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https://www.readbyqxmd.com/read/29317849/is-medical-treatment-of-alcohol-withdrawal-syndrome-a-stag-hunt-challenges-and-opportunities-in-managing-risk-and-uncertainty-in-addiction-cessation
#1
Roger Lee Mendoza
Purpose: While the individual and social costs of alcoholism or alcohol use disorder are well established, few are aware that medical problems can arise during detoxification, some of which can be life-threatening. This study determines if sustained treatment for Alcohol Withdrawal Syndrome (AWS) might be based on the strategic choices and expectations of patients and health care providers alike, as well as the risk mitigation options available to them. Design/approach: AWS was modeled as a Stag Hunt to explain both risk and decision-making in medical treatments for detoxification, since it can deduce a set of equilibrium strategies available to both patient and provider...
2018: Risk Management and Healthcare Policy
https://www.readbyqxmd.com/read/29297725/prescription-drug-monitoring-programs-and-pharmacist-orientation-toward-dispensing-controlled-substances
#2
Michael Fendrich, Janelle K Bryan, Katinka Hooyer
OBJECTIVES: We sought to understand how pharmacists viewed and used a newly implemented prescription drug monitoring program (PDMP). We also sought to understand pharmacist orientation toward dispensing of controlled substances and the people who obtain them. METHODS: We conducted three mini focus groups. The focus group findings were used to inform the design of a structured survey. We emailed a survey to 160 pharmacists who were employed in one statewide community chain store; we obtained 48 survey responses...
January 3, 2018: Substance Use & Misuse
https://www.readbyqxmd.com/read/29286953/co-management-strategies-for-hospitals-and-orthopedic-and-neurosurgery-practices
#3
Scott G Tromanhauser
Co-management arrangements can be a very effective means of aligning physicians and their hospitals to gain care delivery efficiencies, control costs, and reduce variation in practices. In an era of value-based care delivery all aspects must be examined and the appropriate incentives put in place to reduce waste and optimize asset and resource utilization. This article will review legal considerations, define basic co-management structure and goals, and suggest examples of metrics used to achieve success.
December 28, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29285865/sorting-into-payment-schemes-and-medical-treatment-a-laboratory-experiment
#4
Jeannette Brosig-Koch, Nadja Kairies-Schwarz, Johanna Kokot
In this study, we introduce the opportunity for physicians to sort into capitation or fee-for-service payment. Using a controlled medically framed laboratory experiment with a sequential within-subject design allows isolating sorting from incentive effects. We observe a strong preference for fee-for-service payment, which does not depend on subjects' prior experience with one of the two payment schemes. Further, we identify a significant sorting effect. Subjects choosing capitation deviate ex ante less from patient-optimal medical treatment than subjects who sort into fee-for-service payment...
December 2017: Health Economics
https://www.readbyqxmd.com/read/29285542/adoption-of-electronic-health-records-and-perceptions-of-financial-and-clinical-outcomes-among-ophthalmologists-in-the-united-states
#5
Michele C Lim, Michael V Boland, Colin A McCannel, Arvind Saini, Michael F Chiang, K David Epley, Flora Lum
Importance: Assessing the rate of electronic health record (EHR) adoption and ophthalmologists' perceptions on financial and clinical productivity is important in understanding how to direct future design and health care policy. Objective: To assess adoption rate and perceptions of financial and clinical outcomes of EHRs among ophthalmologists in the United States. Design, Setting, and Participants: Population-based, cross-sectional study...
December 28, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29284064/policies-for-biosimilar-uptake-in-europe-an-overview
#6
Evelien Moorkens, Arnold G Vulto, Isabelle Huys, Pieter Dylst, Brian Godman, Simon Keuerleber, Barbara Claus, Maria Dimitrova, Guenka Petrova, Ljiljana Sović-Brkičić, Juraj Slabý, Robin Šebesta, Ott Laius, Allan Karr, Morgane Beck, Jaana E Martikainen, Gisbert W Selke, Susan Spillane, Laura McCullagh, Gianluca Trifirò, Patricia Vella Bonanno, Asbjørn Mack, Antra Fogele, Anita Viksna, Magdalena Władysiuk, Helder Mota-Filipe, Dmitry Meshkov, Marija Kalaba, Simona Mencej Bedrač, Jurij Fürst, Corrine Zara, Peter Skiöld, Einar Magnússon, Steven Simoens
BACKGROUND: Across European countries, differences exist in biosimilar policies, leading to variations in uptake of biosimilars and divergences in savings all over Europe. OBJECTIVES: The aim of this article is to provide an overview of different initiatives and policies that may influence the uptake of biosimilars in different European countries. Recommendations will be formulated on how to create sustainable uptake. METHODS: An overview of policies on biosimilars was obtained via a questionnaire, supplemented with relevant articles...
2017: PloS One
https://www.readbyqxmd.com/read/29282154/using-incentives-to-recruit-physicians-into-behavioral-trials-lessons-learned-from-four-studies
#7
Deepika Mohan, Matthew R Rosengart, Baruch Fischhoff, Derek C Angus, David J Wallace, Coreen Farris, Donald M Yealy, Amber E Barnato
OBJECTIVE: To describe lessons learned from the use of different strategies for recruiting physicians responsible for trauma triage, we summarize recruitment data from four behavioral trials run in the United States between 2010 and 2016. RESULTS: We ran a series of behavioral trials with the primary objective of understanding the influence of heuristics on physician decision making in trauma triage. Three studies were observational; one tested an intervention. The trials used different methods of recruitment (in-person vs...
December 28, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29246532/an-e-health-interactive-self-assessment-website-sanoia%C3%A2-in-rheumatoid-arthritis-a-12-month-randomized-controlled-trial-in-320-patients
#8
Laure Gossec, Alain Cantagrel, Martin Soubrier, Jean-Marie Berthelot, Jean-Michel Joubert, Bernard Combe, Wienia Czarlewski, Daniel Wendling, Emmanuelle Dernis, Laurent Grange, Catherine Beauvais, Aleth Perdriger, Henri Nataf, Maxime Dougados, Hervé Servy
INTRODUCTION: Sanoia is an online interactive electronic e-health platform developed to allow patient self-assessment and self-monitoring. The objective was to assess in rheumatoid arthritis (RA) patients, the efficacy on patient-physician interactions, of giving access to Sanoia. METHODS: In this French, multi-center, 12-months randomized controlled trial (CarNET: NCT02200068), patients with RA and internet access were randomized to: access without incentives to the Sanoia platform after minimal training, or usual care...
December 12, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/29229710/financial-incentives-for-physicians-to-improve-health-care
#9
M Ruth Lavergne
No abstract text is available yet for this article.
December 11, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/29214317/connections-between-hospital-financial-distress-physician-incentive-and-patient-access-to-breast-reconstruction
#10
Tomer Avraham, Cary P Gross, Brigid K Killelea
No abstract text is available yet for this article.
December 6, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29204975/characteristics-and-disparities-among-primary-care-practices-in-the-united-states
#11
David Michael Levine, Jeffrey A Linder, Bruce E Landon
BACKGROUND: Despite new incentives for US primary care, concerns abound that patient-centered practice capabilities are lagging. OBJECTIVE: Describe the practice structure, patient-centered capabilities, and payment relationships of US primary care practices; identify disparities in practice capabilities. DESIGN: Analysis of the 2015 Medical Organizations Survey (MOS), part of the nationally representative Medical Expenditure Panel Survey (MEPS)...
December 4, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29200334/performance-and-participation-of-physicians-in-year-one-of-medicare-s-value-based-payment-modifier-program
#12
Karen E Joynt Maddox, Arnold M Epstein, Lok Wong Samson, Lena M Chen
In 2015 Medicare launched the Physician Value-Based Payment Modifier program, the largest US ambulatory care pay-for-performance program to date and a precursor to the forthcoming Merit-based Incentive Payment System. In its first year, the program included practices with a hundred or more clinicians. We found that 1,010 practices met this criterion, 899 of which had at least one attributed beneficiary. Of these latter practices, 263 (29.3 percent) failed to report performance data and received a 1 percent reporting-based penalty...
December 2017: Health Affairs
https://www.readbyqxmd.com/read/29188286/association-of-dermatologist-density-with-the-volume-and-costs-of-dermatology-procedures-among-medicare-beneficiaries
#13
Sally Y Tan, Daphne Tsoucas, Arash Mostaghimi
Importance: The persistent shortage of dermatologists in the United States affects access to care and patient outcomes. Objective: To characterize the effect of geographic variations in dermatologist density on the provision of dermatology procedures within Medicare. Design, Setting, and Participants: This was a cross-sectional study using the 2013 Medicare Provider Utilization and Payment Database. Dermatology-related procedures were defined by the top 50 billing codes accounting for more than 95% of procedures billed by dermatologists...
November 29, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/29182351/the-influence-of-provider-characteristics-and-market-forces-on-response-to-financial-incentives
#14
Brock O'Neil, Mark Tyson, Amy J Graves, Daniel A Barocas, Sam S Chang, David F Penson, Matthew J Resnick
OBJECTIVES: Alternative payment models, such as accountable care organizations, use financial incentives as levers for change to facilitate the transition from volume to value. However, implementation raises concerns about adverse changes in market competition and the resultant physician response. We sought to identify physician characteristics and market-level factors associated with variation in response to financial incentives for cancer care that may ultimately be leveraged in risk-shared payment models...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29177993/classification-of-hospital-admissions-into-emergency-and-elective-care-a-machine-learning-approach
#15
Jonas Krämer, Jonas Schreyögg, Reinhard Busse
Rising admissions from emergency departments (EDs) to hospitals are a primary concern for many healthcare systems. The issue of how to differentiate urgent admissions from non-urgent or even elective admissions is crucial. We aim to develop a model for classifying inpatient admissions based on a patient's primary diagnosis as either emergency care or elective care and predicting urgency as a numerical value. We use supervised machine learning techniques and train the model with physician-expert judgments. Our model is accurate (96%) and has a high area under the ROC curve (>...
November 25, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/29153847/effect-of-incentive-payments-on-chronic-disease-management-and-health-services-use-in-british-columbia-canada-interrupted-time-series-analysis
#16
M Ruth Lavergne, Michael R Law, Sandra Peterson, Scott Garrison, Jeremiah Hurley, Lucy Cheng, Kimberlyn McGrail
We studied the effects of incentive payments to primary care physicians for the care of patients with diabetes, hypertension, and Chronic Obstructive Pulmonary Disease (COPD) in British Columbia, Canada. We used linked administrative health data to examine monthly primary care visits, continuity of care, laboratory testing, pharmaceutical dispensing, hospitalizations, and total h ealth care spending. We examined periods two years before and two years after each incentive was introduced, and used segmented regression to assess whether there were changes in level or trend of outcome measures across all eligible patients following incentive introduction, relative to pre-intervention periods...
November 10, 2017: Health Policy
https://www.readbyqxmd.com/read/29153353/-something-humane-has-been-lost-re-evaluation-of-the-attitudes-of-senior-physicians-towards-the-g-drg-system-a-qualitative-normative-analysis
#17
Marco Knoll, Ina Otte, Sabine Salloch, Caroline Ruiner, Esta Kruppa, Jochen Vollmann
Only a few years after the implementation of the G-DRG (German Diagnosis Related Group) system physicians already began to complain of its negative effects on the quality of inpatient healthcare. The present study examines the recent experiences senior physicians have made with regard to the impact of the G-DRG system on the quality of healthcare and medical professionalism. Nine qualitative guided expert interviews were conducted focusing on the experiences of physicians in leading positions dealing with the G-DRG system in their everyday work...
November 15, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/29148344/moderating-effects-of-patient-characteristics-on-the-impact-of-financial-incentives
#18
Meredith B Rosenthal, Andrea B Troxel, Kevin G Volpp, Walter F Stewart, Thomas D Sequist, James B Jones, AnneMarie G Hirsch, Karen Hoffer, Jingsan Zhu, Wenli Wang, Amanda Hodlofski, Darra Finnerty, Jack J Huang, David A Asch
While financial incentives to providers or patients are increasingly common as a quality improvement strategy, their impact on patient subgroups and health care disparities is unclear. To examine these patterns, we analyzed data from a randomized clinical trial of financial incentives to lower low-density lipoprotein (LDL) cholesterol levels in patients at risk for cardiovascular disease. Patients with higher baseline LDL experienced greater cholesterol reductions in the shared incentive arm (0.23 mg/dL per unit change in baseline LDL, 95% CI [-0...
May 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148329/the-implementation-of-performance-management-systems-in-u-s-physician-organizations
#19
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/29138742/hysterectomy-pathway-as-the-global-engine-of-practice-change-implications-for-value-in-care
#20
Amin Sanei-Moghaddam, Sharon Goughnour, Robert Edwards, John Comerci, Joseph Kelley, Nicole Donnellan, Faina Linkov, Suketu Mansuria
Introduction: In 2012, University of Pittsburgh Medical Center (UPMC) introduced a hysterectomy clinical pathway to reduce the number of total abdominal hysterectomies performed for benign gynecological indications. This study focused on exploring physician and patient factors impacting the utilization of hysterectomy clinical pathways. Methods: An online survey with 24 questions was implemented to explore physicians' attitudes and perceived barriers toward implementing the pathway...
2017: Central Asian Journal of Global Health
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