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https://www.readbyqxmd.com/read/27911487/external-inspection-of-compliance-with-standards-for-improved-healthcare-outcomes
#1
REVIEW
Gerd Flodgren, Daniela C Gonçalves-Bradley, Marie-Pascale Pomey
BACKGROUND: Inspection systems are used in healthcare to promote quality improvements (i.e. to achieve changes in organisational structures or processes, healthcare provider behaviour and patient outcomes). These systems are based on the assumption that externally promoted adherence to evidence-based standards (through inspection/assessment) will result in higher quality of healthcare. However, the benefits of external inspection in terms of organisational-, provider- and patient-level outcomes are not clear...
December 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27911073/reducing-risky-alcohol-use-what-health-care-systems-can-do
#2
Amity E Quinn, Mary Brolin, Maureen T Stewart, Brooke Evans, Constance Horgan
Risky, non-dependent alcohol use is prevalent in the United States, affecting 25% of adults (Centers for Disease Control and Prevention, 2014b). Massachusetts has higher rates of alcohol use and binge drinking than most states (Substance Abuse and Mental Health Services Administration, 2015). Serious physical, social, and economic consequences result. Excessive alcohol use contributes to cancer, cardiovascular disease, sleep disorders, birth defects, motor vehicle injuries, and suicide, and it complicates management of chronic illnesses (Green, McKnight-Eily, Tan, Mejia, & Denny, 2016; Laramee et al...
April 27, 2016: Issue Brief
https://www.readbyqxmd.com/read/27911013/the-cost-of-care-homes-for-people-with-dementia-in-england-a-modelling-approach
#3
Renee Romeo, Martin Knapp, Suzanne Salverda, Martin Orrell, Jane Fossey, Clive Ballard
OBJECTIVES: To examine the cost of care for people with dementia in institutional care settings, to understand the major cost drivers and to highlight opportunities for service development. METHODS: Data on 277 residents with dementia in 16 UK residential or nursing homes were collected. We estimated care and support costs and fitted models to the data. Sensitivity analyses were also conducted. RESULTS: Care home residents cost £792 weekly: 95% of the costs accounted for by direct fees...
December 2, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27910721/care-delivery-considerations-for-widespread-and-equitable-implementation-of-inherited-cancer-predisposition-testing
#4
Deborah Cragun, Anita Y Kinney, Tuya Pal
DNA sequencing advances through next-generation sequencing (NGS) and several practice changing events, have led to shifting paradigms for inherited cancer predisposition testing. These changes necessitated a means by which to maximize health benefits without unnecessarily inflating healthcare costs and exacerbating health disparities. Areas covered: NGS-based tests encompass multi-gene panel tests, whole exome sequencing, and whole genome sequencing, all of which test for multiple genes simultaneously, compared to prior sequencing practices through which testing was performed sequentially for one or two genes...
December 2, 2016: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/27910720/the-management-of-infection-with-mycobacterium-tuberculosis-in-young-children-post-2015-an-opportunity-to-close-the-policy-practice-gap
#5
Stephen M Graham
The treatment of infection with Mycobacterium tuberculosis in young children is supported by universal policy based on strong rationale and evidence of effectiveness, but has rarely been implemented in tuberculosis endemic countries. Areas covered: This review highlights a number of important recent developments that provide an unprecedented opportunity to close the policy-practice gap, as well as ongoing needs to facilitate implementation under programmatic conditions and scale-up. Expert commentary: The WHO's End TB Strategy and Stop TB Partnership's Plan to End TB provide ambitious targets for prevention at a time when National Tuberculosis Programs in tuberculosis endemic countries are increasing attention to the challenges of management and prevention of tuberculosis disease in children...
December 2, 2016: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/27909958/using-group-medical-visits-with-those-who-have-diabetes-examining-the-evidence
#6
REVIEW
Laura M Housden, Sabrina T Wong
The number of people with diabetes is expected to rise to over 592 million by the year 2035. Past work provides evidence that the conventional method of primary care delivery may not meet many patients' needs. An alternative to the conventional one-on-one appointment is care offered to a group of patients through group medical visits (GMVs). Group medical visits for diabetes have a positive impact on physiologic and self-care outcomes including improved HbA1c, blood pressure control and self-management skills...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27909819/cost-effects-of-preterm-birth-a-comparison-of-health-care-costs-associated-with-early-preterm-late-preterm-and-full-term-birth-in-the-first-3%C3%A2-years-after-birth
#7
Josephine Jacob, Moritz Lehne, Andrea Mischker, Normen Klinger, Claudia Zickermann, Jochen Walker
Preterm birth is one of the main causes for infant morbidity and mortality. Apart from negative health outcomes, preterm birth also produces significant health care expenditures. This study evaluates the costs associated with preterm birth in different health sectors during the first 3 years of infants' lives. In a retrospective observational study based on claims data from a German statutory health insurance company, average costs for medication, hospital treatment, ambulatory treatment, and non-medical remedies during the first 3 years after birth were analyzed for early preterm, late preterm, and full-term births...
December 1, 2016: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/27909793/epidermolysis-bullosa-house-austria-and-epidermolysis-bullosa-clinical-network-example-of-a-centre-of-expertise-implemented-in-a-european-reference-network-to-face-the-burden-of-a-rare-disease
#8
Martin Laimer, Gabriela Pohla-Gubo, Anja Diem, Christine Prodinger, Johann W Bauer, Helmut Hintner
Accurately addressing the diverse and complex issues of rare diseases (RD) in terms of prevention, recognition, diagnosis, treatment, care and research along key RD specificities, such as great heterogeneity, a limited number of patients, scarcity of relevant knowledge and expertise as well as enormous costs for patient care is a challenging task for healthcare providers and authorities that makes a supranational approach particularly feasible. The European Union has acknowledged RD matters by several initiatives, including efforts to implement national centres of expertise and European reference networks as well as a cross-border referral mechanism to foster access to expert services and to boost dissemination of clinical expertise and research activities...
December 1, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27909581/expansion-of-health-insurance-in-moldova-and-associated-improvements-in-access-and-reductions-in-direct-payments
#9
Thomas Hone, Jarno Habicht, Silviu Domente, Rifat Atun
BACKGROUND: Moldova is the poorest country in Europe. Economic constraints mean that Moldova faces challenges in protecting individuals from excessive costs, improving population health and securing health system sustainability. The Moldovan government has introduced a state benefit package and expanded health insurance coverage to reduce the burden of health care costs for citizens. This study examines the effects of expanded health insurance by examining factors associated with health insurance coverage, likelihood of incurring out-of-pocket (OOP) payments for medicines or services, and the likelihood of forgoing health care when unwell...
December 2016: Journal of Global Health
https://www.readbyqxmd.com/read/27909571/affordable-art-in-kenya-the-only-hope-for-involuntary-childlessness
#10
S W Ndegwa
The reported overall subfertility rate in Kenia is 26.1% with 50% attributed to tubal factors and 15% due to male factors. This is probably an underestimation taking into consideration that due to the stigma and myths of the disease, many couples are seeking alternative care from religious sects, witchdoctors, herbalists. Because the costs associated with IVF in private centres are only affordable for the happy few, the only true hope for most Kenyans struggling with unintended childlessness lies in the introduction of affordable ART services...
June 27, 2016: Facts, Views & Vision in ObGyn
https://www.readbyqxmd.com/read/27909516/the-role-of-noacs-in-atrial-fibrillation-management-a-qualitative-study
#11
Katherine Kirley Md Ms, Goutham Rao Md, Victoria Bauer Bs, Christopher Masi Md PhD
Patients with atrial fibrillation (AF) benefit from anticoagulation to reduce stroke risk. However, 30-60% of patients with AF are not anticoagulated. This study explored physicians' reasons for under-treatment of AF, focusing on the role of the novel oral anticoagulants (NOACs). We interviewed primary care physicians and cardiologists involved in AF management in a variety of practice settings. We conducted interviews using a semi-structured format and analyzed the data using the Framework Method. Four themes emerged...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909374/cardiorespiratory-physiotherapy-around-the-clock-experience-at-a-university-hospital
#12
Marianne Devroey, Catherine Buyse, Michelle Norrenberg, Anne-Marie Ros, Jean-Louis Vincent
Purpose: To document and describe the use of a hospital-wide, 24-hour cardiorespiratory physiotherapy service run by an intensive care unit (ICU) team of physiotherapists. Methods: We prospectively collected data on all non-ICU hospital patients who used the 24-hours-per-day cardiorespiratory physiotherapy service over a 1-year period between July 2013 and June 2014. The ICU physiotherapists documented the reason, origin of referral, time of call, and type and frequency of treatment of each patient. Results: Over the 1-year period, the ICU physiotherapists administered 2,192 out-of-hours cardiorespiratory physiotherapy treatments (n=685 patients) outside the ICU...
2016: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/27909034/advance-care-planning-in-patients-with-incurable-cancer-study-protocol-for-a-randomised-controlled-trial
#13
Stephanie Johnson, Josephine Clayton, Phyllis N Butow, William Silvester, Karen Detering, Jane Hall, Belinda E Kiely, Jonathon Cebon, Stephen Clarke, Melanie L Bell, Martin Stockler, Phillip Beale, Martin H N Tattersall
INTRODUCTION: There is limited evidence documenting the effectiveness of Advance Care Planning (ACP) in cancer care. The present randomised trial is designed to evaluate whether the administration of formal ACP improves compliance with patients' end-of-life (EOL) wishes and patient and family satisfaction with care. METHODS AND ANALYSIS: A randomised control trial in eight oncology centres across New South Wales and Victoria, Australia, is designed to assess the efficacy of a formal ACP intervention for patients with cancer...
December 1, 2016: BMJ Open
https://www.readbyqxmd.com/read/27908954/chlorhexidine-impregnated-dressings-and-prevention-of-catheter-associated-bloodstream-infections-in-a-pediatric-intensive-care-unit
#14
Duygu Sönmez Düzkaya, Nejla Canbulat Sahiner, Gülzade Uysal, Tülay Yakut, Agop Çitak
BACKGROUND: Bloodstream infections related to use of catheters are associated with increased morbidity and mortality rates, prolonged hospital lengths of stay, and increased medical costs. OBJECTIVES: To compare the effectiveness of chlorhexidine-impregnated dressings with that of standard dressings in preventing catheter-related bloodstream infections. METHODS: A total of 100 children were randomly divided into 2 groups of 50 each: a chlorhexidine group and a standard group...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27908665/diffuse-resistance-courtship-in-the-scorpion-rhopalurus-rochai-scorpiones-buthidae
#15
Shayanne Chantall-Rocha, Hilton F Japyassú
Male-female courtship signals are frequently subject to arms races, with patterns of behaviour evolving reciprocally to manipulate the reproductive output. Female resistance should be particularly effective when asymmetrical offspring care occurs under low and unpredictable resource distribution, because this would increase maternal costs. Our hypothesis is that under these conditions females will evolve diffuse mating strategies to avoid predictable exploitation by male optimal counter tactics. Mating in scorpions is a complex process, and female resistance occurs through specific behaviours...
November 28, 2016: Behavioural Processes
https://www.readbyqxmd.com/read/27908645/a-brief-measure-of-language-skills-at-3-years-of-age-and-special-education-use-in-middle-childhood
#16
Laura Lee McIntyre, William E Pelham, Matthew H Kim, Thomas J Dishion, Daniel S Shaw, Melvin N Wilson
OBJECTIVE: To test whether a language screener administered during early childhood predicts special education referrals and placement in middle childhood. STUDY DESIGN: A series of logistic regressions was conducted in a longitudinal study of 731 children. Predictor variables included scores on the early language screener (Fluharty Preschool Speech and Language Screening Test-Second Edition [Fluharty-2]) at ages 3 and 4 years, a standardized measure of academic achievement at age 5 years, and parent report of special education services at ages 7...
November 28, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27908605/direct-health-care-costs-associated-with-obesity-in-chinese-population-in-2011
#17
Jingcheng Shi, Yao Wang, Wenwei Cheng, Hui Shao, Lizheng Shi
AIMS: Overweight and obesity are established major risk factors for type 2 diabetes, and major public health concerns in China. This study aims to assess the economic burden associated with overweight and obesity in the Chinese population ages 45 and older. METHODS: The Chinese Health and Retirement Longitudinal Study (CHARLS) in 2011 included 13,323 respondents of ages 45 and older living in 450 rural and urban communities across China. Demographic information, height, weight, direct health care costs for outpatient visits, hospitalization, and medications for self-care were extracted from the CHARLS database...
November 12, 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/27908435/antimicrobial-stewardship-programs-that-target-only-high-cost-broad-spectrum-antimicrobials-miss-opportunities-to-reduce-clostridium-difficile-infections
#18
Christine Bui, Elizabeth Zhu, Monica A Donnelley, Machelle D Wilson, Margaret Morita, Stuart H Cohen, Jennifer Brown
Antimicrobial stewardship programs are promoted as a strategy to reduce Clostridium difficile infections. We implemented an antimicrobial stewardship program comprised of formulary restriction plus prospective audit with feedback for high-cost and broad-spectrum antimicrobials. Subsequently, we reviewed all heath care facility-onset, health care facility-associated C difficile infections. We found that most of these infections were associated with the antecedent receipt of nonaudited, and often unnecessary, antimicrobials...
December 1, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27908433/central-venous-catheter-infections-in-home-parenteral-nutrition-patients-outcomes-from-sustain-american-society-for-parenteral-and-enteral-nutrition-s-national-patient-registry-for-nutrition-care
#19
Vicki M Ross, Peggi Guenter, Mandy L Corrigan, Debra Kovacevich, Marion F Winkler, Helaine E Resnick, Tina L Norris, Lawrence Robinson, Ezra Steiger
BACKGROUND: Home parenteral nutrition (HPN) is a high-cost, complex nutrition support therapy that requires the use of central venous catheters. Central line-associated bloodstream infections (CLABSIs) are among the most serious risks of this therapy. Sustain: American Society for Parenteral and Enteral Nutrition's National Patient Registry for Nutrition Care (Sustain registry) provides the most current and comprehensive data for studying CLABSI among a national cohort of HPN patients in the United States...
December 1, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27908328/the-new-usual-care
#20
REVIEW
Jared Radbel, Daniel Boutsikaris
Recent literature continues to refine which components of the early goal-directed therapy (EGDT) algorithm are necessary. Given it utilizes central venous pressure, continuous central venous oxygen saturation, routine blood transfusions, and inotropic medications, this algorithm can be timely, invasive, costly, and potentially harmful. New trials highlight early recognition, early fluid resuscitation, appropriate antibiotic treatment, source control, and the application of a multidisciplinary evidence-based approach as essential components of current sepsis management...
February 2017: Emergency Medicine Clinics of North America
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