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https://www.readbyqxmd.com/read/28726549/homeless-veterans-experiences-with-substance-use-recovery-and-treatment-through-photo-elicitation
#1
Samuel F Sestito, Keri L Rodriguez, Shaddy K Saba, James W Conley, Michael A Mitchell, Adam J Gordon
BACKGROUND: Homeless Veterans often have addictions and comorbidities that complicate utilization of longitudinal healthcare services, such as primary care. An understanding of experiences of Veterans enrolled in a Homeless Patient Aligned Care Team (H-PACT) may improve addiction treatment engagement in these settings. We aimed to describe H-PACT Veterans' experiences with substance use (SU), substance use recovery (SUR), and substance use treatment (SUT). METHODS: Homeless Veterans were recruited from a Veteran primary care medical home clinic between September 2014 and March 2015...
July 20, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28724505/readmission-to-hospital-of-medical-patients-a-cohort-study
#2
Mette Gothardt Rasmussen, Pernille Ravn, Stig Molsted, Lise Tarnow, Susanne Rosthøj
INTRODUCTION: The incidence of acute readmissions is higher among elderly medical patients than in the general population. Risk factor identification is needed in order to prevent readmissions. OBJECTIVE: To estimate the incidence of acute readmissions among medical patients ≥65years discharged from departments of internal medicine and to identify risk factors associated with readmissions. MATERIAL AND METHODS: We included patients discharged between 1st of January 2011 and 1st of December 2014 and collected data regarding primary diagnosis and comorbidities...
July 16, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28720628/the-patient-centered-medical-home-pcmh-framing-typology-for-understanding-the-structure-function-and-outcomes-of-pcmhs
#3
Autumn M Kieber-Emmons, William L Miller
INTRODUCTION: Patient-centered medical homes (PCHMs) aspire to transform today's challenged primary care services. However, it is unclear which PCMH characteristics produce specific outcomes of interest for care delivery. This study tested a novel typology of PCMH practice transformation, the PCMH framing typology, and evaluated measurable outcomes by each type. METHODS: Using the Patient-Centered Primary Care Collaborative 2012 to 2013 Annual Review, this secondary analysis of the published PCMH literature extracted data from publications of 59 PCMHs...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28720627/costs-of-transforming-established-primary-care-practices-to-patient-centered-medical-homes-pcmhs
#4
Neil S Fleming, Briget da Graca, Gerald O Ogola, Steven D Culler, Jessica Austin, Patrice McConnell, Russell McCorkle, Phil Aponte, Michael Massey, Cliff Fullerton
BACKGROUND: The patient-centered medical home (PCMH) shows promise for improving care and reducing costs. We sought to reduce the uncertainty regarding the time and cost of PCMH transformation by quantifying the direct costs of transforming 57 practices in a medical group to National Committee for Quality Assurance (NCQA)-recognized Level III PCMHs. METHODS: We conducted structured interviews with corporate leaders, and with physicians, practice administrators, and office managers from a representative sample of practices regarding time spent on PCMH transformation and NCQA application, and related purchases...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28720620/in-this-issue-opiates-tobacco-social-determinants-of-health-social-accountability-for-non-profit-hospitals-more-on-pcmh-and-clinical-topics
#5
EDITORIAL
Marjorie A Bowman, Anne Victoria Neale, Dean A Seehusen
This issue contains several articles about the factors contributing to the complex and deadly interplay between social determinants of health, pain, mental illness, and addictive substances such as opioids and tobacco. One article clearly is a call to action: more than half of opioid prescriptions in the United States are given to patients with mental health problems. Two articles report work on the next steps for social determinants of health in health care settings. Social accountability based on community health needs assessments required of community hospitals should lead to the creation of more family medicine residency positions...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28720035/home-visiting-and-the-health-of-preterm-infants
#6
Patrick H Casey, Carmen Irby, Sandra Withers, Susan Dorsey, Jingyun Li, Malik Rettiganti
The results of home visiting programs which target medically fragile low-birth-weight preterm infants (LBWPT) have been inconsistent. We provided nurse/social worker home visits to families of LBWPT infants on a regular schedule. Teams were trained in approaches to improve the health and development of the infants. The completion of immunization series was sigmificantly higher and the infant mortality rates of the home visits childen were significanly lower compared to national and state rates. We used state Medicaid data and examined frequency of hospitalization, emergency department visits, routine and nonscheduled visits to primary care physician, and pharmacy use of the home-visited subjects compared with a propensity-matched group...
August 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28718325/collaborative-care-for-psychiatric-disorders-in-older-adults-a-systematic-review
#7
Pallavi Dham, Sarah Colman, Karen Saperson, Carrie McAiney, Lillian Lourenco, Nick Kates, Tarek K Rajji
OBJECTIVE: To evaluate the mode of implementation, clinical outcomes, cost-effectiveness, and the factors influencing uptake and sustainability of collaborative care for psychiatric disorders in older adults. DESIGN: Systematic review. SETTING: Primary care, home health care, seniors' residence, medical inpatient and outpatient. PARTICIPANTS: Studies with a mean sample age of 60 years and older. INTERVENTION: Collaborative care for psychiatric disorders...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28716014/the-comprehensive-post-acute-stroke-services-compass-study-design-and-methods-for-a-cluster-randomized-pragmatic-trial
#8
Pamela W Duncan, Cheryl D Bushnell, Wayne D Rosamond, Sara B Jones Berkeley, Sabina B Gesell, Ralph B D'Agostino, Walter T Ambrosius, Blair Barton-Percival, Janet Prvu Bettger, Sylvia W Coleman, Doyle M Cummings, Janet K Freburger, Jacqueline Halladay, Anna M Johnson, Anna M Kucharska-Newton, Gladys Lundy-Lamm, Barbara J Lutz, Laurie H Mettam, Amy M Pastva, Mysha E Sissine, Betsy Vetter
BACKGROUND: Patients discharged home after stroke face significant challenges managing residual neurological deficits, secondary prevention, and pre-existing chronic conditions. Post-discharge care is often fragmented leading to increased healthcare costs, readmissions, and sub-optimal utilization of rehabilitation and community services. The COMprehensive Post-Acute Stroke Services (COMPASS) Study is an ongoing cluster-randomized pragmatic trial to assess the effectiveness of a comprehensive, evidence-based, post-acute care model on patient-centered outcomes...
July 17, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28712004/a-comparison-of-perceptions-of-quality-of-life-among-adults-with-spinal-cord-injury-in-the-united-states-versus-the-united-kingdom
#9
Alina Palimaru, William E Cunningham, Marcus Dillistone, Arturo Vargas-Bustamante, Honghu Liu, Ron D Hays
PURPOSE: To identify which aspects of life are most important to adults with spinal cord injury (SCI) and compare perspectives in the United States and the United Kingdom. METHODS: We conducted 20 in-depth interviews with adults with SCI (ten in the US and ten in the UK). Verbatim transcriptions were independently analyzed line-by-line by two coders using an inductive approach. Codes were grouped into themes about factors that constitute and affect quality of life (QOL)...
July 15, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28710700/enhancing-state-medical-home-capacity-through-a-care-coordination-technical-assistance-model
#10
Susan Berry, Patti Barovechio, Emily Mabile, Tri Tran
Introduction A practice-based care coordination (CC) model was developed by Louisiana's Title V Children's Special Health Services (CSHS) program to meet the overwhelming needs of the New Orleans post-Katrina population. The pilot clinic demonstrated an improvement in medical home (MH) capacity over the course of 3 months. The purpose of the current study is to evaluate the replicability of the model and sustainability of MH improvement over at least 2 years, while identifying factors that may modify the effect of the intervention...
July 14, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28708933/colorectal-cancer-screening-at-us-community-health-centers-examination-of-sociodemographic-disparities-and-association-with-patient-provider-communication
#11
Sue C Lin, Duane McKinley, Alek Sripipatana, Laura Makaroff
BACKGROUND: Colorectal cancer (CRC) screening rates are low among underserved populations. High-quality patient-physician communication potentially influences patients' willingness to undergo CRC screening. Community health centers (HCs) provide comprehensive primary health care to underserved populations. This study's objectives were to ascertain national CRC screening rates and to explore the relations between sociodemographic characteristics and patient-provider communication on the receipt of CRC screening among HC patients...
July 14, 2017: Cancer
https://www.readbyqxmd.com/read/28707258/-connecting-the-dots-a-qualitative-study-of-home-health-nurse-perspectives-on-coordinating-care-for-recently-discharged-patients
#12
Christine D Jones, Jacqueline Jones, Angela Richard, Kathryn Bowles, Dana Lahoff, Rebecca S Boxer, Frederick A Masoudi, Eric A Coleman, Heidi L Wald
BACKGROUND: In 2012, nearly one-third of adults 65 years or older with Medicare discharged to home after hospitalization were referred for home health care (HHC) services. Care coordination between the hospital and HHC is frequently inadequate and may contribute to medication errors and readmissions. Insights from HHC nurses could inform improvements to care coordination. OBJECTIVE: To describe HHC nurse perspectives about challenges and solutions to coordinating care for recently discharged patients...
July 13, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28705208/testing-feedback-message-framing-and-comparators-to-address-prescribing-of-high-risk-medications-in-nursing-homes-protocol-for-a-pragmatic-factorial-cluster-randomized-trial
#13
Noah M Ivers, Laura Desveaux, Justin Presseau, Catherine Reis, Holly O Witteman, Monica K Taljaard, Nicola McCleary, Kednapa Thavorn, Jeremy M Grimshaw
BACKGROUND: Audit and feedback (AF) interventions that leverage routine administrative data offer a scalable and relatively low-cost method to improve processes of care. AF interventions are usually designed to highlight discrepancies between desired and actual performance and to encourage recipients to act to address such discrepancies. Comparing to a regional average is a common approach, but more recipients would have a discrepancy if compared to a higher-than-average level of performance...
July 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28701576/estimated-impact-of-emergency-medical-service-triage-of-stroke-patients-on-comprehensive-stroke-centers-an-urban-population-based-study
#14
Brian S Katz, Opeolu Adeoye, Heidi Sucharew, Joseph P Broderick, Jason McMullan, Pooja Khatri, Michael Widener, Kathleen S Alwell, Charles J Moomaw, Brett M Kissela, Matthew L Flaherty, Daniel Woo, Simona Ferioli, Jason Mackey, Sharyl Martini, Felipe De Los Rios la Rosa, Dawn O Kleindorfer
BACKGROUND AND PURPOSE: The American Stroke Association recommends that Emergency Medical Service bypass acute stroke-ready hospital (ASRH)/primary stroke center (PSC) for comprehensive stroke centers (CSCs) when transporting appropriate stroke patients, if the additional travel time is ≤15 minutes. However, data on additional transport time and the effect on hospital census remain unknown. METHODS: Stroke patients ≥20 years old who were transported from home to an ASRH/PSC or CSC via Emergency Medical Service in 2010 were identified in the Greater Cincinnati area population of 1...
July 12, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28700461/student-hotspotting-teaching-the-interprofessional-care-of-complex-patients
#15
Pablo Bedoya, Katherine Neuhausen, Alan Dow, E Marshall Brooks, Dawn Mautner, Rebecca S Etz
PROBLEM: Individuals with complex health and social needs drive much of the total cost of care. Addressing these individuals' needs and decreasing costs requires interprofessional teams, called "hotspotters," who engage with communities with high utilization. Training health professions students to succeed in the hotspotting approach may benefit trainees, academic health centers (AHCs), and communities. APPROACH: The Camden Coalition of Healthcare Providers and the Association of American Medical Colleges launched the Interprofessional Student Hotspotting Learning Collaborative in 2014...
July 11, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28699419/chair-rise-capacity-and-associated-factors-in-older-home-care-clients
#16
Miia Tiihonen, Sirpa Hartikainen, Irma Nykänen
AIMS: The aim of this study was to investigate the ability of older home-care clients to perform the five times chair rise test and associated personal characteristics, nutritional status and functioning. METHODS: The study sample included 267 home-care clients aged ≥75 years living in Eastern and Central Finland. The home-care clients were interviewed at home by home-care nurses, nutritionists and pharmacists. The collected data contained sociodemographic factors, functional ability (Barthel Index, IADL), cognitive functioning (MMSE), nutritional status (MNA), depressive symptoms (GDS-15), medical diagnoses and drug use...
July 1, 2017: Scandinavian Journal of Public Health
https://www.readbyqxmd.com/read/28698319/the-supporting-patient-activation-in-transition-to-home-spath-intervention-a-study-protocol-of-a-randomised-controlled-trial-using-motivational-interviewing-to-decrease-re-hospitalisation-for-patients-with-copd-or-heart-failure
#17
Maria Flink, Marléne Lindblad, Oscar Frykholm, Åsa Kneck, Per Nilsen, Kristofer Årestedt, Mirjam Ekstedt
INTRODUCTION: Deficient hospital discharging and patients struggling to handle postdischarge self-management have been identified as potential causes of re-hospitalisation rates. Despite an increased interest in interventions aiming to reduce re-hospitalisation rates, there is yet no best evidence on how to support patients in being active participants in their self-management postdischarge. The aim of this paper is to describe the study protocol for an upcoming randomised controlled trial (RCT) of the Supporting Patient in Activation to Home (sPATH) intervention...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28697523/-assessment-of-idc-pal-as-a-diagnostic-tool-for-family-physicians-to-identify-patients-with-complex-palliative-care-needs-in-germany-a-pilot-study
#18
María Rosa Salvador Comino, Victor Regife Garcia, Maria Auxiliadora Fernández López, Berend Feddersen, María Luisa Martin Roselló, Linda Sanftenberg, Jörg Schelling
Background Palliative medicine is an essential component of the health care system. Basic palliative care should be provided by primary care services (family physician and home nursing) with palliative-medical basic qualification. Often it is very difficult to identify patients that would profit from a specialized palliative care team. For the evaluation of the case complexity of a palliative patient, we present a Spanish diagnostic tool IDC-Pal, which tries to specify when, why and where a palliative patient should be referred...
July 11, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28695425/community-health-workers-bring-cost-savings-to-patient-centered-medical-homes
#19
Maurice L Moffett, Arthur Kaufman, Andrew Bazemore
The Patient-Centered Medical Home (PCMH) model demonstrated that processes of care can be improved while unnecessary care, such as preventable emergency department utilization, can be reduced through better care coordination. A complementary model, the Integrated Primary Care and Community Support (I-PaCS) model, which integrates community health workers (CHWs) into primary care settings, functions beyond improved coordination of primary medical care to include management of the social determinants of health...
July 10, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28694266/comparing-medical-ecology-utilization-and-expenditures-between-1996-1997-and-2011-2012
#20
Michael E Johansen
PURPOSE: This study compared ecology (number of individuals using a service), utilization (number of services used), and expenditures (dollars spent) for various categories of medical services between primarily 1996-1997 and 2011-2012. METHODS: A repeated cross-sectional study was performed using nationally representative data mainly from the 1996, 1997, 2011, and 2012 Medical Expenditure Panel Survey (MEPS). These data were augmented with the 2002-2003 MEPS as well as the 1999-2000 and 2011-2012 National Heath and Nutrition Examination Survey...
July 2017: Annals of Family Medicine
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