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https://www.readbyqxmd.com/read/29231837/the-primary-health-care-system-in-china
#1
REVIEW
Xi Li, Jiapeng Lu, Shuang Hu, K K Cheng, Jan De Maeseneer, Qingyue Meng, Elias Mossialos, Dong Roman Xu, Winnie Yip, Hongzhao Zhang, Harlan M Krumholz, Lixin Jiang, Shengshou Hu
China has made remarkable progress in strengthening its primary health-care system. Nevertheless, the system still faces challenges in structural characteristics, incentives and policies, and quality of care, all of which diminish its preparedness to care for a fifth of the world's population, which is ageing and which has a growing prevalence of chronic non-communicable disease. These challenges include inadequate education and qualifications of its workforce, ageing and turnover of village doctors, fragmented health information technology systems, a paucity of digital data on everyday clinical practice, financial subsidies and incentives that do not encourage cost savings and good performance, insurance policies that hamper the efficiency of care delivery, an insufficient quality measurement and improvement system, and poor performance in the control of risk factors (such as hypertension and diabetes)...
December 9, 2017: Lancet
https://www.readbyqxmd.com/read/29230115/interval-colorectal-cancers-at-ochsner-medical-center-where-do-we-stand
#2
Felicia Humphrey, Mariella Gastañaduy, James Smith, Charles B Whitlow
Background: An interval colorectal cancer is a cancer diagnosed prior to the recommended follow-up time from a previously negative colonoscopy. These cancers are thought to arise from a rapidly growing cancer, missed cancer, or incompletely resected adenomas. Our study aimed to identify interval cancers diagnosed during a 4-year period and to identify any potential risk factors associated with these cancers. Secondly, we compared our interval colorectal cancer rate with other published rates...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29229326/quantifying-the-effect-of-3t-magnetic-resonance-imaging-residual-system-distortions-and-patient-induced-susceptibility-distortions-on-radiation-therapy-treatment-planning-for-prostate-cancer
#3
Mary Adjeiwaah, Mikael Bylund, Josef A Lundman, Camilla Thellenberg Karlsson, Joakim H Jonsson, Tufve Nyholm
PURPOSE: To investigate the effect of magnetic resonance system- and patient-induced susceptibility distortions from a 3T scanner on dose distributions for prostate cancers. METHODS AND MATERIALS: Combined displacement fields from the residual system and patient-induced susceptibility distortions were used to distort 17 prostate patient CT images. VMAT dose plans were initially optimized on distorted CT images and the plan parameters transferred to the original patient CT images to calculate a new dose distribution...
October 20, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29227430/continuing-education-meets-the-learning-organization-the-challenge-of-a-systems-approach-to-patient-safety
#4
John M Eisenberg
Since the release of the report of the Institute of Medicine on medical errors and patient safety in November 1999, health policy makers and health care leaders in several nations have sought solutions that will improve the safety of health care. This attention to patient safety has highlighted the importance of a learning approach and a systems approach to quality measurement and improvement. Balanced with the need for public disclosure of performance, confidential reporting with feedback is one of the prime ways that nations such as the United States, Canada, the United Kingdom, and Australia have approached this challenge...
October 2017: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/29227366/trends-in-physician-reimbursement-for-spinal-procedures-since-2010
#5
Joshua E Meyers, Jiefei Wang, Asham Khan, Jason M Davies, John Pollina
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To identify trends in spinal procedure reimbursement in our practice since 2010. SUMMARY OF BACKGROUND DATA: In an uncertain healthcare climate with continuous reform, trends in physician reimbursement are unclear. Market forces of supply and demand, legislation imposing penalties for quality measures, local competition, and geographic location have the potential to affect reimbursement...
December 8, 2017: Spine
https://www.readbyqxmd.com/read/29225937/use-of-standardised-patients-to-assess-quality-of-healthcare-in-nairobi-kenya-a-pilot-cross-sectional-study-with-international-comparisons
#6
Benjamin Daniels, Amy Dolinger, Guadalupe Bedoya, Khama Rogo, Ana Goicoechea, Jorge Coarasa, Francis Wafula, Njeri Mwaura, Redemptar Kimeu, Jishnu Das
Introduction: The quality of clinical care can be reliably measured in multiple settings using standardised patients (SPs), but this methodology has not been extensively used in Sub-Saharan Africa. This study validates the use of SPs for a variety of tracer conditions in Nairobi, Kenya, and provides new results on the quality of care in sampled primary care clinics. Methods: We deployed 14 SPs in private and public clinics presenting either asthma, child diarrhoea, tuberculosis or unstable angina...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29223193/quality-indicators-for-evaluating-prehospital-emergency-care-a-scoping-review
#7
Ian Howard, Peter Cameron, Lee Wallis, Maaret Castren, Veronica Lindstrom
Introduction Historically, the quality and performance of prehospital emergency care (PEC) has been assessed largely based on surrogate, non-clinical endpoints such as response time intervals or other crude measures of care (eg, stakeholder satisfaction). However, advances in Emergency Medical Services (EMS) systems and services world-wide have seen their scope and reach continue to expand. This has dictated that novel measures of performance be implemented to compliment this growth. Significant progress has been made in this area, largely in the form of the development of evidence-informed quality indicators (QIs) of PEC...
December 10, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29218747/patient-characteristics-and-outcome-measurement-in-a-low-secure-forensic-hospital
#8
Laura Longdon, Rachel Edworthy, Jeremy Resnick, Adrian Byrne, Martin Clarke, Natalie Cheung, Najat Khalifa
BACKGROUND: Health services are increasingly required to measure outcomes after treatment, which can be reported to the funding body and may be scrutinised by the public. Extensive high-quality measurements are time consuming. Routinely collected clinical data might, if anonymised, provide good enough evidence of useful change consequent on service received. RESEARCH QUESTION: Do the Health of the Nation Scale and the 20-item Historical, Clinical, Risk structured professional judgement tool scores provide evidence of clinical and risk change among low security hospital patients at 6 and 12 months after admission? METHODS: One hundred and eight men were either resident on the unit on 1 January 2011 or new admissions to the census date of 31 May 2013...
December 7, 2017: Criminal Behaviour and Mental Health: CBMH
https://www.readbyqxmd.com/read/29218691/reliability-and-validity-assessment-of-administrative-databases-in-measuring-the-quality-of-rectal-cancer-management
#9
Carlo Corbellini, Bruno Andreoni, Luca Ansaloni, Giovanni Sgroi, Mario Martinotti, Ildo Scandroglio, Pierluigi Carzaniga, Mauro Longoni, Diego Foschi, Paolo Dionigi, Eugenio Morandi, Mauro Agnello
PURPOSE: Measurement and monitoring of the quality of care using a core set of quality measures are increasing in health service research. Although administrative databases include limited clinical data, they offer an attractive source for quality measurement. The purpose of this study, therefore, was to evaluate the completeness of different administrative data sources compared to a clinical survey in evaluating rectal cancer cases. METHODS: Between May 2012 and November 2014, a clinical survey was done on 498 Lombardy patients who had rectal cancer and underwent surgical resection...
December 5, 2017: Tumori
https://www.readbyqxmd.com/read/29217445/factors-that-predict-failure-to-meet-mips-quality-measures-for-asymptomatic-carotid-endarterectomy
#10
Anahita Dua, Steven Koprowski, Fadwa Ali, Sapan S Desai
INTRODUCTION: The Physician Quality Reporting System (PQRS) created by the Centers for Medicare and Medicaid Services (CMS) financially penalizes providers who fail to meet expected quality of care measures. The purpose of this study is to evaluate the factors that predict failure to meet PQRS measures for carotid endarterectomy (CEA). METHODS: PQRS measures 260 (discharge by postoperative day 2 following CEA in asymptomatic patients) and 346 (rate of postoperative stroke or death following CEA in asymptomatic patients) were evaluated using hospital records from the state of Florida from 2008-2012...
December 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29216596/understanding-social-and-behavioral-drivers-and-impacts-of-air-quality-sensor-use
#11
Bryan J Hubbell, Amanda Kaufman, Louie Rivers, Kayla Schulte, Gayle Hagler, Jane Clougherty, Wayne Cascio, Dan Costa
BACKGROUND: Lower-cost air quality sensors (hundreds to thousands of dollars) are now available to individuals and communities. This technology is undergoing a rapid and fragmented evolution, resulting in sensors that have uncertain data quality, measure different air pollutants and possess a variety of design attributes. Why and how individuals and communities choose to use sensors is arguably influenced by social context. For example, community experiences with environmental exposures and health effects and related interactions with industry and government can affect trust in traditional air quality monitoring...
December 4, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/29215378/developing-resident-sensitive-quality-measures-a-model-from-pediatric-emergency-medicine
#12
Daniel J Schumacher, Eric S Holmboe, Cees van der Vleuten, Jamiu O Busari, Carol Carraccio
PURPOSE: To begin closing the gap with respect to quality measures available for use among residents, the authors sought to identify and develop resident-sensitive quality measures (RSQMs) for use in the pediatric emergency department (PED) setting. METHOD: In May 2016, the authors reviewed National Quality Measures Clearinghouse (NQMC) measures to identify resident-sensitive measures. To create additional measures focused on common, acute illnesses (acute asthma exacerbation, bronchiolitis, closed head injury [CHI]) in the PED, the authors used a nominal group technique (NGT) and Delphi process from September to December 2016...
December 5, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29208447/impact-of-advanced-practice-registered-nurses-on-quality-measures-the-missouri-quality-initiative-experience
#13
Marilyn J Rantz, Lori Popejoy, Amy Vogelsmeier, Colleen Galambos, Greg Alexander, Marcia Flesner, Cathy Murray, Charles Crecelius, Bin Ge, Gregory Petroski
PURPOSE: The purpose of this article is to review the impact of advanced practice registered nurses (APRNs) on the quality measure (QM) scores of the 16 participating nursing homes of the Missouri Quality Initiative (MOQI) intervention. The MOQI was one of 7 program sites in the US, with specific interventions unique to each site tested for the Centers for Medicaid and Medicare Services Innovations Center. While the goals of the MOQI for long-stay nursing home residents did not specifically include improvement of the QM scores, it was anticipated that improvement most likely would occur...
December 2, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29206677/benchmarking-complications-associated-with-esophagectomy
#14
Donald E Low, Madhan Kumar Kuppusamy, Derek Alderson, Ivan Cecconello, Andrew C Chang, Gail Darling, Andrew Davies, Xavier Benoit D'Journo, Suzanne S Gisbertz, S Michael Griffin, Richard Hardwick, Arnulf Hoelscher, Wayne Hofstetter, Blair Jobe, Yuko Kitagawa, Simon Law, Christophe Mariette, Nick Maynard, Christopher R Morse, Philippe Nafteux, Manuel Pera, C S Pramesh, Sonia Puig, John V Reynolds, Wolfgang Schroeder, Mark Smithers, B P L Wijnhoven
OBJECTIVE: Utilizing a standardized dataset with specific definitions to prospectively collect international data to provide a benchmark for complications and outcomes associated with esophagectomy. SUMMARY OF BACKGROUND DATA: Outcome reporting in oncologic surgery has suffered from the lack of a standardized system for reporting operative results particularly complications. This is particularly the case for esophagectomy affecting the accuracy and relevance of international outcome assessments, clinical trial results, and quality improvement projects...
December 4, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29206577/increased-reporting-of-exclusionary-diagnoses-inflate-apparent-reductions-in-long-stay-antipsychotic-prescribing
#15
Jonathan D Winter, J William Kerns, Katherine M Winter, Roy T Sabo
OBJECTIVE: Over the two years following the 2012 introduction of CMS's National Partnership, combined rates of schizophrenia, Tourette's, and Huntington's in US long-stay residents increased 12%. We evaluated trends in reporting of these diagnoses for the subgroup of long-stay residents on antipsychotics. METHODS: Retrospective analysis of Virginia Medicaid claims identified annual utilization rates of psychiatric diagnoses for long-stay seniors on antipsychotics...
October 24, 2017: Clinical Gerontologist
https://www.readbyqxmd.com/read/29206318/automated-quality-assessment-of-structural-magnetic-resonance-images-in-children-comparison-with-visual-inspection-and-surface-based-reconstruction
#16
Tonya White, Philip R Jansen, Ryan L Muetzel, Gustavo Sudre, Hanan El Marroun, Henning Tiemeier, Anqi Qiu, Philip Shaw, Andrew M Michael, Frank C Verhulst
Motion-related artifacts are one of the major challenges associated with pediatric neuroimaging. Recent studies have shown a relationship between visual quality ratings of T1 images and cortical reconstruction measures. Automated algorithms offer more precision in quantifying movement-related artifacts compared to visual inspection. Thus, the goal of this study was to test three different automated quality assessment algorithms for structural MRI scans. The three algorithms included a Fourier-, integral-, and a gradient-based approach which were run on raw T1 -weighted imaging data collected from four different scanners...
December 5, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/29201377/use-of-wearable-devices-for-post-discharge-monitoring-of-icu-patients-a-feasibility-study
#17
Ryan R Kroll, Erica D McKenzie, J Gordon Boyd, Prameet Sheth, Daniel Howes, Michael Wood, David M Maslove
Background: Wearable devices generate signals detecting activity, sleep, and heart rate, all of which could enable detailed and near-continuous characterization of recovery following critical illness. Methods: To determine the feasibility of using a wrist-worn personal fitness tracker among patients recovering from critical illness, we conducted a prospective observational study of a convenience sample of 50 stable ICU patients. We assessed device wearability, the extent of data capture, sensitivity and specificity for detecting heart rate excursions, and correlations with questionnaire-derived sleep quality measures...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29200994/spatio-temporal-eeg-source-imaging-with-the-hierarchical-bayesian-elastic-net-and-elitist-lasso-models
#18
Deirel Paz-Linares, Mayrim Vega-Hernández, Pedro A Rojas-López, Pedro A Valdés-Hernández, Eduardo Martínez-Montes, Pedro A Valdés-Sosa
The estimation of EEG generating sources constitutes an Inverse Problem (IP) in Neuroscience. This is an ill-posed problem due to the non-uniqueness of the solution and regularization or prior information is needed to undertake Electrophysiology Source Imaging. Structured Sparsity priors can be attained through combinations of (L1 norm-based) and (L2 norm-based) constraints such as the Elastic Net (ENET) and Elitist Lasso (ELASSO) models. The former model is used to find solutions with a small number of smooth nonzero patches, while the latter imposes different degrees of sparsity simultaneously along different dimensions of the spatio-temporal matrix solutions...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/29197765/physical-quality-attributes-of-male-and-female-wild-fallow-deer-dama-dama-muscles
#19
Donna-Mareè Cawthorn, Leon Brett Fitzhenry, Voster Muchenje, Daniel Bureš, Radim Kotrba, Louwrens C Hoffman
Physical meat quality measurements were conducted on the longissimus thoracis et lumborum, biceps femoris, semimembranosus, semitendinosus, infraspinatus and supraspinatus muscles from male (n=6) and female (n=6) fallow deer (Dama dama) harvested in South Africa. Ultimate pH (pHu), drip loss, cooking loss and shear force values were influenced (p≤0.05) by muscle, but not gender. Mean pHu readings were 5.4-5.6 in the muscles with the two forequarter muscles having the highest readings, while drip loss, cooking loss and shear force values ranged from 1...
November 27, 2017: Meat Science
https://www.readbyqxmd.com/read/29196327/oral-health-care-quality-measurement-and-its-role-in-dental-education
#20
Ronald J Hunt, Diptee Ojha
Concerns about health care quality have affected much of the health care delivery system including dentistry and dental education. Believing measurement is the key element in improving quality, the Dental Quality Alliance brought together major stakeholders in oral health care to lead the development of oral health performance measures that can be used to evaluate the performance of dental programs and practices. These measures complement the quality assurance measures dental schools use to ensure compliance with accreditation standards on patient care delivery...
December 2017: Journal of Dental Education
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