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https://www.readbyqxmd.com/read/29031914/bringing-the-medical-home-back-home-in-the-context-of-population-health-home-based-primary-care-and-home-based-palliative-care
#1
Christine S Ritchie, Bruce Leff
With the growth of value-based care, payers and health systems have begun to appreciate the need to provide enhanced services to homebound adults. Recent studies have shown that home-based medical services for this high-cost, high-need population reduce costs and improve outcomes. Home-based medical care services have two flavors that are related to historical context and specialty background-home-based primary care and home-based palliative care. While the type of services provided by home-based primary care and home-based palliative care (together termed "home-based medical care") overlap, home-based primary care tends to encompass longitudinal and preventive care, while home-based palliative care often provides services for shorter durations focused more on distress management and goals of care clarification...
October 11, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28977536/transabdominal-robot-assisted-diaphragmatic-plication-a-3-5-year-experience
#2
Sreeja Biswas Roy, Cassandra Haworth, Taylor Ipsen, Paul Kang, David Hill, Annie Do, Elbert Kuo
OBJECTIVES: Diaphragmatic paralysis, a known cause of dyspnoea, can drastically reduce breathing efficiency, diminishing quality of life. We report our 3.5-year experience with 22 consecutive patients who underwent transabdominal, robot-assisted diaphragmatic plication for diaphragmatic paralysis. METHODS: We retrospectively reviewed 22 consecutive patients who underwent this procedure by a single surgeon from 5 September 2012 to 12 May 2016. The primary outcome measure was change in dyspnoea severity, which was measured with the 5-point Medical Research Council dyspnoea scale (a score of 5 indicates breathlessness so severe, the individual is homebound)...
July 25, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28871007/occurrence-of-depressive-tendency-and-associated-social-factors-among-elderly-persons-forced-by-the-great-east-japan-earthquake-and-nuclear-disaster-to-live-as-long-term-evacuees-a-prospective-cohort-study
#3
Yujiro Kuroda, Hajime Iwasa, Aya Goto, Kazuki Yoshida, Kumiko Matsuda, Yumi Iwamitsu, Seiji Yasumura
PURPOSE: This study examined the incidence of depression and associated factors among elderly persons from Iitate village after the March 2011 earthquake. METHOD: This was a prospective cohort study. As a baseline survey, in May 2010 a self-assessment Basic Checklist (BCL) was distributed to 1611 elderly villagers, of which 1277 responded. Of these respondents, 885 without a tendency to depression (69.3%) were given a follow-up survey in May 2013. The BCL was used to assess depression tendency, instrumental activities of daily living (IADL), physical function, nutritional status, oral function, homeboundness, cognitive function and social activities...
September 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28867476/using-scenarios-and-personas-to-enhance-the-effectiveness-of-heuristic-usability-evaluations-for-older-adults-and-their-care-team
#4
Laura Kneale, Sean Mikles, Yong K Choi, Hilaire Thompson, George Demiris
OBJECTIVE: Using heuristics to evaluate user experience is a common methodology for human-computer interaction studies. One challenge of this method is the inability to tailor results towards specific end-user needs. This manuscript reports on a method that uses validated scenarios and personas of older adults and care team members to enhance heuristics evaluations of the usability of commercially available personal health records for homebound older adults. MATERIALS AND METHODS: Our work extends the Chisnell and Redish heuristic evaluation methodology by using a protocol that relies on multiple expert reviews of each system...
September 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28794581/comparison-of-general-versus-isolated-regional-anesthesia-in-total-shoulder-arthroplasty-a-retrospective-propensity-matched-cohort-analysis
#5
David Y Ding, Siddharth A Mahure, Brent Mollon, Steven D Shamah, Joseph D Zuckerman, Young W Kwon
BACKGROUND: Intraoperative anesthetic typically consists of either general anesthesia (GA) or isolated regional anesthesia (RA). METHODS: A retrospective propensity-matched cohort analysis on patients undergoing TSA was performed to determine differences between GA and RA in regard to patient population, complications, LOS and hospital readmission. RESULTS: 4158 patients underwent TSA with GA or isolated RA. Propensity-matching resulted in 912 patients in each cohort...
December 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28774381/first-in-human-closed-chest-transcatheter-superior-cavopulmonary-anastomosis
#6
Kanishka Ratnayaka, John W Moore, Rodrigo Rios, Robert J Lederman, Sanjeet R Hegde, Howaida G El-Said
BACKGROUND: In the care of patients with congenital heart disease, percutaneous interventional treatments have supplanted many surgical approaches for simple lesions, such as atrial septal defect. By contrast, complex congenital heart defects continue to require open-heart surgery. In single-ventricle patients, a staged approach is employed, which requires multiple open-heart surgeries and significant attendant morbidity and mortality. A nonsurgical transcatheter alternative would be attractive...
August 8, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28753675/can-home-care-for-homebound-patients-with-chronic-heart-failure-reduce-hospitalizations-and-costs
#7
Boris Punchik, Roman Komarov, Dmitry Gavrikov, Anna Semenov, Tamar Freud, Ella Kagan, Yury Goldberg, Yan Press
BACKGROUND: Congestive heart failure (CHF), a common problem in adults, is associated with multiple hospitalizations, high mortality rates and high costs. PURPOSE: To evaluate whether home care for homebound patients with CHF reduces healthcare service utilization and overall costs. METHODS: A retrospective study of healthcare utilization among homebound patients who received home care for CHF from 2012-1015. The outcome measures were number of hospital admissions per month, total number of hospitalization days and days for CHF only, emergency room visits, and overall costs...
2017: PloS One
https://www.readbyqxmd.com/read/28726061/advances-in-psychotherapy-for-depressed-older-adults
#8
REVIEW
Patrick J Raue, Amanda R McGovern, Dimitris N Kiosses, Jo Anne Sirey
PURPOSE OF REVIEW: We review recent advances in psychotherapies for depressed older adults, in particular those developed for special populations characterized by chronic medical illness, acute medical illness, cognitive impairment, and suicide risk factors. We review adaptations for psychotherapy to overcome barriers to its accessibility in non-specialty settings such as primary care, homebound or hard-to-reach older adults, and social service settings. RECENT FINDINGS: Recent evidence supports the effectiveness of psychotherapies that target late-life depression in the context of specific comorbid conditions including COPD, heart failure, Parkinson's disease, stroke and other acute conditions, cognitive impairment, and suicide risk...
September 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/28658111/occurrence-of-and-factors-influencing-elderly-homebound-in-chinese-urban-community-a-cross-sectional-study
#9
Li-Wei Jing, Feng-Lan Wang, Xiao-Li Zhang, Ting Yao, Feng-Mei Xing
Studies on the occurrence of homebound and the factors influencing it are available. However, the study of community homebound in China is still in its preliminary stage. No previous studies about this issue are available. This study aims to assess the occurrence of and factors influencing homebound elderly in Chinese communities and to provide a basis for effective intervention and prevention of homebound elderly people.One sample community from three provinces was randomly selected. Investigations were performed on the selected communities and 2180 elderly people were chosen as the research subjects...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28634565/home-based-telepsychiatry-in-us-urban-area
#10
Alireza Amirsadri, Jaclynne Burns, Albert Pizzuti, Cynthia L Arfken
Telepsychiatry expands access to psychiatric care. However, telepsychiatry for elderly adults is only reimbursed in the US if the patient is assessed while in a clinical setting. This case study presents a homebound older woman previously hospitalized for schizophrenia who had not seen a psychiatrist in over 20 years. Care was provided with hybrid telepsychiatry (team-based practice with social worker traveling to the home with electronic tablet for connection with psychiatrist). The intervention resulted in detecting unrecognized depression and complex trauma...
2017: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/28591975/an-overview-of-home-based-primary-care-learning-from-the-field
#11
Sarah Klein, Martha Hostetter, Douglas McCarthy
ISSUE: Homebound and functionally limited individuals are often unable to access office-based primary care, leading to unmet needs and increased health care spending. GOAL: Show how home-based primary care affects outcomes and costs for Medicare and Medicaid beneficiaries with complex care needs. METHODS: Qualitative synthesis of expert perspectives and the experiences of six case-study sites. FINDINGS AND CONCLUSIONS: Successful home-based primary care practices optimize care by: fielding interdisciplinary teams, incorporating behavioral care and social supports into primary care, responding rapidly to urgent and acute care needs, offering palliative care, and supporting family members and caregivers...
June 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28558857/how-s-your-health-at-home-frail-homebound-patients-reported-health-experience-and-outcomes
#12
Margaret J McGregor, Jay Slater, John Sloan, Kimberlyn M McGrail, Anne Martin-Matthews, Shannon Berg, Alyson Plecash, Leila Sloss, Johanna Trimble, Janice M Murphy
We used a web-based mixed methods survey (HowsYourHealth - Frail) to explore the health of frail older (78% age 80 or older) adults enrolled in a home-based primary care program in Vancouver, Canada. Sixty per cent of eligible respondents participated, representing over one quarter (92/350, 26.2%) of all individuals receiving the service. Despite high levels of co-morbidity and functional dependence, 50 per cent rated their health as good, very good, or excellent. Adjusted odds ratios for positive self-rated health were 7...
May 31, 2017: Canadian Journal on Aging, la Revue Canadienne du Vieillissement
https://www.readbyqxmd.com/read/28558509/examining-fall-recurrence-risk-of-homebound-hispanic-older-adults-receiving-home-care-services
#13
Guillermina R Solis, Jane Dimmitt Champion
INTRODUCTION: Unintentional falls and injuries is a major problem among older adults and the fourth cause of death in the United States. A previous fall event doubles the risk of recurrence and lessens the person's quality of life. Hispanic older adults have higher rates of disability and lower independent functioning due to poor medical health and risk for fall recurrence. Most fall studies focus on fall risk with few studies on fall recurrence in older adults receiving home health care services unrelated to fall incident...
March 2017: Hispanic Health Care International: the Official Journal of the National Association of Hispanic Nurses
https://www.readbyqxmd.com/read/28548888/an-interdisciplinary-intervention-for-fear-of-falling-lessons-learned-from-two-case-studies
#14
James B Robinson, Julie Loebach Wetherell
This article describes two case studies using an interdisciplinary intervention for homebound older adults who experience fear of falling, resulting in debility and isolation. The patients discussed received separate home visits from a physical therapist (two and four visits) and psychologist (six and eight visits) and intervention components included an initial assessment of physical ability, prescription of home exercise program, exposure therapy, and cognitive restructuring. Both patients reported satisfaction with the fear of falling intervention and showed improved ability to walk, both in distance and in requiring less assistance...
May 12, 2017: Clinical Gerontologist
https://www.readbyqxmd.com/read/28452676/telephone-delivered-cognitive-behavioral-therapy-for-older-rural-veterans-with-depression-and-anxiety-in-home-based-primary-care
#15
Terri L Barrera, Jeremy P Cummings, Maria Armento, Jeffrey A Cully, Amber Bush Amspoker, Nancy L Wilson, Michael J Mallen, Srijana Shrestha, Mark E Kunik, Melinda A Stanley
OBJECTIVES: Rural, homebound older adults are at increased risk for anxiety and depression and have limited access to mental health services. These individuals face many barriers to receiving evidence-based mental health treatment and would benefit from interventions that increase access to and efficiency of care. The aim of this study was to evaluate use of a telephone-delivered, modular, cognitive behavioral therapy (CBT) intervention for both late-life depression and anxiety delivered to rural, homebound Veterans...
March 2017: Clinical Gerontologist
https://www.readbyqxmd.com/read/28386536/the-otago-exercise-program-innovative-delivery-models-to-maximize-sustained-outcomes-for-high-risk-homebound-older-adults
#16
Tiffany E Shubert, Lavinia Spring Goto, Matthew Lee Smith, Luohua Jiang, Holly Rudman, Marcia G Ory
BACKGROUND: It is estimated one in two adults age 80 and over fall each year, resulting in substantial morbidity and mortality rates among this oldest-old population. The Otago Exercise program (OEP) is an evidence-based fall prevention program shown to reduce falls by 35% among high-risk older adults. The OEP was designed to be delivered in the home by physical therapists. This model has encountered multiple implementation challenges in the United States health-care system, which has resulted in the development and testing of innovative models to support a broader reach and dissemination of this program...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28380701/falls-risks-and-prevention-behaviors-among-community-dwelling-homebound-and-non-homebound-older-adults
#17
Carri Casteel, Jennifer Jones, Paula Gildner, James M Bowling, Susan J Blalock
The objectives were to examine falls risk factors to determine how the magnitude of risk may differ between homebound and non-homebound older adults, and to describe falls prevention behaviors and participation in falls prevention education. A cross-sectional survey was conducted with convenience samples of community-dwelling older adults recruited through Meals on Wheels programs (homebound, n = 80) and senior centers (non-homebound, n = 84) in North Carolina. Data were collected during home visits and included an interview and medication inventory...
October 1, 2016: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/28303327/rotational-error-in-path-integration-encoding-and-execution-errors-in-angle-reproduction
#18
Elizabeth R Chrastil, William H Warren
Path integration is fundamental to human navigation. When a navigator leaves home on a complex outbound path, they are able to keep track of their approximate position and orientation and return to their starting location on a direct homebound path. However, there are several sources of error during path integration. Previous research has focused almost exclusively on encoding error-the error in registering the outbound path in memory. Here, we also consider execution error-the error in the response, such as turning and walking a homebound trajectory...
June 2017: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
https://www.readbyqxmd.com/read/28285039/the-lawrence-d-dorr-surgical-techniques-technologies-award-differences-in-postoperative-outcomes-between-total-hip-arthroplasty-for-fracture-vs-osteoarthritis
#19
Charles D Qin, Mia M Helfrich, David W Fitz, Kevin D Hardt, Matthew D Beal, David W Manning
BACKGROUND: Hip fracture is an increasingly common expanded indication for total hip arthroplasty (THA) and warrants outcome analysis so as to best inform risk assessment models, public reporting of outcome, and value-based reimbursement schemes. METHODS: The National Surgical Quality Improvement Program data file from 2011 to 2014 was used to identify all patients undergoing THA via current procedural terminology code 27130. Propensity score matching in a 1:5 fashion was used to compare 2 cohorts: THA for osteoarthritis and THA for fracture...
February 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28212250/economic-impact-of-nonmodifiable-risk-factors-in-orthopaedic-fracture-care-is-bundled-payment-feasible
#20
Siddharth A Mahure, Lorraine Hutzler, Richard S Yoon, Joseph A Bosco
OBJECTIVES: To determine whether bundled payments are feasible in the orthopaedic fracture setting, and the potential economic implications of this reimbursement structure. DESIGN: Prospective. SETTING: Multicenter. PATIENTS/PARTICIPANTS: Between 2004 and 2014, a total of 23,643 operatively treated patients with fracture and 544,067 patients with total joint arthroplasty (TJA) were identified using the New York State Statewide Planning and Research Cooperative System database...
March 2017: Journal of Orthopaedic Trauma
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