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https://www.readbyqxmd.com/read/28538960/diagnostic-accuracy-of-computed-tomography-derived-fractional-flow-reserve-a-systematic-review
#1
Christopher M Cook, Ricardo Petraco, Matthew J Shun-Shin, Yousif Ahmad, Sukhjinder Nijjer, Rasha Al-Lamee, Yuetsu Kikuta, Yasutsugu Shiono, Jamil Mayet, Darrel P Francis, Sayan Sen, Justin E Davies
Importance: Computed tomography-derived fractional flow reserve (FFR-CT) is a novel, noninvasive test for myocardial ischemia. Clinicians using FFR-CT must be able to interpret individual FFR-CT results to determine subsequent patient care. Objective: To provide clinicians a means of interpreting individual FFR-CT results with respect to the range of invasive FFRs that this interpretation might likely represent. Evidence Review: We performed a systematic review in accordance with guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses...
May 24, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28538855/-methodology-for-estimating-total-direct-costs-of-comprehensive-care-for-non-communicable-diseases
#2
Nancy Castillo, Miguel Malo, Nilda Villacres, José Chauca, Víctor Cornetero, Karin Roedel de Flores, Rafaela Tapia, Raúl Ríos
RESUMEN Diseases like diabetes mellitus (DM) and hypertension (HT) generate high costs and are the most common cause of mortality in the Americas. In the case of Peru, given demographic and epidemiological changes, particularly the alarming increase in overweight and obesity, the burden of these diseases is constantly increasing, resulting in the need to budget more financial resources to the health services. The total care costs of these diseases and their complications represent a financial burden that should be considered very carefully by health institutions when they draft their budgets...
January 2017: Revista Peruana de Medicina Experimental y Salud Pública
https://www.readbyqxmd.com/read/28538691/the-potential-cost-effectiveness-of-pre-exposure-prophylaxis-combined-with-hiv-vaccines-in-the-united-states
#3
Blythe J S Adamson, Josh J Carlson, James G Kublin, Louis P Garrison
This economic evaluation aims to support policy-making on the combined use of pre-exposure prophylaxis (PrEP) with HIV vaccines in development by evaluating the potential cost-effectiveness of implementation that would support the design of clinical trials for the assessment of combined product safety and efficacy. The target study population is a cohort of men who have sex with men (MSM) in the United States. Policy strategies considered include standard HIV prevention, daily oral PrEP, HIV vaccine, and their combination...
May 24, 2017: Vaccines
https://www.readbyqxmd.com/read/28538650/consequences-of-pediatric-undertriage-and-overtriage-in-a-statewide-trauma-system
#4
Hilary A Hewes, Mathew Christensen, Peter P Taillac, N Clay Mann, Kammy K Jacobsen, Stephen J Fenton
BACKGROUND: With increasing attention to the quality of health care delivery, evaluating trauma triage decisions in a large system of emergency care can help decision makers reduce mortality, morbidity, unnecessary transfers, and healthcare costs. OBJECTIVES: To quantify the magnitude of pediatric traumatic injury undertriage (hospital mortality risk) and overtriage (early trauma center discharge after transfer) in a statewide trauma system. METHODS: A statewide population-based evaluation of pediatric trauma outcomes and secondary triage (interfacility transfers) patterns from 2001-2013 among 45 hospitals in Utah's statewide trauma system...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538594/trends-in-patient-care-for-traumatic-spinal-injuries-in-the-united-states-a-national-inpatient-sample-study-of-the-correlations-with-patient-outcomes-from-2001-to-2012
#5
Christopher M Holland, Marcus D Mazur, Erica F Bisson, Meic H Schmidt, Andrew T Dailey
STUDY DESIGN: Retrospective database review OBJECTIVE.: To examine whether patient characteristics, distribution of care, and patient outcomes for spinal cord injury (SCI) in the United States have changed between 2001 and 2012. SUMMARY OF BACKGROUND DATA: Although patient outcomes after cranial injury are better at high-volume centers with specialized, multidisciplinary teams, similar assessments have not been done for spinal injuries. METHODS: We retrospectively reviewed the National and Nationwide Inpatient Samples for the years 2001, 2002, 2011, and 2012 to identify patients with spinal fracture with or without SCI...
May 22, 2017: Spine
https://www.readbyqxmd.com/read/28538545/comparing-health-care-resource-use-between-implant-and-autologous-reconstruction-of-the-irradiated-breast-a-national-claims-based-assessment
#6
Oluseyi Aliu, Lin Zhong, Matthew D Chetta, Erika D Sears, Tiffany Ballard, Jennifer F Waljee, Kevin C Chung, Adeyiza O Momoh
BACKGROUND: In the debate on reconstruction of the irradiated breast, there is little information on associated health care resource use. Nationwide data were used to examine health care resource use associated with implant and autologous reconstruction. It was hypothesized that failure rates would contribute the most to higher average cumulative cost with either reconstruction method. METHODS: From the 2009 to 2013 MarketScan Commercial Claims and Encounters database, irradiated breast cancer patients who underwent implant or autologous reconstruction were selected...
June 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28538469/an-assessment-of-the-clinical-acceptability-of-direct-acoustic-cochlear-implantation-for-adults-with-advanced-otosclerosis-in-the-united-kingdom
#7
Pádraig Thomas Kitterick, Guna Reddy-Kolanu, David Baguley, Jeremey Lavy, Peter Monksfield, Rupan Banga, Jaydip Ray, Ad Snik, Gerard M O'Donoghue
HYPOTHESIS: Assess the clinical acceptability of direct acoustic cochlear implantation for patients with advanced otosclerosis and the support for conducting a controlled trial of its effectiveness in the United Kingdom. BACKGROUND: Emerging evidence supports the efficacy of direct acoustic cochlear implantation in patients with advanced otosclerosis whose needs cannot be managed using the combination of stapes surgery and hearing aids. A controlled trial would provide evidence for its effectiveness and cost-effectiveness to healthcare commissioners...
May 22, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28538455/operative-fixation-for-clavicle-fractures-socioeconomic-differences-persist-despite-overall-population-increases-in-utilization
#8
William W Schairer, Benedict U Nwachukwu, Russell F Warren, David M Dines, Lawrence V Gulotta
BACKGROUND: Clavicle fractures were traditionally treated conservatively, but recent evidence has shown improved outcomes with surgical management. The purpose of this study was to evaluate the recent trends in operative treatment of clavicle fractures, and to analyze for patient related factors that may affect treatment strategy. METHODS: The Healthcare Cost and Utilization Project (HCUP) California and Florida inpatient, outpatient, and the Emergency Department databases were used to identify all patients with clavicle fractures between 2005 and 2010...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28538251/hyponatremia-in-guillain-barr%C3%A3-syndrome
#9
Kavelin Rumalla, Adithi Y Reddy, Vijay Letchuman, Manoj K Mittal
OBJECTIVES: To evaluate incidence, risk factors, and in-hospital outcomes associated with hyponatremia in patients hospitalized for Guillain-Barré Syndrome (GBS). METHODS: We identified adult patients with GBS in the Nationwide Inpatient Sample (2002-2011). Univariate and multivariable analyses were used. RESULTS: Among 54,778 patients hospitalized for GBS, the incidence of hyponatremia was 11.8% (compared with 4.0% in non-GBS patients) and increased from 6...
June 2017: Journal of Clinical Neuromuscular Disease
https://www.readbyqxmd.com/read/28538138/factors-leading-to-overutilisation-of-hospital-pathology-testing-the-junior-doctor
#10
William Ericksson, Janine Bothe, Heidi Cheung, Kate Zhang, Simone Kelly
Objective Pathology overutilisation is a significant issue affecting the quality and cost of health care. Because junior medical officers (JMOs) order most pathology tests in the hospital setting, the aim of the present study was to identify the main reasons for hospital pathology overutilisation from the perspective of the JMO.Methods A qualitative method, using focus group methodology, was undertaken. Sixteen JMOs from two hospitals participated in three focus groups. Data were analysed using thematic analysis...
May 25, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28538054/achieving-high-reliability-with-people-processes-and-technology
#11
Candice L Saunders, John A Brennan
High reliability as a corporate value in healthcare can be achieved by meeting the "Quadruple Aim" of improving population health, reducing per capita costs, enhancing the patient experience, and improving provider wellness. This drive starts with the board of trustees, CEO, and other senior leaders who ingrain high reliability throughout the organization. At WellStar Health System, the board developed an ambitious goal to become a top-decile health system in safety and quality metrics. To achieve this goal, WellStar has embarked on a journey toward high reliability and has committed to Lean management practices consistent with the Institute for Healthcare Improvement's definition of a high-reliability organization (HRO): one that is committed to the prevention of failure, early identification and mitigation of failure, and redesign of processes based on identifiable failures...
July 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/28538021/global-surgery-current-evidence-for-improving-surgical-care
#12
Jennifer C Fuller, David A Shaye
PURPOSE OF REVIEW: The field of global surgery is undergoing rapid transformation, owing to several recent prominent reports positioning it as a cost-effective means of relieving global disease burden. The purpose of this article is to review the recent advances in the field of global surgery. RECENT FINDINGS: Efforts to grow the global surgical workforce and procedural capacity have focused on innovative methods to increase surgeon training, enhance international collaboration, leverage technology, optimize existing health systems, and safely implement task-sharing...
May 19, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28537963/out-of-pocket-spending-under-the-affordable-care-act-for-patients-with-cancer
#13
Matthew S Dixon, Ashley L Cole, Stacie B Dusetzina
The Patient Protection and Affordable Care Act (ACA) included several key provisions aimed at lowering the out-of-pocket cost burden for patients. In this review, we summarize the effect of 3 provisions under Medicaid, Medicare, and commercial insurance, respectively: expansion of Medicaid eligibility, closing the doughnut hole for Medicare Part D beneficiaries, and requiring an annual limit on out-of-pocket spending for commercially insured patients. Through this review, we find early evidence that these 3 ACA provisions have reduced the out-of-pocket burden or increased access to health insurance for many patients...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28537961/the-affordable-care-act-and-cancer-care-delivery
#14
Gabriel A Brooks, J Russell Hoverman, Carrie H Colla
The Affordable Care Act (ACA) has reformed US health care delivery through insurance coverage expansion, experiments in payment design, and funding for patient-centered clinical and health care delivery research. The impact on cancer care specifically has been far reaching, with new ACA-related programs that encourage coordinated, patient-centered, cost-effective care. Insurance expansions through private exchanges and Medicaid, along with preexisting condition clauses, have helped more than 20 million Americans gain health care coverage...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28537960/the-aca-and-cancer-screening-and-diagnosis
#15
Lindsay M Sabik, Georges Adunlin
The Patient Protection and Affordable Care Act (ACA) included multiple provisions expected to increase cancer screening and subsequently early diagnosis of cancer. Key provisions included new coverage options for low-income adults and young adults, as well as elimination of cost sharing for recommended preventive services across most health insurance plans. This article reviews relevant quantitative studies published since the ACA's passage to assess whether the goal of increasing access to preventive services has been met...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28535440/management-of-ventilator-associated-pneumonia-with-a-new-antibiotic-adjuvant-entity-ceftriaxone-sulbactam-disodium-edetate-a-novel-approach-to-spare-carbapenems
#16
Prachee Sathe, Sagar Maddani, Shilpa Kulkarni, Nita Munshi
BACKGROUND: Ventilator associated pneumonia (VAP) is one of the most serious nosocomial infections in Intensive Care Unit (ICU). The aim of this study was to evaluate a new approach to spare the carbapenems for the management of patients diagnosed with VAP due to Acinetobacter baumannii (A. baumannii). METHOD: This retrospective study was conducted on VAP patients presenting for treatment at tertiary care centre between May 2014 and March 2016. The case sheets of patients who have been treated for VAP with meropenem, antibiotic adjuvant entity (AAE) and colistin were analysed...
May 15, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28535362/tympanostomy-tube-placement-vs-medical-management-for-recurrent-acute-otitis-media-in-tricare-insured-children
#17
Nikhila Raol, Meesha Sharma, Emily F Boss, Wei Jiang, John W Scott, Peter Learn, Joel S Weissman
Objective To compare number of infections and health care utilization in children insured by TRICARE with recurrent acute otitis media (RAOM) managed surgically with tympanostomy tube (TT) placement compared with those managed medically. Study Design Retrospective matched cohort study. Setting TRICARE claims database from 2006 to 2010. Subjects and Methods We matched TRICARE beneficiaries ≤5 years of age diagnosed with RAOM who underwent TT placement with those managed medically using 1:1 coarsened-exact matching on age, sex, race, sponsor rank, and region...
May 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28535331/computer-and-mobile-technology-interventions-for-self-management-in-chronic-obstructive-pulmonary-disease
#18
REVIEW
Catherine McCabe, Margaret McCann, Anne Marie Brady
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterised by airflow obstruction due to an abnormal inflammatory response of the lungs to noxious particles or gases, for example, cigarette smoke. The pattern of care for people with moderate to very severe COPD often involves regular lengthy hospital admissions, which result in high healthcare costs and an undesirable effect on quality of life. Research over the past decade has focused on innovative methods for developing enabling and assistive technologies that facilitate patient self-management...
May 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28535285/delayed-hospital-discharges-of-older-patients-a-systematic-review-on-prevalence-and-costs
#19
Filipa Landeiro, Kenny Roberts, Alastair Mcintosh Gray, José Leal
Purpose of the Study: To determine the prevalence of delayed discharges of elderly inpatients and associated costs. Design and Methods: We searched Medline, Embase, Global Health, CAB Abstracts, Econlit, Web of Knowledge, EBSCO - CINAHL, The Cochrane Library, Health Management Information Consortium, and SCIE - Social Care Online for evidence published between 1990 and 2015 on number of days or proportion of delayed discharges for elderly inpatients in acute hospitals...
May 23, 2017: Gerontologist
https://www.readbyqxmd.com/read/28535103/value-frameworks-for-the-patient-provider-interaction-a-comparison-of-the-asco-value-framework-versus-nccn-evidence-blocks-in-determining-value-in-oncology
#20
Bijal Shah-Manek, Joseph S Galanto, Huong Nguyen, Robert Ignoffo
BACKGROUND: To address the rising concern about oncology drug costs, the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) recently developed unique tools to help providers and patients make informed decisions about the value of an anticancer regimen. The ASCO Value Framework (AVF) allows users to generate a net health benefit (NHB) score along with drug acquisition costs for oncology regimens that have been compared in a prospective randomized clinical trial...
June 2017: Journal of Managed Care & Specialty Pharmacy
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