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https://www.readbyqxmd.com/read/28528171/accountable-care-organizations-and-the-use-of-cancer-screening
#1
Christian P Meyer, Anna Krasnova, Jesse D Sammon, Stuart R Lipsitz, Joel S Weissman, Maxine Sun, Quoc-Dien Trinh
Cancer preventive services, when used appropriately, result in improved health, better quality of life and decreased costs. For these reasons, cancer preventive services represent important priorities within the Affordable Care Act (ACA). Among the many provisions to improve access to preventive services the ACA introduced Accountable Care Organizations (ACOs) as trajectory to deliver coordinated, high-quality care. In order to evaluate this benchmark, we analyzed (in 2016/Boston) screening prevalence of breast cancer, a recommended screening test according to the United States Preventive Services Task Force (USPSTF), and prostate cancer, for which screening is no longer recommended by the USPSTF, among traditional Medicare beneficiaries and those enrolled in ACOs...
May 17, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28486935/emergency-department-use-and-barriers-to-wellness-a-survey-of-emergency-department-frequent-users
#2
Lauren E Birmingham, Thaddeus Cochran, Jennifer A Frey, Kirk A Stiffler, Scott T Wilber
BACKGROUND: There is no common understanding of how needs of emergency department (ED) frequent users differ from other patients. This study sought to examine how to best serve this population. Examinations of why ED frequent users present to the ED, what barriers to care exist, and what service offerings may help these patients achieve an optimal level of health were conducted. METHODS: We performed a prospective study of frequent ED users in an adult only, level 1 trauma center with approximately 90,000 visits per year...
May 10, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28481976/electronically-available-comorbidities-should-be-used-in-surgical-site-infection-risk-adjustment
#3
Sarah S Jackson, Surbhi Leekha, Laurence S Magder, Lisa Pineles, Deverick J Anderson, William E Trick, Keith F Woeltje, Keith S Kaye, Timothy J Lowe, Anthony D Harris
Background: Healthcare-associated infections such as surgical site infections (SSI) are used by Centers for Medicare and Medicaid Services (CMS) as pay-for-performance metrics. Risk adjustment allows a fairer comparison of SSI rates across hospitals. Until 2016, Centers for Disease Control and Prevention (CDC) risk adjustment models for pay-for-performance SSI did not adjust for patient comorbidities. New 2016 CDC models only adjust for body mass index and diabetes. Methods: We performed a multicenter retrospective cohort study of patients undergoing surgical procedures at 28 US hospitals...
May 6, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28479081/identifying-distinct-risk-profiles-to-predict-adverse-events-among-community-dwelling-older-adults
#4
Melissa O'Connor, Alexandra Hanlon, Elizabeth Mauer, Salimah Meghani, Ruth Masterson-Creber, Sherry Marcantonio, Ken Coburn, Janet Van Cleave, Joan Davitt, Barbara Riegel, Kathryn H Bowles, Susan Keim, Sherry A Greenberg, Justine S Sefcik, Maxim Topaz, Dexia Kong, Mary Naylor
Preventing adverse events among chronically ill older adults living in the community is a national health priority. The purpose of this study was to generate distinct risk profiles and compare these profiles in time to: hospitalization, emergency department (ED) visit or death in 371 community-dwelling older adults enrolled in a Medicare demonstration project. Guided by the Behavioral Model of Health Service Use, a secondary analysis was conducted using Latent Class Analysis to generate the risk profiles with Kaplan Meier methodology and log rank statistics to compare risk profiles...
May 4, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/28472291/antibiotic-stewardship-in-small-hospitals-barriers-and-potential-solutions
#5
Edward Stenehjem, David Y Hyun, Ed Septimus, Kalvin C Yu, Marc Meyer, Deepa Raj, Arjun Srinivasan
Antibiotic stewardship programs (ASPs) improve antibiotic prescribing. 73% of United States (US) hospitals have < 200 beds. Small hospitals (< 200 beds) have similar rates of antibiotic prescribing compared to large hospitals but the majority of small hospitals lack ASPs that satisfy the Centers for Disease Control and Prevention's (CDC) core elements. All hospitals, regardless of size, are now required to have ASPs by The Joint Commission and the Centers for Medicare and Medicaid Services has proposed a similar requirement...
May 2, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28466118/who-should-be-referred-for-left-atrial-appendage-occlusion-therapy
#6
REVIEW
Sidakpal S Panaich, David R Holmes
Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting approximately 7 million individuals in USA. It is one of the most significant arrhythmias, which accounts for a majority of embolic strokes, especially in elderly individuals. Although oral anti-coagulation is beneficial in lowering the risk of stroke, 1 in 10 patients have a contra-indication to warfarin therapy. Among patients who do tolerate either warfarin or novel oral anticoagulant (NOAC), major or recurrent bleeding, intracranial bleeds, etc...
June 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28464177/hospital-readmissions-from-patients-perspectives
#7
Beril Cakir, Stephanie Kaltsounis, Katherine D' Jernes, Sara Kopf, Julea Steiner
OBJECTIVES: Healthcare expenditures in the United States have increased exponentially and hospital care accounts for one-third of these costs. Approximately 18% of hospitalized Medicare beneficiaries are being readmitted to the hospital within 30 days. Engaging patients in the discharge process can help better identify patients' postdischarge needs and implement more effective readmission prevention strategies. The objective of our study was to identify the factors that contribute to hospital readmission as seen from patients' perspectives in a large urban community hospital...
May 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28461352/high-price-and-low-price-physician-practices-do-not-differ-significantly-on-care-quality-or-efficiency
#8
Eric T Roberts, Ateev Mehrotra, J Michael McWilliams
Consolidation of physician practices has intensified concerns that providers with greater market power may be able to charge higher prices without having to deliver better care, compared to providers with less market power. Providers have argued that higher prices cover the costs of delivering higher-quality care. We examined the relationship between physician practice prices for outpatient services and practices' quality and efficiency of care. Using commercial claims data, we classified practices as being high- or low-price...
May 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28455223/a-longitudinal-assessment-of-adherence-to-breast-and-cervical-cancer-screening-recommendations-among-women-with-and-without-intellectual-disability
#9
Xinling Xu, Suzanne W McDermott, Joshua R Mann, James W Hardin, Chelsea B Deroche, Dianna D Carroll, Elizabeth A Courtney-Long
Each year in the United States, about 4000 deaths are attributed to cervical cancer, and over 40,000 deaths are attributed to breast cancer (U.S. Cancer Statistics Working Group, 2015). The purpose of this study was to identify predictors of full, partial, and no screening for breast and cervical cancer among women with and without intellectual disability (ID) who are within the age group for screening recommended by the U.S. Preventive Service Task Force (USPSTF), while accounting for changes in recommendations over the study period...
April 25, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28454592/increasing-hiv-testing-among-hard-to-reach-groups-examination-of-rapid-a-community-based-testing-service-in-queensland-australia
#10
Allyson J Mutch, Chi-Wai Lui, Judith Dean, Limin Mao, Jime Lemoire, Joseph Debattista, Chris Howard, Andrea Whittaker, Lisa Fitzgerald
BACKGROUND: The success of 'treatment as prevention' (TasP) to control HIV relies on the uptake of testing across priority population groups. Innovative strategies including; rapid HIV testing (RHT) in community and outreach settings, engaging peer service providers, and not requiring disclosure of sexual history have been designed to increase access. This paper reports on the implementation of 'RAPID', a community-based testing program in Queensland, Australia that employs these strategies to increase access to testing...
April 28, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28441307/90-day-readmission-after-lumbar-spinal-fusion-surgery-in-new-york-state-between-2005-and-2014-a-10-year-analysis-of-a-statewide-cohort
#11
Ali A Baaj, Gernot Lang, Wei-Chun Hsu, Mauricio J Avila, Jialin Mao, Art Sedrakyan
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To assess 90-day readmission and evaluate risk factors associated with readmission after lumbar fusion in New York State. SUMMARY OF BACKGROUND DATA: Readmission is becoming an important metric for quality and efficiency of healthcare. Readmission and its predictors following spine surgery are overall poorly understood and limited evidence is available specifically in lumbar fusion. METHODS: The New York Statewide Planning and Research Cooperative System (SPACRS) was utilized to capture patients undergoing lumbar fusion from 2005-2014...
April 24, 2017: Spine
https://www.readbyqxmd.com/read/28401424/hospital-acquired-conditions-are-associated-with-worse-outcomes-in-crohn-s-disease-related-hospitalizations
#12
Kenneth Obi, Alice Hinton, Lindsay Sobotka, Edward Levine, Darwin Conwell, Cheng Zhang
BACKGROUND: Crohn's disease (CD) is a chronically relapsing condition that frequently requires hospitalization. In 2008, the Centers for Medicare and Medicaid Services selected ten conditions that were deemed healthcare-acquired conditions (HACs). Costs related to HACs are not reimbursed as they are considered to be preventable. AIM: To determine the prevalence and impact of HACs on hospital outcomes of hospitalized CD patients. METHODS: This was a cross-sectional study using data from the Nationwide Inpatient Sample between 2007 and 2011 with an extended time frame between 2002 and 2013 to specifically evaluate the prevalence of HACs...
April 11, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28390184/outcomes-in-older-adults-with-multimorbidity-associated-with-predominant-provider-of-care-specialty
#13
Julie P W Bynum, Chiang-Hua Chang, Andrea Austin, Don Carmichael, Ellen Meara
OBJECTIVES: To determine whether receiving the predominance of ambulatory visits from a primary care provider compared to a specialty provider is associated with better outcomes in older adults with multi morbidity. DESIGN: Observational study using propensity score matching. SETTING: Medicare fee-for-service, 2011-12. PARTICIPANTS: Beneficiaries aged 65 and older with multimorbidity. MEASUREMENTS: The independent variable was an indicator for having a specialty (versus primary care) as the predominant provider of care (PPC)...
April 8, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28340130/falling-down-on-the-job-evaluation-and-treatment-of-fall-risk-among-older-adults-with-upper-extremity-fragility-fractures
#14
Christine M McDonough, Carrie H Colla, Donald Carmichael, Anna N A Tosteson, Tor D Tosteson, John-Erik Bell, Robert V Cantu, Jonathan D Lurie, Julie P W Bynum
Background: Clinical practice guidelines recommend fall risk assessment and intervention for older adults who sustain a fall-related injury to prevent future injury and mobility decline. Objective: The aim of this study was to describe how often Medicare beneficiaries with upper extremity fracture receive evaluation and treatment for fall risk. Design: Observational cohort. Methods: Participants were fee-for-service beneficiaries age 66 to 99 treated as outpatients for proximal humerus or distal radius/ulna ("wrist") fragility fractures...
March 1, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28339427/a-critical-analysis-of-obamacare-affordable-care-or-insurance-for-many-and-coverage-for-few
#15
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
The Affordable Care Act (ACA), of 2010, or Obamacare, was the most monumental change in US health care policy since the passage of Medicaid and Medicare in 1965. Since its enactment, numerous claims have been made on both sides of the aisle regarding the ACA's success or failure; these views often colored by political persuasion. The ACA had 3 primary goals: increasing the number of the insured, improving the quality of care, and reducing the costs of health care. One point often lost in the discussion is the distinction between affordability and access...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28336485/low-dose-computed-tomography-for-lung-cancer-screening-clinical-and-coding-considerations
#16
REVIEW
Yiwey Shieh, Martin Bohnenkamp
Lung cancer screening with low-dose computed tomography (LDCT) was shown to reduce lung cancer mortality in the National Lung Screening Trial, a large randomized-controlled trial of high-risk current and former smokers. Despite ongoing uncertainty over the effectiveness of LDCT in the real-world setting, the Centers for Medicare and Medicaid Services (CMS) decided to cover LDCT as a preventive service. As part of its national coverage determination, CMS set forth a series of requirements for reimbursement of LDCT, including a counseling and shared decision-making visit prior to a LDCT being ordered...
March 21, 2017: Chest
https://www.readbyqxmd.com/read/28330970/variation-in-family-experience-of-pediatric-inpatient-care-as-measured-by-child-hcahps
#17
Sara L Toomey, Marc N Elliott, Alan M Zaslavsky, David J Klein, Sifon Ndon, Shannon Hardy, Melody Wu, Mark A Schuster
BACKGROUND: Making national comparisons of family experience of inpatient pediatric care has been limited by the lack of a publicly available survey. The Agency for Healthcare Research and Quality and Centers for Medicare & Medicaid Services commissioned development of the Child Hospital Consumer Assessment of Healthcare Providers and Systems Survey to address this gap. Using Child Hospital Consumer Assessment of Healthcare Providers and Systems Survey, we measured performance of hospitals in a national field test...
March 22, 2017: Pediatrics
https://www.readbyqxmd.com/read/28329251/factors-associated-with-accelerated-hospitalization-and-re-hospitalization-among-medicare-home-health-patients
#18
Matthew C Lohman, Emily A Scherer, Karen L Whiteman, Rebecca L Greenberg, Martha L Bruce
Background: Preventing hospitalizations and re-hospitalizations of older adults receiving Medicare home health (HH) services is a key goal for patients and care providers. This study aimed to identify factors related to greater risk of and earlier hospitalizations from HH, a key step in targeting preventive efforts. Methods: Data come from Medicare mandated start-of-care assessments from 87,780 HH patients served by 132 agencies in 32 states, collected from January 2013 to March 2015...
January 19, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28301646/traumatic-facial-injuries-among-elderly-nursing-home-residents-never-event-or-frequent-occurrence
#19
Michael Bobian, Nour El-Kashlan, Curtis J Hanba, Peter F Svider, Adam J Folbe, Jean Anderson Eloy, Giancarlo F Zuliani, Michael Carron
Importance: As the nursing home population continues to increase, an understanding of preventable injuries becomes exceedingly important. Although other fall-related injuries have been characterized, little attention has been dedicated to facial trauma. Objectives: To estimate the incidence of facial trauma among nursing home residents and detail mechanisms of injury, injury characteristics, and patient demographic data. Design, Setting, and Participants: The National Electronic Injury Surveillance System was used to calculate a weighted national incidence of facial trauma among individuals older than 60 years from a nationally representative collection of emergency departments from January 1, 2011, through December 31, 2015...
March 16, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28290933/leveraging-the-partnership-for-patients-initiative-to-improve-patient-safety-and-quality-within-the-military-health-system
#20
Heidi B King, Kimberly Kesling, Carmen Birk, Theodore Walker, Heather Taylor, Michael Datena, Brittany Burgess, Lyndsay Bower
INTRODUCTION: Partnership for Patients (PfP) was a national initiative sponsored by the Department of Health and Human Services, Centers for Medicare and Medicaid Services, to reduce preventable hospital acquired conditions (HACs) by 40% and readmissions (within 30 days) by 20%, by the end of 2013 (as compared to the baseline of CY2010). Along with partners across the nation, the Assistant Secretary of Defense for Health Affairs, Dr. Jonathan Woodson, pledged to support PfP in June 2011...
March 2017: Military Medicine
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