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https://www.readbyqxmd.com/read/27906004/a-quantitative-evidence-base-for-population-health-applying-utilization-based-cluster-analysis-to-segment-a-patient-population
#1
Sabine I Vuik, Erik Mayer, Ara Darzi
BACKGROUND: To improve population health it is crucial to understand the different care needs within a population. Traditional population groups are often based on characteristics such as age or morbidities. However, this does not take into account specific care needs across care settings and tends to focus on high-needs patients only. This paper explores the potential of using utilization-based cluster analysis to segment a general patient population into homogenous groups. METHODS: Administrative datasets covering primary and secondary care were used to construct a database of 300,000 patients, which included socio-demographic variables, morbidities, care utilization, and cost...
November 25, 2016: Population Health Metrics
https://www.readbyqxmd.com/read/27905907/addressing-asthma-and-obesity-in-children-with-community-health-workers-proof-of-concept-intervention-development
#2
Molly A Martin, Steven K Rothschild, Elizabeth Lynch, Katherine Kaufer Christoffel, Militza M Pagán, Jose Luis Rodriguez, Anna Barnes, Kelly Karavolos, Antonieta Diaz, Lucretia M Hoffman, Diana Plata, Sandra Villalpando
BACKGROUND: The objective of this study was to design and test the feasibility and impact of a community health worker (CHW) intervention for comorbid asthma and obesity. METHODS: Using a proof of concept study design, we collected pre/post outcomes from a single intervention cohort of urban low-income in a single community area. A community-based participatory research approach was employed. Forty-six children and their caregivers were recruited. Children were 5-12 years old with physician-diagnosed asthma and body mass index (BMI) > 85%...
December 1, 2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27905903/immediate-effect-of-cpap-titration-on-perceived-health-related-quality-of-life-a-prospective-observational-study
#3
Serena Iacono Isidoro, Adriana Salvaggio, Anna Lo Bue, Salvatore Romano, Oreste Marrone, Giuseppe Insalaco
BACKGROUND: Perceived Health Related Quality of Life (HRQoL) is impaired in obstructive sleep apnea (OSA). This study examines changes in HRQoL aspects occurring immediately after CPAP titration. Furthermore, we analyzed variations in each gender and in patients undergoing home or laboratory-based CPAP titration pathways. METHODS: Twohundredfive outpatients (151 M) (56.7 ± 10.3 years) were evaluated, before first visit and nocturnal diagnostic examination (T0), and the morning after CPAP titration (T1)...
December 1, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27905814/medicare-and-medicaid-programs-cy-2017-home-health-prospective-payment-system-rate-update-home-health-value-based-purchasing-model-and-home-health-quality-reporting-requirements-final-rule
#4
(no author information available yet)
This final rule updates the Home Health Prospective Payment System (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor; effective for home health episodes of care ending on or after January 1, 2017. This rule also: Implements the last year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates; updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 2nd-year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between CY 2012 and CY 2014; finalizes changes to the methodology used to calculate payments made under the HH PPS for high-cost "outlier" episodes of care; implements changes in payment for furnishing Negative Pressure Wound Therapy (NPWT) using a disposable device for patients under a home health plan of care; discusses our efforts to monitor the potential impacts of the rebasing adjustments; includes an update on subsequent research and analysis as a result of the findings from the home health study; and finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model, which was implemented on January 1, 2016; and updates to the Home Health Quality Reporting Program (HH QRP)...
November 3, 2016: Federal Register
https://www.readbyqxmd.com/read/27903469/determinants-of-follow-up-failure-in-patients-undergoing-vascular-surgery-procedures
#5
Dejah R Judelson, Jessica P Simons, Julie M Flahive, Virendra I Patel, Christopher T Healey, Brian W Nolan, Daniel J Bertges, Andres Schanzer
OBJECTIVE: The Vascular Study Group of New England (VSGNE) requires documentation of follow-up for >80% of patients at least 9 months post-procedure. However, many participating groups fall short of this goal. We sought to identify factors independently associated with loss to long-term follow-up (LTF). METHODS: The VSGNE was queried from 2008-2012, for all carotid endarterectomy (CEA), endovascular aneurysm repair (EVAR), open abdominal aortic aneurysm repair (OPEN), infrainguinal bypass (INFRA), and suprainguinal bypass (SUPRA) procedures in patients who survived greater than 9 months post-procedure...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27902149/visiting-children-at-home-and-reducing-admissions
#6
Erin Dean
Nurse-led teams caring for children at home rather than in hospital are being introduced in many areas of the country.
November 30, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27900151/can-the-otago-falls-prevention-program-be-delivered-by-video-a-feasibility-study
#7
Jennifer C Davis, Chun Liang Hsu, Winnie Cheung, Penny M A Brasher, Linda C Li, Karim M Khan, Jonathan Sykes, Dawn A Skelton, Teresa Liu-Ambrose
OBJECTIVES: We assessed the feasibility of delivering the Otago Exercise Programme (OEP) via an interactive DVD (ie, OEP-DVD) in combination with monthly physical therapist phone calls to older adults. DESIGN: This pre-post (baseline and 6-month follow-up) study included an intervention group (n=61) based in a rural location and a control group (n=21) based in a city. SETTING: Sechelt and Vancouver, British Columbia. PARTICIPANTS: 82 community-dwelling adults ≥75 years...
2016: BMJ Open Sport & Exercise Medicine
https://www.readbyqxmd.com/read/27898432/the-impact-of-paliperidone-palmitate-long-acting-injection-on-hospital-admissions-in-a-mental-health-setting
#8
Nikola Nikolić, Natalie Page, Adil Akram, Maha Khan
We screened 216 patients in a retrospective observational investigator-initiated study, of whom 45.37% patients (n=98) were retained after the inclusion criteria were applied. These patients had been prescribed paliperidone palmitate long-acting injection (PPLAI) with diagnoses of schizophrenia, schizoaffective disorder and bipolar affective disorder. We investigated whether PPLAI has an effect on the frequency and length of admissions to mental health inpatient units, the number of contacts with Crisis Resolution Home Treatment Teams (CRHTT) and frequency of home visits by the CRHTT per patient, over 6 years, split using a 'mirror image' method...
November 24, 2016: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/27897466/homebound-patients-perspectives-on-technology-and-telemedicine-a-qualitative-analysis
#9
Kristin T L Huang, Tracy J Lu, Forootan Alizadeh, Arash Mostaghimi
Telemedicine holds promise in bridging the gap between homebound patients and high quality health care, but uptake of such technology remains limited. Qualitative interviews conducted with 17 homebound patients found two major barriers to telemedicine. First, participants who lack familiarity with technology are hesitant about telemedicine, as baseline use of technology in the home is limited, participants did not feel capable of learning, and the advantages of telemedicine were unclear. Second, homebound patients place a high value on in-office visits due to therapeutic benefit, face-to-face communication, and the social aspect of medical appointments...
November 29, 2016: Home Health Care Services Quarterly
https://www.readbyqxmd.com/read/27895150/effects-of-va-facility-dog-on-hospitalized-veterans-seen-by-a-palliative-care-psychologist-an-innovative-approach-to-impacting-stress-indicators
#10
Cheryl A Krause-Parello, Cari Levy, Elizabeth Holman, John E Kolassa
The United States is home to 23 million veterans. In many instances, veterans with serious illness who seek healthcare at the VA receive care from a palliative care service. Animal-assisted intervention (AAI) is gaining attention as a therapeutic stress reducing modality; however, its effects have not been well studied in veterans receiving palliative care in an acute care setting. A crossover repeated-measures study was conducted to examine the effects of an animal-assisted intervention (AAI) in the form of a therapy dog on stress indicators in 25 veterans on the palliative care service at the VA Eastern Colorado Healthcare System in Denver, CO...
November 28, 2016: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/27894271/effectiveness-of-a-physical-exercise-intervention-program-in-improving-functional-mobility-in-older-adults-after-hip-fracture-in-later-stage-rehabilitation-protocol-of-a-randomized-clinical-trial-reative-study
#11
Camila Astolphi Lima, Catherine Sherrington, Adriana Guaraldo, Suzana Albuquerque de Moraes, Renata Dos Ramos Varanda, Juliana de Araújo Melo, Kodi Edson Kojima, Monica Perracini
BACKGROUND: Hip fractures resulting from falls increase substantially with advancing age and less than half of older hip fracture survivors regain their former levels of mobility. There is increasing evidence that rehabilitation interventions with exercises that goes beyond the sub-acute phase or even in a later stage of care have a positive impact on various functional abilities. The purpose of this study is to determine if exercise program training for people who have suffered a fall-related hip fracture will improve functional mobility when compared with usual care...
November 29, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27893954/does-primary-care-model-effect-healthcare-at-the-end-of-life-a-population-based-retrospective-cohort-study
#12
Michelle Howard, Mathieu Chalifoux, Peter Tanuseputro
BACKGROUND: Comprehensive primary care may enhance patient experience at end of life. OBJECTIVE: To examine whether belonging to different models of primary care is associated with end-of-life healthcare use and outcomes. DESIGN: Retrospective population cohort study, using health administrative databases to describe health services and costs in the last six months of life across three primary care models: enrolled to a physician remunerated mainly by capitation, with incentives for comprehensive care and access in some to allied health practitioners (Capitation); remunerated mainly from fee-for-service (FFS) with smaller incentives for comprehensive care (Enhanced FFS); and not enrolled, seeing physicians remunerated solely through FFS (Traditional FFS)...
November 28, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27893603/young-low-risk-heterosexual-clients-prefer-a-chlamydia-home-collection-test-to-a-sexually-transmitted-infection-clinic-visit-in-amsterdam-the-netherlands-a-cross-sectional-study
#13
Martijn S van Rooijen, Rik H Koekenbier, Alfons Hendriks, Henry J C de Vries, Petra van Leeuwen, Maaike G van Veen
BACKGROUND: Home-based self-collection of specimens for urogenital and anorectal chlamydia testing has been proven feasible and acceptable. We studied the efficiency of chlamydia home collection kits for young low-risk persons to optimize care at the Amsterdam sexually transmitted infection (STI) clinic. METHODS: Low-risk heterosexual persons under 25 years submitting an appointment request online were offered 3 different ways of chlamydia testing: (1) receiving a home collection kit, (2) coming to the clinic without, or (3) with sexual health counseling...
November 2016: Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/27893567/determining-whether-a-dosage-specific-and-individualized-home-exercise-program-with-consults-reduces-fall-risk-and-falls-in-community-dwelling-older-adults-with-difficulty-walking-a-randomized-control-trial
#14
Estelle Gallo, Maria Stelmach, Fernanda Frigeri, Dong-Hyun Ahn
BACKGROUND AND PURPOSE: The development and implementation of effective interventions to prevent falls in older adults is a public health priority. The purpose of this study was to compare the efficacy of a new practice model, incorporating Shubert's evidence-based fall prevention recommendations, with the usual ambulatory physical therapy (PT) at Rusk Rehabilitation, to decrease fall risk among older adults living in the community. The hypotheses were (1) the proposed program would decrease participants' fall risk, (2) it would be more effective than our usual PT, and (3) the addition of 4 consults after discharge would improve compliance with a home exercise program...
November 23, 2016: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/27893087/targeting-functional-decline-in-alzheimer-disease-a-randomized-trial
#15
Christopher M Callahan, Malaz A Boustani, Arlene A Schmid, Michael A LaMantia, Mary G Austrom, Douglas K Miller, Sujuan Gao, Denisha Y Ferguson, Kathleen A Lane, Hugh C Hendrie
Background: Alzheimer disease results in progressive functional decline, leading to loss of independence. Objective: To determine whether collaborative care plus 2 years of home-based occupational therapy delays functional decline. Design: Randomized, controlled clinical trial. (ClinicalTrial.gov: NCT01314950). Setting: Urban public health system. Patients: 180 community-dwelling participants with Alzheimer disease and their informal caregivers...
November 22, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27891454/efficacy-and-safety-of-intralesional-xantinol-nicotinate-in-the-treatment-of-various-stages-of-oral-submucous-fibrosis
#16
Udita Singh
INTRODUCTION: Oral Submucous Fibrosis (OSMF) is one of the most prevalent potentially malignant disorders seen in South east population since ages. Despite the extensive amount of research held in this field, its treatment still remains a challenge. In this study, we present our experience in successfully managing OSMF with intralesional injections of a peripheral vasodilator namely xantinol nicotinate. AIM: To determine the efficacy and safety of intralesional xantinol nicotinate in the treatment of various stages of OSMF...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27891361/serum-frap-levels-and-pre-eclampsia-among-pregnant-women-in-a-rural-community-of-northern-india
#17
Anant Gupta, Shashi Kant, Sanjeev Kumar Gupta, Shyam Prakash, Mani Kalaivani, Chandrakant S Pandav, Sanjay Kumar Rai, Puneet Misra
INTRODUCTION: There is a balance between the oxidative and the anti-oxidative forces in human body. Some studies document decreased level of anti-oxidant in pre-eclampsia while other studies showed normal level of anti-oxidant in pre-eclampsia and the evidence is equivocal. AIM: The aim of the present study was to assess enzymatic anti-oxidant activities in pre-eclamptic women and compare it with normotensive pregnant women with period of gestation between 28 to 36 weeks...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27890563/exposure-factors-for-cleaning-automotive-care-and-surface-protection-products-for-exposure-assessments
#18
Ji Young Park, Miyoung Lim, Wonho Yang, Kiyoung Lee
Accurately measuring the usage patterns of consumer products (CPs) is important to conduct realistic exposure assessments. We determined the exposure factors for 18 consumer products: household bleach, mold stain remover, all-purpose cleaner, washing machine cleaner, air conditioner cleaner, glass cleaner, drain cleaner, adhesive remover, liquid snow chain, tire shine spray, wheel cleaner, rain repellent, car wax spray, leather polish, furniture polish, anti-fog product, fabric waterproofing spray, and rust inhibitor...
November 24, 2016: Food and Chemical Toxicology
https://www.readbyqxmd.com/read/27890397/a-general-measles-vaccination-campaign-in-urban-guinea-bissau-comparing-child-mortality-among-participants-and-non-participants
#19
S Byberg, S M Thysen, A Rodrigues, C Martins, C Cabral, M Careme, P Aaby, C S Benn, A B Fisker
BACKGROUND: Measles vaccination campaigns targeting children aged 9-59months are conducted every three years in Guinea-Bissau. Studies have demonstrated beneficial non-specific effects of measles vaccine. We compared mortality one year after the December 2012 measles vaccination campaign in Bissau city for children who received campaign measles vaccine with children who did not receive campaign measles vaccine. METHODS: Field workers from Bandim Health Project registered all children living in the Bandim Health Project's study area who received measles vaccination at the campaign posts...
November 24, 2016: Vaccine
https://www.readbyqxmd.com/read/27890310/same-day-total-hip-arthroplasty-performed-at-an-ambulatory-surgical-center-90-day-complication-rate-on-549-patients
#20
Gregg R Klein, Jason M Posner, Harlan B Levine, Mark A Hartzband
BACKGROUND: There is an increasing interest in outpatient total hip arthroplasty (THA), as there are perceived benefits to the patient, insurer, and overall healthcare system. However, the safety of outpatient total joint arthroplasty has not been studied. METHODS: Five hundred forty-nine patients who underwent mini-posterior THA at a freestanding independent ambulatory surgical center (ASC) were reviewed. All patients were discharged to home on the day of surgery...
October 20, 2016: Journal of Arthroplasty
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