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Health care delivery

Denise I Garcia, H Ryan Howard, Robert A Cina, Sachin Patel, Ken Ruggiero, Frank A Treiber, Aaron P Lesher
Access to care for pediatric burns remains a major public health problem in the US. Telemedicine has an opportunity to improve access to care, but current models are expensive and inefficient. We have developed and pilot-tested the TeleBurn App, a novel smartphone application, to treat partial thickness burns while outpatient. The app allows the provision of expert clinical burn care directly in the patient's home through text and image messaging, video conferencing, and instructional videos. We retrospectively reviewed clinical outcomes and usability in pediatric partial thickness burn patients treated using the TeleBurn App compared to standard therapy alone...
March 17, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
Yubraj Acharya
This article evaluates a community-based effort aimed at reducing neonatal mortality. I use nationally representative data from Nepal, where 22 children per 1000 die within the first month of their birth, and evaluate the impact of Community-Based Neonatal Care Package. The identification is based on a before-and-after comparison of outcomes in program districts relative to those in non-program districts. I find that the program was successful in encouraging cleaner deliveries for births that took place at home and in increasing prenatal visits to the health center by pregnant women significantly...
March 19, 2018: Health Policy and Planning
João Manuel Graveto, Cristina Santos, Paulo Santos Costa, Elisabete Fernandes, Susana Alarico, Nádia Osório, Helena Albano, Vânia Oliveira
OBJECTIVE: To describe the determining factors in hand hygiene management among nurses and identify associated collective health challenges. METHOD: Cross-sectional descriptive study. Data were collected using a questionnaire that was applied in four internal medicine units of a hospital of reference in Portugal. RESULTS: The sample was composed of 50 nurses aged 26 to 55 years (mean age of 34.88 years); 80% were women, 58% had a Bachelor's degree, and had 5-30 years of nursing practice (X̄ =11...
2018: Revista Brasileira de Enfermagem
Jacqueline Leigh, Lisa Littlewood
Jacqueline Leigh, Reader, Teaching and Learning, School of Health and Society, University of Salford, , and Lisa Littlewood, Director of Placement and Practice Learning, School of Health and Society, University of Salford, evaluate the changes in the delivery of nurse education as a result of the devolution of health and social care decision-making from Westminster to Greater Manchester.
March 22, 2018: British Journal of Nursing: BJN
Grace Lim, Francesca L Facco, Naveen Nathan, Jonathan H Waters, Cynthia A Wong, Holger K Eltzschig
Obstetric anesthesia has evolved over the course of its history to encompass comprehensive aspects of maternal care, ranging from cesarean delivery anesthesia and labor analgesia to maternal resuscitation and patient safety. Anesthesiologists are concerned with maternal and neonatal outcomes, and with preventing and managing complications that may present during childbirth. The current review will focus on recent advances in obstetric anesthesia, including labor anesthesia and analgesia, cesarean delivery anesthesia and analgesia, the effects of maternal anesthesia on breastfeeding and fever, and maternal safety...
March 21, 2018: Anesthesiology
Eboni G Price-Haywood, Wanda Robinson, Jewel Harden-Barrios, Jeffrey Burton, Todd Burstain
Background: Opioid prescription drug abuse is a major public health concern. Healthcare provider prescribing patterns, especially among non-pain management specialists, are a major factor. Practice guidelines recommend what to do for safe opioid prescribing but do not provide guidance on how to implement best practices. Methods: We describe the implementation of electronic medical record clinical decision support (EMR CDS) for opioid management of chronic noncancer pain in an integrated delivery system...
2018: Ochsner Journal
Karin Stenberg, Jeremy A Lauer, Georgios Gkountouras, Christopher Fitzpatrick, Anderson Stanciole
Background: Policy makers require information on costs related to inpatient and outpatient health services to inform resource allocation decisions. Methods: Country data sets were gathered in 2008-2010 through literature reviews, website searches and a public call for cost data. Multivariate regression analysis was used to explore the determinants of variability in unit costs using data from 30 countries. Two models were designed, with the inpatient and outpatient models drawing upon 3407 and 9028 observations respectively...
2018: Cost Effectiveness and Resource Allocation: C/E
William J Jeffcoate, Loretta Vileikyte, Edward J Boyko, David G Armstrong, Andrew J M Boulton
Diabetic foot ulcers remain a major health care problem. They are common, result in considerable suffering, frequently recur, and are associated with high mortality, as well as considerable health care costs. While national and international guidance exists, the evidence base for much of routine clinical care is thin. It follows that many aspects of the structure and delivery of care are susceptible to the beliefs and opinion of individuals. It is probable that this contributes to the geographic variation in outcome that has been documented in a number of countries...
April 2018: Diabetes Care
Lucy Mackillop, Jane Elizabeth Hirst, Katy Jane Bartlett, Jacqueline Susan Birks, Lei Clifton, Andrew J Farmer, Oliver Gibson, Yvonne Kenworthy, Jonathan Cummings Levy, Lise Loerup, Oliver Rivero-Arias, Wai-Kit Ming, Carmelo Velardo, Lionel Tarassenko
BACKGROUND: Treatment of hyperglycemia in women with gestational diabetes mellitus (GDM) is associated with improved maternal and neonatal outcomes and requires intensive clinical input. This is currently achieved by hospital clinic attendance every 2 to 4 weeks with limited opportunity for intervention between these visits. OBJECTIVE: We conducted a randomized controlled trial to determine whether the use of a mobile phone-based real-time blood glucose management system to manage women with GDM remotely was as effective in controlling blood glucose as standard care through clinic attendance...
March 20, 2018: JMIR MHealth and UHealth
Yasmin van Kasteren, Jill Freyne, M Sazzad Hussain
BACKGROUND: The growth in patient-centered care delivery combined with the rising costs of health care have perhaps not unsurprisingly been matched by a proliferation of patient-centered technology. This paper takes a multistakeholder approach to explore how digital technology can support the cocreation of value between patients and their care teams in the delivery of total knee replacement (TKR) surgery, an increasingly common procedure to return mobility and relieve pain for people suffering from osteoarthritis...
March 20, 2018: Journal of Medical Internet Research
Amit K Mathur, Jayant Talwalkar
There is growing interest in the quality of health care delivery in liver transplantation. Multiple stakeholders, including patients, transplant providers and their hospitals, payers, and regulatory bodies have an interest in measuring and monitoring quality in the liver transplant process, and understanding differences in quality across centers. This article aims to provide an overview of quality measurement and regulatory issues in liver transplantation performed within the United States. We review how broader definitions of health care quality should be applied to liver transplant care models, outline the status quo including regulatory agencies, public reporting mechanisms, and requirements around quality assurance and performance improvement (QAPI) activities...
March 17, 2018: Journal of Hepatology
T N Anand, Linju M Joseph, A V Geetha, Joyita Chowdhury, Dorairaj Prabhakaran, Panniyammakal Jeemon
BACKGROUND: One of the potential strategies to improve health care delivery in understaffed low- and middle-income countries (LMICs) is task sharing, where specific tasks are transferred from more qualified health care cadre to a lesser trained cadre. Dyslipidemia is a major risk factor for cardiovascular disease but often it is not managed appropriately. OBJECTIVE: We conducted a systematic review with the objective to identify and evaluate the effect of task sharing interventions on dyslipidemia in LMICs...
February 16, 2018: Journal of Clinical Lipidology
Stevenson K Chea, Tabitha W Mwangi, Kennedy K Ndirangu, Osman A Abdullahi, Patrick K Munywoki, Amina Abubakar, Amin S Hassan
BACKGROUND: Home delivery, referring to pregnant women giving birth in the absence of a skilled birth attendant, is a significant contributor to maternal mortality, and is encouragingly reported to be on a decline in the general population in resource limited settings. However, much less is known about home delivery amongst HIV-infected women in sub-Saharan Africa (sSA). We described the prevalence and correlates of home delivery among HIV-infected women attending care at a rural public health facility in Kilifi, Coastal Kenya...
2018: PloS One
Angela Grocott, Wilfred McSherry
(1) Background: There is limited empirical knowledge concerning aspects of healthcare that contribute to a good patient experience from the patient's perspective and how patient feedback informs service development. (2) Aim: To examine the issues that influence the effectiveness of communication on patient satisfaction, experience and engagement, in an acute National Health Service (NHS) setting, through identification of the patient's requirements and expectations. (3) Method: Data was gathered from a large teaching hospital using a Friends and Family Test (FFT) and a communication specific survey...
March 20, 2018: Healthcare (Basel, Switzerland)
Sandy Oelschlegel, Kelsey Leonard Grabeel, Emily Tester, Robert E Heidel, Jennifer Russomanno
Patient engagement in health care decisions largely depends on a patient's health literacy and the health literacy attributes of the health care organization. Librarians have an established role in connecting patients with health information in the context of their care. However, librarians can play a larger role in helping to make changes in their organization's health literacy attributes. This article discusses one medical library's process of leading systematic assessment of their organization's health literacy attributes...
April 2018: Medical Reference Services Quarterly
Sean M Murphy, Jared A Leff, Benjamin P Linas, Jake R Morgan, Kathryn McCollister, Bruce R Schackman
BACKGROUND: Health economic evaluation findings assist stakeholders in improving the quality, availability, scalability, and sustainability of evidence-based services, and in maximizing the efficiency of service delivery. The Center for Health Economics of Treatment Interventions for Substance Use Disorders, HCV, and HIV (CHERISH) is a NIDA-funded multi-institutional center of excellence whose mission is to develop and disseminate health-economic research on healthcare utilization, health outcomes, and health-related behaviors that informs substance use disorder treatment policy, and HCV and HIV care of people who use substances...
March 20, 2018: Substance Abuse
Erin E Morgan, Steven Paul Woods, Jennifer E Iudicello, Igor Grant, Javier Villalobos
Two factors that influence HIV health behaviors and therefore may contribute to gaps in the HIV treatment continuum are poor health-related self-efficacy and HIV-associated neurocognitive disorders (HAND). However, the relationship between HAND and self-efficacy has not been assessed. In an HIV sample, 91 individuals with intact cognition (HAND-) and 40 individuals with HAND (HAND+) were administered a measure of self-efficacy for healthcare interactions with providers. Participants with HAND had significantly lower scores on this measure, which were correlated with poorer episodic and semantic memory performance, as well as self-reported memory symptoms in daily life...
March 20, 2018: Journal of Clinical Psychology in Medical Settings
Elliott C Dasenbrook, Gregory S Sawicki
Cystic Fibrosis (CF) patient registries are valuable data sources for researchers studying the natural history, treatment paradigms, and long-term health outcomes of individuals with CF. In this review, we discuss the role of CF patient registries in facilitating comparative effectiveness research, particularly evaluating therapies and variation in health care delivery. We also discuss the limitations of registry-based research, particularly indication bias, as well as statistical methods that can be used to address these issues...
March 16, 2018: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
Shanta R Dube
Currently, in the U.S. and worldwide, childhood trauma is a public health crisis. Childhood adversities, such as abuse, neglect, and related household stressors, are common, interrelated and contribute to multiple adverse social, behavioral and health outcomes throughout the lifespan. The present article provides further discussion regarding adverse childhood experiences (ACEs) screening in healthcare utilizing the etic and emic perspectives. Screening in the healthcare system leans toward the etic view: objective observations of symptoms, which may then lead to intervention delivery...
March 16, 2018: Child Abuse & Neglect
Daniel Nyato, Evodius Kuringe, Mary Drake, Caterina Casalini, Soori Nnko, Amani Shao, Albert Komba, Stefan D Baral, Mwita Wambura, John Changalucha
BACKGROUND: Across sub-Saharan Africa (SSA), HIV disproportionately affects men-who-have-sex-with-men (MSM) compared with other men of the same age group in the general population. Access to HIV services remains low among this group although several effective interventions have been documented. It is therefore important to identify what has worked well to increase the reach of HIV services among MSM. METHODS: We searched MEDLINE, POPLINE and the Web of Science databases to collect published articles reporting HIV interventions among MSM across sub-Saharan Africa...
March 20, 2018: BMC Public Health
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