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https://www.readbyqxmd.com/read/27914968/segmenting-high-cost-medicare-patients-into-potentially-actionable-cohorts
#1
Karen E Joynt, Jose F Figueroa, Nancy Beaulieu, Robert C Wild, E John Orav, Ashish K Jha
BACKGROUND: Providers are assuming growing responsibility for healthcare spending, and prior studies have shown that spending is concentrated in a small proportion of patients. Using simple methods to segment these patients into clinically meaningful subgroups may be a useful and accessible strategy for targeting interventions to control costs. METHODS: Using Medicare fee-for-service claims from 2011 (baseline year, used to determine comorbidities and subgroups) and 2012 (spending year), we used basic demographics and comorbidities to group beneficiaries into 6 cohorts, defined by expert opinion and consultation: under-65 disabled/ESRD, frail elderly, major complex chronic, minor complex chronic, simple chronic, and relatively healthy...
November 30, 2016: Healthcare
https://www.readbyqxmd.com/read/27914632/the-us-food-and-drug-administration-s-risk-evaluation-and-mitigation-strategy-rems-program-current-status-and-future-direction
#2
Jasmanda Wu, Juhaeri Juhaeri
The US Food and Drug Administration (FDA) Amendments Act of 2007 granted the FDA new authorities to enhance drug safety by requiring application holders to submit a proposed Risk Evaluation and Mitigation Strategy (REMS). A REMS is a required risk management plan that uses tools beyond the package insert. REMS elements may include a medication guide and patient package insert for patients and a communication plan focused on health care professionals. Elements to assure safe use (ETASUs) are put in place to mitigate a specific known serious risk when other less restrictive elements of a REMS are not sufficient to mitigate such risk...
November 30, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27914190/culturally-competent-patient-provider-communication-in-the-management-of-cancer-an-integrative-literature-review
#3
REVIEW
Ottilia Brown, Wilma Ten Ham-Baloyi, Dalena Rm van Rooyen, Colleen Aldous, Leonard Charles Marais
BACKGROUND: Managing cancer in a multicultural environment poses several challenges, which include the communication between the patient and the healthcare provider. Culture is an important consideration in clinical care as it contributes to shaping patients' health-related values, beliefs, and behaviours. This integrative literature review gathered evidence on how culturally competent patient-provider communication should be delivered to patients diagnosed with cancer. DESIGN: Whittemore and Knafl's approach to conducting an integrative literature review was used...
2016: Global Health Action
https://www.readbyqxmd.com/read/27913940/cost-analysis-and-cost-benefit-analysis-of-a-medication-review-with-follow-up-service-in-aged-polypharmacy-patients
#4
Amaia Malet-Larrea, Estíbaliz Goyenechea, Miguel A Gastelurrutia, Begoña Calvo, Victoria García-Cárdenas, Juan M Cabases, Aránzazu Noain, Fernando Martínez-Martínez, Daniel Sabater-Hernández, Shalom I Benrimoj
BACKGROUND: Drug related problems have a significant clinical and economic burden on patients and the healthcare system. Medication review with follow-up (MRF) is a professional pharmacy service aimed at improving patient's health outcomes through an optimization of the medication. OBJECTIVE: To ascertain the economic impact of the MRF service provided in community pharmacies to aged polypharmacy patients comparing MRF with usual care, by undertaking a cost analysis and a cost-benefit analysis...
December 2, 2016: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/27913159/assessing-functional-performance-using-computer-based-simulations-of-everyday-activities
#5
Sara J Czaja, David A Loewenstein, Chin Chin Lee, Shih Hua Fu, Philip D Harvey
Current functional capacity (FC) measures for patients with schizophrenia typically involve informant assessments or are in paper and pencil format, requiring in-person administration by a skilled assessor. This approach presents logistic problems and limits the possibilities for remote assessment, an important issue for these patients. This study evaluated the feasibility of using a computer-based assessment battery, including simulations of everyday activities. The battery was compared to in-person standard assessments of cognition and FC with respect to baseline convergence and sensitivity to group differences...
November 29, 2016: Schizophrenia Research
https://www.readbyqxmd.com/read/27912906/patient-and-provider-factors-associated-with-endometrial-pipelle-sampling-failure
#6
Shalkar Adambekov, Sharon L Goughnour, Suketu Mansuria, Nicole Donnellan, Esther Elishaev, Hugo J Villanueva, Robert P Edwards, Dana H Bovbjerg, Faina Linkov
OBJECTIVE: To explore risk factors associated with sampling failure in women who underwent Pipelle biopsy. METHODS: A consecutive sample of 201 patient records was selected from women who underwent Pipelle biopsy procedures for suspected uterine pathology in a large healthcare system over a 6-month period (January 2013 through June 2013). Personal and medical data including age, BMI, gravidity and parity, and previous history of Pipelle biopsy were abstracted from medical records for each patient...
November 29, 2016: Gynecologic Oncology
https://www.readbyqxmd.com/read/27912783/exploring-levers-and-barriers-to-accessing-primary-care-for-marginalised-groups-and-identifying-their-priorities-for-primary-care-provision-a-participatory-learning-and-action-research-study
#7
Patrick O'Donnell, Edel Tierney, Austin O'Carroll, Diane Nurse, Anne MacFarlane
BACKGROUND: The involvement of patients and the public in healthcare has grown significantly in recent decades and is documented in health policy documents internationally. Many benefits of involving these groups in primary care planning have been reported. However, these benefits are rarely felt by those considered marginalised in society and they are often excluded from participating in the process of planning primary care. It has been recommended to employ suitable approaches, such as co-operative and participatory initiatives, to enable marginalised groups to highlight their priorities for care...
December 3, 2016: International Journal for Equity in Health
https://www.readbyqxmd.com/read/27912763/global-health-partnership-for-student-peer-to-peer-psychiatry-e-learning-lessons-learned
#8
REVIEW
Roxanne C Keynejad
BACKGROUND: Global 'twinning' relationships between healthcare organizations and institutions in low and high-resource settings have created growing opportunities for e-health partnerships which capitalize upon expanding information technology resources worldwide. E-learning approaches to medical education are increasingly popular but remain under-investigated, whilst a new emphasis on global health teaching has coincided with university budget cuts in many high income countries. RESULTS: King's Somaliland Partnership (KSP) is a paired institutional partnership health link, supported by Tropical Health and Education Trust (THET), which works to strengthen the healthcare system and improve access to care through mutual exchange of skills, knowledge and experience between Somaliland and King's Health Partners, UK...
December 3, 2016: Globalization and Health
https://www.readbyqxmd.com/read/27911667/barriers-and-benefits-in-telemedicine-arising-between-a-high-technology-hospital-service-provider-and-remote-public-healthcare-units-a-qualitative-study-in-brazil
#9
Carlos Henrique Amaral de Souza, Renata Albaladejo Morbeck, Milton Steinman, Cora Pereira Hors, Mario Maia Bracco, Elisa H Kozasa, Eliseth Ribeiro Leão
BACKGROUND: In Brazil, the Program for Institutional Development of the Unified Healthcare System (PROADI-SUS) has implemented a telemedicine service for urgent situations and emergencies. It is delivered by a high-technology (HT) hospital to 15 remote healthcare units (RUs) in 11 different Brazilian states. The aim of this study was to investigate possible barriers and benefits in telemedicine service among these units. MATERIALS AND METHODS: We performed a qualitative study on the perceptions of physicians involved in telemedicine service in their role as providers and consultants...
December 2, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/27911487/external-inspection-of-compliance-with-standards-for-improved-healthcare-outcomes
#10
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/27910120/at-the-margins-of-biomedicine-the-ambiguous-position-of-registered-medical-practitioners-in-rural-indian-healthcare
#11
Papreen Nahar, Nanda Kishore Kannuri, Sitamma Mikkilineni, G V S Murthy, Peter Phillimore
This analysis challenges a tendency in public health and the social sciences to associate India's medical pluralism with a distinction between biomedicine, as a homogeneous entity, and its non-biomedical 'others'. We argue that this overdrawn dichotomy obscures the important part played by 'informal' biomedical practice, an issue with salience well beyond India. Based on a qualitative study in rural Andhra Pradesh, South India, we focus on a figure little discussed in the academic literature - the Registered Medical Practitioner (RMP) - who occupies a niche in the medical market-place as an informal exponent of biomedical treatment...
December 2, 2016: Sociology of Health & Illness
https://www.readbyqxmd.com/read/27910035/self-care-as-a-professional-imperative-physician-burnout-depression-and-suicide
#12
Catherine M Kuhn, Ellen M Flanagan
PURPOSE: Burnout has been identified in approximately half of all practicing physicians, including anesthesiologists. In this narrative review, the relationship between burnout, depression, and suicide is explored, with particular attention to the anesthesiologist. Throughout this review, we highlight our professional imperative regarding this epidemic. SOURCE: The authors searched the existing English language literature via PubMed from 1986 until present using the search terms physician burnout, depression, and suicide, with particular attention to studies regarding anesthesiologists and strategies to address these problems...
December 1, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27909937/exploring-the-migration-profiles-of-primary-healthcare-users-in-south-africa
#13
Jo Vearey, Thea de Gruchy, Mphatso Kamndaya, Helen L Walls, Candice M Chetty-Makkan, Johanna Hanefeld
South Africa's public healthcare system responses seldom engage with migration. Our exploratory study investigates migration profiles and experiences of primary healthcare (PHC) users. A cross-sectional survey involving non-probability sampling was conducted with 229 PHC users at six purposively selected PHC clinics in three districts of SA. The survey captured socio-demographic information, migration histories, and PHC experiences. Chi square and Fischer's exact tests were used to compare categorical variables, whilst Mann-Whitney U tests compared continuous variables between groups...
December 1, 2016: Journal of Immigrant and Minority Health
https://www.readbyqxmd.com/read/27909642/seasonal-variations-and-trends-in-hospitalization-for-peptic-ulcer-disease-in-the-united-states-a-12-year-analysis-of-the-nationwide-inpatient-sample
#14
Ritesh Kanotra, Moiz Ahmed, Nileshkumar Patel, Badal Thakkar, Shantanu Solanki, Sarah Tareen, Matthew J Fasullo, Mayurathan Kesavan, Nikhil Nalluri, Ahsan Khan, Dhaval Pau, Liliane Deeb, Jeffrey Abergel, Ananya Das
BACKGROUND: Peptic ulcer disease (PUD) is a major public health burden significantly impacting the cost of hospitalization in the United States (US). We examined the trends, characteristics, complications, cost, and seasonality of PUD-related hospitalizations from 2000 to 2011. METHODS: With the use of the Nationwide Inpatient Sample from 2000 through 2011, we identified PUD-related hospitalizations using the International Classification of Diseases (ICD-9), 9th Revision, and the Clinical Modification code 531...
October 30, 2016: Curēus
https://www.readbyqxmd.com/read/27909581/expansion-of-health-insurance-in-moldova-and-associated-improvements-in-access-and-reductions-in-direct-payments
#15
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/27909568/implementation-of-minimal-invasive-gynaecological-surgery-certification-will-challenge-gynaecologists-with-new-legal-and-ethical-issues
#16
V Tanos, R Socolov, P Demetriou, M Kyprianou, A Watrelot, Y Van Belle, R Campo
The introduction of a certification / diploma program in Minimal Invasive Surgery (MIS) is expected to improve surgical performance, patient's safety and outcome. The Gynaecological Endoscopic Surgical Education and Assessment programme (GESEA) and the ESHRE Certification for Reproductive Endoscopic Surgery (ECRES) provides a structured learning path, recognising different pillars of competence. In order to achieve a high level of competence a two steps validation is necessary: (a) the individual should be certified of having the appropriate theoretical knowledge and (b) the endoscopic psychomotor skills before entering in the diploma programme reflecting the surgical competence...
June 27, 2016: Facts, Views & Vision in ObGyn
https://www.readbyqxmd.com/read/27909073/accuracy-of-outpatient-service-data-for-activity-based-funding-in-new-south-wales-australia
#17
Esther N Munyisia, David Reid, Ping Yu
BACKGROUND: Despite increasing research on activity-based funding (ABF), there is no empirical evidence on the accuracy of outpatient service data for payment. OBJECTIVE: This study aimed to identify data entry errors affecting ABF in two drug and alcohol outpatient clinic services in Australia. METHODS: An audit was carried out on healthcare workers' (doctors, nurses, psychologists, social workers, counsellors, and aboriginal health education officers) data entry errors in an outpatient electronic documentation system...
December 1, 2016: HIM Journal
https://www.readbyqxmd.com/read/27908164/comparison-of-low-contrast-detectability-between-two-ct-reconstruction-algorithms-using-voxel-based-3d-printed-textured-phantoms
#18
Justin Solomon, Alexandre Ba, François Bochud, Ehsan Samei
PURPOSE: To use novel voxel-based 3D printed textured phantoms in order to compare low-contrast detectability between two reconstruction algorithms, FBP (filtered-backprojection) and SAFIRE (sinogram affirmed iterative reconstruction) and determine what impact background texture (i.e., anatomical noise) has on estimating the dose reduction potential of SAFIRE. METHODS: Liver volumes were segmented from 23 abdominal CT cases. The volumes were characterized in terms of texture features from gray-level co-occurrence and run-length matrices...
December 2016: Medical Physics
https://www.readbyqxmd.com/read/27907013/development-and-implementation-of-the-ebola-traveler-monitoring-program-and-clinical-outcomes-of-monitored-travelers-during-october-may-2015-minnesota
#19
Aaron DeVries, Pamela Talley, Kristin Sweet, Susan Kline, Patricia Stinchfield, Pritish Tosh, Richard Danila
BACKGROUND: In October 2014, the United States began actively monitoring all persons who had traveled from Guinea, Liberia, and Sierra Leone in the previous 21 days. State public health departments were responsible for monitoring all travelers; Minnesota has the largest Liberian population in the United States. The MDH Ebola Clinical Team (ECT) was established to assess travelers with symptoms of concern for Ebola virus disease (EVD), coordinate access to healthcare at appropriate facilities including Ebola Assessment and Treatment Units (EATU), and provide guidance to clinicians...
2016: PloS One
https://www.readbyqxmd.com/read/27906960/perceptions-and-attitudes-towards-medication-error-reporting-in-primary-care-clinics-a-qualitative-study-in-malaysia
#20
A Samsiah, Noordin Othman, Shazia Jamshed, Mohamed Azmi Hassali
OBJECTIVE: To explore and understand participants' perceptions and attitudes towards the reporting of medication errors (MEs). METHODS: A qualitative study using in-depth interviews of 31 healthcare practitioners from nine publicly funded, primary care clinics in three states in peninsular Malaysia was conducted for this study. The participants included family medicine specialists, doctors, pharmacists, pharmacist assistants, nurses and assistant medical officers...
2016: PloS One
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