic pancreatitis prevalence in primary care. METHODS: Participating primary care physicians reported the prevalence of chronic pancreatitis among their registered patients, environmental factors and disease characteristics. The data were centrally reviewed and chronic pancreatitis cases defined according to M-ANNHEIM criteria for diagnosis and severity and TIGAR-O classification for etiology...
December 27, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28088798/the-intracranial-b2leed3s-score-and-the-risk-of-intracranial-hemorrhage-in-ischemic-stroke-patients-under-antiplatelet-treatment
#6
Pierre Amarenco, Leila Sissani, Julien Labreuche, Eric Vicaut, Marie Germaine Bousser, Angel Chamorro, Marc Fisher, Ian Ford, Kim M Fox, Michael G Hennerici, Heinrich Mattle, Peter M Rothwell, Philippe Gabriel Steg, Hans-Christoph Diener, Ralph L Sacco, Jacoba P Greving, Ale Algra
BACKGROUND: Chronic antiplatelet therapy in the post-acute phase of non-cardioembolic ischemic stroke is limited by the risk of intracranial hemorrhage (ICH) complications. METHODS: We developed an ICH risk score based on the PERFORM trial cohort (n = 19,100), which included patients with a non-cardioembolic ischemic stroke or transient ischemic attack, and externally validated this score in one contemporary trial of very similar size and inclusion criteria, the PRoFESS trial (n = 20,332 patients)...
January 14, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28079394/the-positive-emotions-after-acute-coronary-events-behavioral-health-intervention-design-rationale-and-preliminary-feasibility-of-a-factorial-design-study
#7
Jeffery C Huffman, Ariana M Albanese, Kirsti A Campbell, Christopher M Celano, Rachel A Millstein, Carol A Mastromauro, Brian C Healy, Wei-Jean Chung, James L Januzzi, Linda M Collins, Elyse R Park
BACKGROUND: Positive psychological constructs, such as optimism, are associated with greater participation in cardiac health behaviors and improved cardiac outcomes. Positive psychology interventions, which target psychological well-being, may represent a promising approach to improving health behaviors in high-risk cardiac patients. However, no study has assessed whether a positive psychology intervention can promote physical activity following an acute coronary syndrome. OBJECTIVE: In this article we will describe the methods of a novel factorial design study to aid the development of a positive psychology-based intervention for acute coronary syndrome patients and aim to provide preliminary feasibility data on study implementation...
November 1, 2016: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28071958/is-type-d-personality-an-independent-risk-factor-for-recurrent-myocardial-infarction-or-all-cause-mortality-in-post-acute-myocardial-infarction-patients
#8
Emelie Condén, Andreas Rosenblad, Philippe Wagner, Jerzy Leppert, Lisa Ekselius, Cecilia Åslund
Background Type D personality refers to a combination of simultaneously high levels of negative affectivity and social inhibition. The present study aimed to examine whether type D personality was independently associated with recurrent myocardial infarction or all-cause mortality in post-acute myocardial infarction patients, using any of the previously proposed methods for measuring type D personality. Design This was a prospective cohort study. Methods Utilising data from the Västmanland Myocardial Infarction Study, 946 post-acute myocardial infarction patients having data on the DS14 instrument used to measure type D personality were followed-up for recurrent myocardial infarction and all-cause mortality until 9 December 2015...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28067536/history-of-erectile-dysfunction-as-a-predictor-of-poor-physical-performance-after-an-acute-myocardial-infarction
#9
Leonida Compostella, Caterina Compostella, Li Van Stella Truong, Nicola Russo, Tiziana Setzu, Sabino Iliceto, Fabio Bellotto
Background Erectile dysfunction may predict future cardiovascular events and indicate the severity of coronary artery disease in middle-aged men. The aim of this study was to evaluate whether erectile dysfunction (expression of generalized macro- and micro-vascular pathology) could predict reduced effort tolerance in patients after an acute myocardial infarction. Patients and methods One hundred and thirty-nine male patients (60 ± 12 years old), admitted to intensive cardiac rehabilitation 13 days after a complicated acute myocardial infarction, were evaluated for history of erectile dysfunction using the International Index of Erectile Function questionnaire...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28056466/subacute-subclinical-brain-infarctions-after-transcatheter-aortic-valve-implantation-negatively-impact-cognitive-function-in-long-term-follow-up
#10
Alexander Ghanem, Jonas Dörner, Leonie Schulze-Hagen, Andreas Müller, Marius Wilsing, Jan-Malte Sinning, Julian Lütkens, Christian Frerker, Karl-Heinz Kuck, Ingo Gräff, Hans Schild, Nikos Werner, Eberhard Grube, Georg Nickenig
AIMS: To date every post-procedural cerebrovascular embolic event (CVE) is dreaded for its potential to accelerate cognitive decline after transcatheter aortic valve implantation (TAVI). This study differentiates the impact of acute (procedural) and post-acute cerebrovascular embolic events (CVEs) on cognitive performance. METHODS: Magnetic resonance imaging (MRI) before, early and late after TAVI was performed to quantify embolic burden. Quantification of diffusion- and T1-weighted lesions, as well as white-matter and total brain volumes, as well as cognitive function testing (MMSE) were assessed in 28 patients with a medium follow-up period of 34 months...
2017: PloS One
https://www.readbyqxmd.com/read/28049200/a-mouse-model-of-post-stroke-pneumonia-induced-by-intra-tracheal-inoculation-with-streptococcus-pneumoniae
#11
Eva Mracsko, Sabine Stegemann-Koniszewski, Shin-Young Na, Alexander Dalpke, Dunja Bruder, Felix Lasitschka, Roland Veltkamp
BACKGROUND: Stroke-induced immunodeficiency increases the risk of infectious complications, which adversely affects neurological outcome. Among those, pneumonia affects as many as one third of stroke patients and is the main contributor to mortality in the post-acute phase of stroke. Experimental findings on post-stroke susceptibility to spontaneous pneumonia in mice are contradictory. Here, we established a mouse model inducing standardized bacterial pneumonia and characterized the impaired pulmonary cellular and humoral immune responses after experimental stroke...
January 4, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28042404/in-hospital-and-one-year-clinical-outcome-of-percutaneous-coronary-intervention-in-a-tertiary-hospital-in-oman-oman-pci-registry
#12
Prashanth Panduranga, Majdah Al-Rashidi, Fatma Al-Hajri
OBJECTIVES: The aim of the study was to investigate the in-hospital and one-year clinical outcome of patients treated with percutaneous coronary intervention (PCI) in a tertiary hospital in Oman. METHODS: We conducted a retrospective, single-center, observational study looking at patients > 18 years old who underwent a PCI from 1 January to 31 December 2013. The primary end point was the occurrence of a major adverse cardiovascular event (MACE), defined as death, any myocardial infarction (MI), cerebrovascular accident (CVA), and target vessel revascularization (TVR) with either repeat PCI or coronary artery bypass surgery (CABG)...
January 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28034774/the-use-of-the-risk-assessment-and-prediction-tool-in-surgical-patients-in-a-bundled-payment-program
#13
James Slover, Kathleen Mullaly, Raj Karia, John Bendo, Patricia Ursomanno, Aubrey Galloway, Richard Iorio, Joseph Bosco
OBJECTIVES: The purpose of this study was to evaluate the relationship between the Risk Assessment and Predictor Tool (RAPT) and patient discharge disposition in an institution participating in bundled payment program for total joint replacement, spine fusion and cardiac valve surgery patients. METHOD: Between April 2014 and April 2015, RAPT scores of 767 patients (535 primary unilateral total joint arthroplasty; 150 cardiac valve replacement; 82 spinal fusions) were prospectively captured...
December 26, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/28033089/geographic-variations-in-incremental-costs-of-heart-disease-among-medicare-beneficiaries-by-type-of-service-2012
#14
Rita Wakim, Matthew Ritchey, Jason Hockenberry, Michele Casper
Using 2012 data on fee-for-service Medicare claims, we documented regional and county variation in incremental standardized costs of heart disease (ie, comparing costs between beneficiaries with heart disease and beneficiaries without heart disease) by type of service (eg, inpatient, outpatient, post-acute care). Absolute incremental total costs varied by region. Although the largest absolute incremental total costs of heart disease were concentrated in southern and Appalachian counties, geographic patterns of costs varied by type of service...
December 29, 2016: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28030509/impact-of-early-operative-pelvic-fixation-on-long-term-self-reported-outcome-following-severe-pelvic-fracture
#15
John P Sharpe, Louis J Magnotti, Wade C Gobbell, Xin Huang, Edward A Perez, Timothy C Fabian, Martin A Croce
BACKGROUND: Traumatic disruption of the pelvic ring is a significant cause of life-threatening hemorrhage. For those patients who survive the initial injury, these fractures are associated with long periods of immobilization and intense rehabilitation. There is little published information available regarding long-term functional outcomes in these patients. This study evaluated the impact of severe pelvic fractures on those long-term outcomes. METHODS: All patients with severe pelvic fractures over an 18-year period were identified...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28024459/post-acute-hospital-healthcare-services-for-people-with-mild-stroke-a-scoping-review
#16
Tenelle Hodson, Louise Gustafsson, Petrea Cornwell, Amanda Love
BACKGROUND: People with mild stroke comprise a significant proportion of the overall stroke population. Previously this population has been viewed as having limited impairments, receiving minimal services following hospital discharge. Recent findings demonstrate that the implications of mild stroke are more significant than originally comprehended, warranting further services. OBJECTIVES: To identify the evidence-base regarding services for people with mild stroke, post-acute hospital discharge, that target secondary prevention and/or changes following stroke...
December 26, 2016: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/28024441/the-effects-of-telehealth-use-for-post-acute-rehabilitation-patient-outcomes
#17
Stephanie A Hicks, Verena R Cimarolli
Introduction Previous research has shown that home telehealth services can reduce hospitalisations and emergency department visits and improve clinical outcomes among older adults with chronic conditions. However, there is a lack of research on the impact of telehealth (TH) use on patient outcomes in post-acute rehabilitation settings. The current study examined the effects of TH for post-acute rehabilitation patient outcomes (i.e. discharge setting and change in functional independence) when controlling for other factors (e...
January 1, 2016: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28017450/prevalence-of-stroke-related-sarcopenia-and-its-association-with-poor-oral-status-in-post-acute-stroke-patients-implications-for-oral-sarcopenia
#18
Ai Shiraishi, Yoshihiro Yoshimura, Hidetaka Wakabayashi, Yuri Tsuji
BACKGROUND & AIMS: The aim of the study was to investigate the prevalence of stroke-related sarcopenia and its association with poor oral status in post-acute stroke patients. METHODS: This cross-sectional study included 202 consecutive stroke patients who were admitted to convalescent rehabilitation wards in Japan. The Revised Oral Assessment Guide (ROAG) was used to assess oral status. Sarcopenia was defined as a loss of skeletal muscle mass index (SMI) with bioelectrical impedance and decreased muscle strength as measured by handgrip strength; cut-off values were adopted from the Asian Working Group for Sarcopenia...
December 10, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28008280/thicker-carotid-intima-media-thickness-and-increased-plasma-vegf-levels-suffered-by-post-acute-thrombotic-stroke-patients
#19
Yuyun Yueniwati, Ni Komang Darmiastini, Eko Arisetijono
BACKGROUND AND OBJECTIVES: Atherosclerosis causes reduction of the oxygen supply to structures in the far arterial wall, provoking the release of factors that drive angiogenesis of vasa vasorum, including VEGF. Other studies have revealed the inflammatory response in atherosclerosis and the role of platelet factor 4 (PF4) as an anti-angiogenic chemokine through the inhibition of VEGF. This cross-sectional study aims at measuring the effect of atherosclerosis assessed through carotid intima-media thickness (CIMT) against plasma VEGF levels in patients with post-acute thrombotic stroke...
2016: International Journal of General Medicine
https://www.readbyqxmd.com/read/28005124/comprehensive-care-for-joint-replacement-cjr-bundle-expense-in-perioperative-pain-management
#20
Susan D Bear
The implementaion of the Comprehensive Care for Joint Replacement (CJR) model has necessitated value-focused care for a 90-day period. Pain management in joint arthroplasty therefore represents a focused opportunity to achieve lasting change in the delivery of care. To be successful, orthopedic surgeons must integrate approaches that take into account administration route and therapy duration, and various combinations thereof, to achieve improved longer term outcomes for joint arthroplasty patients. In addition, pain management choices must be based on value and not on simple costs, as patient satisfaction scores affect CJR repayments...
November 2016: American Journal of Orthopedics
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