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https://www.readbyqxmd.com/read/28550706/st-michael-s-improvement-program-a-collaborative-approach-to-sustainable-cost-savings
#1
Anne Trafford, Danielle Jane
In response to a challenging financial environment and increasing patient demand, St. Michael's Hospital needed to find long-term sustainable solutions to continue to provide high-quality patient care and invest in key priorities. By conducting Operational Reviews in focused areas, the hospital achieved $7.4 million of in-year savings in the first year, found standardizations, process efficiencies and direct cost savings that positioned itself for success in future funding models. Initiatives were grounded in evidence and relied heavily on the effective execution by the leadership, front-line staff and physicians...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28550698/boomr-better-coordinated-cross-sectoral-medication-reconciliation-for%C3%A2-residential-care
#2
Vincent Vuong, Denis O'Donnell, Hrishikesh Navare, Debra Merrill, Michal Racki, Sheila Burton, Lori Anderson, Carla Beaton
There is evidence that medication errors often arise during the transition of residents from acute care to long-term care (LTC) homes due to lapses in communication and documentation. Better Coordinated Cross-Sectoral Medication Reconciliation (BOOMR) is an integrated practice change improving medication safety during patient transitions through the health system. Our Medication Reconciliation (MedRec) redesign improved patient engagement using "the patient's story," increased quality of information, workflow efficiency and reduced unnecessary medications...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28550494/cost-effectiveness-of-combined-serum-anti-helicobacter-pylori-igg-antibody-and-serum-pepsinogen-concentrations-for-screening-for-gastric-cancer-risk-in-japan
#3
Shota Saito, Motoi Azumi, Yusuke Muneoka, Katsuhiko Nishino, Takashi Ishikawa, Yuichi Sato, Shuji Terai, Kouhei Akazawa
BACKGROUND: A combination of assays for the presence of serum anti-Helicobacter pylori IgG antibody (HPA) and serum pepsinogen (PG) concentrations can be used to screen for gastric cancer risk. In Japan, this "ABC method" is considered an effective means of stratifying gastric cancer risk. This study aimed to ascertain its cost-effectiveness for assessing gastric cancer risk. METHODS: A Markov model was constructed to compare the cost-effectiveness of two strategies for gastric cancer-risk screening over a 30-year period: the ABC method, which uses a combination of assessing the presence of HPA and measuring serum PG concentrations and scheduling endoscopies accordingly, and annual endoscopic screening...
May 26, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28549592/economic-outcomes-of-pharmacist-physician-medication-therapy-management-for-polypharmacy-elderly-a-prospective-randomized-controlled-trial
#4
Hsiang-Wen Lin, Chih-Hsueh Lin, Chin-Kai Chang, Che-Yi Chou, I-Wen Yu, Cheng-Chieh Lin, Tsai-Chung Li, Chia-Ing Li, Yow-Wen Hsieh
BACKGROUND/PURPOSE: With an increasing geriatric population, the need for effective management of chronic conditions and medication use in the elderly is growing. Medication use in the elderly presents significant challenges due to changes in pharmacodynamic and pharmacokinetic profiles. We aimed to examine the impact of a collaborative physician-pharmacist medication therapy management (MTM) program for polypharmacy elderly patients. METHODS: Elderly patients with multiple chronic conditions on polypharmacy were enrolled in this prospective, randomized, and controlled study over 16 months of implementation...
May 23, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28549434/the-potential-of-task-shifting-in-scaling-up-services-for-prevention-of-mother-to-child-transmission-of-hiv-a-time-and-motion-study-in-dar-es-salaam-tanzania
#5
Helga Naburi, Anna Mia Ekström, Phares Mujinja, Charles Kilewo, Karim Manji, Gunnel Biberfeld, David Sando, Guerino Chalamila, Till Bärnighausen
BACKGROUND: In many African countries, prevention of mother-to-child transmission of HIV (PMTCT) services are predominantly delivered by nurses. Although task-shifting is not yet well established, community health workers (CHWs) are often informally used as part of PMTCT delivery. According to the 2008 World Health Organization (WHO) Task-shifting Guidelines, many PMTCT tasks can be shifted from nurses to CHWs. METHODS: The aim of this time and motion study in Dar es Salaam, Tanzania, was to estimate the potential of task-shifting in PMTCT service delivery to reduce nurses' workload and health system costs...
May 26, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28549400/bemfola-%C3%A2-fixed-dose-pens-potentially-reduce-drug-wastage-and-associated-costs-of-infertility-treatment
#6
Graham Foxon, Paul Mitchell, Nikki Turner, Anne McConnell, Helen Kendrew, Julian Jenkins
Bemfola(®) is a recombinant follicle-stimulating hormone (FSH) used during infertility treatment. One main differentiator between FSH products is their delivery device; consisting of multi-dose pens (Gonal-f(®)), vials or multi-dose preparations (Menopur(®)), or adjustable daily disposable dose pens (Bemfola(®)). To determine the potential impact of delivery device on drug wastage during infertility treatment this study retrospectively analysed Gonal-f(®) and Menopur(®) prescription and usage data from five UK clinics...
May 26, 2017: Human Fertility: Journal of the British Fertility Society
https://www.readbyqxmd.com/read/28549007/surgeon-experience-and-medicare-expenditures-for-laparoscopic-compared-to-open-colectomy
#7
Kyle H Sheetz, Andrew M Ibrahim, Scott E Regenbogen, Justin B Dimick
OBJECTIVE: To quantify the extent to which payments for laparoscopic and open colectomy are influenced by a surgeon's experience with laparoscopy. BACKGROUND: Numerous studies suggest that healthcare costs for laparoscopic colectomy are lower than open surgery. None have assessed the importance of surgeon experience on the relative financial benefits of laparoscopy. METHODS: We conducted a study of 182,852 national Medicare beneficiaries undergoing laparoscopic or open colectomy between 2010 and 2012...
May 25, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28548852/unification-of-the-w1x-and-g4-mp2-6x-composite-protocols
#8
Bun Chan
We have devised the composite procedures WG and WGh to unify the W1X and the (computationally more economical) G4(MP2)-6X protocols. The WG procedure employs a combination of MP2, MP2-F12, CCSD-F12b, and CCSD(T) to approximate the all-electron scalar-relativistic CCSD(T)/CBS energy. In addition, it incorporates features such as the scaling of the energy components and an empirical "higher-level-correction" term. The WGh protocol represents a somewhat more economical variant of WG with partial removal of diffuse functions...
May 26, 2017: Journal of Chemical Theory and Computation
https://www.readbyqxmd.com/read/28547735/the-burden-of-headache-disorders-in-ethiopia-national-estimates-from-a-population-based-door-to-door-survey
#9
Mehila Zebenigus, Redda Tekle-Haimanot, Dawit K Worku, Hallie Thomas, Timothy J Steiner
BACKGROUND: Headache disorders are the third-highest cause of disability worldwide, with migraine and medication-overuse headache (MOH) the major contributors. In Ethiopia we have shown these disorders to be highly prevalent: migraine 17.7%, TTH 20.6%, probable MOH (pMOH) 0.7%, any headache yesterday (HY) 6.4%. To inform local health policy, we now estimate disability and other burdens attributable to headache in this country. METHODS: In a cross-sectional survey using cluster-randomized sampling, we visited households unannounced in four diverse regions (urban and rural) of Ethiopia...
December 2017: Journal of Headache and Pain
https://www.readbyqxmd.com/read/28547682/adherence-to-clinical-guidelines-and-the-potential-economic-benefits-of-admission-avoidance-for-acute-uncomplicated-diverticulitis
#10
I S Reynolds, E O'Connell, R M Heaney, W Khan, I Z Khan, R Waldron, K Barry
BACKGROUND: The treatment paradigm for acute diverticulitis is changing. There is an increasing trend towards managing patients with uncomplicated diverticulitis in the community. AIMS: The aim of this study was to analyse how acute diverticulitis is managed in our institution and also to analyse national data pertaining to treatment of acute diverticulitis. METHODS: A prospective database of all patients admitted to our institution over a 2-year period (2014-2016) with acute diverticulitis was maintained...
May 25, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28546862/block-sparsity-based-joint-compressed-sensing-recovery-of-multi-channel-ecg-signals
#11
Anurag Singh, Samarendra Dandapat
In recent years, compressed sensing (CS) has emerged as an effective alternative to conventional wavelet based data compression techniques. This is due to its simple and energy-efficient data reduction procedure, which makes it suitable for resource-constrained wireless body area network (WBAN)-enabled electrocardiogram (ECG) telemonitoring applications. Both spatial and temporal correlations exist simultaneously in multi-channel ECG (MECG) signals. Exploitation of both types of correlations is very important in CS-based ECG telemonitoring systems for better performance...
April 2017: Healthcare Technology Letters
https://www.readbyqxmd.com/read/28546370/pediatric-oxygen-therapy-a-review-and-update
#12
Brian K Walsh, Craig D Smallwood
Oxygen is a colorless, odorless, tasteless gas that is utilized by the body for respiration. Oxygen has played a major role in respiratory care. Oxygen therapy is useful in treating hypoxemia but is often thought of as a benign therapy. After many years of study, we have learned a great deal of the benefits and potential risk of this powerful drug. Today oxygen gas is cheap, widely available, and easy to administer. Oxygen delivery devices vary in cost from a few cents for a simple nasal cannula to $25-$50 for some humidified systems...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28545427/advantages-and-limitations-for-users-of-double-pit-pour-flush-latrines-a-qualitative-study-in-rural-bangladesh
#13
Faruqe Hussain, Thomas Clasen, Shahinoor Akter, Victoria Bawel, Stephen P Luby, Elli Leontsini, Leanne Unicomb, Milan Kanti Barua, Brittany Thomas, Peter J Winch
BACKGROUND: In rural Bangladesh, India and elsewhere, pour-flush pit latrines are the most common sanitation system. When a single pit latrine becomes full, users must empty it themselves and risk exposure to fresh feces, pay an emptying service to remove pit contents or build a new latrine. Double pit pour-flush latrines may serve as a long-term sanitation option including high water table areas because the pits do not need to be emptied immediately and the excreta decomposes into reusable soil...
May 25, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28544824/sutureless-valves-reduce-hospital-costs-compared-to-traditional-valves
#14
François Laborde, Thierry Folliguet, Gabriel Ghorayeb, Konstantinos Zannis
BACKGROUND: The study aim was to assess differences in clinical outcome, safety, and associated costs between sutureless and aortic isolated aortic valve replacement (AVR) with a standard bioprosthesis. METHODS: A retrospective comparative study was conducted to investigate 65 patients, each of whom had undergone isolated AVR with a traditional aortic valve (T) or a Perceval S sutureless aortic prosthesis (P) between January 2010 and December 2012. Cost data were drawn from the proprietary cost accounting system of the hospital, excluding acquisition costs of the devices...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28543642/bidirectional-superior-cavopulmonary-anastomosis-with-or-without-cardiopulmonary-bypass-a-randomized-study
#15
Sachin Talwar, Anish Gupta, Ashima Nehra, Neeti Makhija, Poonam Malhotra Kapoor, Vishnubhatla Sreenivas, Shiv Kumar Choudhary, Balram Airan
OBJECTIVES: This study aims to compare the bidirectional superior cavopulmonary anastomosis (BDG) with or without cardiopulmonary bypass (CPB). METHODS: 100 patients undergoing BDG were randomized into two groups: Off-CPB or on-CPB groups. All patients underwent near-infrared spectrophotometry (NIRS) and bispectral index (BIS) monitoring and pre- and postoperative serum 100 beta protein measurements (Sβ100) and neuro-cognitive evaluation. Postoperative intensive care unit (ICU) parameters were also studied...
May 21, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28542734/cost-related-medication-nonadherence-among-adolescent-and-young-adult-cancer-survivors
#16
Sapna Kaul, Jaqueline C Avila, Hemalkumar B Mehta, Ana M Rodriguez, Yong-Fang Kuo, Anne C Kirchhoff
BACKGROUND: This study investigated cost-related medication nonadherence among survivors of adolescent and young adult cancer and a comparison group in the United States. METHODS: A cross-sectional analysis of the 2013 to 2015 National Health Interview Survey was performed. N=953 patients who were diagnosed with cancer between the ages of 15 and 39 years were identified, and a comparison group was created using propensity scores. Cost-related medication nonadherence was determined by individuals' report of skipping medication, taking less medication, or delaying filling medication to save money in the previous year...
May 23, 2017: Cancer
https://www.readbyqxmd.com/read/28542336/does-ngal-reduce-costs-a-cost-analysis-of-urine-ngal-ungal-serum-creatinine-scr-for-acute-kidney-injury-aki-diagnosis
#17
Amay Parikh, John A Rizzo, Pietro Canetta, Catherine Forster, Meghan Sise, Omar Maarouf, Eugenia Singer, Antje Elger, Saban Elitok, Kai Schmidt-Ott, Jonathon Barasch, Thomas L Nickolas
INTRODUCTION: Urine neutrophil gelatinase-associated lipocalin (uNGAL) is a sensitive and specific diagnostic test for acute kidney injury (AKI) in the Emergency Department (ED), but its economic impact has not been investigated. We hypothesized that uNGAL used in combination with serum creatinine (sCr) would reduce costs in the management of AKI in patients presenting to the ED in comparison to using sCr alone. MATERIALS AND METHODS: A cost simulation model was developed for clinical algorithms to diagnose AKI based on sCr alone vs...
2017: PloS One
https://www.readbyqxmd.com/read/28542239/projected-savings-through-public-health-voluntary-licences-of-hiv-drugs-negotiated-by-the-medicines-patent-pool-mpp
#18
Sandeep Juneja, Aastha Gupta, Suerie Moon, Stephen Resch
The Medicines Patent Pool (MPP) was established in 2010 to ensure timely access to low-cost generic versions of patented antiretroviral (ARV) medicines in low- and middle-income countries (LMICs) through the negotiation of voluntary licences with patent holders. While robust data on the savings generated by MPP and other major global public health initiatives is important, it is also difficult to quantify. In this study, we estimate the savings generated by licences negotiated by the MPP for ARV medicines to treat HIV/AIDS in LMICs for the period 2010-2028 and generate a cost-benefit ratio-based on people living with HIV (PLHIVs) in any new countries which gain access to an ARV due to MPP licences and the price differential between originator's tiered price and generics price, within the period where that ARV is patented...
2017: PloS One
https://www.readbyqxmd.com/read/28542194/using-g6pd-tests-to-enable-the-safe-treatment-of-plasmodium-vivax-infections-with-primaquine-on-the-thailand-myanmar-border-a-cost-effectiveness-analysis
#19
Angela Devine, Minnie Parmiter, Cindy S Chu, Germana Bancone, François Nosten, Ric N Price, Yoel Lubell, Shunmay Yeung
BACKGROUND: Primaquine is the only licensed antimalarial for the radical cure of Plasmodium vivax infections. Many countries, however, do not administer primaquine due to fear of hemolysis in those with glucose-6-phosphate dehydrogenase (G6PD) deficiency. In other settings, primaquine is given without G6PD testing, putting patients at risk of hemolysis. New rapid diagnostic tests (RDTs) offer the opportunity to screen for G6PD deficiency prior to treatment with primaquine. Here we assessed the cost-effectiveness of using G6PD RDTs on the Thailand-Myanmar border and provide the model as an online tool for use in other settings...
May 24, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28541463/reducing-surgical-infections-and-implant-costs-via-a-novel-paradigm-of-enhanced-physician-awareness
#20
Nitin Agarwal, Prateek Agarwal, Ashley Querry, Anna Mazurkiewicz, Brittany Whiteside, Oscar C Marroquin, Stephen F Koscumb, Daniel A Wecht, Robert M Friedlander
BACKGROUND: Studies have demonstrated that physicians are often unaware of prescription drug, laboratory, diagnostic, and surgical supply costs. OBJECTIVE: To investigate the effects of increased physician awareness on infection incidence and surgical device cost containment. METHODS: Within our institution, physicians were informed of individual, independently adjudicated, craniotomy and ventricular shunt infection incidence and rankings among peers, after which a protocol aimed at reducing skin bacterial burden was implemented for craniotomies...
May 24, 2017: Neurosurgery
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