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https://www.readbyqxmd.com/read/27933488/effects-of-economic-recession-on-elderly-patients-perceptions-of-access-to-health-care-and-medicines-in-portugal
#1
Filipa Alves da Costa, Inês Teixeira, Filipa Duarte-Ramos, Luís Proença, Ana Rita Pedro, Cristina Furtado, José Aranda da Silva, José Cabrita
Background In view of the current financial and demographic situation in Portugal, accessibility to health care may be affected, including the ability to adhere to medication. Objective To evaluate the perceived effects of the crisis on elderly patient's access to medicines and medical care, and its implications on medicine-taking behaviour. Setting Community pharmacy. Method A cross-sectional study was undertaken during April 2013, where elderly patients answered a self-administered questionnaire based on their health-related experiences in the current and previous year...
December 9, 2016: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/27932381/improving-the-efficiency-of-care-for-pediatric-patients-hospitalized-with-asthma
#2
Kathleen W Bartlett, Victoria M Parente, Vanessa Morales, Jillian Hauser, Heather S McLean
BACKGROUND: Asthma exacerbations are a leading cause of hospitalization among children. Despite the existence of national pediatric asthma guidelines, significant variation in care persists. At Duke Children's Hospital, we determined that our average length of stay (ALOS) and cost for pediatric asthma admissions exceeded that of our peers. Our aim was to reduce the ALOS of pediatric patients hospitalized with asthma from 2.9 days to 2.6 days within 12 months by implementing an asthma pathway within our new electronic health record...
December 8, 2016: Hospital Pediatrics
https://www.readbyqxmd.com/read/27932156/dosing-eculizumab-for-antibody-mediated-rejection-in-kidney-transplantation-a-case-report
#3
B Smith, V Kumar, D Mompoint-Williams, R D Reed, P A MacLennan, K Stegner, J E Locke
Severe antibody-mediated rejection (AMR) of a blood type-incompatible (ABOi) living donor kidney transplantation (LDKT) can lead to graft failure, and aggressive therapies, such as the anticomplement antibody eculizumab, are often used to rescue the affected graft. Eculizumab therapy can be crippling financially. Current literature suggests a wide variation in the amount and timing of eculizumab given as rescue therapy in the setting of AMR. Herein we describe a limited-eculizumab regimen in the setting of severe AMR that is both clinically and cost effective...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932005/estimating-community-level-costs-of-preterm-birth
#4
E S Hall, J M Greenberg
OBJECTIVES: To develop generalizable methods for estimating the economic impact of preterm birth at the community level on initial hospital expenditures, educational attainment and lost earnings as well as to estimate potential savings associated with reductions in preterm birth. STUDY DESIGN: The retrospective, population-based analysis used vital statistics and population demographics from Hamilton County, Ohio, USA, in 2012. METHODS: We adjusted previously reported, mean initial hospital cost estimates (stratified by each week of gestation) to 2012 dollars using national cost-to-charge ratios...
December 2016: Public Health
https://www.readbyqxmd.com/read/27931681/mycobacterial-contamination-of-bronchoscopes-challenges-and-possible-solutions-in-low-resource-settings
#5
Dania Khalid Saeed, Sadia Shakoor, Seema Irfan, Rumina Hasan
The use of bronchoscopes has increased in tuberculosis (TB) diagnostics to circumvent the diagnostic challenges that are associated with low sputum volume and smear-negative TB. In healthcare facilities situated in low income countries that have a high burden of TB, adequate decontamination of bronchoscopes is a challenge and often overlooked to save on time and costs. This amplifies the risk of outbreaks and pseudo-outbreaks due to Mycobacterium tuberculosis and nontuberculosis mycobacteria. In this minireview, we review published literature of contaminated bronchoscopes causing pseudo-outbreaks of M...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/27930955/environmental-impacts-and-production-performances-of-organic-agriculture-in-china-a-monetary-valuation
#6
Fanqiao Meng, Yuhui Qiao, Wenliang Wu, Pete Smith, Steffanie Scott
Organic agriculture has developed rapidly in China since the 1990s, driven by the increasing domestic and international demand for organic products. Quantification of the environmental benefits and production performances of organic agriculture on a national scale helps to develop sustainable high yielding agricultural production systems with minimum impacts on the environment. Data of organic production for 2013 were obtained from a national survey organized by the Certification and Accreditation Administration of China...
December 5, 2016: Journal of Environmental Management
https://www.readbyqxmd.com/read/27929743/knowledge-behaviors-and-practices-of-community-and-hospital-pharmacists-towards-biosimilar-medicines-results-of-a-french-web-based-survey
#7
Morgane Beck, Bruno Michel, Marie-Christine Rybarczyk-Vigouret, Dominique Levêque, Christelle Sordet, Jean Sibilia, Michel Velten
This study's aims were: 1) to extract a comprehensive overview of the knowledge, experience and opinions of both community pharmacists and hospital pharmacists regarding biosimilar medicines in France; and 2) to identify the perceived problems and solutions to promoting their prescription. A 2015 web-based survey was conducted by the Observatoire des Médicaments, des Dispositifs Médicaux et de l'Innovation Thérapeutique of Alsace. A total of 802 pharmacists responded to the survey. Many (536, 66.8%, [95% confidence interval (CI) 63...
December 8, 2016: MAbs
https://www.readbyqxmd.com/read/27929693/use-of-recycled-external-fixators-in-management-of-compound-injuries
#8
Swagat Mahapatra, Nandakumar Rengarajan
BACKGROUND: Compound fractures form a bulk of Orthopaedic Trauma cases in a developing country like India. External Fixation devices are the mainstays of treatment of these open fractures. They are generally used as a one use disposable device and add a great burden to the health care costs, especially in a developing country. In our study we evaluated the efficacy and complication rate of recycled external fixators with that of new external fixators. MATERIALS AND METHODS: This was a prospective randomised interventional study conducted in a tertiary care teaching hospital of a developing country...
December 8, 2016: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27929667/optimizing-mri-logistics-focused-process-improvements-can-increase-throughput-in-an-academic-radiology-department
#9
Jeremy J O'Brien, Jeremy Stormann, Kelli Roche, Ines Cabral-Goncalves, Annamarie Monks, Donna Hallett, Koenraad J Mortele
OBJECTIVE: The purpose of this study was to describe and evaluate the effect of focused process improvements on protocol selection and scheduling in the MRI division of a busy academic medical center, as measured by examination and room times, magnet fill rate, and potential revenue increases and cost savings to the department. MATERIALS AND METHODS: Focused process improvements, led by a multidisciplinary team at a large academic medical center, were directed at streamlining MRI protocols and optimizing matching protocol ordering to scheduling while maintaining or improving image quality...
December 8, 2016: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/27929467/an-optimized-protocol-for-electrophoretic-mobility-shift-assay-using-infrared-fluorescent-dye-labeled-oligonucleotides
#10
Yi-Wen Hsieh, Amel Alqadah, Chiou-Fen Chuang
Electrophoretic Mobility Shift Assays (EMSA) are an instrumental tool to characterize the interactions between proteins and their target DNA sequences. Radioactivity has been the predominant method of DNA labeling in EMSAs. However, recent advances in fluorescent dyes and scanning methods have prompted the use of fluorescent tagging of DNA as an alternative to radioactivity for the advantages of easy handling, saving time, reducing cost, and improving safety. We have recently used fluorescent EMSA (fEMSA) to successfully address an important biological question...
November 29, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27928760/cost-effectiveness-analysis-of-prophylaxis-treatment-strategies-to-reduce-the-incidence-of-febrile-neutropenia-in-patients-with-early-stage-breast-cancer-or-non-hodgkin-lymphoma
#11
Kelly Fust, Xiaoyan Li, Michael Maschio, Guillermo Villa, Anju Parthan, Richard Barron, Milton C Weinstein, Luc Somers, Caroline Hoefkens, Gary H Lyman
OBJECTIVE: The objective of this study was to evaluate the cost effectiveness of no prophylaxis, primary prophylaxis (PP), or secondary prophylaxis (SP) with granulocyte colony-stimulating factors (G-CSFs), i.e., pegfilgrastim, lipegfilgrastim, filgrastim (6- and 11-day), or lenograstim (6- and 11-day), to reduce the incidence of febrile neutropenia (FN) in patients with stage II breast cancer receiving TC (docetaxel, cyclophosphamide) and in patients with non-Hodgkin lymphoma (NHL) receiving R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) over a lifetime horizon from a Belgian payer perspective...
December 7, 2016: PharmacoEconomics
https://www.readbyqxmd.com/read/27928190/single-center-retrospective-evaluation-of-inhaled-corticosteroid-use-for-chronic-obstructive-pulmonary-disease-exacerbation-patients-receiving-systemic-corticosteroids
#12
Taylor Steuber, Dane Shiltz
Purpose: To determine the frequency of inappropriate inhaled corticosteroid (ICS) therapy when it is prescribed concurrently with systemic corticosteroids; to identify cost-savings potential in the setting of chronic obstructive pulmonary disease (COPD) exacerbations. Methods: Patients admitted to 1 of 8 hospital locations utilizing an integrated electronic health record within the health system for COPD exacerbations treated with systemic corticosteroids (equivalent to at least 30 mg of oral prednisone) between July 1, 2013 and June 30, 2014 were included in a retrospective chart review...
November 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/27927162/use-of-low-density-lipoprotein-particle-number-levels-as-an-aid-in-statin-treatment-decisions-for-intermediate-risk-patients-a-cost-effectiveness-analysis
#13
Dov Shiffman, Andre R Arellano, Michael P Caulfield, Judy Z Louie, Lance A Bare, James J Devlin, Olle Melander
BACKGROUND: The 2013 ACC/AHA guideline recommended either no statin therapy or moderate-intensity statin therapy (MST) for intermediate risk patients-those with 5-7.5% 10-year risk and without cardiovascular disease (CVD), hypercholesterolemia or diabetes. The guideline further suggested that the therapy choice be based on patient-clinician discussions of risks and benefits. Since low-density lipoprotein particle (LDL-P) levels were reported to be associated with CVD independently of traditional risk factors in intermediate and low risk patients, we investigated the cost-effectiveness of using LDL-P levels to identify intermediate risk patients likely to benefit from initiating or intensifying statin therapy...
December 7, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27926814/the-economic-impact-of-insulin-related-hypoglycemia-in-denmark-an-analysis-using-the-local-impact-of-hypoglycemia-tool
#14
Nicki Hoskins, Christian Klyver Tikkanen, Ulrik Pedersen-Bjergaard
AIMS: To estimate the direct cost of hypoglycemia in insulin-treated adults with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) in Denmark. MATERIALS AND METHODS: The Local Impact of Hypoglycemia Tool (LIHT) was used to estimate the costs associated with insulin-related hypoglycemia. Average utilization of healthcare resources, including the costs of pre-hospitalization, hospital admission, healthcare professional contact and follow-up, glucose/glucagon, and extra SMBG tests to monitor blood glucose following an episode, was used to calculate an average cost per severe and per non-severe hypoglycemic episode...
December 7, 2016: Journal of Medical Economics
https://www.readbyqxmd.com/read/27926758/association-between-surgeon-scorecard-use-and-operating-room-costs
#15
Corinna C Zygourakis, Victoria Valencia, Christopher Moriates, Christy K Boscardin, Sereina Catschegn, Alvin Rajkomar, Kevin J Bozic, Kent Soo Hoo, Andrew N Goldberg, Lawrence Pitts, Michael T Lawton, R Adams Dudley, Ralph Gonzales
Importance: Despite the significant contribution of surgical spending to health care costs, most surgeons are unaware of their operating room costs. Objective: To examine the association between providing surgeons with individualized cost feedback and surgical supply costs in the operating room. Design, Setting, and Participants: The OR Surgical Cost Reduction (OR SCORE) project was a single-health system, multihospital, multidepartmental prospective controlled study in an urban academic setting...
December 7, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27926638/determining-optimal-route-of-hysterectomy-for-benign-indications-clinical-decision-tree-algorithm
#16
Jennifer J Schmitt, Daniel A Carranza Leon, John A Occhino, Amy L Weaver, Sean C Dowdy, Jamie N Bakkum-Gamez, Kalyan S Pasupathy, John B Gebhart
OBJECTIVE: To evaluate practice change after initiation of a robotic surgery program using a clinical algorithm to determine the optimal surgical approach to benign hysterectomy. METHODS: A retrospective postrobot cohort of benign hysterectomies (2009-2013) was identified and the expected surgical route was determined from an algorithm using vaginal access and uterine size as decision tree branches. We excluded the laparoscopic hysterectomy route. A prerobot cohort (2004-2005) was used to evaluate a practice change after the addition of robotic technology (2007)...
December 2, 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27926614/clinical-coordination-in-accountable-care-organizations-a-qualitative-study
#17
Valerie A Lewis, Karen Schoenherr, Taressa Fraze, Aleen Cunningham
BACKGROUND: Accountable care organizations (ACOs) are becoming a common payment and delivery model. Despite widespread interest, little empirical research has examined what efforts or strategies ACOs are using to change care and reduce costs. Knowledge of ACOs' clinical efforts can provide important context for understanding ACO performance, particularly to distinguish arenas where ACOs have and have not attempted care transformation. PURPOSE: The aim of the study was to understand ACOs' efforts to change clinical care during the first 18 months of ACO contracts...
December 6, 2016: Health Care Management Review
https://www.readbyqxmd.com/read/27926593/cost-effectiveness-of-direct-acting-anti-viral-treatment-in-hepatitis-c-infected-liver-transplant-candidates-with-compensated-cirrhosis-and-hepatocellular-carcinoma
#18
James Salazar, Varun Saxena, James G Kahn, John P Roberts, Neil Mehta, Michael Volk, Jennifer C Lai
BACKGROUND: HCV(+) donors represent an effective strategy to increase liver donor availability to HCV-infected recipients. However, many HCV(+) transplant candidates are now receiving treatment with direct acting anti-virals (DAA) that lower the risk of posttransplant HCV recurrence but could make the patient ineligible for HCV(+) livers. METHODS: We compared pretransplant DAA treatment versus deferred DAA treatment using a cost-effectiveness decision analysis model to estimate incremental cost-effectiveness ratios (ICERs; cost per quality-adjusted life year [QALY] gained) from the societal perspective across a range of HCV(+) liver availability rates...
December 6, 2016: Transplantation
https://www.readbyqxmd.com/read/27925855/costs-associated-with-influenza-related-hospitalization-in-the-elderly
#19
Núria Torner, Encarna Navas, Núria Soldevila, Diana Toledo, Gemma Navarro, Aurea Morillo, Maria José Pérez, Angela Domínguez
Seasonal influenza epidemics remain a considerable burden in adults, especially in those at higher risk of complications. The aim of this study was to determine the costs associated with influenza-related hospitalization in patients aged ≥65 years admitted to 20 hospitals from seven Spanish regions during the 2013-14 and 2014-15 influenza seasons. Bivariate analysis was used to compare costs in vaccinated and unvaccinated cases. Costs were calculated according to the Spanish National Health System diagnosis-related group tables for influenza and other respiratory system conditions (GRD 89 and GRD 101)...
December 7, 2016: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/27925577/the-role-of-ultrasound-compared-to-biopsy-of-temporal-arteries-in-the-diagnosis-and-treatment-of-giant-cell-arteritis-tabul-a-diagnostic-accuracy-and-cost-effectiveness-study
#20
Raashid Luqmani, Ellen Lee, Surjeet Singh, Mike Gillett, Wolfgang A Schmidt, Mike Bradburn, Bhaskar Dasgupta, Andreas P Diamantopoulos, Wulf Forrester-Barker, William Hamilton, Shauna Masters, Brendan McDonald, Eugene McNally, Colin Pease, Jennifer Piper, John Salmon, Allan Wailoo, Konrad Wolfe, Andrew Hutchings
BACKGROUND: Giant cell arteritis (GCA) is a relatively common form of primary systemic vasculitis, which, if left untreated, can lead to permanent sight loss. We compared ultrasound as an alternative diagnostic test with temporal artery biopsy, which may be negative in 9-61% of true cases. OBJECTIVE: To compare the clinical effectiveness and cost-effectiveness of ultrasound with biopsy in diagnosing patients with suspected GCA. DESIGN: Prospective multicentre cohort study...
November 2016: Health Technology Assessment: HTA
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