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https://www.readbyqxmd.com/read/28817444/strategies-for-reducing-population-surgical-costs-in-medicare-local-referrals-to-low-cost-hospitals
#1
Hari Nathan, Jyothi R Thumma, Edward C Norton, Justin B Dimick
OBJECTIVE: We sought to assess hospital cost variation for elective inpatient surgical procedures within small geographic areas. SUMMARY BACKGROUND DATA: Previous studies have documented cost variation for inpatient surgical procedures on a national basis, suggesting opportunities for savings. Cost variation within small geographic areas is more relevant to policymakers, providers, and patients, but it has not been studied. METHODS: Using Medicare payment data, we identified elderly patients undergoing 1 of 7 elective inpatient surgical procedures during 2010-2012...
August 16, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28814838/post-acute-care-for-stroke-a-retrospective-cohort-study-in-taiwan
#2
Chung-Liang Lai, Ming-Miau Tsai, Jia-Yuan Luo, Wan-Chun Liao, Pi-Shan Hsu, Han-Yu Chen
BACKGROUND: Stroke often causes functional decline in patients. Therefore, after the acute phase, many patients require post-acute care (PAC) to maximize their functional progress, reduce disability, and make it possible for them to return to their home and community. PAC can be provided in different settings. Taiwan's National Health Insurance (NHI) proposed a PAC pilot program, effective since 2014, for stroke patients that allowed patients with the potential for functional improvement to receive PAC rehabilitation in regional or community hospitals...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28810445/enduring-somatic-threat-perceptions-and-post-traumatic-stress-disorder-symptoms-in-survivors-of-cardiac-events
#3
Laura Meli, Carmela Alcántara, Jennifer A Sumner, Brendan Swan, Bernard P Chang, Donald Edmondson
Post-traumatic stress disorder due to acute cardiovascular events may be uniquely defined by enduring perceptions of somatic threat. We tested whether post-traumatic stress disorder at 1 month post-acute coronary syndrome indeed required both high peritraumatic threat during the acute coronary syndrome and ongoing cardiac threat perceptions. We assessed peritraumatic threat during emergency department enrollment of 284 patients with a provisional acute coronary syndrome diagnosis and cardiac threat perceptions and post-traumatic stress disorder symptoms 1 month post-discharge...
April 1, 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28809645/screening-for-functional-cognition-in-postacute-care-and-the-improving-medicare-post-acute-care-transformation-impact-act-of-2014
#4
Gordon Muir Giles, Dorothy Farrar Edwards, M Tracy Morrison, Carolyn Baum, Timothy J Wolf
Occupational therapists have a long history of assessing functional cognition, defined as the ability to use and integrate thinking and performance skills to accomplish complex everyday activities. In response to passage of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 (Pub. L. 113-185), the American Occupational Therapy Association has been advocating that the Centers for Medicare and Medicaid Services consider functional cognition for inclusion in routine patient assessment in postacute care settings, with important implications for occupational therapy...
September 2017: American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association
https://www.readbyqxmd.com/read/28808918/idarucizumab-in-dabigatran-treated-patients-with-acute-ischemic-stroke-receiving-alteplase-a-systematic-review-of-the-available-evidence
#5
REVIEW
Slaven Pikija, Laszlo K Sztriha, J Sebastian Mutzenbach, Stefan M Golaszewski, Johann Sellner
BACKGROUND AND PURPOSE: Current guidelines do not recommend the use of intravenous recombinant tissue plasminogen activator in patients with acute ischemic stroke who receive direct oral anticoagulants. While the humanized monoclonal antibody idarucizumab can quickly reverse the anticoagulant effects of the thrombin inhibitor dabigatran, safety data for subsequent tissue plasminogen activator treatment are sparse. Here, we review current knowledge about dabigatran reversal prior to systemic reperfusion treatment in acute ischemic stroke...
August 14, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28805361/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the-long-term-care-hospital-prospective-payment-system-and-policy-changes-and-fiscal-year-2018-rates-quality-reporting-requirements-for-specific-providers-medicare
#6
(no author information available yet)
We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2018. Some of these changes implement certain statutory provisions contained in the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, the 21st Century Cures Act, and other legislation...
August 14, 2017: Federal Register
https://www.readbyqxmd.com/read/28791062/success-rate-of-conventional-dacryocystorhinostomy-in-post-acute-dacryocystitis-compared-to-endonasal-dacryocystorhinostomy-in-acute-dacryocystitis
#7
Rajesh Subhash Joshi, Ajay Sharad Deshpande
PURPOSE: To determine the success rate of conventional dacryocystorhinostomy (DCR) and endoscopic DCR performed in patients with acute dacryocystitis. METHODS: Records of patients with acute dacryocystitis and operated during 2007-2008 were reviewed. Patients who completed a follow-up of 60 months were included in our study. Demographic characteristics, surgery types, success rate, and follow-up periods were recorded. Success was defined as the elimination of epiphora, absence of dacryocystitis, and negative syringing test result (i...
July 2017: Journal of Ophthalmic & Vision Research
https://www.readbyqxmd.com/read/28777233/validating-performance-of-a-hospital-discharge-planning-decision-tool-in-community-hospitals
#8
Diane E Holland, Cheryl Brandt, Paul V Targonski, Kathryn H Bowles
PURPOSE OF STUDY: The Early Screen for Discharge Planning (ESDP) is a decision support tool developed in an urban academic medical center. High ESDP scores identify patients with nonroutine discharge plans who would benefit from early discharge planning intervention. We aimed to determine the predictive performance of the ESDP in a different practice setting. PRIMARY PRACTICE SETTING: Rural regional community hospital. METHODOLOGY AND SAMPLE: We designed a comparative, descriptive survey study and enrolled a convenience sample of 222 patients (identified at admission) who provided informed consent...
September 2017: Professional Case Management
https://www.readbyqxmd.com/read/28777005/predicting-two-year-mortality-from-discharge-after-acute-coronary-syndrome-an-internationally-based-risk-score
#9
Stuart J Pocock, Yong Huo, Frans Van de Werf, Simon Newsome, Chee Tang Chin, Ana Maria Vega, Jesús Medina, Héctor Bueno
BACKGROUND: Long-term risk of post-discharge mortality associated with acute coronary syndrome remains a concern. The development of a model to reliably estimate two-year mortality risk from hospital discharge post-acute coronary syndrome will help guide treatment strategies. METHODS: EPICOR (long-tErm follow uP of antithrombotic management patterns In acute CORonary syndrome patients, NCT01171404) and EPICOR Asia (EPICOR Asia, NCT01361386) are prospective observational studies of 23,489 patients hospitalized for an acute coronary syndrome event, who survived to discharge and were then followed up for two years...
August 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28770372/the-impact-of-anger-in-adherence-to-treatment-and-beliefs-about-disease-1%C3%A2-year-after-stroke
#10
A Catarina Santos, José M Ferro
Anger is a frequent neuropsychiatric symptom after stroke, which can disrupt treatment and recovery, in particular by affecting adherence behaviour to treatment and health care education. This study aimed to follow-up a cohort of stroke patients 12 months after their stroke to describe the presence of anger, compare levels and profile of acute and post-acute anger and analyse its impact on the adherence to treatment and beliefs about stroke. We followed (13.3 months mean follow-up) 91 stroke patients with a standardized protocol, using State-Trait Anger Expression Inventory-2 (STAXI-2) to assess the frequency and profile of anger and its components and one questionnaire to measure adherence to treatment and health education (meaning on the treatment) (Adh-T)...
August 2, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28759896/an-analysis-of-diagnoses-that-drive-readmission-what-can-we-learn-from-the-hospitals-in-southern-new-england-with-the-highest-and-lowest-readmission-performance
#11
Blake Morphis, Rouba Youssef, Rebekah Gardner, Elizabeth M Goldberg
T Background: The Hospital Readmission Reduction Program was instituted by the Centers for Medicare & Medicaid Services in 2012 to incentivize hospitals to reduce readmissions. OBJECTIVE: To examine the most common diagnoses driving readmissions among fee-for-service Medicare beneficiaries in the hospitals with the highest and lowest readmission performance in Southern New England from 2014 to 2016. METHODS: This is a retrospective observational study using publicly available Hospital Compare data and Medicare Part A claims data...
August 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28751848/anmco-position-paper-long-term-follow-up-of-patients-with-pulmonary-thromboembolism
#12
Carlo D'Agostino, Pietro Zonzin, Iolanda Enea, Michele Massimo Gulizia, Walter Ageno, Piergiuseppe Agostoni, Michele Azzarito, Cecilia Becattini, Amedeo Bongarzoni, Francesca Bux, Franco Casazza, Nicoletta Corrieri, Michele D'Alto, Nicola D'Amato, Andrea Maria D'Armini, Maria Grazia De Natale, Giovanni Di Minno, Giuseppe Favretto, Lucia Filippi, Valentina Grazioli, Gualtiero Palareti, Raffaele Pesavento, Loris Roncon, Laura Scelsi, Antonella Tufano
Venous thromboembolism (VTE), including pulmonary embolism and deep venous thrombosis, is the third most common cause of cardiovascular death. The management of the acute phase of VTE has already been described in several guidelines. However, the management of the follow-up (FU) of these patients has been poorly defined. This consensus document, created by the Italian cardiologists, wants to clarify this issue using the currently available evidence in VTE. Clinical and instrumental data acquired during the acute phase of the disease are the cornerstone for planning the FU...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28751839/the-future-of-telemedicine-for-the-management-of-heart-failure-patients-a-consensus-document-of-the-italian-association-of-hospital-cardiologists-a-n-m-c-o-the-italian-society-of-cardiology-s-i-c-and-the-italian-society-for-telemedicine-and-ehealth-digital
#13
Andrea Di Lenarda, Giancarlo Casolo, Michele Massimo Gulizia, Nadia Aspromonte, Simonetta Scalvini, Andrea Mortara, Gianfranco Alunni, Renato Pietro Ricci, Roberto Mantovan, Giancarmine Russo, Gian Franco Gensini, Francesco Romeo
Telemedicine applied to heart failure patients is a tool for recording and providing remote transmission, storage and interpretation of cardiovascular parameters and/or useful diagnostic images to allow for intensive home monitoring of patients with advanced heart failure, or during the vulnerable post-acute phase, to improve patient's prognosis and quality of life. Recently, several meta-analyses have shown that telemedicine-supported care pathways are not only effective but also economically advantageous...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28748734/biochemical-alterations-induced-by-nickel-oxide-nanoparticles-in-female-wistar-albino-rats-after-acute-oral-exposure
#14
Naresh Dumala, Bhanuramya Mangalampalli, Kalyan Kamal Srinivasa Sarika, Paramjit Grover
CONTEXT: Nickel oxide (NiO) nanoparticles (NPs) with appropriate surface chemistry have been widely used for their potential new applications in biomedical industry. Increased usage of these NPs, enhances the chance of exposure of personnel involved in the work place. OBJECTIVE: This study was designed to assess the ability of NiO NPs to cause biochemical alterations post-acute oral exposure in female Wistar rats. MATERIALS AND METHODS: Rats were administered with 125, 250, and 500 mg/kg doses of NiO NPs for haematological, biochemical and histopathological studies...
July 27, 2017: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/28732512/prolonged-acute-care-and-post-acute-care-admission-and-recovery-of-physical-function-in-survivors-of-acute-respiratory-failure-a-secondary-analysis-of-a-randomized-controlled-trial
#15
Anna Neumeier, Amy Nordon-Craft, Dan Malone, Margaret Schenkman, Brendan Clark, Marc Moss
BACKGROUND: The proportion of survivors of acute respiratory failure is growing; yet, many do not regain full function and require prolonged admission in an acute or post-acute care facility. Little is known about their trajectory of functional recovery. We sought to determine whether prolonged admission influenced the trajectory of physical function recovery and whether patient age modified the recuperation rate. METHODS: We performed a secondary analysis of a randomized clinical trial of intensive physical therapy for patients with acute respiratory failure requiring mechanical ventilation for ≥4 days...
July 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28732362/acute-atorvastatin-treatment-restores-the-cardioprotective-effects-of-ischemic-postconditioning-in-hyperlipidemic-rats
#16
Tao Sun, Hong-Ju Zhang, Chayakrit Krittanawong, Su Wang, Ying Tao, Zhao Li, Qiancheng Yin, Donghua Zhang, Qian Wang, Ji Huang, Jingmei Zhang, Zhizhong Li, Yutong Cheng
BACKGROUND: Ischemic Postconditioning (IPC) reduces ischemia/reperfusion (I/R) injury under normal conditions. HMG-CoA reductase inhibitors (statins), which inhibit the synthesis of mevalonate, can interfere with the cardioprotective effect of IPC. However, the beneficial role of IPC in hyperlipidemic patients, post-acute administration of statins remains unknown. This study was to determine if acute administration of atorvastatin affect the infarct size-limiting effect of IPC in hyperlipidemic rats...
July 14, 2017: Oncotarget
https://www.readbyqxmd.com/read/28727751/oral-health-and-cardiovascular-care-perceptions-of-people-with-cardiovascular-disease
#17
Paula Sanchez, Bronwyn Everett, Yenna Salamonson, Shilpi Ajwani, Sameer Bhole, Joshua Bishop, Karen Lintern, Samantha Nolan, Rohan Rajaratnam, Julie Redfern, Maria Sheehan, Fiona Skarligos, Lissa Spencer, Ravi Srinivas, Ajesh George
MAIN OBJECTIVE: The aim of this study was to explore the perception of patients with cardiovascular disease towards oral health and the potential for cardiac care clinicians to promote oral health. METHOD: A needs assessment was undertaken with twelve patients with cardiovascular disease attending cardiac rehabilitation between 2015 and 2016, in three metropolitan hospitals in Sydney, Australia. These patients participated in face-to-face semi-structured interviews...
2017: PloS One
https://www.readbyqxmd.com/read/28727670/effect-of-psychosocial-and-vocational-interventions-on-return-to-work-rates-post-acute-myocardial-infarction-a-systematic-review
#18
Lisa OʼBrien, Sonal Wallace, Lorena Romero
PURPOSE: To examine whether the effects of psychosocial and vocational interventions delivered in the first 3 mo post-acute myocardial infarction (AMI) are effective for improving work outcomes compared with other interventions. METHODS: A search was completed for English language publications up to March 2016 across 4 electronic databases and gray literature. Inclusion criteria were (1) psychosocial and/or vocational interventions; (2) adults 18 years or older with an AMI who were within the first 3 mo post-AMI; (3) randomized or clinically controlled trials; and (4) reporting of at least 1 return-to-work (RTW) outcome: including return to paid/unpaid employment, either full-time or part-time, to the previous job role or on modified duties...
July 19, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28726539/rethinking-transitions-of-care-an-interprofessional-transfer-triage-protocol-in-post-acute-care
#19
Radha V Patel, Lauri Wright, Brittany Hay
Readmissions to hospitals from post-acute care (PAC) units within long-term care settings have been rapidly increasing over the past decade, and are drivers of increased healthcare costs. With an average of $11,000 per admission, there is a need for strategies to reduce 30-day preventable hospital readmission rates. In 2018, incentives and penalties will be instituted for long-term care facilities failing to meet all-cause, all-condition hospital readmission rate performance measures. An interprofessional team (IPT) developed and implemented a Transfer Triage Protocol used in conjunction with the INTERACT programme to enhance clinical decision-making and assess the potential to reduce the facility's 30-day preventable hospital readmission rates by 10% within 6 weeks of implementation...
July 20, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28718295/accelerometer-determined-physical-activity-and-all-cause-mortality-in-a-national-prospective-cohort-study-of-adults-post-acute-stroke
#20
Paul D Loprinzi, Ovuokerie Addoh
PURPOSE: No epidemiological study has examined the association of objectively measured physical activity with all-cause mortality among adults who have had a stroke, which was the purpose of this study. DESIGN: Prospective. SETTING: National Health and Nutrition Examination Survey 2003 to 2006. PARTICIPANTS: One hundred eighty-four patients with stroke. MEASURES: Physical activity assessed via accelerometry (ActiGraph 7164), with stroke assessed via self-report of physician diagnosis...
January 1, 2017: American Journal of Health Promotion: AJHP
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