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https://www.readbyqxmd.com/read/28226336/educational-outreach-to-opioid-prescribers-the-case-for-academic-detailing
#1
Margot Trotter Davis, Brian Bateman, Jerry Avorn
Nonmedical use of opioid medications constitutes a serious health threat as the rates of addiction, overdoses, and deaths have risen in recent years. Increasingly, inappropriate and excessively liberal prescribing of opioids by physicians is understood to be a central part of the crisis. Public health officials, hospital systems, and legislators are developing programs and regulations to address the problem in sustained and systematic ways that both insures effective treatment of pain and appropriate limits on the availability of opioids...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28226301/the-influence-of-welfare-systems-on-pay-for-performance-programs-for-general-practitioners-a-critical-review
#2
REVIEW
Mehdi Ammi, Grant Fortier
While pay-for-performance (P4P) programs are increasingly common tools used to foster quality and efficiency in primary care, the evidence concerning their effectiveness is at best mixed. In this article, we explore the influence of welfare systems on four P4P-related dimensions: the level of healthcare funders' commitment to P4Ps (by funding and length of program operation), program design (specifically target-based vs. participation-based program), physicians' acceptance of the program and program effects...
February 16, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28221895/use-of-evidence-based-prostate-cancer-imaging-in-a-nongovernmental-integrated-health-care-system
#3
Ramzi G Salloum, Maureen O'Keeffe-Rosetti, Debra P Ritzwoller, Mark C Hornbrook, Jennifer Elston Lafata, Matthew E Nielsen
PURPOSE: The overuse of imaging, particularly for staging of low-risk prostate cancer, is well documented and widespread. The existing literature, which focuses on the elderly in fee-for-service settings, points to financial incentives as a driver of overuse and may not identify factors relevant to policy solutions within integrated health care systems, where physicians are salaried. METHODS: Imaging rates were analyzed among men with incident prostate cancer diagnosed between 2004 and 2011 within the Colorado and Northwest regions of Kaiser Permanente...
February 21, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28212657/pharmacists-views-and-reported-practices-in-relation-to-a-new-generic-drug-substitution-policy-in-lebanon-a-mixed-methods-study
#4
Fadi El-Jardali, Racha Fadlallah, Rami Z Morsi, Nour Hemadi, Mounir Al-Gibbawi, Magda Haj, Suzan Khalil, Youssef Saklawi, Diana Jamal, Elie A Akl
BACKGROUND: Governments in both developed and developing countries have adopted generic drug substitution policies to decrease pharmaceutical expenditures and improve access to medicine. In August 2015, the Ministry of Public Health (MOPH) in Lebanon introduced generic drug substitution and a unified medical prescription form as policy instruments to promote generic drug use. The objective of this exploratory study was to examine the attitudes of community pharmacists and the reported practices in relation to the implementation of the new generic drug substitution policy...
February 17, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28196461/national-rates-and-patterns-of-depression-screening-in-primary-care-results-from-2012-and-2013
#5
Ayse Akincigil, Elizabeth B Matthews
OBJECTIVES: Despite high prevalence rates of depression in primary care, depressive symptoms are often undetected by physicians. Screening for depression is now recommended as a part of routine primary care; however, recent estimates of rates and patterns of depression screening are lacking in the literature. This study examined national rates and patterns of depression screening among visits to office-based primary care physicians. METHODS: A secondary analysis of data from the 2012 and 2013 National Ambulatory Medical Care Survey was conducted...
February 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28196448/provider-perspectives-on-advance-care-planning-documentation-in-the-electronic-health-record
#6
Ellis Dillon, Judith Chuang, Atul Gupta, Sharon Tapper, Steve Lai, Peter Yu, Christine Ritchie, Ming Tai-Seale
CONTEXT: Advance care planning (ACP) is valued by patients and clinicians, yet documenting ACP in an accessible manner is problematic. OBJECTIVES: In order to understand how providers incorporate electronic health record (EHR) ACP documentation into clinical practice, we interviewed providers in primary care and specialty departments about ACP practices (n = 13) and analyzed EHR data on 358 primary care providers (PCPs) and 79 specialists at a large multispecialty group practice...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28167594/incidences-and-costs-of-illness-for-diarrhea-and-acute-respiratory-infections-for-children-5-years-of-age-in-rural-bangladesh
#7
Amal K Halder, Stephen P Luby, Shamima Akhter, Probir K Ghosh, Richard B Johnston, Leanne Unicomb
Understanding illness costs associated with diarrhea and acute respiratory infections (ARI) could guide prevention and treatment strategies. This study aimed to determine incidence of childhood diarrhea and ARI and costs of homecare, hospitalization, and outpatient treatment by practitioner type in rural Bangladesh. From each of 100 randomly selected population clusters we sampled 17 households with at least one child < 5 years of age. Childhood diarrhea incidence was 3,451 and ARI incidence was 5,849/1,000 child-years...
February 6, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28156512/a-cluster-randomized-trial-of-a-patient-centered-communication-intervention-in-advanced-cancer-the-values-and-options-in-cancer-care-voice-study
#8
Richard L Kravitz, Paul Duberstein, Daniel J Tancredi, Guibo Xing, Ronald M Epstein
: 2 Background: Observational studies demonstrate links between patient-centered communication, prognosis discordance, quality of life (QoL) and aggressive treatments near the end of life, yet there are few randomized evaluations of communication interventions in advanced cancer. METHODS: We completed a cluster randomized controlled trial in cancer clinics in Western NY and Northern CA with medical oncologists (n = 38 randomized to intervention or control) and their community-dwelling adult patients with advanced non-hematologic cancer (n = 265; 194 with enrolled caregivers)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28155754/-objectives-hospital-at-home-hah-care-is-becoming-increasingly-popular-in-france-and-requires-the-involvement-of-general-practitioners-gps-in-the-care-of-their-patients-the-objective-of-this-study-was-to-identify-the-incentives-and-barriers-to-the-involvement
#9
https://www.readbyqxmd.com/read/28152827/changing-physician-compensation-and-implementing-new-technology-to-enhance-pathways-compliance
#10
John Russell Hoverman, Nate Gosse, Marcus A Neubauer, Vanessa Torres
: 187 Background: Pathways have shown to decrease cost of care while maintaining efficacy of treatment. In 2005, The US Oncology Network, which includes Texas Oncology, P.A. (TOPA) developed physician-led clinical pathways based on national guidelines, cost and efficacy. This abstract reviews the impact of changes TOPA initiated to improve pathway compliance Methods: Since 2011, TOPA has assessed pathways compliance using the iKnowMed (iKM) electronic medical record. Individual compliance was reported to each physician, but no incentives were tied to this...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28133401/physician-agency-and-patient-survival
#11
Mireille G Jacobson, Tom Y Chang, Craig C Earle, Joseph P Newhouse
We investigate the role of physician agency in determining health care supply and patient outcomes. We show that an increase in health care supply due to a change in private physician incentives has a theoretically ambiguous impact on patient welfare. The increase can reflect either induced demand for ineffective care or a reduction in prior rationing of effective care. Furthermore, physician market structure matters in determining the welfare effects of changes in private physician incentives. We then analyze a change to Medicare fees that caused physicians to increase their provision of chemotherapy...
February 2017: Journal of Economic Behavior & Organization
https://www.readbyqxmd.com/read/28132998/end-of-life-care-bonus-promoting-end-of-life-care-in-nursing-homes-an-11-year-retrospective-longitudinal-prefecture-wide-study-in-japan
#12
Sho Nishiguchi, Nagisa Sugaya, Kentaro Sakamaki, Shunsaku Mizushima
The end-of-life (EOL) care bonus introduced by the Japanese government works as a financial incentive and framework of quality preservation, including advance care planning, for EOL care among nursing home residents. This study aims to clarify the effects of the EOL care bonus in promoting EOL care in nursing homes. A longitudinal observational study using a questionnaire was conducted. We invited 378 nursing homes in Kanagawa prefecture in Japan, a region with a rapidly aging population, to participate in the study...
January 30, 2017: Bioscience Trends
https://www.readbyqxmd.com/read/28131024/-too-much-medicine-insights-and-explanations-from-economic-theory-and-research
#13
Martin Hensher, John Tisdell, Craig Zimitat
Increasing attention has been paid in recent years to the problem of "too much medicine", whereby patients receive unnecessary investigations and treatments providing them with little or no benefit, but which expose them to risks of harm. Despite this phenomenon potentially constituting an inefficient use of health care resources, it has received limited direct attention from health economists. This paper considers "too much medicine" as a form of overconsumption, drawing on research from health economics, behavioural economics and ecological economics to identify possible explanations for and drivers of overconsumption...
January 18, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28127752/malpractice-claim-fears-and-the-costs-of-treating-medicare-patients-a-new-approach-to-estimating-the-costs-of-defensive-medicine
#14
James D Reschovsky, Cynthia B Saiontz-Martinez
OBJECTIVE: To estimate the cost of defensive medicine among elderly Medicare patients. DATA SOURCES: We use a 2008 national physician survey linked to respondents' elderly Medicare patients' claims data. STUDY DESIGN: Using a sample of survey respondent/beneficiary dyads stratified by physician specialty, we estimated cross-sectional regressions of annual costs on patient covariates and a medical malpractice fear index formed from five validated physician survey questions...
January 26, 2017: Health Services Research
https://www.readbyqxmd.com/read/28125364/improving-oncology-quality-measurement-in-accountable-care-filling-gaps-with-cross-cutting-measures
#15
Tom Valuck, David Blaisdell, Donna P Dugan, Kimberly Westrich, Robert W Dubois, Robert S Miller, Mark McClellan
: Payment for health care services, including oncology services, is shifting from volume-based fee-for-service to value-based accountable care. The objective of accountable care is to support providers with flexibility and resources to reform care delivery, accompanied by accountability for maintaining or improving outcomes while lowering costs. These changes depend on health care payers, systems, physicians, and patients having meaningful measures to assess care delivery and outcomes and to balance financial incentives for lowering costs while providing greater value...
February 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28114600/the-effects-of-pay-for-performance-programs-on-health-health-care-use-and-processes-of-care-a-systematic-review
#16
Aaron Mendelson, Karli Kondo, Cheryl Damberg, Allison Low, Makalapua Motu'apuaka, Michele Freeman, Maya O'Neil, Rose Relevo, Devan Kansagara
Background: The benefits of pay-for-performance (P4P) programs are uncertain. Purpose: To update and expand a prior review examining the effects of P4P programs targeted at the physician, group, managerial, or institutional level on process-of-care and patient outcomes in ambulatory and inpatient settings. Data Sources: PubMed from June 2007 to October 2016; MEDLINE, PsycINFO, CINAHL, Business Economics and Theory, Business Source Elite, Scopus, Faculty of 1000, and Gartner Research from June 2007 to February 2016...
January 10, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28095788/are-interventions-to-increase-the-uptake-of-screening-for-cardiovascular-disease-risk-factors-effective-a-systematic-review-and-meta-analysis
#17
A T Cheong, S M Liew, E M Khoo, N F Mohd Zaidi, K Chinna
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death globally. However, many individuals are unaware of their CVD risk factors. The objective of this systematic review is to determine the effectiveness of existing intervention strategies to increase uptake of CVD risk factors screening. METHODS: A systematic search was conducted through Pubmed, CINAHL, EMBASE and Cochrane Central Register of Controlled Trials. Additional articles were located through cross-checking of the references list and bibliography citations of the included studies and previous review papers...
January 17, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28072793/merit-based-incentive-payment-system-meaningful-changes-in-the-final-rule-brings-cautious-optimism
#18
Laxmaiah Manchikanti, Standiford Helm Ii, Aaron K Calodney, Joshua A Hirsch
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) eliminated the flawed Sustainable Growth Rate (SGR) act formula - a longstanding crucial issue of concern for health care providers and Medicare beneficiaries. MACRA also included a quality improvement program entitled, "The Merit-Based Incentive Payment System, or MIPS." The proposed rule of MIPS sought to streamline existing federal quality efforts and therefore linked 4 distinct programs into one. Three existing programs, meaningful use (MU), Physician Quality Reporting System (PQRS), value-based payment (VBP) system were merged with the addition of Clinical Improvement Activity category...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28070707/value-based-assessment-of-radiology-reporting-using-radiologist-referring-physician-two-way-feedback-system-a-design-thinking-based-approach
#19
Faiq Shaikh, Kenneth Hendrata, Brian Kolowitz, Omer Awan, Rasu Shrestha, Christopher Deible
In the era of value-based healthcare, many aspects of medical care are being measured and assessed to improve quality and reduce costs. Radiology adds enormously to health care costs and is under pressure to adopt a more efficient system that incorporates essential metrics to assess its value and impact on outcomes. Most current systems tie radiologists' incentives and evaluations to RVU-based productivity metrics and peer-review-based quality metrics. In a new potential model, a radiologist's performance will have to increasingly depend on a number of parameters that define "value," beginning with peer review metrics that include referrer satisfaction and feedback from radiologists to the referring physician that evaluates the potency and validity of clinical information provided for a given study...
January 9, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/28062017/non-invasive-prenatal-testing-and-the-unveiling-of-an-impaired-translation-process
#20
Blake Murdoch, Vardit Ravitsky, Ubaka Ogbogu, Sarah Ali-Khan, Gabrielle Bertier, Stanislav Birko, Tania Bubela, Jeremy De Beer, Charles Dupras, Meika Ellis, Palmira Granados Moreno, Yann Joly, Kalina Kamenova, Zubin Master, Alessandro Marcon, Mike Paulden, François Rousseau, Timothy Caulfield
Non-invasive prenatal testing (NIPT) is an exciting technology with the potential to provide a variety of clinical benefits, including a reduction in miscarriages, via a decline in invasive testing. However, there is also concern that the economic and near-future clinical benefits of NIPT have been overstated and the potential limitations and harms underplayed. NIPT, therefore, presents an opportunity to explore the ways in which a range of social pressures and policies can influence the translation, implementation, and use of a health care innovation...
January 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
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