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https://www.readbyqxmd.com/read/28096203/hospital-variation-in-functional-recovery-after-stroke
#1
Janet Prvu Bettger, Laine Thomas, Li Liang, Ying Xian, Cheryl D Bushnell, Jeffrey L Saver, Gregg C Fonarow, Eric D Peterson
BACKGROUND: Functional status is a key patient-centric outcome, but there are little data on whether functional recovery post-stroke varies among hospitals. This study examined the distribution of functional status 3 months after stroke, determined whether these outcomes vary among hospitals, and identified hospital characteristics associated with better (or worse) functional outcomes. METHODS AND RESULTS: Observational analysis of the AVAIL study (Adherence Evaluation After Ischemic Stroke-Longitudinal) included 2083 ischemic stroke patients enrolled from 82 US hospitals participating in Get With The Guidelines-Stroke and AVAIL...
January 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28079634/characteristics-of-patients-with-satisfactory-functional-gain-following-total-joint-arthroplasty-in-a-postacute-rehabilitation-setting
#2
Avital Hershkovitz, Marina Vesilkov, Yichayaou Beloosesky, Shai Brill
BACKGROUND AND PURPOSE: Total joint arthroplasty (TJA) is an effective and successful treatment of osteoarthritis of the hip and knee as quantified by several measures, such as pain relief, improved walking, improved self-care, functions, and increased quality of life. Data are lacking as to the definition of a satisfactory functional gain in a postacute setting and identifying the characteristics of older patients with TJA who may achieve that gain. Our aim was to characterize patients who may achieve a satisfactory functional gain in a postacute rehabilitation setting following TJA...
January 10, 2017: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/28069851/less-intense-postacute-care-better-outcomes-for-enrollees-in-medicare-advantage-than-those-in-fee-for-service
#3
Peter J Huckfeldt, José J Escarce, Brendan Rabideau, Pinar Karaca-Mandic, Neeraj Sood
Traditional fee-for-service (FFS) Medicare's prospective payment systems for postacute care provide little incentive to coordinate care or control costs. In contrast, Medicare Advantage plans pay for postacute care out of monthly capitated payments and thus have stronger incentives to use it efficiently. We compared the use of postacute care in skilled nursing and inpatient rehabilitation facilities by enrollees in Medicare Advantage and FFS Medicare after hospital discharge for three high-volume conditions: lower extremity joint replacement, stroke, and heart failure...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069850/spending-on-care-after-surgery-driven-by-choice-of-care-settings-instead-of-intensity-of-services
#4
Lena M Chen, Edward C Norton, Mousumi Banerjee, Scott E Regenbogen, Anne H Cain-Nielsen, John D Birkmeyer
The rising popularity of episode-based payment models for surgery underscores the need to better understand the drivers of variability in spending on postacute care. Examining postacute care spending for fee-for-service Medicare beneficiaries after three common surgical procedures in the period 2009-12, we found that it varied widely between hospitals in the lowest versus highest spending quintiles for postacute care, with differences of 129 percent for total hip replacement, 103 percent for coronary artery bypass grafting (CABG), and 82 percent for colectomy...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28059877/rehabilitation-services-provision-and-payment
#5
Christoph Gutenbrunner, Melanie Blumenthal, Veronika Geng, Christoph Egen
Persons with spinal cord injury (SCI) experience disability and have significant need for rehabilitation. To deliver appropriate rehabilitation, interventions and programs suitable services must exist. A prerequisite for system improvement is a description of rehabilitation services. The aim of this paper was to develop a rehabilitation service framework for SCI. Additionally, principles and models of payment of rehabilitation services will be discussed. Health-related rehabilitation services should be available along the continuum of care and implemented at all levels of health care...
February 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28055085/delirium-update-for-postacute-care-and-long-term-care-settings-a-narrative-review
#6
Martin M Forsberg
Advances have been made in our understanding of the neuropathogenesis, recognition, and strategies for reducing the incidence of delirium in acute-care settings. However, relatively little attention has been given to delirium in elderly patients in the postacute care (PAC) and long-term care (LTC) settings. The present article reviews the most relevant current research pertaining to this population. Hospital patients with delirium are often discharged to PAC settings. Delirium that develops in the LTC setting is often more insidious and subtle in presentation...
January 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/28055062/cost-of-joint-replacement-using-bundled-payment-models
#7
Amol S Navathe, Andrea B Troxel, Joshua M Liao, Nan Nan, Jingsan Zhu, Wenjun Zhong, Ezekiel J Emanuel
Importance: Medicare launched the mandatory Comprehensive Care for Joint Replacement bundled payment model in 67 urban areas for approximately 800 hospitals following its experience in the voluntary Acute Care Episodes (ACE) and Bundled Payments for Care Improvement (BPCI) demonstration projects. Little information from ACE and BPCI exists to guide hospitals in redesigning care for mandatory joint replacement bundles. Objective: To analyze changes in quality, internal hospital costs, and postacute care (PAC) spending for lower extremity joint replacement bundled payment episodes encompassing hospitalization and 30 days of PAC...
January 3, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28052981/variation-in-functional-status-after-hip-fracture-facility-and-regional-influence-on-mobility-and-self-care
#8
Srinivas Teppala, Kenneth J Ottenbacher, Karl Eschbach, Amit Kumar, Soham Al Snih, Winston J Chan, Timothy A Reistetter
BACKGROUND: Recent reports show substantial geographic variation in postacute health care spending. Little is known about variation in functional outcomes after postacute rehabilitation for patients with hip fracture. We examined variation in mobility and self-care after hip fracture rehabilitation across inpatient rehabilitation facilities (IRFs), hospital referral regions (HRRs) and states. METHODS: Retrospective cohort study using data from the Centers for Medicare and Medicaid Services (CMS) from 2006 to 2009...
January 3, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28032896/extension-for-community-healthcare-outcomes-care-transitions-enhancing-geriatric-care-transitions-through-a-multidisciplinary-videoconference
#9
Grace Farris, Mousumi Sircar, Jonathan Bortinger, Amber Moore, J Elyse Krupp, John Marshall, Alan Abrams, Lewis Lipsitz, Melissa Mattison
OBJECTIVES: To examine whether a novel videoconference that connects an interdisciplinary hospital-based team with clinicians at postacute care sites improves interprofessional communication and reduces medication errors. DESIGN: Prospective cohort. SETTING: One tertiary care medical center and eight postacute care sites. PARTICIPANTS: Hospital-based providers (hospitalists, geriatricians, pharmacists, social workers, medical trainees, and subspecialists) and postacute care clinicians...
December 29, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27984469/commentary-on-physical-therapy-dosing-frequency-and-type-of-intervention-in-pediatric-postacute-hospital-care
#10
Dana McCarty, Kerry Blazek
No abstract text is available yet for this article.
January 2017: Pediatric Physical Therapy
https://www.readbyqxmd.com/read/27984468/physical-therapy-dosing-frequency-and-type-of-intervention-in-pediatric-postacute-hospital-care
#11
Helene M Dumas, Maria A Fragala-Pinkham, Elaine L Rosen, Eric Folmar
PURPOSE: To examine differences in physical therapy dosing frequency recommendations based on children's characteristics and to describe types of intervention recommended at postacute hospital admission. METHODS: Demographic and clinical information, recommended physical therapy intervention frequency, and intervention types were collected for all admissions from April 1, 2015, to March 1, 2016. Differences across 2 groups, children with recommendations for "less" (≤3x/wk) or "more" (≥4x/wk) frequent therapy, were examined...
January 2017: Pediatric Physical Therapy
https://www.readbyqxmd.com/read/27956073/an-unintended-consequence-of-culture-change-in-va-community-living-centers
#12
Jill Harrison, Denise A Tyler, Renée R Shield, Whitney L Mills, Kristen E Morgan, Maxwell E Cutty, Danielle L Coté, Susan M Allen
OBJECTIVE: Although a growing body of evidence suggests that culture change and its corollary, person-centered care improves resident outcomes in the nursing home setting, little is known about the effect of culture change in a postacute setting in which patients receive skilled nursing and rehabilitation services for a relatively short period of time before returning home. DESIGN: Data for this study were collected as part of a larger project to understand the impact of Veterans Health Administration (VHA) policies to shift the mission of VHA Community Living Centers (CLCs) from long-stay custodial care to short-stay skilled nursing and rehabilitative care...
December 9, 2016: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/27926614/clinical-coordination-in-accountable-care-organizations-a-qualitative-study
#13
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
#14
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
#15
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
#16
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-peripheral-blood-mononuclear-cells-inform-about-overall-plasma-viral-load-in-acute-and-post-acute-phase-after-simian-immunodeficiency-virus-infection
#17
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 this 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...
December 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
#18
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
#19
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
#20
EDITORIAL
Tamara G Fong, Asha Albuquerque, Sharon K Inouye
No abstract text is available yet for this article.
December 2016: Journal of the American Geriatrics Society
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