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Accountable Care Organizations

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https://www.readbyqxmd.com/read/29149187/epidemiology-and-impact-on-all-cause-mortality-of-sepsis-in-norwegian-hospitals-a-national-retrospective-study
#1
Siri Tandberg Knoop, Steinar Skrede, Nina Langeland, Hans Kristian Flaatten
BACKGROUND: Although sepsis is the leading cause of death from infection, there are few population-level epidemiological sepsis reports. The impact of sepsis-related deaths on all-cause hospital mortality is insufficiently described, in particular in Europe where data are non-existent. The objective of this study was to provide nationwide epidemiological results on sepsis hospitalizations in Norway and to estimate sepsis' contribution to overall hospital mortality in a European setting...
2017: PloS One
https://www.readbyqxmd.com/read/29148329/the-implementation-of-performance-management-systems-in-u-s-physician-organizations
#2
Alexander F Pimperl, Hector P Rodriguez, Julie A Schmittdiel, Stephen M Shortell
Performance management systems (PMSYS) aid in improving the quality and efficiency of care, but little is known about factors that influence more robust PMSYS among physician organizations. Using a nationally representative survey of U.S. medical practices, we examined the extent to which organizational capabilities and external factors were associated with more developed PMSYS. Linear regression estimated the relative impact of these factors on PMSYS. On average, practices implemented a minority (32 points out of 100) of the PMSYS processes assessed...
March 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29143674/the-role-of-human-rights-litigation-in-improving-access-to-reproductive-health-care-and-achieving-reductions-in-maternal-mortality
#3
Jennifer Templeton Dunn, Katherine Lesyna, Anna Zaret
BACKGROUND: Improving maternal health, reducing global maternal mortality, and working toward universal access to reproductive health care are global priorities for United Nations agencies, national governments, and civil society organizations. Human rights lawyers have joined this global movement, using international law and domestic constitutions to hold nations accountable for preventable maternal death and for failing to provide access to reproductive health care services. CASE PRESENTATION: This article discusses three decisions in which international treaty bodies find the nations of Brazil and Peru responsible for violations of the Convention on the Elimination of All Forms of Discrimination Against Women and the International Covenant on Civil and Political Rights and also two domestic decisions alleging constitutional violations in India and Uganda...
November 8, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29137499/improving-care-and-lowering-costs-evidence-and-lessons-from-a-global-analysis-of-accountable-care-reforms
#4
Mark McClellan, Krishna Udayakumar, Andrea Thoumi, Jonathan Gonzalez-Smith, Kushal Kadakia, Natalia Kurek, Mariam Abdulmalik, Ara W Darzi
Policy makers and providers are under increasing pressure to find innovative approaches to achieving better health outcomes as efficiently as possible. Accountable care, which holds providers accountable for results rather than specific services, is emerging in many countries to support such care innovations. However, these reforms are challenging and complex to implement, requiring significant policy and delivery changes. Despite global interest, the evidence on how to implement accountable care successfully remains limited...
November 2017: Health Affairs
https://www.readbyqxmd.com/read/29135767/implementing-accountable-care-organizations-lessons-from-a-qualitative-analysis-of-four-private-sector-organizations
#5
Daniel M Walker, Jennifer L Hefner, Lindsey N Sova, Brian Hilligoss, Paula H Song, Ann Scheck McAlearney
Accountable care organizations (ACOs) are emerging across the healthcare marketplace and now include Medicare, Medicaid, and private sector payers covering more than 24 million lives. However, little is known about the process of organizational change required to achieve cost savings and quality improvements from the ACO model. This study applies the complex innovation implementation framework to understand the challenges and facilitators associated with the ACO implementation process. We conducted four case studies of private sector ACOs, selected to achieve variation in terms of geography and organizational maturity...
November 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/29132634/a-model-to-determine-payments-associated-with-radiology-procedures
#6
Thusitha Mabotuwana, Christopher S Hall, Shiby Thomas, Christoph Wald
OBJECTIVE: Across the United States, there is a growing number of patients in Accountable Care Organizations and under risk contracts with commercial insurance. This is due to proliferation of new value-based payment models and care delivery reform efforts. In this context, the business model of radiology within a hospital or health system context is shifting from a primary profit-center to a cost-center with a goal of cost savings. Radiology departments need to increasingly understand how the transactional nature of the business relates to financial rewards...
December 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29123864/right-sided-bochdalek-hernia-in-an-elderly-patient-a-case-review-of-adult-bochdalek-hernias-from-1982-to-2015-in-japan
#7
Yasuhiro Ohtsuka, Tiberiu H Suzuki
Case: An 89-year-old woman was admitted to our hospital because of dyspnea following abdominal pain and vomiting. According to chest computed tomography findings, a diagnosis of acute respiratory failure due to right-sided Bochdalek hernia was made. Outcome: Emergency laparotomy revealed that a bowel loop from the terminal ileum to the transverse colon had herniated into the right thoracic cavity through the foramen of Bochdalek. The herniated organs were reduced to the abdominal cavity and the foramen was repaired by direct suturing...
April 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29117321/the-international-glossary-on-infertility-and-fertility-care-2017
#8
Fernando Zegers-Hochschild, G David Adamson, Silke Dyer, Catherine Racowsky, Jacques de Mouzon, Rebecca Sokol, Laura Rienzi, Arne Sunde, Lone Schmidt, Ian D Cooke, Joe Leigh Simpson, Sheryl van der Poel
STUDY QUESTION: Can a consensus and evidence-driven set of terms and definitions be generated to be used globally in order to ensure consistency when reporting on infertility issues and fertility care interventions, as well as to harmonize communication among the medical and scientific communities, policy-makers, and lay public including individuals and couples experiencing fertility problems? SUMMARY ANSWER: A set of 283 consensus-based and evidence-driven terminologies used in infertility and fertility care has been generated through an inclusive consensus-based process with multiple stakeholders...
September 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29105700/-seeking-compulsory-treatment-as-life-saving-in-the-presence-of-eating-disorders-a-complex-choice
#9
Walter Milano, Armando Cotugno, Riccardo Dalle Grave, Maria Gabriella Gentile, Giovanni Gravina, Caterina Renna, Pierandrea Salvo, Patrizia Todisco, Lorenzo Maria Donini
Eating disorders (and especially anorexia nervosa) are associated with severe disability, poor quality of life and high mortality rate. Anorexia nervosa ranks among the main causes of death among young women. Despite physical and psycho-social impairment, patients suffering from anorexia nervosa do not recognize low body weight and extreme calorie restriction as a clinical problem and are ambivalent towards treatment. Some patients with anorexia nervosa refuse treatments though presenting severe medical complications and having a high mortality risk...
September 2017: Rivista di Psichiatria
https://www.readbyqxmd.com/read/29102480/what-are-the-key-elements-for-implementing-intensive-primary-care-a-multisite-veterans-health-administration-case-study
#10
Evelyn T Chang, Pushpa V Raja, Susan E Stockdale, Marian L Katz, Donna M Zulman, Jessica A Eng, Kathy H Hedrick, Jeffrey L Jackson, Neha Pathak, Brook Watts, Carrie Patton, Gordon Schectman, Steven M Asch
Many integrated health systems and accountable care organizations have turned to intensive primary care programs to improve quality of care and reduce costs for high-need high-cost patients. How best to implement such programs remains an active area of discussion. In 2014, the Veterans Health Administration (VHA) implemented five distinct intensive primary care programs as part of a demonstration project that targeted Veterans at the highest risk for hospitalization. We found that programs evolved over time, eventually converging on the implementation of the following elements: 1) an interdisciplinary care team, 2) chronic disease management, 3) comprehensive patient assessment and evaluation, 4) care and case management, 5) transitional care support, 6) preventive home visits, 7) pharmaceutical services, 8) chronic disease self-management, 9) caregiver support services, 10) health coaching, and 11) advanced care planning...
October 25, 2017: Healthcare
https://www.readbyqxmd.com/read/29102416/hair-mercury-hg-levels-fish-consumption-and-semen-parameters-among-men-attending-a-fertility-center
#11
Lidia Mínguez-Alarcón, Myriam C Afeiche, Paige L Williams, Mariel Arvizu, Cigdem Tanrikut, Chitra J Amarasiriwardena, Jennifer B Ford, Russ Hauser, Jorge E Chavarro
General population exposure to methylmercury (MeHg), the most common organic mercury compound found in the environment, occurs primarily through the consumption of contaminated fish and shellfish. Due to limited studies and lack of consideration of effect modification by fish consumption, it remains uncertain if exposure to mercury affects semen parameters. Thus, we investigated whether hair Hg levels, a biomarker of mercury exposure, were associated with semen parameters among men attending an academic fertility center, and whether this relationship was modified by intake of fish...
October 28, 2017: International Journal of Hygiene and Environmental Health
https://www.readbyqxmd.com/read/29101960/market-evaluation-finances-bundled-payments-and-accountable-care-organizations
#12
REVIEW
Shazia Mehmood Siddique, Shivan J Mehta
To control costs and improve quality, changes in health care delivery and financing have emerged, resulting in shifting of financial risk to providers for the quality and cost of care, including emergence of accountable care organizations and bundled payment models. This article discusses health care financing and delivery models in the context of procedures and surgeries that happen outside of the operating room. It describes the history of health insurance, trends in ambulatory surgery centers, and new payment models that have emerged from the Affordable Care Act and the Medicare Access and Children's Health Insurance Program Reauthorization Act...
December 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29099826/-governance-in-a-project-addressing-care-of-disabled-elderly-persons-within-the-regional-healthcare-system-of-tuscany-italy
#13
Claudio Pedace, Antonella Rosa, Paolo Francesconi, Anna Acampora, Walter Ricciardi, Gianfranco Damiani
Population aging and the concurrent increase of age-related chronic degenerative diseases and disability are associated with an increased proportion of elderly persons who are dependent in activities of daily living (ADL). ADL-dependent persons need continuous and long-term health and social care according to the "taking charge" rationale, in order to warrant access and continuity of care. A healthcare system needs to respond to the long-term and complex needs, such as those of disabled elderly people, by providing appropriate health and social care services in Primary Care...
July 2017: Igiene e Sanità Pubblica
https://www.readbyqxmd.com/read/29098739/organ-donation-and-transplantation-awareness-and-roles-of-healthcare-professionals-a-systematic-literature-review
#14
REVIEW
Funmi Ojawoniyi, Kevin Gormley, Emma Mcgleenan, Helen Rose Noble
AIMS AND OBJECTIVES: To examine the role of healthcare professionals in the organ donation and transplantation process. BACKGROUND: Globally, there remains a perennial disequilibrium between organ donation and organ transplantation. Several factors account for this disequilibrium; however, as healthcare professionals are not only strategically positioned as the primary intermediaries between organ donors and transplant recipients, but also professionally situated as the implementers of organ donation and transplantation processes, they are often blamed for the global organ shortage...
November 3, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29091509/a-person-centered-registry-based-learning-health-system-for-palliative-care-a-path-to-coproducing-better-outcomes-experience-value-and-science
#15
Arif H Kamal, Kathryn B Kirkland, Diane E Meier, Tamara S Morgan, Eugene C Nelson, Steven Z Pantilat
BACKGROUND: Palliative care offers an approach to the care of people with serious illness that focuses on quality of life and aligning care with individual and family goals, and values in the context of what is medically achievable. OBJECTIVE: Measurement of the impact of palliative care is critical for determining what works for which patients in what settings, to learn, improve care, and ensure access to high value care for people with serious illness. METHODS: A learning health system that includes patients and families partnering with clinicians and care teams, is directly linked to a registry to support networks for improvement and research, and offers an ideal framework for measuring what matters to a range of stakeholders interested in improving care for this population...
November 1, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29090623/care-transformation-strategies-and-approaches-of-accountable-care-organizations
#16
Valerie A Lewis, Katherine I Tierney, Taressa Fraze, Genevra F Murray
Although accountable care organizations (ACOs) proliferate, little is known about the activities and strategies ACOs are pursuing to meet goals of reducing costs and improving quality. We use semistructured interviews with executives at 16 ACOs to understand ACO approaches. We identified two overarching ACO approaches to changing clinical care: a practice-based transformation approach, working to overhaul care processes and teams from the inside out; and an overlay approach, where ACO activities were centralized and delivered external to physician practices...
October 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29078880/impact-of-complications-on-length-of-stay-in-elective-laparoscopic-colectomies
#17
Mary Megan Mrdutt, Claire L Isbell, J Scott Thomas, Courtney N Shaver, Rahila Essani, Rajalakshmi Warrier, Harry Troy Papaconstantinou
BACKGROUND: Length of hospital stay (LOS) is an indirect measure of surgical quality and a surrogate for cost. The impact of postoperative complications on LOS following elective colorectal surgery is not well defined. The purpose of this study is to determine the contribution of specific complications towards LOS in elective laparoscopic colectomy patients. MATERIALS AND METHODS: American College of Surgeon's National Surgical Quality Improvement Program database (2011-2014) was queried for patients undergoing elective laparoscopic partial colectomy with primary anastomosis...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29078249/-prevention-of-surgical-site-infections-with-special-focus-on-vascular-surgery
#18
Peter Bischoff, Petra Gastmeier
Background Surgical site infections range between the most commonly and second most commonly reported health-care-associated infections worldwide, depending on the analysis. They are associated with increased morbidity and mortality. Not only for the individual patient, the negative consequences of acquiring a surgical site infection affect the patient's relatives, the hospital and health systems in general. In vascular surgery, gram-positive pathogens of the normal flora of the patient's skin and mucosa (nose/throat) represent the almost half of the number of pathogens detected at the infected surgical site...
October 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29077731/healthy-competition-drives-success-in-results-based-aid-lessons-from-the-salud-mesoam%C3%A3-rica-initiative
#19
Charbel El Bcheraoui, Erin B Palmisano, Emily Dansereau, Alexandra Schaefer, Alexander Woldeab, Maziar Moradi-Lakeh, Benito Salvatierra, Bernardo Hernandez-Prado, Ali H Mokdad
OBJECTIVES: The Salud Mesoamérica Initiative (SMI) is a three-operation strategy, and is a pioneer in the world of results-based aid (RBA) in terms of the success it has achieved in improving health system inputs following its initial operation. This success in meeting pre-defined targets is rare in the world of financial assistance for health. We investigated the influential aspects of SMI that could have contributed to its effectiveness in improving health systems, with the aim of providing international donors, bilateral organizations, philanthropies, and recipient countries with new perspectives that can help increase the effectiveness of future assistance for health, specifically in the arena of RBA...
2017: PloS One
https://www.readbyqxmd.com/read/29076334/a-method-for-assessing-the-retention-of-trace-elements-in-human-body-using-neural-network-technology
#20
Yulia Tunakova, Svetlana Novikova,, Aligejdar Ragimov, Rashat Faizullin, Vsevolod Valiev
Models that describe the trace element status formation in the human organism are essential for a correction of micromineral (trace elements) deficiency. A direct trace element retention assessment in the body is difficult due to the many internal mechanisms. The trace element retention is determined by the amount and the ratio of incoming and excreted substance. So, the concentration of trace elements in drinking water characterizes the intake, whereas the element concentration in urine characterizes the excretion...
2017: Journal of Healthcare Engineering
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