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https://www.readbyqxmd.com/read/28108823/which-clinical-and-patient-factors-influence-the-national-economic-burden-of-hospital-readmissions-after-total-joint-arthroplasty
#1
Steven M Kurtz, Edmund C Lau, Kevin L Ong, Edward M Adler, Frank R Kolisek, Michael T Manley
BACKGROUND: The Affordable Care Act of 2010 advanced the economic model of bundled payments for total joint arthroplasty (TJA), in which hospitals will be financially responsible for readmissions, typically at 90 days after surgery. However, little is known about the financial burden of readmissions and what patient, clinical, and hospital factors drive readmission costs. QUESTIONS/PURPOSES: (1) What is the incidence, payer mix, and demographics of THA and TKA readmissions in the United States? (2) What patient, clinical, and hospital factors are associated with the cost of 30- and 90-day readmissions after primary THA and TKA? (3) Are there any differences in the economic burden of THA and TKA readmissions between payers? (4) What types of THA and TKA readmissions are most costly to the US hospital system? METHODS: The recently developed Nationwide Readmissions Database from the Healthcare Cost and Utilization Project (2006 hospitals from 21 states) was used to identify 719,394 primary TJAs and 62,493 90-day readmissions in the first 9 months of 2013 based on International Classification of Diseases, 9th Revision, Clinical Modification codes...
January 20, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28106650/trends-in-ambulatory-management-of-urinary-incontinence-in-women-in-the-united-states
#2
James C Forde, Bilal Chughtai, Meagan Cea, Benjamin V Stone, Alexis Te, Tara F Bishop
OBJECTIVES: Urinary incontinence (UI) is a common condition, but despite the availability of guidelines, variations exist in the care of patients. We sought to assess the changes in assessment and management of women with UI over time in the United States. METHODS: The National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey are annual surveys from a nationally representative sample of visits to physicians. From 1999 through 2010, we identified visits by women to physicians where the chief complaint was UI using reason-for-visit and International Classification of Diseases, Ninth Revision codes...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28105763/triggering-of-acute-myocardial-infarction-by-respiratory-infection
#3
Lorcan Ruane, Thomas Buckley, Soon Y Soo Hoo, Peter S Hansen, Catherine McCormack, Elizabeth Shaw, Judith Fethney, Geoffrey H Tofler
BACKGROUND: Respiratory infection has been associated with an increased short term risk of myocardial infarction (MI). However, previous studies have predominantly been conducted without angiographic confirmation of MI. The possibility can therefore not be excluded that raised troponin levels or electrocardiogram abnormalities that may be seen with respiratory infections are due to non-ischaemic causes. AIMS: To investigate the association between respiratory infection and angiographically confirmed MI...
January 20, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28103711/the-experience-of-hospital-death
#4
Elise C Carey, Ann M Dose, Katherine M Humeniuk, Yichen C Kuan, Ashley D Hicks, Abigale L Ottenberg, Jon C Tilburt, Barbara Koenig
BACKGROUND: The quality of perimortem care received by patients who died at our hospitals was unknown. OBJECTIVE: To describe the quality of hospital care experienced in the last week of life, as perceived by decedents' families. DESIGN: Telephone survey that included established measures and investigator-developed content. SETTING: Large, tertiary care center known for high-quality, cost-effective care. PARTICIPANTS: Family members of 104 patients who died in-hospital (10% of annual deaths) over the course of 1 year...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28103443/effects-of-childhood-asthma-on-the-development-of-obesity-among-school-aged-children
#5
Zhanghua Chen, Muhammad T Salam, Tanya L Alderete, Rima Habre, Theresa M Bastain, Kiros Berhane, Frank D Gilliland
RATIONALE: Asthma and obesity often occur together in children. It is unknown whether asthma contributes to the childhood obesity epidemic. OBJECTIVES: We aimed to investigate the effects of asthma and asthma medication use on the development of childhood obesity. METHODS: The primary analysis was conducted among 2,171 non-obese children who were 5-8 years of age at study enrollment in the Southern California Children's Health Study (CHS) and were followed for up to 10 years...
January 19, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28100993/cdc-group-eo-4-and-candida-tropicalis-peritonitis-in-a-patient-on-peritoneal-dialysis-after-upper-endoscopy-colonoscopy-and-coil-embolization-of-the-gastroduodenal-artery
#6
Shameek Gayen, Yonah Ziemba, Shikha Jaiswal, Adam Frank, Yasmin Brahmbhatt
Peritoneal dialysis (PD) is an excellent form of renal replacement therapy for many patients with end-stage renal disease (ESRD). Over 10,000 patients receive PD in the United States [United States Renal Data System: 2015 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States, 2015]. PD has superior outcomes compared to hemodialysis in the first 2 years of ESRD [Sinnakirouchenan and Holley: Adv Chronic Kidney Dis 2011;18: 428-432]. However, peritonitis is a known complication and may result in significant morbidity and necessitate transition to hemodialysis, which increases medical costs [Holley and Piraino: Semin Dial 1990;3: 245-248]...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28100561/investigation-of-the-degree-of-organisational-influence-on-patient-experience-scores-in-acute-medical-admission-units-in-all-acute-hospitals-in-england-using-multilevel-hierarchical-regression-modelling
#7
Paul Sullivan, Derek Bell
OBJECTIVES: Previous studies found that hospital and specialty have limited influence on patient experience scores, and patient level factors are more important. This could be due to heterogeneity of experience delivery across subunits within organisations. We aimed to determine whether organisation level factors have greater impact if scores for the same subspecialty microsystem are analysed in each hospital. SETTING: Acute medical admission units in all NHS Acute Trusts in England...
January 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28100464/six-month-market-exclusivity-extensions-to-promote-research-offer-substantial-returns-for-many-drug-makers
#8
Aaron S Kesselheim, Benjamin N Rome, Ameet Sarpatwari, Jerry Avorn
To incentivize pharmaceutical manufacturers to invest in areas of unmet medical need, policy makers frequently propose extending the market exclusivity period of desired drugs. Some such proposals are modeled after the pediatric exclusivity patent extension program, which since 1997 has provided six additional months of market exclusivity for drugs studied in children. The most recent proposal would encourage rare disease research by providing six months of extended exclusivity for any existing drug that is granted subsequent FDA approval for a new rare disease indication...
January 18, 2017: Health Affairs
https://www.readbyqxmd.com/read/28100427/the-possible-role-of-propofol-in-drug-induced-torsades-de-pointes-a-real-world-single-center-analysis
#9
Victor A Abrich, Harish Ramakrishna, Arjun Mehta, Farouk Mookadam, Komandoor Srivathsan
BACKGROUND: Torsades de pointes (TdP) is a polymorphic ventricular tachycardia associated with QT prolongation. Propofol is a sedative-anesthetic with proarrhythmic effects on cardiac myocytes. We performed a retrospective study to determine the incidence of TdP following propofol exposure at Mayo Clinic (Rochester, MN) from 08/11/1998-11/20/2015. METHODS: We queried our database using key search terms to identify patients exposed to propofol who developed TdP perioperatively or during non-surgical sedation...
January 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28100387/-economic-burden-of-esophageal-cancer-in-china-from-1996-to-2015-a-systematic-review
#10
L W Guo, C L Shi, H Y Huang, L Wang, X P Yue, S Z Liu, J Li, K Su, M Dai, X B Sun, J F Shi
Objective: To explore existing evidence of economic burden of esophageal cancer in China over the past 20 years. Methods: Based on PubMed, CNKI and Wanfang, literatures published from 1996 to 2015 were retrieved with the key words such as " economic burden" , "cost of illness" and so on. Then the information excerpted from those literatures were analyzed after several exclusionary procedures for non-esophageal cancer related literatures. The information about subjects and data source, methodology, main results were structurally abstracted and then analyzed...
January 10, 2017: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
https://www.readbyqxmd.com/read/28100193/long-time-sickness-absence-among-parents-of-pre-school-children-with-cerebral-palsy-spina-bifida-and-down-syndrome-a-longitudinal-study
#11
Idunn Brekke, Elena Albertini Früh, Lisbeth Gravdal Kvarme, Henrik Holmstrøm
BACKGROUND: Taking care of a child with special needs can be draining and difficult and require a lot of parental time and resources. The present study investigated the long-term sickness absence of parents who have children with spina bifida, cerebral palsy and Down syndrome compared to that of parents without a child with special needs. METHODS: The sample consisted of primiparae women who gave birth between 2001 and 2005 and the fathers of the children (N = 202,593)...
January 18, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28100075/urinary-incontinence-in-alzheimer-s-disease
#12
Hsiang-Ying Lee, Ching-Chia Li, Yung-Shun Juan, Yu-Han Chang, Hsin-Chih Yeh, Chia-Chun Tsai, Kuang-Shun Chueh, Wen-Jeng Wu, Yuan-Han Yang
OBJECTIVES: Urinary incontinence (UI) is more prevalent in the elderly populations with dementia than without dementia, and Alzheimer's disease (AD) is the most common cause of dementia. Urinary incontinence may complicate AD morbidity and mortality. Therefore, this study aimed to evaluate the prevalence and annual incidence and determine the risk possibility of UI, which is the main type of incontinence in patients with AD in Taiwan. METHODS: A total of 933 patients with AD were included in the study cohort, and a total of 2799 patients without AD by 1:3 proportion compared to the study cohort were used as a matched cohort...
February 2017: American Journal of Alzheimer's Disease and Other Dementias
https://www.readbyqxmd.com/read/28099741/abortion-choices-among-women-in-cambodia-after-introduction-of-a-socially-marketed-medicated-abortion-product
#13
Khim Sotheary, Dianna Long, Gary Mundy, Yasmin Madan, Paul D Blumenthal
OBJECTIVE: To assess whether a social marketing initiative focusing on medicated abortion via a mifepristone/misoprostol "combipack" has contributed to reducing unsafe abortion in Cambodia. METHODS: In a questionnaire-based cross-sectional study, annual household surveys were conducted across 13 Cambodian provinces in 2010, 2011, and 2012. One married woman of reproductive age who was not pregnant and did not wish to be within the next 2 years in each randomly selected household was approached for inclusion...
February 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28099530/nationwide-seropositivity-of-hepatitis-a-in-republic-of-korea-from-2005-to-2014-before-and-after-the-outbreak-peak-in-2009
#14
Kyung-Ah Kim, Anna Lee, Moran Ki, Sook-Hyang Jeong
BACKGROUND/AIMS: The epidemiologic shift of hepatitis A virus (HAV) infection in the South Korean population resulted in a peak outbreak of hepatitis in 2009. The aim of this study was to clarify the seropositivity of anti-HAV antibody (anti-HAV) and its demographic characteristics before and after the peak outbreak from 2005 to 2014. METHODS: This retrospective study analyzed the anti-HAV data of all individuals from 1,795 medical institutions referred to a major central laboratory from January 2005 through December 2014, as a sentineal tool for monitoring annual variation of anti-HAV positivity...
2017: PloS One
https://www.readbyqxmd.com/read/28099402/transplant-center-volume-and-the-risk-of-pancreas-allograft-failure
#15
Tarek Alhamad, Andrew F Malone, Daniel C Brennan, Robert J Stratta, Su-Hsin Chang, Jason R Wellen, Timothy A Horwedel, Krista L Lentine
BACKGROUND: Successful pancreas transplantation requires surgical expertise and multidisciplinary medical management. The impact of transplant center volume on pancreas allograft survival remains unclear. METHODS: We examined Organ Procurement and Transplantation Network (OPTN) data on 11,568 simultaneous pancreas-kidney (SPK) and 4308 solitary pancreas (pancreas transplant alone and pancreas after kidney) transplants between 2000 and 2013. RESULTS: Average annual transplant center volume was categorized by tertiles into low, medium and high volume, respectively, as follows: 1-6 (n=3,861), 7-13 (n=3,891), and 14-34 (n=3,888) for SPK, and 1-3 (n=1,417), 4-10 (n=1,518), and 11-33 (n=1,377) for solitary pancreas transplants...
January 17, 2017: Transplantation
https://www.readbyqxmd.com/read/28099310/national-institutes-of-health-funding-to-departments-of-orthopaedic-surgery-at-u-s-medical-schools
#16
Jason Silvestre, Jaimo Ahn, L Scott Levin
BACKGROUND: The National Institutes of Health (NIH) is the largest supporter of biomedical research in the U.S., yet its contribution to orthopaedic research is poorly understood. In this study, we analyzed the portfolio of NIH funding to departments of orthopaedic surgery at U.S. medical schools. METHODS: The NIH RePORT (Research Portfolio Online Reporting Tools) database was queried for NIH grants awarded to departments of orthopaedic surgery in 2014. Funding totals were determined for award mechanisms and NIH institutes...
January 18, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28099052/mhealth-intervention-elements-and-user-characteristics-determine-utility-a-mixed-methods-analysis
#17
Lyndsay A Nelson, Shelagh A Mulvaney, Kevin B Johnson, Chandra Y Osborn
BACKGROUND: Mobile health (mHealth) interventions are improving the medication adherence of adults with type 2 diabetes mellitus (T2DM), but few studies examine how users experience these interventions. Therefore, we used a mixed-methods approach to understand how T2DM users experience a text messaging and interactive voice response (IVR)-delivered medication adherence intervention called MEssaging for Diabetes (MED). METHODS: Adults with T2DM used MED as part of a 3-month pilot study...
January 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28097328/diabetes-outpatient-care-and-acute-complications-before-and-after-high-deductible-insurance-enrollment-a-natural-experiment-for-translation-in-diabetes-next-d-study
#18
J Frank Wharam, Fang Zhang, Emma M Eggleston, Christine Y Lu, Stephen Soumerai, Dennis Ross-Degnan
Importance: High-deductible health plans (HDHPs) have expanded under the Affordable Care Act and are expected to play a major role in the future of US health policy. The effects of modern HDHPs on chronically ill patients and adverse outcomes are unknown. Objective: To determine the association of HDHP with high-priority diabetes outpatient care and preventable acute complications. Design, Setting, and Participants: Controlled interrupted-time-series study using a large national health insurer database from January 1, 2003, to December 31, 2012...
January 9, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28097106/postmeal-triglyceridemia-and-variability-of-hba1c-and-postmeal-glycemia-were-predictors-of-annual-decline-in-estimated-glomerular-filtration-rate-in-type-2-diabetic-patients-with-different-stages-of-nephropathy
#19
Ayaka Tsuboi, Akiko Takenouchi, Miki Kurata, Keisuke Fukuo, Tsutomu Kazumi
BACKGROUND: This study examined associations of annual glycemic variability and postprandial dysmetabolism with annual decline in estimated glomerular filtration rate (eGFR) in type 2 diabetic patients with different stages of nephropathy. METHODS: Intrapersonal mean and coefficient of variation (CV) of HbA1c, fasting and postmeal concentrations of plasma glucose (FPG and PMPG, respectively) and serum triglycerides (FTG and PMTG, respectively) during the first 12 months after enrollment were calculated in a cohort of 168 type 2 diabetic patients: 53 with optimal albumin/creatinine ratio (ACR < 10 mg/g), 62 with high normal ACR (10-29 mg/g) and 53 with elevated ACR (≧30 mg/g)...
2017: Journal of Diabetes and Metabolic Disorders
https://www.readbyqxmd.com/read/28096756/116th-annual-meeting-medical-library-association-inc-toronto-on-canada-may-15-20-2015
#20
Nicole Mitchell
No abstract text is available yet for this article.
January 2017: Journal of the Medical Library Association: JMLA
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