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https://www.readbyqxmd.com/read/28651296/early-discharge-hospital-at-home
#1
REVIEW
Daniela C Gonçalves-Bradley, Steve Iliffe, Helen A Doll, Joanna Broad, John Gladman, Peter Langhorne, Suzanne H Richards, Sasha Shepperd
BACKGROUND: Early discharge hospital at home is a service that provides active treatment by healthcare professionals in the patient's home for a condition that otherwise would require acute hospital inpatient care. This is an update of a Cochrane review. OBJECTIVES: To determine the effectiveness and cost of managing patients with early discharge hospital at home compared with inpatient hospital care. SEARCH METHODS: We searched the following databases to 9 January 2017: the Cochrane Effective Practice and Organisation of Care Group (EPOC) register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and EconLit...
June 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28650410/identification-of-risk-factors-in-lymphatic-surgeries-for-melanoma-a-national-surgical-quality-improvement-program-review
#2
Mona Ascha, Mustafa S Ascha, Brian Gastman
INTRODUCTION: Sentinel lymph node biopsy (SLNB) and lymphadenectomy (LAD) are commonly performed in the staging and care of patients with malignant melanoma. These procedures are accompanied by complications that may result in hospital readmission, negatively affecting patient outcomes and potentially affecting surgical procedure reimbursement. The National Surgical Quality Improvement Program (NSQIP) database offers a large data set allowing physicians to evaluate 30-day readmission for surgical complications...
June 23, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28650359/outcomes-of-concurrent-operations-results-from-the-american-college-of-surgeons-national-surgical-quality-improvement-program
#3
Jason B Liu, Julia R Berian, Kristen A Ban, Yaoming Liu, Mark E Cohen, Peter Angelos, Jeffrey B Matthews, David B Hoyt, Bruce L Hall, Clifford Y Ko
OBJECTIVE: To determine whether concurrently performed operations are associated with an increased risk for adverse events. BACKGROUND: Concurrent operations occur when a surgeon is simultaneously responsible for critical portions of 2 or more operations. How this practice affects patient outcomes is unknown. METHODS: Using American College of Surgeons' National Surgical Quality Improvement Program data from 2014 to 2015, operations were considered concurrent if they overlapped by ≥60 minutes or in their entirety...
June 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28649894/comparison-of-all-cause-stroke-and-bleed-specific-healthcare-resource-utilization-among-patients-with-non-valvular-atrial-fibrillation-nvaf-and-newly-treated-with-dabigatran-or-warfarin
#4
Xue Song, Pranav Gandhi, Adrienne M Gilligan, Prachi Arora, Cheng Wang, Caroline Henriques, Stephen Sander, David M Smith
OBJECTIVE: We compared healthcare utilization outcomes and persistence among non-valvular atrial fibrillation (NVAF) patients newly treated with dabigatran or warfarin. METHODS: Using a nationwide, US administrative claims database, a retrospective matched-cohort of newly diagnosed NVAF patients (age≥18 years) treated with dabigatran or warfarin (propensity score matched 1:1) in 01/01/2011-12/31/2013 was evaluated. All-cause, stroke- and bleed-specific per-patient per-month (PPPM) HCRU, incidence rate of hospitalization for stroke or bleed, 30-day readmission, and persistence were reported...
June 26, 2017: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/28649454/methods-guiding-stakeholder-engagement-in-planning-a-pragmatic-study-on-changing-stroke-systems-of-care
#5
Sabina B Gesell, Karen Potvin Klein, Jacqueline Halladay, Janet Prvu Bettger, Janet Freburger, Doyle M Cummings, Barbara J Lutz, Sylvia Coleman, Cheryl Bushnell, Wayne Rosamond, Pamela W Duncan
BACKGROUND: The Comprehensive Post-Acute Stroke Services (COMPASS) Study is one of the first large pragmatic randomized-controlled clinical trials using comparative effectiveness research methods, funded by the Patient-Centered Outcomes Research Institute. In the COMPASS Study, we compare the effectiveness of a patient-centered, transitional care intervention versus usual care for stroke patients discharged home from acute care. Outcomes include stroke patient post-discharge functional status and caregiver strain 90 days after discharge, and hospital readmissions...
April 2017: Journal of clinical and translational science
https://www.readbyqxmd.com/read/28649225/microsurgical-vs-endoscopic-excision-of-colloid-cysts-an-analysis-of-complications-and-costs-using-a-longitudinal-administrative-database
#6
Ian David Connolly, Eli Johnson, Layton Lamsam, Anand Veeravagu, John Ratliff, Gordon Li
OBJECTIVE: Open microsurgical and endoscopic approaches are the two main surgical options for excision of colloid cysts. Controversy remains as to which is superior. Previous studies consist of small cohort sizes. This topic has not been investigated using national administrative claims data which benefits from larger patient numbers. METHODS: Current Procedural Terminology (CPT) and International Classification of Disease version 9 (ICD-9) coding at inpatient visit was used to select for index surgical procedures corresponding to microsurgical or endoscopic excision of colloid cysts...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28648845/substance-abuse-and-gender-differences-in-first-episode-psychosis-impact-on-hospital-readmissions
#7
Josep M Crosas, Jesus Cobo, Maribel Ahuir, Carla Hernández, Rebeca García, Esther Pousa, Joan-Carles Oliva, José-Antonio Monreal, Diego J Palao
INTRODUCTION: There have been controversial results in the study of gender differences in first episode psychosis (FEP). Substance abuse is the main existing comorbidity in FEP, and has been associated with worse prognosis and greater symptom severity. OBJECTIVES: To explore gender differences in FEP in relation to drug abuse, and their relationship with hospital readmissions. METHODOLOGY: Descriptive and prospective study (18 months). RESULTS: We included 141 patients (31...
June 22, 2017: Revista de Psiquiatrí́a y Salud Mental
https://www.readbyqxmd.com/read/28648477/time-to-antibiotics-administration-and-outcome-in-community-acquired-pneumonia-secondary-analysis-of-a-randomized-controlled-trial
#8
Christophe Marti, Gregor John, Daniel Genné, Virginie Prendki, Olivier T Rutschmann, Jérôme Stirnemann, Nicolas Garin
BACKGROUND: The association between early antibiotic administration and outcomes remains controversial in patients hospitalized for community-acquired pneumonia. METHODS: We performed a secondary analysis of a randomized controlled trial comparing two antibiotic treatment strategies for patients hospitalized for moderately severe CAP. The univariate and multivariate associations between time to antibiotic administration (TTA) and time to clinical stability were assessed using a Cox proportional hazard model...
June 22, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28648393/etiologies-trends-and-predictors-of-30-day-readmissions-in-patients-with-diastolic-heart-failure
#9
Shilpkumar Arora, Sopan Lahewala, Hafeez Ul Hassan Virk, Saman Setareh-Shenas, Prashant Patel, Varun Kumar, Byomesh Tripathi, Harshil Shah, Viralkumar Patel, Umesh Gidwani, Abhishek Deshmukh, Apurva Badheka, Radha Gopalan
An estimated half of all heart failure (HF) populations has been categorized to have diastolic HF (DHF), but sparse data are available describing etiologies and predictors of 30-day readmission in DHF population. The study cohort was derived from the National Readmission Database 2013 to 2014, a subset of the Healthcare Cost and Utilization Project sponsored by the Agency for Healthcare Research and Quality. DHF was identified using International Classification of Diseases, 9th Revision code 428.3x in primary diagnosis field...
June 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28648327/incidence-of-acute-complications-following-surgery%C3%A2-for-syndactyly-and-polydactyly-an-analysis-of-the-national-surgical-quality-improvement-program-database-from-2012-to-2014
#10
Thomas J McQuillan, Jessica E Hawkins, Amy L Ladd
PURPOSE: Congenital hand differences are infrequent phenomena, and their treatment represents a relatively small fraction of cases performed by hand surgeons. Little is known about the incidence of wound complications and acute postoperative problems given the relative rarity of these procedures. This study sought to characterize the incidence of complications within 30 days of surgery for congenital hand differences. METHODS: The National Surgical Quality Improvement Program (NSQIP) contains prospective data regarding 30-day morbidity from 64 pediatric centers across the United States...
June 22, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28648218/innovative-information-technology-powered-population-health-care-management-improves-outcomes-and-reduces-hospital-readmissions-and-emergency-department-visits
#11
Sharon Anderson, Michele Campbell, Donna Mahoney, Ann Kathryn Muther, Janice Nevin, Patricia Resnik, Tabassum Salam, Terri Steinberg
BACKGROUND: Patients with chronic conditions are often the most frequent users of health care. Moreover, adapting to developments in one's illness, understanding how to self-manage a chronic illness, and sharing information between primary care and specialty providers, can be a full-time job for someone with a chronic illness. In response to these challenges, Christiana Care Health System (Wilmington, Delaware) developed Care Link, an information technology (IT)-enhanced care management support to enable populations of patients to achieve better clinical outcomes at lower cost...
July 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28648204/long-term-prognosis-of-chronic-kidney-disease-in-non-st-elevation-acute-coronary-syndrome-treated-with-invasive-strategy
#12
Ildefonso Roldán Torres, Inmaculada Salvador Mercader, Claudia Cabadés Rumbeu, José Luis Díez Gil, José Ferrando Cervelló, Marta Monteagudo Viana, Rubén Fernández Galera, Vicente Mora Llabata
BACKGROUND AND AIM: Patients with chronic kidney disease (CKD) have an increased risk of adverse cardiovascular outcomes after non-ST elevation acute coronary syndrome (NSTEACS). However, the information available on this specific population, is scarce. We evaluate the impact of CKD on long-term prognosis in patients with NSTEACS managed with invasive strategy. METHODS: We conduct a prospective registry of patients with NSTEACS and coronary angiography. CKD was defined as a glomerular filtration rate < 60ml/min/1,73m(2)...
May 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28647838/preoperative-education-for-hip-and-knee-replacement-never-stop-learning
#13
REVIEW
Paul K Edwards, Simon C Mears, C Lowry Barnes
PURPOSE OF REVIEW: Participation in alternative payment models has focused efforts to improve outcomes and patient satisfaction while also lowering cost for elective hip and knee replacement. The purpose of this review is to determine if preoperative education classes for elective hip and knee replacement achieve these goals. RECENT FINDINGS: Recent literature demonstrates that patients who attend education classes prior to surgery have decreased anxiety, better post-operative pain control, more realistic expectations of surgery, and a better understanding of their surgery...
June 24, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28647723/a-retrospective-cohort-study-of-high-impact-users-among-patients-with-cerebrovascular-conditions
#14
Ahsan Rao, Alice Jones, Alex Bottle, Ara Darzi, Paul Aylin
OBJECTIVE: To apply group-based trajectory modelling (GBTM) to the hospital administrative data to evaluate, model and visualise trends and changes in the frequency of long-term hospital care use of the subgroups of patients with cerebrovascular conditions. DESIGN: A retrospective cohort study of patients with cerebrovascular conditions. SETTINGS: Secondary care of all patients with cerebrovascular conditions admitted to English National Hospital Service hospitals...
June 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28647577/transitions-from-skilled-nursing-facility-to-home-the-relationship-of-early-outpatient-care-to-hospital-readmission
#15
Jennifer L Carnahan, James E Slaven, Christopher M Callahan, Wanzhu Tu, Alexia M Torke
BACKGROUND: Many adults are discharged to skilled nursing facilities (SNFs) prior to returning home from the hospital. Patient characteristics and factors that can help to prevent postdischarge adverse outcomes are poorly understood. OBJECTIVE: To identify whether early post-SNF discharge care reduces likelihood of 30-day hospital readmissions. DESIGN: Secondary data analysis using the Electronic Medical Record, Medicare, Medicaid and the Minimum Data Set...
June 21, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28647562/post-operative-complications-of-spina-bifida-patients-undergoing-urological-laparotomy-a-multi-institutional-analysis
#16
Christopher J Loftus, David C Moore, Joshua A Cohn, Douglas F Milam, Roger R Dmochowski, Dan Wood, Melissa R Kaufman, Hadley M Wood
OBJECTIVE: To characterize peri-operative morbidity and mortality of adult spina bifida patients undergoing laparotomy. METHODS: We retrospectively studied the post-operative complications of 59 operations of spina bifida patients undergoing abdominal laparotomies for urological indications at three institutions. We evaluated post-operative complications using the Clavien-Dindo classification scale. RESULTS: The overall complication rate was 91...
June 21, 2017: Urology
https://www.readbyqxmd.com/read/28647511/the-futile-cycle-of-hospital-readmission-in-patients-with-diabetes
#17
EDITORIAL
Janya Swami, Mary Korytkowski
No abstract text is available yet for this article.
June 17, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28647446/social-and-geographic-determinants-of-hysterectomy-in-ontario-a-population-based-retrospective-cross-sectional-analysis
#18
Innie Chen, Michelle R Wise, Sheila Dunn, Geoffrey Anderson, Naushaba Degani, Guylaine Lefebvre, Arlene S Bierman
OBJECTIVES: This study sought to determine whether social factors (neighbourhood education and income) and geographic factors (urban or rural dwelling and local service area) are associated with hysterectomy rates, proportion of hysterectomies performed minimally invasively, and hysterectomy complication and readmission rates in Ontario. METHODS: The Canadian Institute for Health Information Discharge Abstract Database was used to perform a population-based retrospective cross-sectional study on women who had an abdominal, vaginal, and laparoscopic hysterectomy in 2007 for benign gynaecologic conditions in hospitals in Ontario, Canada...
June 21, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28647442/the-impact-of-the-transition-from-volume-to-value-on-heart-failure-care-implications-of-novel-payment-models-and-quality-improvement-initiatives
#19
REVIEW
Dushyanth Srinivasan, Nihar R Desai
In response to wide variation in quality and outcomes as well as escalating health care costs, the U.S. health care system is transitioning away from a volume based payment system to a quality- and value-based system. Medicare, the largest insurer and payer of healthcare, has accelerated the movement towards value-based care with the development and implementation of myriad alternative payment models and pay for performance programs as part of the Affordable Care Act. Given that heart failure affects a significant number of Medicare patients and these patients account for a disproportionate amount of healthcare utilization and spending, heart failure has become a focal point for these initiatives...
June 21, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28647078/hospital-readmission-following-thoracic-surgery
#20
REVIEW
Richard K Freeman
Hospital readmission costs the health care system in excess of 1 billion dollars a year. The Hospital Readmission Reduction Program was instituted as part of the Affordable Care Act in 2012 and penalizes hospitals with high rates of readmission. Strategies exist to minimize hospital readmissions and should be implemented by thoracic surgeons.
August 2017: Thoracic Surgery Clinics
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