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Healthcare systems

David C Classen, William Munier, Nancy Verzier, Noel Eldridge, David Hunt, Mark Metersky, Chesley Richards, Yun Wang, P Jeffrey Brady, Amy Helwig, James Battles
The explicit declaration in the landmark 1999 Institute of Medicine report "To Err Is Human" that, in the United States, 44,000 to 98,000 patients die each year as a consequence of "medical errors" gave widespread validation to the magnitude of the patient safety problem and catalyzed a number of U.S. federal government programs to measure and improve the safety of the national healthcare system. After more than 10 years, one of those federal programs, the Medicare Patient Safety Monitoring System (MPSMS), has reached a level of maturity and stability that has made it useful for the consistent measurement of the safety of inpatient care...
October 20, 2016: Journal of Patient Safety
Shane Sinclair, Reanne Booker, Tak Fung, Shelley Raffin-Bouchal, Bert Enns, Kate Beamer, Naree Ager
PURPOSE/OBJECTIVES: To examine the relationships between spiritual, religious, and sociodemographic factors and post-traumatic growth, quality of life, and spiritual well-being in outpatients undergoing bone marrow and/or stem cell transplantation (BMSCT).
. DESIGN: Cross-sectional, descriptive, exploratory.
. SETTING: Outpatient bone marrow transplantation clinic at the Tom Baker Cancer Centre in Calgary, Alberta, Canada.
. SAMPLE: 100 patients (21 pre-BMSCT and 79 post-BMSCT) accrued consecutively via non-probability sampling...
November 1, 2016: Oncology Nursing Forum
Cristina Longo, Vasiliki Rahimzadeh, Kieran O'Doherty, Gillian Bartlett
AIM: Primary care physicians will play a central role in the successful implementation of pharmacogenomics (PGx); however, important challenges remain. We explored the perspectives of stakeholders on key challenges of the PGx translation process in primary care using deliberative consultations. METHODS: Primary care physicians, patients and policy-makers attended deliberations, where they discussed four ethical questions raised by PGx research and implementation in the primary care context...
October 21, 2016: Pharmacogenomics
Erik David Storholm, Michael J Silverberg, Derek D Satre
Access to substance use disorder (SUD) treatment is a critical issue for women with HIV. This study examined differences in SUD diagnoses, comorbid psychiatric diagnoses, and predictors of SUD treatment initiation among a diverse sample of HIV-positive women (n = 228) and a demographically similar cohort of HIV-negative women (n = 693). Diagnoses and service utilization data were obtained from electronic health records of members of a large integrated healthcare system in Northern California. HIV-positive women were less likely to initiate SUD treatment...
October 21, 2016: Journal of Psychoactive Drugs
Lucinda B Leung, Arturo Vargas-Bustamante, Ana E Martinez, Xiao Chen, Hector P Rodriguez
OBJECTIVE: To conduct a parallel analysis of disparities in diabetes care quality among Latino and Asian community health center (CHC) patients by English language preference. STUDY SETTING/DATA COLLECTION: Clinical outcomes (2011) and patient survey data (2012) for Type 2 diabetes adults from 14 CHCs (n = 1,053). STUDY DESIGN: We estimated separate regression models for Latino and Asian patients by English language preference for Clinician & Group-Consumer Assessment of Healthcare Providers and System, Patient Assessment of Chronic Illness Care, hemoglobin A1c, and self-reported hypoglycemic events...
October 21, 2016: Health Services Research
K Malkiewicz, E Malkiewicz, K A Eaton, E Widström
Poland is one of the largest European countries in terms of area and population. The country's economic situation does not allow for the allocation of sufficient public funds for healthcare in general and oral healthcare in particular. The health policy of the state focuses primarily on prophylaxis and treatment of diseases, directly threatening the health and lives of the inhabitants. Currently, expenditure on oral health accounts for only 2.7% of the public funds allocated to healthcare. In this context, providing oral care financed from public funds at an appropriate level constitutes a challenge for state institutions, centres providing medical and dental services and private practices...
October 21, 2016: British Dental Journal
T Renton, S Master
Since the 'Francis Report', UK regulation focusing on patient safety has significantly changed. Healthcare workers are increasingly involved in NHS England patient safety initiatives aimed at improving reporting and learning from patient safety incidents (PSIs). Unfortunately, dentistry remains 'isolated' from these main events and continues to have a poor record for reporting and learning from PSIs and other events, thus limiting improvement of patient safety in dentistry. The reasons for this situation are complex...
October 21, 2016: British Dental Journal
Samir Malkani, Sheri A Keitz, David M Harlan
The current diabetes epidemic threatens to overwhelm the healthcare system unless we redesign how diabetes care is delivered. The number of endocrinologists is grossly inadequate to provide care for all individuals with diabetes, but with the appropriate utilization of the primary care workforce and alternative healthcare providers working together in teams, effective diabetes care can be provided to all. We propose a patient-centered, goal-based approach with resources devoted to care coordination, measurement of outcomes, appropriate use of technology, and measurement of patient satisfaction...
December 2016: Current Diabetes Reports
Ajaratu Keshinro, Ioannis Hatzaras, Kenneth Rifkind, Shubhada Dhage, Kathie-Ann Joseph
INTRODUCTION: Cancer screening is a key component of primary care, and access to regular screening mammography (SMG) is highly dependent on recommendation and referral by a primary care provider (PCP). Women with no health insurance or who are underinsured often lack access to a regular PCP and thus access to routine screening. METHODS: We retrospectively reviewed the charts of 173 surgical patients diagnosed between January 2012 and December 2013. The main outcome variables were PCP status, method of cancer detection, and breast cancer stage at diagnosis...
October 20, 2016: Annals of Surgical Oncology
A R Vosoughi, M J Emami, B Pourabbas, H Mahdaviazad
OBJECTIVES: Hip fracture is one of the most common public health problems with a significant financial burden on the patient and on the healthcare system. This study was conducted to assess the 3-month and 1-year mortality rates of patients with operated hip fractures and to determine the influence of predictors of mortality. METHODS: In this prospective cross-sectional study, all admitted patients aged more than 50 years with hip fracture at Chamran Hospital from January 2008 to August 2013 were enrolled...
October 20, 2016: Musculoskeletal Surgery
Adele Diederich
Most of the parties involved in healthcare decisions - governments, politicians, healthcare professionals, pharmaceutical companies, special interest groups - actively work to make their desires known. In Israel the public is part of the decision committee; in Germany health care decision are made more or less without the public being involved. In a recently published IJHPR article, Giora Kaplan and Orna Baron-Epel raise the question of how well acquainted senior decision makers in the Israeli health system are with the public's priorities regarding the services being considered for inclusion in the public funding list...
2016: Israel Journal of Health Policy Research
Lai Heng Lee
The group of new oral anticoagulants or NOACs, now termed direct oral anticoagulants or DOACs, with their favourable results from large scale phase III clinical trials, represent a major advancement and expanded armamentarium in antithrombotic therapy. Dabigatran, rivaroxaban, apixaban and edoxaban are now in clinical routine use for prevention and treatment of arterial and venous thrombotic diseases as addressed in their clinical trials. Usage of the DOACs is expected to increase as clinicians gain more experience and reassurance with data from the real world studies which are generally consistent with that from clinical trials...
2016: Thrombosis Journal
Deven A Karvelas, Sean D Rundell, Janna L Friedly, Alfred C Gellhorn, Laura S Gold, Bryan A Comstock, Patrick J Heagerty, Brian W Bresnahan, David R Nerenz, Jeffrey G Jarvik
BACKGROUND: The association between early physical therapy (PT) and subsequent healthcare utilization following a new visit for low back pain is not clear, particularly in the setting of acute low back pain. PURPOSE: To estimate the association between initiating early physical therapy following a new visit for an episode of low back pain and subsequent back-pain-specific health care utilization in older adults. STUDY DESIGN/SETTING: Prospective cohort study...
October 17, 2016: Spine Journal: Official Journal of the North American Spine Society
Carlos Sardinero-García, Andrés Santiago-Sáez, M Del Carmen Bravo-Llatas, Bernardo Perea-Pérez, M Elena Albarrán-Juan, Elena Labajo-González, Julián Benito-León
OBJECTIVE: To analyse the sentences due to loss of chance that were passed by the Contentious-Administrative Court (i.e., in public medicine), in which both the origin of the disease to be treated and the damages were neurological. METHODS: We analysed the 90 sentences concerning neurological conditions that referred to the concept of loss of chance that were passed in Spain from 2003 (year of the first sentence) until May 2014. FINDINGS: Of the 90 sentences, 52 (57...
October 17, 2016: Gaceta Sanitaria
Jianhua Chen, Hai Yu, Hengjin Dong
BACKGROUND: Many countries are developing health mechanisms to pursue the goal of universal coverage. In China, a rural health insurance system entitled New Cooperative Medical System (NCMS) has being developed since 2003. This paper aims to explore the changes in the health service needs and utilization among rural residents in Ningbo, China after the implementation of the new rural cooperative medical system (NCMS), and provide evidence to further improve the strategies of NCMS in China...
October 20, 2016: BMC Health Services Research
Fawziah Marra, Mei Chong, Mehdi Najafzadeh
BACKGROUND: Recent studies have shown an increasing incidence of herpes zoster (HZ) infection, which may be related to the introduction of varicella vaccination programs in children. We examined the epidemiology and treatment costs of HZ and post-herpetic neuralgia (PHN) over time in British Columbia, Canada. METHODS: The cohort consisted of all cases with HZ infection from January 1, 1997 and December 31, 2012. Incident zoster was defined as a case (ICD-9 053 or ICD-10 B02) without a previous episode of HZ or PHN in the previous 12 months...
October 20, 2016: BMC Infectious Diseases
Armando H Norman, Andrew J Russell, Claudia Merli
The UK's Quality and Outcomes Framework (QOF) is the largest pay-for-performance scheme in the world. This ethnographic study explored how QOF's monetary logic influences the approach to healthcare in UK general practice. From August 2013 to April 2014, we researched two UK general practice surgeries and one general practice training programme. These environments provided the opportunity for studying various spaces such as QOF meetings, consultation rooms, QOF recoding sessions, and the collection of computer-screen images depicting how patients' biomarkers are evaluated and costed through software systems...
October 11, 2016: Social Science & Medicine
Benjamin B Massenburg, Hillary E Jenny, Saurabh Saluja, John G Meara, Mark G Shrime, Nivaldo Alonso
BACKGROUND: Cleft lip and/or palate (CLP) is estimated to occur in 1 out of every 700 births, but for many people residing in low- and middle-income countries this deformity may be repaired late in life or not at all. This study aims to analyze worldwide provider-perceived barriers to the surgical repair of CLP in low- and middle-income countries. METHODS: From 2011 to 2014, Smile Train distributed a multiple-choice, voluntary survey to healthcare providers to identify areas of need in CLP care worldwide...
October 2016: Journal of Craniofacial Surgery
Isabell B Purdy, Mary Alice Melwak, Joan R Smith, Carole Kenner, Rebecca Chuffo-Siewert, Donna J Ryan, Sue Hall
BACKGROUND: The neonatal intensive care unit (NICU) can be a stressful environment for infants, their families, and the healthcare team. There is an immediate need for neonatal nurses to embrace and translate the new National Perinatal Association recommendations for psychosocial support of NICU parents into clinical practice to demonstrate best practices for infants, their families, and the whole team. PURPOSE: To summarize the current evidence-based practice recommendations and to provide suggestions for team members to develop strategies to adopt and implement them through quality improvement (QI) projects...
October 19, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Angela Barriga, José M Conejero, Juan Hernández, Elena Jurado, Enrique Moguel, Fernando Sánchez-Figueroa
In the last few years, telerehabilitation and telecare have become important topics in healthcare since they enable people to remain independent in their own homes by providing person-centered technologies to support the individual. These technologies allows elderly people to be assisted in their home, instead of traveling to a clinic, providing them wellbeing and personalized health care. The literature shows a great number of interesting proposals to address telerehabilitation and telecare scenarios, which may be mainly categorized into two broad groups, namely wearable devices and context-aware systems...
October 18, 2016: Sensors
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