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Accountable Care Organizations

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https://www.readbyqxmd.com/read/28448780/integration-strategies-of-pharmacists-in-primary-care-based-accountable-care-organizations-a-report-from-the-accountable-care-organization-research-network-services-and-education
#1
Tina Joseph, Genevieve M Hale, Sara M Eltaki, Yesenia Prados, Renee Jones, Matthew J Seamon, Cynthia Moreau, Stephanie A Gernant
BACKGROUND: The accountable care organization (ACO) is an innovative health care delivery model centered on value-based care. ACOs consisting of primary care providers are increasingly becoming commonplace in practice; however, medication management remains suboptimal. PROGRAM DESCRIPTION: As experts in medication management, pharmacists perform direct patient care and assist in the transition from one provider to another, which places them in an ideal position to manage multiple aspects of patient care...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28448328/hospice-or-community-network-choices-in-end-of-life-care-in-jamaica
#2
Roger Lee Mendoza
AIM: National and international healthcare agencies and organizations typically attribute slow or haphazard growth in hospice and palliative care in developing countries to various resource constraints. This study provides evidence of the substantial and widening gap between policy advocacy and individual decision-making concerning end-of-life care. It does so by establishing the incentives and risks that underlie choices of patients and providers against the relative scarcity of hospices in these countries...
April 26, 2017: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/28447302/comment-on-the-new-indian-injection-technique-recommendations-critical-appraisal-of-the-real-world-implementation-of-the-current-guidelines
#3
Felice Strollo, Sandro Gentile
With an eye on the sequence of two Indian papers concurrently published in Diabetes Therapy, this paper analyzes skin differences among races and points to a lack of organized structured education sessions as the main cause of the high prevalence of lipodystrophy (LD) and consequent poor metabolic control. Only half of all insulin-treated patients reach their therapeutic targets worldwide. The factors involved in this are manifold, including the choice of overlong and repeatedly reused needles, as well as a failure to systematically rotate injection sites, all of which lead to skin LD...
April 26, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28441271/alternative-payment-models-and-urology
#4
Deborah R Kaye, David C Miller, Chad Ellimoottil
PURPOSE OF REVIEW: The Medicare Access and CHIP Reauthorization Act (MACRA) is a historic bill that was recently passed that establishes how quality measurement and practice patterns will affect physician reimbursement. Alternative payment models (APMs) are an essential component of MACRA and Medicare's vision of paying for high-value care. This review describes APMs in the context of MACRA and their impact on urology. RECENT FINDINGS: The majority of urologists will be affected by MACRA...
April 22, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28432853/an-evidence-based-approach-to-reducing-cardiac-telemetry-alarm-fatigue
#5
Ekta Srinivasa, Jaspreet Mankoo, Charles Kerr
BACKGROUND: It is estimated that between 80% and 99% of alarms in the clinical areas are in actionable alarms (Gross, Dahl, & Nielson). Alarm management is one of the Joint Commission's National Patient Safety Goals (2014) because sentinel events have directly been linked to the devices generating these alarms. PURPOSE: At an acute care facility in Boston, a multidisciplinary team consisting of Nursing, Biomedical Engineers, Patient Safety and Providers was formed to conduct a pilot study on the state of telemetry alarms on a surgical floor...
April 22, 2017: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/28432127/sex-differences-in-hospitalizations-with-maintenance-hemodialysis
#6
Scott V Adams, Matthew Rivara, Elani Streja, Alfred K Cheung, Onyebuchi A Arah, Kamyar Kalantar-Zadeh, Rajnish Mehrotra
Hospitalization is a major source of morbidity among patients with ESRD undergoing maintenance hemodialysis and is a significant contributor to health care costs. To identify subgroups at the highest risk of hospitalization, we analyzed by sex, age, and race, adjusting for demographic and clinical characteristics, the hospitalization rates, and 30-day readmissions for 333,756 hospitalizations among 111,653 patients undergoing maintenance hemodialysis in facilities operated by a large dialysis organization in the United States (2007-2011)...
April 21, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28424767/direct-and-indirect-costs-of-asthma-management-in-greece-an-expert-panel-approach
#7
Kyriakos Souliotis, Hara Kousoulakou, Georgios Hillas, Petros Bakakos, Michalis Toumbis, Stelios Loukides, Theodoros Vassilakopoulos
OBJECTIVE: Asthma is a major cause of morbidity and mortality and is associated with significant economic burden worldwide. The objectives of this study were to map current resource use associated with the disease management and to estimate the annual direct and indirect costs per adult patient with asthma. METHODS: A Delphi panel with seven leading pulmonologists was conducted. A semistructured questionnaire was developed to elicit data on resource use and treatment patterns...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28424378/-recognition-care-and-prevention-of-suicidal-behaviour-in-adults
#8
Zoltán Rihmer, Attila Németh, Tamás Kurimay, Dóra Perczel-Forintos, György Purebl, Péter Döme
Suicide is a major public health problem everywhere in the world and in the WHO European Region suicide accounts for over 120,000 deaths per year. 1. Recognition and diagnosis: An underlying psychiatric disorder is present in up to 90% of people who completed suicide. Comorbidity with depression, anxiety, substance abuse and personality disorders is high. In order to achieve successful prevention of suicidality, adequate diagnostic procedures and appropriate treatment for the underlying disorder are essential...
2017: Psychiatria Hungarica: A Magyar Pszichiátriai Társaság Tudományos Folyóirata
https://www.readbyqxmd.com/read/28420358/healthcare-utilization-in-older-patients-using-personal-emergency-response-systems-an-analysis-of-electronic-health-records-and-medical-alert-data-brief-description-a-longitudinal-retrospective-analyses-of-healthcare-utilization-rates-in-older-patients-using
#9
Stephen Agboola, Sara Golas, Nils Fischer, Mariana Nikolova-Simons, Jorn Op den Buijs, Linda Schertzer, Joseph Kvedar, Kamal Jethwani
BACKGROUND: Personal Emergency Response Systems (PERS) are traditionally used as fall alert systems for older adults, a population that contributes an overwhelming proportion of healthcare costs in the United States. Previous studies focused mainly on qualitative evaluations of PERS without a longitudinal quantitative evaluation of healthcare utilization in users. To address this gap and better understand the needs of older patients on PERS, we analyzed longitudinal healthcare utilization trends in patients using PERS through the home care management service of a large healthcare organization...
April 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28414799/comprehensive-evaluation-of-ten-deformable-image-registration-algorithms-for-contour-propagation-between-ct-and-cone-beam-ct-images-in-adaptive-head-neck-radiotherapy
#10
Xin Li, Yuyu Zhang, Yinghua Shi, Shuyu Wu, Yang Xiao, Xuejun Gu, Xin Zhen, Linghong Zhou
Deformable image registration (DIR) is a critical technic in adaptive radiotherapy (ART) for propagating contours between planning computerized tomography (CT) images and treatment CT/cone-beam CT (CBCT) images to account for organ deformation for treatment re-planning. To validate the ability and accuracy of DIR algorithms in organ at risk (OAR) contour mapping, ten intensity-based DIR strategies, which were classified into four categories-optical flow-based, demons-based, level-set-based and spline-based-were tested on planning CT and fractional CBCT images acquired from twenty-one head & neck (H&N) cancer patients who underwent 6~7-week intensity-modulated radiation therapy (IMRT)...
2017: PloS One
https://www.readbyqxmd.com/read/28413148/incorporating-site-less-clinical-trials-into-drug-development-a-framework-for-action
#11
Irl B Hirsch, Joe Martinez, E Ray Dorsey, Gerald Finken, Alexander Fleming, Chris Gropp, Philip Home, Daniel I Kaufer, Spyros Papapetropoulos
PURPOSE: Options for leveraging available telemedicine technologies, ranging from simple webcams and telephones to smartphone apps and medical-grade wearable sensors, are evolving faster than the culture of clinical research. Until recently, most clinical trials relied on paper-based processes and technology. This cost- and labor-intensive system, while slowly changing, remains an obstacle to new drug development. Alternatives that use existing tools and processes for collecting real-world data in home settings warrant closer examination...
April 13, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28410975/engagement-of-nurses-in-their-profession-qualitative-study-on-engagement
#12
Rosa García-Sierra, Jordi Fernández-Castro, Fermín Martínez-Zaragoza
OBJECTIVE: To identify common issues of nurses with high engagement to enable us to develop the construct as it applies to nursing in more depth. METHOD: Based on the constructivist paradigm and with a phenomenological approach, a qualitative content analysis was conducted using an inductive approach. Participants were nurses working in direct care in different healthcare areas. The sample size was determined by data saturation and 15 participants were interviewed...
April 12, 2017: Enfermería Clínica
https://www.readbyqxmd.com/read/28408362/ehealth-search-patterns-a-comparison-of-private-and-public-health-care-markets-using-online-panel-data
#13
Janina Anne Schneider, Christopher Patrick Holland
BACKGROUND: Patient and consumer access to eHealth information is of crucial importance because of its role in patient-centered medicine and to improve knowledge about general aspects of health and medical topics. OBJECTIVES: The objectives were to analyze and compare eHealth search patterns in a private (United States) and a public (United Kingdom) health care market. METHODS: A new taxonomy of eHealth websites is proposed to organize the largest eHealth websites...
April 13, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28399317/patterns-of-new-physical-problems-emerging-in-long-term-care-residents-with-dementia
#14
Christine R Kovach, Julie Ellis, Crystal-Rae Evans
Individuals receiving skilled nursing care have multiple comorbid conditions that impact comfort and resource use. The current study describes variations in the trajectories of new physical problems emerging over 8 weeks and the predictive value for future health and behavior in a sample of 72 residents with dementia. Residents had two to 37 new physical problems occurring over 8 weeks. Sixty-five percent of the sample had five or more new problems and were identified by three unstable trajectories. Common problems, illnesses, and symptoms accounted for 28...
April 11, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/28395527/assessing-cognitive-related-disability-in-schizophrenia-reliability-validity-and-underlying-factors-of-the-evaluation-of-cognitive-processes-involved-in-disability-in-schizophrenia-scale
#15
Christine Passerieux, Virginie Bulot, Marie-Christine Hardy-Baylé, Paul Roux
PURPOSE: We have developed a new scale that assesses disability caused by cognitive impairments in schizophrenia, in order to evaluate the functional impact of schizophrenia and help the prescription of rehabilitation interventions. The aim of the study was to assess its psychometrical properties. MATERIALS AND METHODS: Mental healthcare professionals and relatives of individuals with schizophrenia developed and rated the evaluation of cognitive processes involved in disability in schizophrenia scale, which included 13 items...
April 11, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28395006/association-between-hospitals-engagement-in-value-based-reforms-and-readmission-reduction-in-the-hospital-readmission-reduction-program
#16
Andrew M Ryan, Sam Krinsky, Julia Adler-Milstein, Cheryl L Damberg, Kristin A Maurer, John M Hollingsworth
Importance: Medicare is experimenting with numerous concurrent reforms aimed at improving quality and value for hospitals. It is unclear if these myriad reforms are mutually reinforcing or in conflict with each other. Objective: To evaluate whether hospital participation in voluntary value-based reforms was associated with greater improvement under Medicare's Hospital Readmission Reduction Program (HRRP). Design, Setting, and Participants: Retrospective, longitudinal study using publicly available national data from Hospital Compare on hospital readmissions for 2837 hospitals from 2008 to 2015...
April 10, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28394870/postoperative-morbidity-after-radical-resection-of-primary-retroperitoneal-sarcoma-a-report-from-the-transatlantic-rps-working-group
#17
Andrea J MacNeill, Alessandro Gronchi, Rosalba Miceli, Sylvie Bonvalot, Carol J Swallow, Peter Hohenberger, Frits Van Coevorden, Piotr Rutkowski, Dario Callegaro, Andrew J Hayes, Charles Honoré, Mark Fairweather, Amanda Cannell, Jens Jakob, Rick L Haas, Milena Szacht, Marco Fiore, Paolo G Casali, Raphael E Pollock, Francesco Barretta, Chandrajit P Raut, Dirk C Strauss
OBJECTIVE: To investigate the safety of radical resection for retroperitoneal sarcoma (RPS). BACKGROUND: The surgical management of RPS frequently involves complex multivisceral resection. Improved oncologic outcomes have been demonstrated with this approach compared to marginal excision, but the safety of radical resection has not been shown in a large study population. METHODS: The Transatlantic Retroperitoneal Sarcoma Working Group (TARPSWG) is an international collaborative of sarcoma centers...
April 7, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28385025/private-sector-accountable-care-organization-development-a-qualitative-study
#18
Ann Scheck McAlearney, Brian Hilligoss, Paula H Song
OBJECTIVES: To explore accountable care organizations (ACOs) as they develop in the private sector, including their motivation for development, perspectives from consumers regarding these emerging ACOs, and the critical success factors associated with ACO development. STUDY DESIGN: Comprehensive organizational case studies of 4 full-risk private sector ACOs that included in-person interviews with providers and administrators and focus groups with local consumers...
March 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28384376/a-two-step-method-to-identify-positive-deviant-physician-organizations-of-accountable-care-organizations-with-robust-performance-management-systems
#19
Alexander F Pimperl, Hector P Rodriguez, Julie A Schmittdiel, Stephen M Shortell
OBJECTIVE: To identify positive deviant (PD) physician organizations of Accountable Care Organizations (ACOs) with robust performance management systems (PMSYS). DATA SOURCE: Third National Survey of Physician Organizations (NSPO3, n = 1,398). STUDY DESIGN: Organizational and external factors from NSPO3 were analyzed. DATA COLLECTION/EXTRACTION METHODS: Linear regression estimated the association of internal and contextual factors on PMSYS...
April 6, 2017: Health Services Research
https://www.readbyqxmd.com/read/28376085/status-and-methodology-of-publicly-available-national-hiv-care-continua-and-90-90-90-targets-a-systematic-review
#20
Reuben Granich, Somya Gupta, Irene Hall, John Aberle-Grasse, Shannon Hader, Jonathan Mermin
BACKGROUND: In 2014, the Joint United Nations Program on HIV/AIDS (UNAIDS) issued treatment goals for human immunodeficiency virus (HIV). The 90-90-90 target specifies that by 2020, 90% of individuals living with HIV will know their HIV status, 90% of people with diagnosed HIV infection will receive antiretroviral treatment (ART), and 90% of those taking ART will be virally suppressed. Consistent methods and routine reporting in the public domain will be necessary for tracking progress towards the 90-90-90 target...
April 2017: PLoS Medicine
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