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https://www.readbyqxmd.com/read/28441676/transitioning-from-volume-to-value-one-academic-medical-center-s-approach-to-improving-population-health
#1
Stephanie A C Halvorson, Mary E Tanski, Thomas R Yackel
PROBLEM: The U.S. health care system is undergoing a major transformation. Clinical delivery systems are now being paid according to the value of the care they provide, in accordance with the Triple Aim, which incorporates improving the quality and cost of care and the patient experience. Increasingly, financial risk is being transferred from insurers to clinical delivery systems that become responsible for both episode-based clinical care and the longitudinal care of patients. Thus, these delivery systems need to develop strategies to manage the health of populations...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441452/systematic-review-finds-that-study-data-not-published-in-full-text-articles-have-unclear-impact-on-meta-analyses-results-in-medical-research
#2
Christine M Schmucker, Anette Blümle, Lisa K Schell, Guido Schwarzer, Patrick Oeller, Laura Cabrera, Erik von Elm, Matthias Briel, Joerg J Meerpohl
BACKGROUND: A meta-analysis as part of a systematic review aims to provide a thorough, comprehensive and unbiased statistical summary of data from the literature. However, relevant study results could be missing from a meta-analysis because of selective publication and inadequate dissemination. If missing outcome data differ systematically from published ones, a meta-analysis will be biased with an inaccurate assessment of the intervention effect. As part of the EU-funded OPEN project (www...
2017: PloS One
https://www.readbyqxmd.com/read/28441373/cost-effectiveness-analysis-of-interventions-to-reduce-risk-of-aspiration-in-elderly-cancer-survivors-residing-in-skilled-nursing-facilities
#3
S Mantravadi
BACKGROUND: Aspiration can occur in patients of any age group, but it can be prevented. The primary population at risk is made up of survivors of cancer because of their increased risk of mucositis, mucosal atrophy, and dysphagia associated with chemotherapy, radiotherapy, and the disease process itself. The rate of incidence of aspiration cannot be quantified, because minor cases of aspiration often go unreported. Sequelae ensuing from aspirations can include pneumonia, end-stage kidney disease, dialysis, and death...
April 2017: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/28441153/discharge-criteria-for-the-late-preterm-infant-a-review-of-the-literature
#4
Jenny M Quinn, Marteen Sparks, Sheila M Gephart
BACKGROUND: Standardized late preterm infant (LPI) discharge criteria ensure best practice and help guide the neonatal provider to determine the appropriate level of care following birth. However, the location can vary from the well newborn setting to the neonatal intensive care unit (NICU). PURPOSE: The purpose of this review is to examine differences in LPI discharge criteria between the well newborn setting and the NICU by answering the clinical questions, "What are the recommended discharge criteria for the LPI and do they differ if admitted to the well newborn setting versus the NICU?" SEARCH STRATEGY: Databases searched include CINAHL, TRIP, PubMed, and the Cochrane Library...
April 24, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28441001/-mexican-asthma-guidelines-guima-2017
#5
Désirée Larenas-Linnemann, Jorge Salas-Hernández, Juan Carlos Vázquez-García, Ignacio Ortiz-Aldana, Margarita Fernández-Vega, Blanca Estela Del Río-Navarro, María Del Carmen Cano-Salas, Jorge Agustín Luna-Pech, José Antonio Ortega-Martell, Jade Romero-Lombard, Erika Del Carmen López-Estrada, Jimena Villaverde-Rosas, José Luis Mayorga-Butrón, Mario Humberto Vargas-Becerra, Martín Bedolla-Barajas, Noel Rodríguez-Pérez, Ambrocio Aguilar-Aranda, Carlos Adrián Jiménez-González, Carlos García-Bolaños, Claudia Garrido-Galindo, David Alejandro Mendoza-Hernández, Enrique Mendoza-López, Gerardo López-Pérez, Guillermo Hideo Wakida-Kuzonoki, Héctor Hernán Ruiz-Gutiérrez, Héctor León-Molina, Héctor Martínez-De la Lanza, Héctor Stone-Aguilar, Javier Gómez-Vera, Jorge Olvera-Salinas, José Joel Oyoqui-Flores, José Luis Gálvez-Romero, José Santos Lozano-Sáenz, Juan Ignacio Salgado-Gama, Marcos Alejandro Jiménez-Chobillon, Martha Angélica García-Avilés, Martha Patricia Guinto-Balanzar, Miguel Alejandro Medina-Ávalos, Robert Camargo-Angeles, Rogelio García-Torrentera, Saraí Toral-Freyre, Gabriel Montes-Narváez, Héctor Solorio-Gómez, Juan Rosas-Peña, Sergio Jesús Romero-Tapia, Adela Reyes-Herrera, Francisco Cuevas-Schacht, Joaquín Esquer-Flores, José Antonio Sacre-Hazouri, Lorenzo Compean-Martínez, Pablo Julián Medina-Sánchez, Sergio Garza-Salinas, Carlos Báez-Loyola, Iraís Romero-Alvarado, José Luis Miguel-Reyes, Laura Elizabeth Huerta-Espinosa, Manuel Ángel Correa-Flores, Ricardo Castro-Martínez
BACKGROUND: The need for a national guideline, with a broad basis among specialists and primary care physicians was felt in Mexico, to try unifying asthma management. As several high-quality asthma guidelines exist worldwide, it was decided to select the best three for transculturation. METHODS: Following the internationally recommended methodology for guideline transculturation, ADAPTE, a literature search for asthma guidelines, published 1-1-2007 through 31-12-2015 was conducted...
2017: Revista Alergia Mexico: Organo Oficial de la Sociedad Mexicana de Alergia e Inmunología, A.C
https://www.readbyqxmd.com/read/28440983/-detection-of-cardiovascular-risk-in-healthcare-workers-on-the-basis-of-who-jnc-7-atp-iii-criteria
#6
Roma Rubí Rodríguez-Reyes, José Eduardo Navarro-Zarza, Tania Leticia Tello-Divicino, Isela Parra-Rojas, Oscar Zaragoza-García, Iris Paola Guzmán-Guzmán
BACKGROUND: Anthropometric and blood pressure measurements are significant parameters in the assessment of cardiovascular risk (CVR). The aim was to establish the distribution of clinical-anthropometric parameters in health care workers according to the criteria established by WHO/JNC 7/ATP III. METHODS: Observational, cross-sectional study in 350 workers of a general hospital. Definitions of anthropometric alterations were made considering the criteria established by WHO and the Asian ATP III, while altered blood pressure was defined by criteria JNC 7 and ATP III...
May 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28440898/comparing-induction-of-labour-with-oral-misoprostol-or-foley-catheter-at-term-cost-effectiveness-analysis-of-a-randomised-controlled-multi-centre-non-inferiority-trial
#7
Mieke L G Ten Eikelder, Gert-Jan van Baaren, Katrien Oude Rengerink, Marta Jozwiak, Jan Willem de Leeuw, Gunilla Kleiverda, Inge Evers, Karin de Boer, Josien Brons, Kitty W M Bloemenkamp, Ben W Mol
OBJECTIVE: To assess the costs of labour induction with oral misoprostol compared to Foley catheter. DESIGN: Economic evaluation alongside a randomised controlled trial. SETTING: Obstetric departments of six tertiary and 23 secondary care hospitals in the Netherlands. POPULATION: Women with a viable term singleton pregnancy in cephalic presentation, intact membranes, an unfavourable cervix (Bishop score <6) without a previous caesarean section, had been randomised for labour induction with oral misoprostol (n = 924) or Foley catheter (n = 921)...
April 25, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28440861/findings-from-the-families-on-track-intervention-pilot-trial-for-children-with-fetal-alcohol-spectrum-disorders-and-their-families
#8
Christie L M Petrenko, Mary E Pandolfino, Luther K Robinson
BACKGROUND: Individuals with fetal alcohol spectrum disorders (FASD) are at high risk for costly, debilitating mental health problems and secondary conditions, such as school disruption, trouble with the law, and substance use. The study objective was to pilot a multi-component intervention designed to prevent secondary conditions in children with FASD and improve family adaptation. METHODS: Thirty children with FASD or prenatal alcohol exposure (PAE) (ages 4 to 8) and their primary caregivers were enrolled...
April 25, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/28440578/developing-social-marketed-individual-preconception-care-consultations-which-consumer-preferences-should-it-meet
#9
Sabine F van Voorst, Chantal A Ten Kate, Lieke C de Jong-Potjer, Eric A P Steegers, Semiha Denktaş
AIMS: Preconception care (PCC) is care that aims to improve the health of offspring by addressing risk factors in the pre-pregnancy period. Consultations are recognized as a method to promote perinatal health. However, prospective parents underutilize PCC services. Uptake can improve if delivery approaches satisfy consumer preferences. Aim of this study was to identify preferences of women (consumers) as a first step to social marketed individual PCC consultations. METHODS: In depth, semi-structured interviews were performed to identify women's views regarding the four components of the social marketing model: product (individual PCC consultation), place (setting), promotion (how women are made aware of the product) and price (costs)...
April 25, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28440535/socioeconomic-status-and-its-relationship-to-chronic-respiratory-disease
#10
Sonu Sahni, Ankoor Talwar, Sameer Khanijo, Arunabh Talwar
Socioeconomic status (SES) is defined as an individual's social or economic standing, and is a measure of an individual's or family's social or economic position or rank in a social group. It is a composite of several measures including income, education, occupation, location of residence or housing. Studies have found a lower SES has been linked to disproportionate access to health care in many diseases. There is emerging data in pulmonary diseases such as COPD, asthma, cystic fibrosis, pulmonary hypertension and other chronic respiratory conditions that allude to a similar observation noted in other chronic diseases...
2017: Advances in Respiratory Medicine
https://www.readbyqxmd.com/read/28440211/a-cluster-randomised-trial-cost-effectiveness-analysis-and-psychosocial-evaluation-of-insulin-pump-therapy-compared-with-multiple-injections-during-flexible-intensive-insulin-therapy-for-type-1-diabetes-the-repose-trial
#11
Simon Heller, David White, Ellen Lee, Julia Lawton, Daniel Pollard, Norman Waugh, Stephanie Amiel, Katharine Barnard, Anita Beckwith, Alan Brennan, Michael Campbell, Cindy Cooper, Munyaradzi Dimairo, Simon Dixon, Jackie Elliott, Mark Evans, Fiona Green, Gemma Hackney, Peter Hammond, Nina Hallowell, Alan Jaap, Brian Kennon, Jackie Kirkham, Robert Lindsay, Peter Mansell, Diana Papaioannou, David Rankin, Pamela Royle, W Henry Smithson, Carolin Taylor
BACKGROUND: Insulin is generally administered to people with type 1 diabetes mellitus (T1DM) using multiple daily injections (MDIs), but can also be delivered using infusion pumps. In the UK, pumps are recommended for patients with the greatest need and adult use is less than in comparable countries. Previous trials have been small, of short duration and have failed to control for training in insulin adjustment. OBJECTIVE: To assess the clinical effectiveness and cost-effectiveness of pump therapy compared with MDI for adults with T1DM, with both groups receiving equivalent structured training in flexible insulin therapy...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28440005/comparing-the-burden-of-illness-of-haemophilia-between-resource-constrained-and-unconstrained-countries-the-s%C3%A3-o-paulo-toronto-hemophilia-study
#12
J D A Carneiro, V Blanchette, M C Ozelo, S V Antunes, P R Villaca, N L Young, D Castro, L R Brandão, M Carcao, A Abad, B M Feldman
INTRODUCTION: Although the regular replacement of clotting factor concentrates (prophylaxis) has been well established as the standard of care for severe haemophilia, the high cost of factor concentrates has limited access to prophylaxis in countries with under-developed or developing economies. AIMS: We studied the health gap that could be addressed by providing unlimited access to clotting factor concentrates with implementation of long-term prophylaxis initiated from an early age in life...
April 24, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28439999/cost-effectiveness-of-introducing-a-nursing-based-programme-of-ultrasound-guided-peripheral-venous-access-in-a-regional-teaching-hospital
#13
Émilie Gosselin, Johanne Lapré, Stéphan Lavoie, Stéphane Rhein
AIM: To analyse the cost-effectiveness of care provided to patients in need of peripheral venous access by comparing the traditional approach with a nurse-based ultrasound-guided programme. BACKGROUND: Letting nurses insert ultrasound-guided catheters is a promising cost-saving approach, but there are few data available to document the efficiency of this type of programme. METHOD: A cost-efficiency evaluative research design was used. Data were collected over a 6-year timeframe, before and after the implementation of the nurse-based programme...
April 25, 2017: Journal of Nursing Management
https://www.readbyqxmd.com/read/28439903/did-health-care-reform-help-kentucky-address-disparities-in-coverage-and-access-to-care-among-the-poor
#14
Joseph A Benitez, E Kathleen Adams, Eric E Seiber
OBJECTIVE: To evaluate the impact of Kentucky's full rollout of the Affordable Care Act on disparities in access to care due to poverty. DATA SOURCE: Restricted version of the Behavioral Risk Factor Surveillance System (BRFSS) for Kentucky and years 2011-2015. STUDY DESIGN: We use a difference-in-differences framework to compare trends before and after implementation of the Affordable Care Act (ACA) in health insurance coverage, several access measures, and health care utilization for residents in higher versus lower poverty ZIP codes...
April 25, 2017: Health Services Research
https://www.readbyqxmd.com/read/28439744/change-in-cost-after-5%C3%A2-years-of-experience-with-robotic-assisted-hysterectomy-for-the-treatment-of-endometrial-cancer
#15
Andrea M Avondstondt, Michelle Wallenstein, Christopher R D'Adamo, Robert M Ehsanipoor
Health care costs are an important consideration in the decision of hysterectomy routes and robotic surgery is often critiqued for its high cost. We sought to compare the cost of robotic-assisted hysterectomies performed after initial acquisition of the robotic surgical system to cases performed after 5 years of experience. The first 20 patients at a community teaching hospital who underwent robotic-assisted hysterectomy for endometrial cancer by a single gynecologic oncology surgeon were designated Group 1 and 20 patients undergoing robotic hysterectomies 5 years later for the same indication were designated Group 2...
April 24, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28439405/the-start-back-tool-in-chiropractic-practice-a-narrative-review
#16
REVIEW
Yasmeen Khan
BACKGROUND: The Keele STarT Back Tool was designed for primary care medical physicians in the UK to determine the risk for persistent disabling pain in patients with musculoskeletal pain and to tailor treatments accordingly. In medical and physical therapy settings, STarT Back Tool's tailored care plans improved patients' low back pain outcomes and lowered costs. OBJECTIVE: Review studies using the STarT Back Tool in chiropractic patient populations. METHODS: PubMed, The Cochrane Library, Index to Chiropractic Literature, and Science Direct databases were searched...
2017: Chiropractic & Manual Therapies
https://www.readbyqxmd.com/read/28439134/pharmacy-dashboard-an-innovative-process-for-pharmacy-workload-and-productivity
#17
Ashley Kinney, Quyen Bui, Jane Hodding, Jennifer Le
Background: Innovative approaches, including LEAN systems and dashboards, to enhance pharmacy production continue to evolve in a cost and safety conscious health care environment. Furthermore, implementing and evaluating the effectiveness of these novel methods continues to be challenging for pharmacies. Objective: To describe a comprehensive, real-time pharmacy dashboard that incorporated LEAN methodologies and evaluate its utilization in an inpatient Central Intravenous Additives Services (CIVAS) pharmacy...
March 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28439133/importance-of-pharmacy-involvement-in-the-treatment-of-sepsis
#18
Joseph B Cavanaugh, Jesse B Sullivan, Nicole East, Jessica N Nodzon
Purpose: A review of the impact of pharmacists on appropriate medication selection, timing of administration, and as members of a multidisciplinary sepsis response team. Summary: Early goal-directed therapy (EGDT), currently recommended by the 2013 Surviving Sepsis Campaign guidelines for the management of patients with sepsis, includes the administration of appropriate antibiotics in patients with septic shock within the first hour. Multidisciplinary teams containing pharmacists have been shown to decrease time to antibiotic delivery, time to antibiotic administration, and patient mortality...
March 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28438480/educating-emergency-department-registered-nurses-edrns-in-screening-brief-intervention-and-referral-to-treatment-sbirt-changes-in-attitudes-and-knowledge-over-time
#19
Ann M Mitchell, Irene Kane, Dawn L Lindsay, Holly Hagle, Kathy Puskar, Jim Aiello, Lynn Boucek, Emily Knapp
Alcohol and other drug (AOD) diagnoses in the ED co-occur with injury-related presenting conditions including: falls, motor vehicle accidents, poisonings, and both intentional and unintentional injuries. Clinical attention to ED admissions resulting from hazardous AOD use can significantly improve patient care and reduce high cost utilization of ED visits and treatment. The EDRN-SBIRT project is designed to improve the knowledge and attitudes of ED nurses working in a large academic medical center to identify and address risky AOD use as it relates to an ED visit...
April 21, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28438453/effect-of-bundled-payments-and-health-care-reform-as-alternative-payment-models-in-total-joint-arthroplasty-a-clinical-review
#20
REVIEW
Ahmed Siddiqi, Peter B White, Jaydev B Mistry, Chukwuweike U Gwam, James Nace, Michael A Mont, Ronald E Delanois
BACKGROUND: In an effort to control rising healthcare costs, healthcare reforms have developed initiatives to evaluate the efficacy of alternative payment models (APMs) for Medicare reimbursements. The Center for Medicare and Medicaid Services Innovation Center (CMMSIC) introduced the voluntary Bundled Payments for Care Improvement (BPCI) model experiment as a means to curtail Medicare cost by allotting a fixed payment for an episode of care. The purpose of this review is to (1) summarize the preliminary clinical results of the BPCI and (2) discuss how it has led to other healthcare reforms and alternative payment models...
March 20, 2017: Journal of Arthroplasty
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