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https://www.readbyqxmd.com/read/29154464/patient-centered-medical-home-implementation-and-improved-chronic-disease-quality-a-longitudinal-observational-study
#1
Ann-Marie Rosland, Edwin Wong, Matthew Maciejewski, Donna Zulman, Rebecca Piegari, Stephan Fihn, Karin Nelson
OBJECTIVE: To examine associations between clinics' extent of patient-centered medical home (PCMH) implementation and improvements in chronic illness care quality. DATA SOURCE: Data from 808 Veterans Health Administration (VHA) primary care clinics nationwide implementing the Patient Aligned Care Teams (PACT) PCMH initiative, begun in 2010. DESIGN: Clinic-level longitudinal observational study of clinics that received training and resources to implement PACT...
November 20, 2017: Health Services Research
https://www.readbyqxmd.com/read/29150794/shunt-surgery-in-idiopathic-normal-pressure-hydrocephalus-is-cost-effective-a-cost-utility-analysis
#2
Mats Tullberg, Josefine Persson, Jakob Petersen, Per Hellström, Carsten Wikkelsø, Åsa Lundgren-Nilsson
BACKGROUND: The objective was to evaluate the cost-effectiveness of shunt surgery in patients with idiopathic normal pressure hydrocephalus (iNPH). METHODS: Health-related quality of life was evaluated before and 6 months after surgery using the EQ-5D-3 L (EuroQOL group five-dimensions health survey) in 30 patients (median age, 71 years; range, 65-89 years) diagnosed with iNPH. The costs associated with shunt surgery were assessed by a detailed survey with interviews and extraction of register data concerning the cost of hospital care, primary care, residential care, home-care service and informal care...
November 17, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29148907/impact-of-patients-expressed-wishes-on-their-surrogate-decision-makers-preferred-decision-making-roles-in-japan
#3
Shuji Tsuda, Mieko Nakamura, Shigeru Aoki, Hiroshi Ono, Mitsuru Takagi, Hiroki Ohashi, Junichiro Miyachi, Yoshinori Matsui, Toshiyuki Ojima
BACKGROUND: Home medical care (HMC) patients and their families are expected to prepare for end-of-life decision making. OBJECTIVE: We investigated the decision readiness of HMC patients and their family surrogates. DESIGN: Cross-sectional survey. SETTING/SUBJECTS: We collected data from dyads, consisting of a HMC patient aged 65 years or older and a family member of the patient, recruited at four Japanese primary care clinics from January 2016 to November 2016...
November 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29145792/evaluating-feasibility-and-acceptability-of-a-local-psycho-educational-intervention-for-pregnant-women-with-common-mental-problems-affected-by-armed-conflict-in-swat-pakistan-a-parallel-randomized-controlled-feasibility-trial
#4
Muhammad Naseem Khan, Mukesh Dherani, Anna Chiumento, Najia Atif, Katie Bristow, Siham Sikander, Atif Rahman
BACKGROUND: The current research was conducted in the Swat valley, where widespread conflict and militancy had been experienced prior to the field activities. The aim of this trial was to evaluate the feasibility and acceptability of a locally developed psycho-educational intervention. METHODS: This mixed-methods study incorporated a quantitative and qualitative component. For the quantitative component, trial participants were identified from a cross-sectional study conducted in the earlier phase of the research, with Self-Reporting Questionnaire (SRQ) score of ≥9...
December 2017: International Journal of Social Psychiatry
https://www.readbyqxmd.com/read/29144156/upmc-prescription-for-wellness-a-quality-improvement-case-study-for-supporting-patient-engagement-and-health-behavior-change
#5
Rebecca J Maners, Eric Bakow, Michael D Parkinson, Gary S Fischer, Geoffrey R Camp
Addressing patient health and care behaviors that underlie much of chronic disease continues to challenge providers, medical practices, health systems, and insurers. Improving health and care as described by the Quadruple Aim requires innovation at the front lines of clinical care: the doctor-patient interaction and office practice. This article describes the use of Lean Six Sigma in a quality improvement (QI) effort to design an effective and scalable method for physicians to prescribe health coaching for healthy behaviors in a primary care medical home within a large integrated delivery and financing system...
November 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29143427/effectiveness-of-educational-program-using-printed-educational-material-on-care-burden-distress-among-staff-of-residential-aged-care-facilities-without-medical-specialists-and-or-registered-nurses-cluster-quasi-randomization-study
#6
Koji Fukuda, Seishi Terada, Mamoru Hashimoto, Katsuyuki Ukai, Ryo Kumagai, Mizue Suzuki, Masahiro Nagaya, Mika Yoshida, Hideyuki Hattori, Kenta Murotani, Kenji Toba
AIM: Behavioral and psychological symptoms of dementia are an important source of distress for caregivers. The aim of the present study was to evaluate the effectiveness of educational intervention using printed educational material for reducing distress induced by behavioral and psychological symptoms of dementia among caregivers working at facilities without medical specialists and/or registered nurses. METHODS: A cluster quasi-randomized, controlled comparative trial was carried out at 17 facilities in Japan...
November 15, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29137672/the-primary-health-care-in-the-emirate-of-abu-dhabi-are-they-aligned-with-the-chronic-care-model-elements
#7
Marília Silva Paulo, Tom Loney, Luís Velez Lapão
BACKGROUND: Abu Dhabi is the capital of the United Arab Emirates (UAE) and the largest of the seven emirates in terms of land mass and population. Abu Dhabi emirate has three different geographical regions: the Central Capital District, the Eastern Region, and the Western Region. The health system has been regulated by the Health Authority - Abu Dhabi (HAAD), and has been provided by the Abu Dhabi Health Services Company (SEHA), since 2007. The UAE has a high population-burden of morbidity and mortality related to chronic diseases...
November 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29137666/utilization-of-the-behavior-change-wheel-framework-to-develop-a-model-to-improve-cardiometabolic-screening-for-people-with-severe-mental-illness
#8
Christina Mangurian, Grace C Niu, Dean Schillinger, John W Newcomer, James Dilley, Margaret A Handley
BACKGROUND: Individuals with severe mental illness (e.g., schizophrenia, bipolar disorder) die 10-25 years earlier than the general population, primarily from premature cardiovascular disease (CVD). Contributing factors are complex, but include systemic-related factors of poorly integrated primary care and mental health services. Although evidence-based models exist for integrating mental health care into primary care settings, the evidence base for integrating medical care into specialty mental health settings is limited...
November 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29133110/provision-of-medical-abortion-by-mid-level-healthcare-providers-in-kyrgyzstan-testing-an-intervention-to-expand-safe-abortion-services-to-under-served-rural-and-peri-urban-areas
#9
Brooke Ronald Johnson, Elmira Maksutova, Aigull Boobekova, Ainura Davletova, Chinara Kazakbaeva, Yelena Kondrateva, Sihem Landoulsi, Gunta Lazdane, Kubanychbek Monolbaev, Armando H Seuc Jo
OBJECTIVE: To demonstrate the feasibility and safety of training mid-level healthcare providers (midwives and family nurses) to provide medical abortion and post-abortion contraception in under-served areas in Kyrgyzstan. STUDY DESIGN: This was an implementation study at four referral facilities and 28 Felsher Obstetric Points in two districts to train their midwives and family nurses to deliver safe and effective abortion care with co-packaged mifepristone-misoprostol and provide contraceptives post-abortion...
November 10, 2017: Contraception
https://www.readbyqxmd.com/read/29131897/comparison-of-hospital-resource-use-and-outcomes-among-hospitalists-primary-care-physicians-and-other-generalists
#10
Jennifer P Stevens, David J Nyweide, Sha Maresh, Laura A Hatfield, Michael D Howell, Bruce E Landon
Importance: A physician's prior experience caring for a patient may be associated with patient outcomes and care patterns during and after hospitalization. Objective: To examine differences in the use of health care resources and outcomes among hospitalized patients cared for by hospitalists, their own primary care physicians (PCPs), or other generalists. Design, Setting, and participants: This retrospective study analyzed admissions for the 20 most common medical diagnoses among elderly fee-for-service Medicare patients from January 1 through December 31, 2013...
November 13, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29129193/experiences-of-three-states-implementing-the-medicaid-health-home-model-to-address-opioid-use-disorder-case-studies-in-maryland-rhode-island-and-vermont
#11
Lisa Clemans-Cope, Jane B Wishner, Eva H Allen, Nicole Lallemand, Marni Epstein, Brenda C Spillman
PURPOSE: The United States is facing an unprecedented opioid epidemic. The Affordable Care Act (ACA) included several provisions designed to increase care coordination in state Medicaid programs and improve outcomes for those with chronic conditions, including substance use disorders. Three states-Maryland, Rhode Island, and Vermont - adopted the ACA's optional Medicaid health home model for individuals with opioid use disorder. The model coordinates opioid use disorder treatment that features opioid agonist therapy provided at opioid treatment programs (OTPs) and Office-based Opioid Treatment (OBOT) with medical and behavioral health care and other services, including those addressing social determinants of health...
December 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/29113956/rationale-and-design-of-the-home-trial-a-pragmatic-randomized-controlled-trial-of-home-based-human-papillomavirus-hpv-self-sampling-for-increasing-cervical-cancer-screening-uptake-and-effectiveness-in-a-u-s-healthcare-system
#12
Rachel L Winer, Jasmin A Tiro, Diana L Miglioretti, Chris Thayer, Tara Beatty, John Lin, Hongyuan Gao, Kilian Kimbel, Diana S M Buist
Women who delay or do not attend Papanicolaou (Pap) screening are at increased risk for cervical cancer. Trials in countries with organized screening programs have demonstrated that mailing high-risk (hr) human papillomavirus (HPV) self-sampling kits to under-screened women increases participation, but U.S. data are lacking. HOME is a pragmatic randomized controlled trial set within a U.S. integrated healthcare delivery system to compare two programmatic approaches for increasing cervical cancer screening uptake and effectiveness in under-screened women (≥3...
November 4, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29110907/what-is-the-impact-of-professional-nursing-on-patients-outcomes-globally-an-overview-of-research-evidence
#13
REVIEW
Samantha Coster, Mary Watkins, Ian J Norman
BACKGROUND: Nursing is an integral part of all healthcare services, and has the potential of having a wide and enduring impact on health outcomes for a global ageing population. Over time nurses have developed new roles and assumed greater responsibilities. It is increasingly important to demonstrate the safety and overall impact of nurses' practice through research, to support the case for greater investment and development of nursing services around the world. OBJECTIVE: To provide an overview of existing research evidence on the impact of nursing on patient outcomes, identify gaps in evidence, and point to future priorities for global research...
October 19, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29083272/healthcare-provider-perceptions-of-the-role-of-interprofessional-care-in-access-to-and-outcomes-of-primary-care-in-an-underserved-area
#14
Shaowei Wan, Peter G Teichman, David Latif, Jennifer Boyd, Rahul Gupta
To meet the needs of an aging population who often have multiple chronic conditions, interprofessional care is increasingly adopted by patient-centred medical homes and Accountable Care Organisations to improve patient care coordination and decrease costs in the United States, especially in underserved areas with primary care workforce shortages. In this cross-sectional survey across multiple clinical settings in an underserved area, healthcare providers perceived overall outcomes associated with interprofessional care teams as positive...
October 30, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/29077863/seen-through-the-patients-eyes-safety-of-chronic-illness-care
#15
Melissa Desmedt, Mirko Petrovic, Jochen Bergs, Dominique Vandijck, Hubertus Vrijhoef, Johan Hellings, Peter Vermeir, Lieselot Cool, Ezra Dessers
Objective: Due to the increasing burden of chronic diseases, a considerable part of care delivery will continue to shift from secondary to primary care, and home care settings. Despite the growing importance of primary care, concerns about the safety of patients in hospitals have thus far driven most research in the field. Therefore, the present study sought to explore patients' perceptions and experiences of the safety of primary chronic care. Design: An observational, cross-sectional study design was applied...
October 25, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29070083/human-immunodeficiency-virus-infection-acquired-through-a-traditional-healer-s-ritual-a-case-report
#16
Pedro Pallangyo, Paulina Nicholaus, Henry Mayala, Andrew Kabeho, Anna Nkinda, Mohamed Janabi
BACKGROUND: Globally, over 36 million people were infected with human immunodeficiency virus by the end of 2015. The Sub-Saharan African region home to less than one-fifth of the global population disproportionately harbors over two-thirds of the total infections and related deaths. Residents of Sub-Saharan Africa continue to face limited access to allopathic medicine and it is estimated that over 80% of primary health care needs in the region are met through traditional healing practices...
October 26, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29061326/walk-in-model-for-ill-care-in-an-urban-academic-pediatric-clinic
#17
Stephen Warrick, John Morehous, Zeina M Samaan, Mona Mansour, Tracy Huentelman, Pamela J Schoettker, Srikant Iyer
OBJECTIVES: Since the Institute of Medicine's 2001 charge to reform healthcare, there has been a focus on the role of the medical home. Access to care in the proper setting and at the proper time is central to healthcare reform. We aimed to increase the volume of patients receiving care for acute illnesses within the medical home rather than the emergency department or urgent care center from 41% to 60%. METHODS: We used quality improvement methods to create a separate non-emergency care stream in a large academic primary care clinic serving 19,000 patients (> 90% Medicaid)...
October 20, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/29061154/a-multi-centre-randomised-trial-to-compare-the-effectiveness-of-geriatrician-led-admission-avoidance-hospital-at-home-versus-inpatient-admission
#18
Sasha Shepperd, Andrea Cradduck-Bamford, Chris Butler, Graham Ellis, Mary Godfrey, Alastair Gray, Anthony Hemsley, Pradeep Khanna, Peter Langhorne, Patricia McCaffrey, Lubena Mirza, Maj Pushpangadan, Scott Ramsay, Rebekah Schiff, David Stott, John Young, Ly-Mee Yu
BACKGROUND: There is concern that existing models of acute hospital care will become unworkable as the health service admits an increasing number of frail older people with complex health needs, and that there is inadequate evidence to guide the planning of acute hospital level services. We aim to evaluate whether geriatrician-led admission avoidance to hospital at home is an effective alternative to hospital admission. METHODS/DESIGN: We are conducting a multi-site randomised open trial of geriatrician-led admission avoidance hospital at home, compared with admission to hospital...
October 23, 2017: Trials
https://www.readbyqxmd.com/read/29058625/the-impact-of-patient-advisors-on-healthcare-outcomes-a-systematic-review
#19
Anjana E Sharma, Margae Knox, Victor L Mleczko, J Nwando Olayiwola
BACKGROUND: Patient advisory councils are a way for healthcare organizations to promote patient engagement. Despite mandates to implement patient advisory councils through programs like the Patient-Centered Medical Home (PCMH), there is a paucity of data measuring the impact of patients functioning in advisory roles. Our objective is to investigate whether patient engagement in patient advisory councils is linked to improvements in clinical quality, patient safety or patient satisfaction...
October 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29052345/views-of-diverse-primary-care-patients-on-the-roles-of-healthcare-providers-and-staff-and-the-influence-of-other-variables-in-their-weight-management
#20
C M Tucker, J L Williams, G M Wippold, L A Bilello, T A Morrissette, A J Good, N R Shah, N E Rowland
The prevalence of overweight/obesity is disproportionately higher among racial/ethnic minority and low-income patients. The purpose of this study was to survey racially diverse, low-income patients regarding their experiences with and desires regarding their providers' involvement in weight management. Adult patients (N = 529), including mostly African American (42.7%), White (44.6%) and low-income (55.5% with incomes <$30 000) patients from 7 Patient-Centered Medical Homes voluntarily completed a brief anonymous survey while waiting to see their providers...
October 20, 2017: Clinical Obesity
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