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https://www.readbyqxmd.com/read/27926614/clinical-coordination-in-accountable-care-organizations-a-qualitative-study
#1
Valerie A Lewis, Karen Schoenherr, Taressa Fraze, Aleen Cunningham
BACKGROUND: Accountable care organizations (ACOs) are becoming a common payment and delivery model. Despite widespread interest, little empirical research has examined what efforts or strategies ACOs are using to change care and reduce costs. Knowledge of ACOs' clinical efforts can provide important context for understanding ACO performance, particularly to distinguish arenas where ACOs have and have not attempted care transformation. PURPOSE: The aim of the study was to understand ACOs' efforts to change clinical care during the first 18 months of ACO contracts...
December 6, 2016: Health Care Management Review
https://www.readbyqxmd.com/read/27917479/hospital-postacute-care-referral-networks-is-referral-concentration-associated-with-medicare-style-bundled-payments
#2
Ramandeep Kaur, Jennifer N Perloff, Christopher Tompkins, Christine E Bishop
OBJECTIVE: To evaluate whether Medicare-style bundled payments are lower or higher for beneficiaries discharged from hospitals with postacute care (PAC) referrals concentrated among fewer PAC providers. DATA SOURCE: Medicare Part A and Part B claim (2008-2012) for all beneficiaries residing in any of 17 market areas: the Provider of Service file, the Healthcare Cost Report Information System, and the Dartmouth Atlas. STUDY DESIGN: An observational study in which hospitals were distinguished according to PAC referral concentration, which is the tendency to utilize fewer rather than more PAC providers...
December 5, 2016: Health Services Research
https://www.readbyqxmd.com/read/27912997/postacute-care-in-cancer-rehabilitation
#3
REVIEW
Ying Guo, Jack B Fu, Hong Guo, Jennifer Camp, Ki Y Shin, Shi-Ming Tu, Lynn J Palmer, Rajesh Yadav
Acute care is usually associated with disease progression, treatments for cancer, and medical comorbidities. Patients with cancer may develop sudden functional deficits that require rehabilitation. Some of these patients benefit from acute rehabilitation, others benefit from subacute rehabilitation. After acute rehabilitation, continuous care for these patients has not been well described. Three studies are presented to demonstrate that cancer rehabilitation is a continuous process. Rehabilitation professionals should know how to detect fall risk, monitor symptoms, and render symptom management...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27905155/optimising-qualitative-longitudinal-analysis-insights-from-a-study-of-traumatic-brain-injury-recovery-and-adaptation
#4
Joanna K Fadyl, Alexis Channon, Alice Theadom, Kathryn M McPherson
Knowledge about aspects that influence recovery and adaptation in the postacute phase of disabling health events is key to understanding how best to provide appropriate rehabilitation and health services. Qualitative longitudinal research makes it possible to look for patterns, key time points and critical moments that could be vital for interventions and supports. However, strategies that support robust data management and analysis for longitudinal qualitative research in health-care are not well documented in the literature...
November 30, 2016: Nursing Inquiry
https://www.readbyqxmd.com/read/27902344/pre-infection-transcript-levels-of-fam26f-in-pbmcs-inform-about-overall-plasma-viral-load-in-acute-and-postacute-phase-after-siv-infection
#5
Aneela Javed, Nicole Leuchte, Gabriela Salinas, Lennart Opitz, Christiane Stahl-Hennig, Sieghart Sopper, Ulrike Sauermann
CD8+ cells from simian immunodeficiency virus (SIV)-infected long-term non-progressors and some uninfected macaques can suppress viral replication in vitro without killing the infected cells. The aim of the study was to identify factors responsible for non-cytolytic viral suppression by transcriptional profiling and to investigate their potential impact on SIV-replication. Results of microarray experiments and further validation with cells from infected and uninfected macaques revealed that FAM26F RNA levels distinguished CD8+ cells of controllers and non-controllers (p=0...
October 18, 2016: Journal of General Virology
https://www.readbyqxmd.com/read/27882909/european-initiative-for-the-application-of-the-international-classification-of-functioning-disability-and-health-development-of-clinical-assessment-schedules-for-specified-rehabilitation-services
#6
Birgit Prodinger, Anke Scheel-Sailer, Reuben Escorpizo, Gerold Stucki
BACKGROUND: Clinical assessment schedule (CLAS) is a core part of the ICF-based implementation of functioning reporting across health conditions and along the continuum of care. AIM: The Physical and Rehabilitation Medicine Section and Board of the European Union of Medical Specialists (UEMS PRM) workshop held in January 2016 aimed to develop and specify a CLAS within the context of rehabilitation services. SETTING: UEMS PRM Workshop in Nottwil, Switzerland, January 2016...
November 24, 2016: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27879279/heart-rate-turbulence-is-a-powerful-predictor-of-cardiac-death-and-ventricular-arrhythmias-in-postmyocardial-infarction-and-heart-failure-patients-a-systematic-review-and-meta-analysis
#7
Marcello Disertori, Michela Masè, Marta Rigoni, Giandomenico Nollo, Flavia Ravelli
BACKGROUND: Heart rate turbulence (HRT) has been proposed as a candidate marker of altered autonomic tone, and some studies showed its prognostic value for both cardiac death (CD) and sudden death. Nevertheless, HRT is not currently used in the clinical practice. METHODS AND RESULTS: We performed a systematic review and meta-analysis of the predictive value of HRT for the end points of total mortality, CD, and fatal and nonfatal ventricular arrhythmias in postacute myocardial infarction and heart failure patients...
December 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27858957/the-search-for-effective-delirium-treatment-for-persons-with-dementia-in-the-postacute-care-setting
#8
EDITORIAL
Tamara G Fong, Asha Albuquerque, Sharon K Inouye
No abstract text is available yet for this article.
November 12, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27823730/the-pssmar-study-postacute-sarcopenia-supplementation-with-%C3%AE-hydroxymethylbutyrate-after-resistance-training-study-protocol-of-a-randomized-double-blind-controlled-trial
#9
Dolores Sánchez-Rodríguez, Ester Marco, Natalia Ronquillo-Moreno, Ramón Miralles, Sergi Mojal, Olga Vázquez-Ibar, Ferran Escalada, Josep M Muniesa
No abstract text is available yet for this article.
December 2016: Maturitas
https://www.readbyqxmd.com/read/27811551/comparing-the-contributions-of-acute-and-postacute-care-facility-characteristics-to-outcomes-after-hospitalization-for-hip-fracture
#10
Mark D Neuman, Jeffrey H Silber, Molly R Passarella, Rachel M Werner
OBJECTIVE: To quantify the contribution of acute versus postacute care factors to survival and functional outcomes after hip fracture. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study using Medicare data; subjects included previously ambulatory nursing home residents hospitalized for hip fracture between 2005 and 2009. METHODS: We used logistic regression to measure the associations of hospital and nursing home factors with functional and survival outcomes at 30 and 180 days among patients discharged to a nursing facility; we quantified the contribution of hospital versus nursing home factors to outcomes by the ω statistic...
November 2, 2016: Medical Care
https://www.readbyqxmd.com/read/27801939/comparison-of-frailty-measures-as-predictors-of-outcomes-after-orthopedic-surgery
#11
Zara Cooper, Selwyn O Rogers, Long Ngo, Jamey Guess, Eva Schmitt, Richard N Jones, Douglas K Ayres, Jeremy D Walston, Thomas M Gill, Lauren J Gleason, Sharon K Inouye, Edward R Marcantonio
OBJECTIVES: To apply the Frailty Phenotype (FP) and Frailty Index (FI) before major elective orthopedic surgery to categorize frailty status and assess associations with postoperative outcomes. DESIGN: Prospective cohort study. SETTING: Two tertiary hospitals in Boston, Massachusetts. PARTICIPANTS: Individuals aged 70 and older undergoing scheduled orthopedic surgery enrolled in the Successful Aging after Elective Surgery (SAGES) Study (N = 415)...
November 1, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27789951/shortened-questionnaires-to-assess-anxiety-and-depression-during-in-hospital-rehabilitation-clinical-validation-and-cutoff-scores
#12
Giorgio Bertolotti, Loretta Moroni, Roberto Burro, Antonio Spanevello, Roberto Fe Pedretti, Giandomenico Giorgetti
BACKGROUND: A postacute phase needs reliable routine screening instruments in order to identify the patients to be referred for a clinical interview with a psychologist. The aim of this study was to estimate the clinical cutoff scores of the anxiety and depression questionnaires and their clinical validity using a gold standard. METHODS: The study involved 177 patients with pulmonary, cardiac, or neurological disease undergoing in-hospital rehabilitation. Receiver operating characteristic curves were used to determine the best concordance between questionnaire's scores and the gold standards...
2016: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/27789517/early-cessation-of-adenosine-diphosphate-receptor-inhibitors-among-acute-myocardial-infarction-patients-treated-with-percutaneous-coronary-intervention-insights-from-the-translate-acs-study-treatment-with-adenosine-diphosphate-receptor-inhibitors-longitudinal
#13
Emil L Fosbøl, Christine Ju, Kevin J Anstrom, Marjorie E Zettler, John C Messenger, Ron Waksman, Mark B Effron, Brian A Baker, David J Cohen, Eric D Peterson, Tracy Y Wang
BACKGROUND: Guidelines recommend the use of adenosine diphosphate receptor inhibitor (ADPri) therapy for 1 year postacute myocardial infarction; yet, early cessation of therapy occurs frequently in clinical practice. METHODS AND RESULTS: We examined 11 858 acute myocardial infarction patients treated with percutaneous coronary intervention discharged alive on ADPri therapy from 233 United States TRANSLATE-ACS study (Treatment With Adenosine Diphosphate Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events After Acute Coronary Syndrome) participating hospitals to determine the prevalence of early ADPri cessation (within 1 year), patient-reported reasons for cessation, and associated risk of major adverse cardiovascular events at 1 year...
November 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27776908/the-high-value-healthcare-collaborative-observational-analyses-of-care-episodes-for-hip-and-knee-arthroplasty-surgery
#14
William B Weeks, William J Schoellkopf, Lyle S Sorensen, Andrew L Masica, Robert E Nesse, James N Weinstein
BACKGROUND: Broader use of value-based reimbursement models will require providers to transparently demonstrate health care value. We sought to determine and report cost and quality data for episodes of hip and knee arthroplasty surgery among 13 members of the High Value Healthcare Collaborative (HVHC), a consortium of health care systems interested in improving health care value. METHODS: We conducted a retrospective, cross-sectional observational cohort study of 30-day episodes of care for hip and knee arthroplasty in fee-for-service Medicare beneficiaries aged 65 or older who had hip or knee osteoarthritis and used 1 of 13 HVHC member systems for uncomplicated primary hip arthroplasty (N = 8853) or knee arthroplasty (N = 16,434), respectively, in 2012 or 2013...
September 28, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27748659/healthcare-resource-use-and-costs-in-long-term-survivors-of-acute-respiratory-distress-syndrome-a-5-year-longitudinal-cohort-study
#15
A Parker Ruhl, Minxuan Huang, Elizabeth Colantuoni, Robert K Lord, Victor D Dinglas, Alexandra Chong, Kristin A Sepulveda, Pedro A Mendez-Tellez, Carl B Shanholtz, Donald M Steinwachs, Peter J Pronovost, Dale M Needham
OBJECTIVE: To evaluate the time-varying relationship of annual physical, psychiatric, and quality of life status with subsequent inpatient healthcare resource use and estimated costs. DESIGN: Five-year longitudinal cohort study. SETTING: Thirteen ICUs at four teaching hospitals. PATIENTS: One hundred thirty-eight patients surviving greater than or equal to 2 years after acute respiratory distress syndrome. INTERVENTIONS: None...
September 29, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27699631/estimating-the-societal-benefits-of-tha-after-accounting-for-work-status-and-productivity-a-markov-model-approach
#16
Lane Koenig, Qian Zhang, Matthew S Austin, Berna Demiralp, Thomas K Fehring, Chaoling Feng, Richard C Mather, Jennifer T Nguyen, Asha Saavoss, Bryan D Springer, Adolph J Yates
BACKGROUND: Demand for total hip arthroplasty (THA) is high and expected to continue to grow during the next decade. Although much of this growth includes working-aged patients, cost-effectiveness studies on THA have not fully incorporated the productivity effects from surgery. QUESTIONS/PURPOSES: We asked: (1) What is the expected effect of THA on patients' employment and earnings? (2) How does accounting for these effects influence the cost-effectiveness of THA relative to nonsurgical treatment? METHODS: Taking a societal perspective, we used a Markov model to assess the overall cost-effectiveness of THA compared with nonsurgical treatment...
December 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27648877/noninvasive-brain-stimulation-after-stroke-it-is-time-for-large-randomized-controlled-trials
#17
Christian Grefkes, Gereon R Fink
PURPOSE OF REVIEW: We here provide an update about studies published recently in the field of noninvasive neuromodulation of the motor system, aiming at facilitating recovery of function after stroke. RECENT FINDINGS: A number of longitudinal studies have confirmed that repeated stimulation of the motor cortex in combination with motor training improves performance compared with control or sham stimulation. In the early postacute stroke phase, enhancement of ipsilesional motor cortex excitability by means of repetitive transcranial magnetic stimulation (rTMS) seems to be a well tolerated and effective strategy to promote motor recovery...
December 2016: Current Opinion in Neurology
https://www.readbyqxmd.com/read/27646810/medicare-quality-measure-puts-pressure-on-postacute-care-facilities
#18
Kate Traynor
No abstract text is available yet for this article.
October 1, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27638970/examining-the-impact-of-comorbid-serious-mental-illness-on-rehospitalization-among-medical-and-surgical-inpatients
#19
Nancy P Hanrahan, Sara Bressi, Steven C Marcus, Phyllis Solomon
OBJECTIVE: Multiple barriers to quality health care may affect the outcomes of postacute treatment for individuals with serious mental illness (SMI). This study examined rehospitalization for medical and surgical inpatients with and without a comorbid diagnosis of SMI which included psychotic disorders, bipolar disorder and major depression. METHODS: We examined hospital discharge records for medical and surgical inpatients from a large urban health system. Descriptive statistics and logistic regression models compared 7-, 30-, 60-, 90- and 180-day rehospitalization among medical and surgical inpatients with SMI (n=3221) and without an SMI diagnosis (n=70,858)...
September 2016: General Hospital Psychiatry
https://www.readbyqxmd.com/read/27618227/hindbrain-a2-noradrenergic-neuron-adenosine-5-monophosphate-activated-protein-kinase-activation-upstream-kinase-phosphorylase-protein-expression-and-receptivity-to-hormone-and-fuel-reporters-of-short-term-food-deprivation-are-regulated-by-estradiol
#20
Karen P Briski, Fahaad S H Alenazi, Manita Shakya, Paul W Sylvester
Estradiol (E) mitigates acute and postacute adverse effects of 12 hr-food deprivation (FD) on energy balance. Hindbrain 5'-monophosphate-activated protein kinase (AMPK) regulates hyperphagic and hypothalamic metabolic neuropeptide and norepinephrine responses to FD in an E-dependent manner. Energy-state information from AMPK-expressing hindbrain A2 noradrenergic neurons shapes neural responses to metabolic imbalance. Here we investigate the hypothesis that FD causes divergent changes in A2 AMPK activity in E- vs...
September 12, 2016: Journal of Neuroscience Research
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