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https://www.readbyqxmd.com/read/28067032/outcomes-of-cancer-survivorship-care-provided-by-advanced-practice-rns-compared-to-other-models-of-care-a-systematic-review
#1
Julie Spears, Melissa Craft, Sara White
Problem Identification: Advanced practice RNs (APRNs) have become leaders in providing survivorship care. However, outcomes of survivorship care provided by APRNs compared to other providers remain unclear. Literature Search: A systematic literature search included articles published after 2005 that described a survivorship model of care and use of a survivorship care plan (SCP), as well as reported outcomes. Data Evaluation: Sixteen studies were appraised and ranked by strength...
6, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/28062809/new-core-quality-measures-only-a-beginning
#2
David Nowels, Douglas B Kamerow
A plethora of quality measures are used in health care for quality improvement, accountability (including reimbursement), and research. The Core Quality Measures Collaborative, with input from the American Association of Family Physicians, recently released several groups of reduced core measure sets, including one for primary care. The proposed measures are less helpful for the increasing proportion patients with multiple morbidities or advancing illness. Going forward, the development of quality measures that assess multidimensional patient experiences and how closely the health care patients receive matches their goals in the face of multiple morbidities and advancing illness should be the focus...
January 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28056832/telemedicine-and-primary-care-obesity-management-in-rural-areas-innovative-approach-for-older-adults
#3
John A Batsis, Sarah N Pletcher, James E Stahl
BACKGROUND: The growing prevalence of obesity is paralleling a rise in the older adult population creating an increased risk of functional impairment, nursing home placement and early mortality. The Centers for Medicare and Medicaid recognized the importance of treating obesity and instituted a benefit in primary care settings to encourage intensive behavioral therapy in beneficiaries by primary care clinicians. This benefit covers frequent, brief, clinic visits designed to address older adult obesity...
January 5, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28031028/enablers-and-barriers-to-implementing-collaborative-care-for-anxiety-and-depression-a-systematic-qualitative-review
#4
REVIEW
Gritt Overbeck, Annette Sofie Davidsen, Marius Brostrøm Kousgaard
BACKGROUND: Collaborative care is an increasingly popular approach for improving quality of care for people with mental health problems through an intensified and structured collaboration between primary care providers and health professionals with specialized psychiatric expertise. Trials have shown significant positive effects for patients suffering from depression, but since collaborative care is a complex intervention, it is important to understand the factors which affect its implementation...
December 28, 2016: Implementation Science: IS
https://www.readbyqxmd.com/read/28027265/the-importance-of-patient-satisfaction-a-blessing-a-curse-or-simply-irrelevant
#5
Justin B Cohen, Terence M Myckatyn, Keith Brandt
New regulations require that physician performance must be evaluated and graded in both objective and subjective ways. This represents a novel factor in American health care delivery driven by the reality that the United States spends more than any other nation on health care yet still lags behind in key outcome measures. Patient satisfaction has been established as a core component of physician rankings and reimbursement. In fact, it already has acted as both a powerful motivator and stressor. Patient feedback has driven hospital administrators' agendas to improve facilities and provide relative luxuries to inpatients, and individual providers have been tempted to ignore sound medical judgment by relenting to patient requests to increase their satisfaction scores...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28024954/primary-care-physicians-perspective-on-financial-issues-and-adult-immunization-in-the-era-of-the-affordable-care-act
#6
Laura P Hurley, Megan C Lindley, Mandy A Allison, Lori A Crane, Michaela Brtnikova, Brenda L Beaty, Megan Snow, Carolyn B Bridges, Allison Kempe
BACKGROUND: Financial barriers to adult vaccination are poorly understood. Our objectives were to assess among general internists (GIM) and family physicians (FP) shortly after Affordable Care Act (ACA) implementation: (1) proportion of adult patients deferring or refusing vaccines because of cost and frequency of physicians not recommending vaccines for financial reasons; (2) satisfaction with reimbursement for vaccine purchase and administration by payer type; (3) knowledge of Medicare coverage of vaccines; and (4) awareness of vaccine-specific provisions of the ACA...
December 23, 2016: Vaccine
https://www.readbyqxmd.com/read/28018873/restrictions-for-reimbursement-of-direct-acting-antiviral-treatment-for-hepatitis-c-virus-infection-in-canada-a-descriptive-study
#7
Alison D Marshall, Sahar Saeed, Lisa Barrett, Curtis L Cooper, Carla Treloar, Julie Bruneau, Jordan J Feld, Lesley Gallagher, Marina B Klein, Mel Krajden, Naglaa H Shoukry, Lynn E Taylor, Jason Grebely
BACKGROUND: In Canada, interferon-free, direct-acting antiviral hepatitis C virus (HCV) regimens are costly. This presents challenges for universal drug coverage of the estimated 220 000 people with chronic HCV infection nationwide. The study objective was to appraise criteria for reimbursement of 4 HCV direct-acting antivirals in Canada. METHODS: We reviewed the reimbursement criteria for simeprevir, sofosbuvir, ledipasvir-sofosbuvir and paritaprevir-ritonavir-ombitasvir plus dasabuvir in the 10 provinces and 3 territories...
October 2016: CMAJ Open
https://www.readbyqxmd.com/read/27999502/pain-functional-scores-and-radiographic-severity-of-illness-influence-the-perception-of-time-spent-with-the-physician-by-patients-presenting-for-initial-evaluation-of-knee-osteoarthritis
#8
Ronak Kedia, Chandni Dargan, Omar Hassan, Vinod Dasa
BACKGROUND: Patient satisfaction has become a significant factor in reimbursement schedules for physicians. A matter of debate is whether the patient's perception of time spent with the physician improves patient satisfaction. We sought to determine whether patient-physican time correlates with patient satisfaction and which factors are associated with patient perception of time. METHODS: A total of 73 patients who presented for an initial evaluation of knee osteoarthritis were evaluated by the same orthopedic surgeon at an outpatient clinic in New Orleans, LA...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27998046/supervised-exercise-therapy-it-does-work-but-how-to-set-up-a-program
#9
David Hageman, Marijn M VAN DEN Houten, Steffie Spruijt, Lindy N Gommans, Marc R Scheltinga, Joep A Teijink
Intermittent claudication (IC) is a manifestation of peripheral arterial disease. IC has a high prevalence in the older population, is closely associated with other expressions of atherosclerotic disease and often co-exists in multimorbid patients. Treatment of IC should address reduction of cardiovascular risk and improvement of functional capacity and health-related quality of life (QoL). As recommended by contemporary international guidelines, the first-line treatment includes supervised exercise therapy (SET)...
December 19, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27997508/cost-variation-of-anterior-cervical-fusions-in-elderly-medicare-beneficiaries
#10
Varun Puvanesarajah, David J Kirby, Amit Jain, Brian C Werner, Hamid Hassanzadeh
STUDY DESIGN: Retrospective database review OBJECTIVE.: To determine how demographics and comorbid diagnoses influence hospital costs during admission for anterior cervical fusions (ACFs) in the elderly Medicare population. SUMMARY OF BACKGROUND DATA: Elective ACFs to treat degenerative cervical pathology are extremely common within the elderly population. Though it is well known that every patient has a significantly different medical profile that guides treatment and post-operative care, little information is available regarding how hospital costs vary from patient to patient...
December 16, 2016: Spine
https://www.readbyqxmd.com/read/27987615/practice-patterns-of-endovenous-ablation-therapy-for-the-treatment-of-venous-reflux-disease
#11
Faisal Aziz, Jose Diaz, John Blebea, Fedor Lurie
OBJECTIVE: The purpose of this study was to assess practice patterns of endovenous ablation therapy for the treatment of venous reflux disease among the vein specialist members of the American Venous Forum (AVF). METHODS: An online survey was conducted of AVF members designed to identify demographics, treatment practices, and clinical variables in the selection of vein ablation devices. RESULTS: The survey was distributed to 798 practicing physicians, of whom 129 (16%) responded...
January 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/27987602/cost-analysis-and-implications-of-routine-deep-venous-thrombosis-duplex-ultrasound-scanning-after-endovenous-ablation
#12
REVIEW
Luis Suarez, Erica Tangney, Thomas F O'Donnell, Mark D Iafrati
BACKGROUND: Duplex ultrasound (DUS) is performed by the majority of physicians after endovenous ablation (EVA) of the great saphenous vein to screen for endovenous heat-induced thrombosis (EHIT) at the saphenofemoral junction extending into the femoral vein. Several factors should be considered in assessing the value and cost of routine DUS after EVA: the natural history of EHIT is poorly defined, the incidence appears low, and the majority are both asymptomatic and Kabnick type 2 (projecting only slightly into the femoral vein)...
January 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/27986487/the-disproportionate-growth-of-office-based-atherectomy
#13
Dipankar Mukherjee, Homayoun Hashemi, Brian Contos
OBJECTIVE: The purpose of this study was to evaluate the trends in procedure volume, clinical sites of care, and Medicare expenditure for peripheral vascular interventions (PVIs) for lower extremity occlusive disease since the Centers for Medicare and Medicaid Services instituted reimbursement policy changes that broadened payment for procedures performed in physician-owned office-based laboratories (OBLs). METHODS: We analyzed fee-for-service Medicare claims data from 2011 to 2014 to obtain the frequency of use of PVI by type, care setting, and physician specialty...
December 13, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27984651/neoadjuvant-long-course-chemoradiation-remains-strongly-favored-over-short-course-radiotherapy-by-radiation-oncologists-in-the-united-states
#14
Yvonne M Mowery, Joseph K Salama, S Yousuf Zafar, Harvey G Moore, Christopher G Willett, Brian G Czito, M Benjamin Hopkins, Manisha Palta
BACKGROUND: Short-course radiotherapy (SC-RT) and long-course chemoradiotherapy (LC-CRT) are accepted neoadjuvant treatments of rectal cancer. In the current study, the authors surveyed US radiation oncologists to assess practice patterns and attitudes regarding SC-RT and LC-CRT for patients with rectal cancer. METHODS: The authors distributed a survey to 1701 radiation oncologists regarding treatment of neoadjuvant rectal cancer. Respondents were asked questions regarding the number of patients with rectal cancer treated, preference for SC-RT versus LC-CRT, and factors influencing regimen choice...
December 16, 2016: Cancer
https://www.readbyqxmd.com/read/27984440/evaluation-of-a-program-for-improving-advanced-imaging-interpretation
#15
Adam C Powell, James W Long, Erin M Kren, Amit K Gupta, David C Levin
OBJECTIVES: Self-referred imaging has grown rapidly, raising concerns about increased costs and compromised quality of care. A quality improvement program using imaging interpretation criteria was designed by a national payer to ensure that noninvasive diagnostic images are interpreted by appropriately trained physicians. The objective of this program evaluation was to compare self-referral rates before and after institution of the imaging interpretation criteria program. METHODS: The imaging interpretation criteria program allocated privileges to bill for advanced imaging interpretation according to physician specialty...
December 14, 2016: Journal of Patient Safety
https://www.readbyqxmd.com/read/27979429/the-finnish-experience-to-save-asthma-costs-by-improving-care-in-1987-2013
#16
Tari Haahtela, Fredrik Herse, Jussi Karjalainen, Timo Klaukka, Miika Linna, Riika-Leena Leskelä, Olof Selroos, Eeva Reissell
The Finnish National Asthma Program 1994-2004 markedly improved asthma care in the 1990s. We evaluated the changes in costs during 26 years from 1987 to 2013. Direct and indirect costs were calculated by using data from national registries. Costs from both the societal and patient perspectives were included. The costs were based on patients with persistent, physician-diagnosed asthma verified by lung function measurements. We constructed minimum and maximum scenarios to assess the effect of improved asthma care on total costs...
December 12, 2016: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27968907/occupational-challenges-of-physicians-involved-in-tuberculosis-control-in-china-a-qualitative-study
#17
Shanquan Chen, Hui Zhang, Yan Qu, Yushan Wu, Qian Long, Limei Ran, Qiuji Xue, Kai Chen, Fei Luo, Lan Yao, Lai-Yi Wong, Hong Fung, Manli Chen, Li Xiang
BACKGROUND: Despite its dramatic improvement, China's tuberculosis burden is still high according to the 2015 WHO TB report. Evidence show that experienced physicians do better in reducing delay diagnosis and patient mortality and are more likely to follow the treatment guidelines. However, in China, few studies have focused on physicians specialised in tuberculosis; and these few studies were mainly centred on the prevalence and risk factors among them. We assessed the occupational challenges of these physicians in China...
October 2016: Lancet
https://www.readbyqxmd.com/read/27956124/is-physician-quality-reporting-system-worth-the-cost-to-report-to-center-for-medicare-and-medicaid-services
#18
Stephen T Duncan, Cale A Jacobs, Christian P Christensen, Ryan M Nunley, William B Macaulay
BACKGROUND: The Center for Medicare and Medicaid Services (CMS) has proposed a move to payment based on patient-reported outcomes (PROs), and failure to report on PROs will result in a penalty of 2% in 2016. However, the cost to the physician to collect PROs is not known. METHODS: Using data from the 2013 Medical Group Management Association Compensation and Financial survey and Center for Medicare and Medicaid Services reimbursement, a calculation was performed to determine the cost to the physician to report on PROs for patients undergoing total knee arthroplasty and total hip arthroplasty...
November 17, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27931538/western-guidelines-or-practice-algorithms-yorkshire-pudding-or-dal-makhni
#19
EDITORIAL
Sundeep Mishra
Physicians to be able deliver contemporary care need to be updated on the recent developments in diagnosis and treatment. However, there is numerous data available practically on each and every aspect of day-today clinical practice. Clinical guidelines may provide a quick solution for everyday problems but many times they themselves are too many, too voluminous and may confuse more than simplify. More-over, they are based on Western derived clinical data, even clinical practice, developed for ethico-legal and reimbursement purposes and therefore may not be applicable to clinical practice in majority of the world...
November 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27926678/cost-minimization-analysis-of-open-and-endoscopic-carpal-tunnel-release
#20
Steven Zhang, Molly Vora, Alex H S Harris, Laurence Baker, Catherine Curtin, Robin N Kamal
BACKGROUND: Carpal tunnel release is the most common upper-limb surgical procedure performed annually in the U.S. There are 2 surgical methods of carpal tunnel release: open or endoscopic. Currently, there is no clear clinical or economic evidence supporting the use of one procedure over the other. We completed a cost-minimization analysis of open and endoscopic carpal tunnel release, testing the null hypothesis that there is no difference between the procedures in terms of cost. METHODS: We conducted a retrospective review using a private-payer and Medicare Advantage database composed of 16 million patient records from 2007 to 2014...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
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