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https://www.readbyqxmd.com/read/29745485/-transformations-of-family-medicine-practices-an-overview-of-recent-literature
#1
Christine Cohidon, Nicolas Senn
This article presents a brief selection of studies published since early 2017 that explore various aspects of the functioning and organization of family medicine around the world. The duration of consultation in family medicine varies widely around the world, from less than 5 minutes to more than 20 minutes. An international survey on coordination of care in family medicine based on patients' experience shows that it could be improved, particularly in Switzerland, and that the oldest populations would benefit the most...
May 9, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29700789/pay-for-performance-and-veteran-care-in-the-vha-and-the-community-a-systematic-review
#2
Karli K Kondo, Jessica Wyse, Aaron Mendelson, Gabriella Beard, Michele Freeman, Allison Low, Devan Kansagara
BACKGROUND: Although pay-for-performance (P4P) strategies have been used by the Veterans Health Administration (VHA) for over a decade, the long-term benefits of P4P are unclear. The use of P4P is further complicated by the increased use of non-VHA healthcare providers as part of the Veterans Choice Program. We conducted a systematic review and key informant interviews to better understand the effectiveness and potential unintended consequences of P4P, as well as the implementation factors and design features important in both VHA and non-VHA/community settings...
April 26, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29672402/postoperative-surgical-site-infections-understanding-the-discordance-between-surveillance-systems
#3
Mariam N Ali-Mucheru, Maria T Seville, Vickie Miller, Priya Sampathkumar, David A Etzioni
OBJECTIVE: To characterize agreement in the ascertainment of surgical site infections (SSIs) between the National Surgical Quality Improvement Program (NSQIP), National Healthcare Safety Network (NHSN), and administrative data. BACKGROUND: The NSQIP, NHSN, and administrative data are the primary systems used to monitor and report SSIs for the purpose of quality control and benchmarking of hospitals and surgeons. These systems have different methods for identifying SSIs...
April 18, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29650707/errors-in-electronic-health-record-based-data-query-of-statin-prescriptions-in-patients-with-coronary-artery-disease-in-a-large-academic-multispecialty-clinic-practice
#4
Eric Y Shin, Patricia Ochuko, Kunal Bhatt, Brian Howard, Gerard McGorisk, Linda Delaney, Kristan Langdon, Marjan Khosravanipour, Andiran A Nambi, Allison Grahovec, Douglas C Morris, Penny Z Castellano, Leslee J Shaw, Laurence S Sperling, Abhinav Goyal
BACKGROUND: With the recent implementation of the Medicare Quality Payment Program, providers face increasing accountability for delivering high-quality care. Such pay-for-performance programs aim to leverage systematic data captured by electronic health record (EHR) systems to measure performance; however, the fidelity of EHR query for assessing performance has not been validated compared with manual chart review. We sought to determine whether our institution's methodology of EHR query could accurately identify cases in which providers failed to prescribe statins for eligible patients with coronary artery disease...
April 12, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29606288/the-impact-of-pay-for-performance-on-the-quality-of-care-in-ophthalmology-empirical-evidence-from-germany
#5
T Herbst, J Foerster, M Emmert
BACKGROUND: Pay-for-performance (P4P) has become a popular approach to increase effectiveness and efficiency in healthcare. So far, there is little evidence regarding the potential of P4P in the German healthcare setting. The aim of this study was to determine the impact of P4P on the quality of care in cataract surgery. METHODS: In 2012, a P4P program was implemented in a German surgical centre for ophthalmology. Five quality measures regarding process quality, outcomes, and patient satisfaction were measured over a period of 4...
March 22, 2018: Health Policy
https://www.readbyqxmd.com/read/29594189/incentive-design-and-quality-improvements-evidence-from-state-medicaid-nursing-home-pay-for-performance-programs
#6
R Tamara Konetzka, Meghan M Skira, Rachel M Werner
Pay-for-performance (P4P) programs have become a popular policy tool aimed at improving health care quality. We analyze how incentive design affects quality improvements in the nursing home setting, where several state Medicaid agencies have implemented P4P programs that vary in incentive structure. Using the Minimum Data Set and the Online Survey, Certification, and Reporting data from 2001 to 2009, we examine how the weights put on various performance measures that are tied to P4P bonuses, such as clinical outcomes, inspection deficiencies, and staffing levels, affect improvements in those measures...
2018: American Journal of Health Economics
https://www.readbyqxmd.com/read/29526260/pay-for-performance-incentive-program-in-a-large-dental-group-practice
#7
Douglas A Conrad, Peter Milgrom, R Mike Shirtcliff, Howard L Bailit, Sharity Ludwig, Jeanne Dysert, Gary Allen, Joana Cunha-Cruz
BACKGROUND: Dentists increasingly are employed in large group practices that use financial incentive systems to influence provider performance. The authors describe the design and initial implementation of a pay-for-performance (P4P) incentive program for a large capitated Oregon group dental practice that cares primarily for patients receiving Medicaid. The authors do not assess the effectiveness of the incentive system on provider and staff member performance. METHODS: The data come from use of care files and integrated electronic health records, provider and staff member surveys, and interviews and community surveys from 6 counties...
March 8, 2018: Journal of the American Dental Association
https://www.readbyqxmd.com/read/29514241/designing-surveillance-of-healthcare-associated-infections-in-the-era-of-automation-and-reporting-mandates
#8
Maaike S M van Mourik, Eli N Perencevich, Petra Gastmeier, Marc J M Bonten
Surveillance and feedback of infection rates to clinicians and other stakeholders is a cornerstone of healthcare-associated infection (HAI) prevention programs. In addition, HAIs are increasingly included in public reporting and payment mandates. Conventional manual surveillance methods are resource intensive and lack standardization. Developments in information technology have propelled a movement toward the use of standardized and semiautomated methods.When developing automated surveillance systems, several strategies can be chosen with regard to the degree of automation and standardization and the definitions used...
March 5, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29504023/effect-of-payment-model-on-patient-outcomes-in-outpatient-physical-therapy
#9
Derek Charles, Sylvester Boyd, Logan Heckert, Austin Lake, Kevin Petersen
Although the literature has well recognized the effectiveness of physical therapy for treating musculoskeletal injuries, reimbursement is evolving towards value-based or alternative payment models and away from procedure orientated, fee-for-service in the outpatient setting. Alternative models include cased-based clinics, pay-for-performance, out-of-network services, accountable care organizations, and concierge practices. There is the possibility that alternative payment models could produce different and even superior patient outcomes...
2018: Journal of Allied Health
https://www.readbyqxmd.com/read/29469212/administrative-reform-and-pay-for-performance-methods-of-primary-health-service-delivery-a-comparison-of-3-health-districts-in-cambodia-2006-2012
#10
Keovathanak Khim, Rohan Jayasuriya, Peter Leslie Annear
Since 1999, performance-based financing or pay-for-performance (P4P) methods have been piloted in the Cambodian public health sector, first as one part of external contracting approaches with international nongovernment organizations and from 2009 as a part of internal contracting arrangements between units within the Ministry of Health under a wider public sector administrative reform. This study analyses these reforms and compares outcomes in 3 health districts. The study analysed routine quantitative data for primary care service delivery by using the interrupted time series method...
February 22, 2018: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/29450830/personalized-medicine-and-pay-for-performance-should-pharmaceutical-firms-be-fully-penalized-when-treatment-fails
#11
Fernando Antoñanzas, Roberto Rodríguez-Ibeas, Carmelo A Juárez-Castelló
In this article, we model the behavior of a pharmaceutical firm that has marketing authorization for a new therapy believed to be a candidate for personalized use in a subset of patients, but that lacks information as to why a response is seen only in some patients. We characterize the optimal outcome-based reimbursement policy a health authority should follow to encourage the pharmaceutical firm to undertake research and development activities to generate the information needed to effectively stratify patients...
February 15, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29444671/tailoring-an-educational-program-on-the-ahrq-patient-safety-indicators-to-meet-stakeholder-needs-lessons-learned-in-the-va
#12
Marlena H Shin, Peter E Rivard, Michael Shwartz, Ann Borzecki, Enzo Yaksic, Kelly Stolzmann, Lisa Zubkoff, Amy K Rosen
BACKGROUND: Given that patient safety measures are increasingly used for public reporting and pay-for performance, it is important for stakeholders to understand how to use these measures for improvement. The Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs) are one particularly visible set of measures that are now used primarily for public reporting and pay-for-performance among both private sector and Veterans Health Administration (VA) hospitals. This trend generates a strong need for stakeholders to understand how to interpret and use the PSIs for quality improvement (QI)...
February 14, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29409528/approaches-towards-improving-the-quality-of-maternal-and-newborn-health-services-in-south-asia-challenges-and-opportunities-for-healthcare-systems
#13
REVIEW
Naeem Uddin Mian, Muhammad Adeel Alvi, Mariam Zahid Malik, Sarosh Iqbal, Rubeena Zakar, Muhammad Zakria Zakar, Shehzad Hussain Awan, Faryal Shahid, Muhammad Ashraf Chaudhry, Florian Fischer
BACKGROUND: South Asia is experiencing a dismal state of maternal and newborn health (MNH) as the region has been falling behind in reducing the levels of maternal and neonatal mortality. Most of the efforts are focused on enhancing coverage of MNH services; however, quality remains a serious concern if the region is to achieve expected outcomes in terms of standardised MNH services within healthcare delivery systems. This research consists of a review of South Asian quality improvement (QI) approaches/interventions, specifically implemented for MNH improvement...
February 6, 2018: Globalization and Health
https://www.readbyqxmd.com/read/29406837/optimization-of-medication-use-at-accountable-care-organizations
#14
Chrisanne Wilks, Erik Krisle, Kimberly Westrich, Kristina Lunner, David Muhlestein, Robert Dubois
BACKGROUND: Optimized medication use involves the effective use of medications for better outcomes, improved patient experience, and lower costs. Few studies systematically gather data on the actions accountable care organizations (ACOs) have taken to optimize medication use. OBJECTIVES: To (a) assess how ACOs optimize medication use; (b) establish an association between efforts to optimize medication use and achievement on financial and quality metrics; (c) identify organizational factors that correlate with optimized medication use; and (d) identify barriers to optimized medication use...
May 30, 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29381671/appointment-reminders-to-decrease-30-day-readmission-rates-to-inpatient-psychiatric-hospitals
#15
Nicole F Habit, Emily Johnson, Barbara J Edlund
PURPOSE OF PROJECT: The purpose of this quality improvement project was to reduce 30-day readmission rates to inpatient psychiatric hospitals by standardizing discharge processes by including scheduling outpatient psychiatric appointments for all patients at discharge and also to include the mailing postal reminders to prompt patients to attend their first outpatient mental health appointment following treatment. PRIMARY PRACTICE SETTING: Inpatient psychiatric hospital...
March 2018: Professional Case Management
https://www.readbyqxmd.com/read/29380905/insights-on-the-effectiveness-of-reward-schemes-from-10-year-longitudinal-case-studies-in-2-italian-regions
#16
Milena Vainieri, Daniel Adrian Lungu, Sabina Nuti
BACKGROUND: Pay for performance (P4P) programs have been widely analysed in literature, and the results regarding their impact on performance are mixed. Moreover, in the real-life setting, reward schemes are designed combining multiple elements altogether, yet, it is not clear what happens when they are applied using different combinations. OBJECTIVES: To provide insights on how P4P programs are influenced by 5 key elements: whom, what, how, how many targets, and how much to reward...
January 30, 2018: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/29304527/is-there-a-preferred-stroke-prevention-strategy-for-diabetic-patients-with-non-valvular-atrial-fibrillation-comparing-warfarin-dabigatran-and-rivaroxaban
#17
Chih-Cheng Hsu, Pai-Feng Hsu, Shih-Hsien Sung, Shih-Te Tu, Ben-Hui Yu, Chi-Jung Huang, Hao-Min Cheng
BACKGROUND:  The prevalence of diabetes is growing, and diabetes is an independent risk factor for both atrial fibrillation (AF) and stroke. However, the relative effectiveness and safety of different oral anticoagulants for diabetic patients with non-valvular AF remain unclear. We aimed to compare thromboembolic events, bleeding and mortality in diabetic AF patients treated with rivaroxaban, dabigatran and warfarin. METHODS AND RESULTS:  Diabetic AF patients taking dabigatran ( n  = 322), rivaroxaban ( n  = 320) or warfarin ( n  = 1,899) were identified from the nationwide diabetes pay-for-performance program ( n  = 814,465) in Taiwan...
January 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29302881/could-pay-for-performance-worsen-health-disparities
#18
Mubeen Shakir, Katrina Armstrong, Jason H Wasfy
Pay-for-performance (P4P) has become a prominent component of health care funding in the Affordable Care Act (ACA) era. Although the ACA's future remains unclear, these programs receive bipartisan support and will likely continue to be a part of payment policies. At the same time, racial and class disparities remain among the most pressing of the many challenges facing the US health system. We review evidence of the effects of P4P on disparities at the population and individual levels. Providers caring for predominantly minority patients or those with lower socioeconomic status are known to have poorer quality metrics...
April 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29299473/economic-evaluation-of-different-suture-closure-methods-barbed-versus-traditional-interrupted-sutures
#19
REVIEW
Randa K Elmallah, Anton Khlopas, Mhamad Faour, Morad Chughtai, Arthur L Malkani, Peter M Bonutti, Martin Roche, Steven F Harwin, Michael A Mont
Healthcare systems are receiving increasing pressures from payers, such as the Centers for Medicare and Medicaid (CMS), to reduce the costs associated with procedures, and with the implementation of the Affordable Care Act, high costs are addressed through pay-for-performance programs. Thus, multiple areas of total knee arthroplasty (TKA) surgery are under scrutiny, including surgical times, material costs, and the costs of associated complications and readmissions. Suture type has been determined to be a factor that may influence closure times, as well as direct material costs...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29298765/impact-of-financial-incentives-on-early-and-late-adopters-among-us-hospitals-observational-study
#20
Igna Bonfrer, Jose F Figueroa, Jie Zheng, E John Orav, Ashish K Jha
OBJECTIVE: To examine how hospitals that volunteered to be under financial incentives for more than a decade as part of the Premier Hospital Quality Incentive Demonstration (early adopters) compared with similar hospitals where these incentives were implemented later under the Hospital Value-Based Purchasing program (late adopters). DESIGN: Observational study. SETTING: 1189 hospitals in the USA (214 early adopters and 975 matched late adopters), using Hospital Compare data from 2003 through 2013...
January 3, 2018: BMJ: British Medical Journal
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