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https://www.readbyqxmd.com/read/28938394/risk-factors-for-failure-of-bone-grafting-of-tibia-nonunions-and-segmental-bone-defects-a-new-preoperative-risk-assessment-score
#1
Michael A Maceroli, Mark J Gage, Brent T Wise, Daniel Connelly, Katherine Ordonio, Renan C Castillo, Molly P Jarman, Jason W Nascone, Robert V OʼToole, Marcus F Sciadini
OBJECTIVE: To develop a clinically useful prediction model of success at the time of surgery to promote bone healing for established tibial nonunion or traumatic bone defects. DESIGN: Retrospective case controlled. SETTING: Level 1 trauma center. PATIENTS: Adult patients treated with surgery for established tibia fracture nonunion or traumatic bone defects from 2007 to 2016. Two hundred three patients met the inclusion criteria and were available for final analysis...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28937935/the-impact-of-the-2006-massachusetts-health-care-reform-law-on-spine-surgery-patient-payer-mix-status-and-age
#2
Nicolas W Villelli, Hong Yan, Jian Zou, Nicholas M Barbaro
OBJECTIVE Several similarities exist between the Massachusetts health care reform law of 2006 and the Affordable Care Act (ACA). The authors' prior neurosurgical research showed a decrease in uninsured surgeries without a significant change in surgical volume after the Massachusetts reform. An analysis of the payer-mix status and the age of spine surgery patients, before and after the policy, should provide insight into the future impact of the ACA on spine surgery in the US. METHODS Using the Massachusetts State Inpatient Database and spine ICD-9-CM procedure codes, the authors obtained demographic information on patients undergoing spine surgery between 2001 and 2012...
September 15, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28937934/an-evaluation-of-new-york-city-s-2015-birth-certificate-gender-marker-regulation
#3
Erica J Lee, Danielle Gurr, Gretchen Van Wye
PURPOSE: In 1971, the New York City (NYC) Department of Health and Mental Hygiene amended Section 207.05 of the NYC Health Code to allow individuals who had undergone "convertive surgery" (interpreted by the code to mean genital surgery) to amend the gender on their birth certificates. This surgery requirement was removed in 2015. In a survey evaluating the regulation change, we sought to characterize the transgender population newly eligible to obtain a gender-congruent NYC birth certificate by comparing respondents with and without genital surgery...
September 22, 2017: LGBT Health
https://www.readbyqxmd.com/read/28937931/design-and-development-of-a-mobile-exercise-application-for-home-care-aides-and-older-adult-medicaid-home-and-community-based-clients
#4
Margaret Danilovich, Laura Diaz, Gustavo Saberbein, William Healey, Gail Huber, Daniel Corcos
We describe a community-engaged approach with Medicaid Home and Community-Based Services (HCBS) home care aide (HCA), client, and physical therapist stakeholders to develop a mobile application (app) exercise intervention through focus groups and interviews. Participants desired a short exercise program with modification capabilities, goal setting, and mechanisms to track progress. Concerns regarding participation were training needs and feasibility within usual care services. Technological preferences were for simple, easy-to-use, and engaging content...
September 22, 2017: Home Health Care Services Quarterly
https://www.readbyqxmd.com/read/28937800/when-is-neuropsychological-testing-medically-necessary-for-children-on-medicaid-in-new-mexico
#5
Noah K Kaufman, Carola Mullins, Andrew S Davis, Silvina Tonarelli, Hugo Sandoval, Luis Ramos-Duran
Healthcare for poor children, also known as Medicaid, is disproportionately relied upon by citizens of poor states such as New Mexico, where (a) there are more unintended pregnancies, (b) domestic violence during and after pregnancies occurs with regularity, (c) youth substance use is much more common, (d) crime rates are some of the worst in the country, (e) many never graduate from high school, and (f) incarceration is often inevitable. Yet, there is a dearth of research into the neuropsychological health of these children...
September 22, 2017: Applied Neuropsychology. Child
https://www.readbyqxmd.com/read/28935515/template-for-an-antibiotic-stewardship-policy-for-post-acute-and%C3%A2-long-term-care-settings
#6
Robin L P Jump, Swati Gaur, Morgan J Katz, Christopher J Crnich, Ghinwa Dumyati, Muhammad S Ashraf, Elizabeth Frentzel, Steven J Schweon, Philip Sloane, David Nace
In response to a rising concern for multidrug resistance and Clostridium difficile infections, the Centers for Medicare and Medicaid services (CMS) will require all long-term care (LTC) facilities to establish an antibiotic stewardship program by November 2017. Thus far, limited evidence describes implementation of antibiotic stewardship in LTC facilities, mostly in academic- or hospital-affiliated settings. To support compliance with CMS requirements and aid facilities in establishing a stewardship program, the Infection Advisory Committee at AMDA-The Society for Post-Acute and Long-Term Care Medicine, has developed an antibiotic stewardship policy template tailored to the LTC setting...
September 18, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28935442/what-are-patient-navigators-doing-for-whom-and-where-a-national-survey-evaluating-the-types-of-services-provided-by-patient-navigators
#7
Kristen J Wells, Patricia Valverde, Amy E Ustjanauskas, Elizabeth A Calhoun, Betsy C Risendal
OBJECTIVE: A nationwide cross-sectional study was conducted to assess patient navigator, patient population, and work setting characteristics associated with performance of various patient navigation (PN) tasks. METHODS: Using respondent-driven sampling, 819 navigators completed a survey assessing frequency of providing 83 PN services, along with information about themselves, populations they serve, and setting in which they worked. Analyses of variance and Pearson correlations were conducted to determine differences and associations in frequency of PN services provided by various patient, navigator, and work setting characteristics...
August 31, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28934777/effectiveness-of-thermal-annular-procedures-in-treating-discogenic-low-back-pain
#8
Standiford Helm Ii, Thomas T Simopoulos, Milan Stojanovic, Salahadin Abdi, Mohamed Ahamed El Terany
BACKGROUND: Discogenic low back is a distinct clinic entity characterized by pain arising from a damaged disc. The diagnosis is clouded by the controversy surrounding discography. The treatment options are limited, with unsatisfactory results from both conservative treatment and surgery. Multiple interventional therapies have been developed to treat discogenic pain, but most have not yet been validated by high quality studies.The best studied treatment for discogenic pain is the use of heat, which has been labeled as thermal intradiscal procedures (TIPs) by the Centers for Medicare and Medicaid Services (CMS)...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28933932/enrollment-in-california-s-medicaid-program-after-the-affordable-care-act-expansion
#9
Jing Wang, Amal N Trivedi
OBJECTIVES: To determine enrollment rates and predictors of enrollment for newly eligible low-income adults in California following the Affordable Care Act's (ACA's) Medicaid expansion. METHODS: We used data from the 2014 to 2015 California Health Interview Survey to examine post-ACA Medicaid enrollment rates and multivariable logistic regression to assess the association of demographic factors, income, and health with enrollment. RESULTS: We found a 78...
September 21, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28933204/healthcare-utilization-and-direct-costs-of-non-infectious-comorbidities-in-hiv-infected-patients-in-the-usa
#10
Joel Gallant, Priscilla Hsue, David Budd, Nicole Meyer
OBJECTIVE: To estimate the incremental healthcare utilization and costs associated with common non-infectious comorbid conditions among commercially and Medicaid-insured HIV-infected patients in the US. METHODS: US administrative claims were used to select adult HIV patients with chronic kidney disease (CKD), cardiovascular disease (CVD) events, or fracture/osteoporosis, three common comorbidities that have been associated with HIV and HIV treatment, between 01/012004 and 06/30/2013...
September 21, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28930833/readmission-due-to-infection-following-total-hip-and-total-knee-procedures-a-retrospective-study
#11
Nadine Zawadzki, Yao Wang, Hui Shao, Emelline Liu, Chao Song, Michele Schoonmaker, Lizheng Shi
Policymakers have expanded readmissions penalty programs to include elective arthroplasties, but little is known about the risk factors for readmissions following these procedures. We hypothesized that infections after total hip arthroplasty (THA) and total knee arthroplasty (TKA) lead to excess readmissions and increased costs. This study aims to evaluate the proportion of readmissions due to infections following THA and TKA.Healthcare Cost and Utilization Project-State Inpatient Databases were used for the study...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28930763/a-new-community-health-center-academic-medicine-partnership-for-medicaid-cost-control-powered-by-the-mega-teaching-health-center
#12
Richard E Rieselbach, Ted Epperly, Aaron Friedman, David Keahey, Eleanor McConnell, Karen Nichols, Greg Nycz, Jeanette Roberts, Kenneth Schmader, Peter Shin, Derri Shtasel
Community health centers (CHCs), a principal source of primary care for over 24 million patients, provide high-quality affordable care for medically underserved and lower-income populations in urban and rural communities. The authors propose that CHCs can assume an important role in the quest for health care reform by serving substantially more Medicaid patients. Major expansion of CHCs, powered by mega teaching health centers (THCs) in partnership with regional academic medical centers (AMCs) or teaching hospitals, could increase Medicaid beneficiaries' access to cost-effective care...
September 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28929700/extending-the-children%C3%A2-s-health-insurance-program-high-stakes-for-families-and-states
#13
Sara Rosenbaum, Rachel Gunsalus, Sara Rothenberg, Sara Schmucker
Issue: Congress must decide whether to extend federal funding authority for the Children’s Health Insurance Program (CHIP), which ends September 30, 2017. CHIP operates much like Medicaid, providing federal matching payments for state program expenses, although CHIP’s funding rate is higher than the federal rate paid for traditional Medicaid and was further enhanced under the Affordable Care Act. States can use their CHIP funds to expand Medicaid, operate separate CHIP programs, or combine the two approaches...
September 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28929296/foster-care-involvement-among-medicaid-enrolled-children-with-autism
#14
Zuleyha Cidav, Ming Xie, David S Mandell
The prevalence and risk of foster care involvement among children with autism spectrum disorder (ASD) relative to children with intellectual disability (ID), children with ASD and ID, and typically developing children were examined using 2001-2007 Medicaid data. Children were followed up to the first foster care placement or until the end of 2007; a discrete time logistic regression analysis was conducted. Both the prevalence and risk of foster care involvement were greatest for children with ASD, and the prevalence increased substantially over the study period among children with ASD...
September 19, 2017: Journal of Autism and Developmental Disorders
https://www.readbyqxmd.com/read/28929269/behavioral-health-integration-in-health-care-settings-lessons-learned-from-a-pediatric-hospital-primary-care-system
#15
Leandra Godoy, Melissa Long, Donna Marschall, Stacy Hodgkinson, Brooke Bokor, Hope Rhodes, Howard Crumpton, Mark Weissman, Lee Beers
Behavioral health integration within primary care has been evolving, but literature traditionally focuses on smaller scale efforts. We detail how behavioral health has been integrated across a large, urban pediatric hospital system's six primary care clinics (serving over 35,000 children annually and insured predominately through Medicaid) and discuss strategies for success in sustaining and expanding efforts to achieve effective integration of behavioral health into primary care. In a time span of 3 years, the clinics have implemented routine, universal behavioral health screening at well child visits, participated in a 15-month behavioral health screening quality improvement learning collaborative, and integrated the work of psychologists and psychiatrists...
September 19, 2017: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/28928288/association-between-insurance-and-transfer-of-injured-children-from-emergency-departments
#16
Yunru Huang, Jamie L Kissee, Parul Dayal, Nancy Ewen Wang, Ilana S Sigal, James P Marcin
OBJECTIVES: To determine if injured children presenting to nondesignated trauma centers are more or less likely to be transferred relative to being admitted based on insurance status. METHODS: We conducted a cross-sectional study by using the Healthcare Cost and Utilization Project Nationwide Emergency Department Sample. Pediatric trauma patients receiving care in emergency departments (EDs) at nontrauma centers who were either admitted locally or transferred to another hospital were included...
September 19, 2017: Pediatrics
https://www.readbyqxmd.com/read/28928117/risk-factors-for-severe-hypoglycemia-in-black-and-white-adults-with-diabetes-the-atherosclerosis-risk-in-communities-aric-study
#17
Alexandra K Lee, Clare J Lee, Elbert S Huang, A Richey Sharrett, Josef Coresh, Elizabeth Selvin
OBJECTIVE: Severe hypoglycemia is a rare but important complication of type 2 diabetes. Few studies have examined the epidemiology of hypoglycemia in a community-based population. RESEARCH DESIGN AND METHODS: We included 1,206 Atherosclerosis Risk in Communities (ARIC) Study participants with diagnosed diabetes (baseline, 1996-1998). Severe hypoglycemic events were identified through 2013 by ICD-9 codes from claims for hospitalizations, emergency department visits, and ambulance use...
September 19, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28927567/discriminative-ability-of-elixhauser-s-comorbidity-measure-is-superior-to-other-comorbidity-scores-for-inpatient-adverse-outcomes-after-total-hip-arthroplasty
#18
Nathaniel T Ondeck, Daniel D Bohl, Patawut Bovonratwet, Ryan P McLynn, Jonathan J Cui, Jonathan N Grauer
BACKGROUND: Identifying patients at highest risk for a complex perioperative course following total hip arthroplasty (THA) is more important than ever in order to educate patients, optimize outcomes, and to minimize cost and length of stay. There are no known studies comparing the clinically relevant discriminative ability of 3 commonly used comorbidity indices for adverse outcomes following THA: Elixhauser Comorbidity Measure (ECM), the Charlson Comorbidity Index (CCI), and the modified Frailty Index (mFI)...
September 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28926499/sharing-clinical-notes-with-patients
#19
Catherine T Fant, Deborah S Adelman
Patient portals are access points to patient information, meeting Centers for Medicare and Medicaid Services incentives. Providing patients with access to clinical notes has garnered positive feedback with few concerns. This article addresses the latest literature on patient access to clinical notes and offers suggestions for NPs in their use.
October 18, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28919292/treatment-patterns-health-care-resource-utilization-and-spending-in-medicaid-beneficiaries-initiating-second-generation-long-acting-injectable-agents-versus-oral-atypical-antipsychotics
#20
Dominic Pilon, Neeta Tandon, Marie-Hélène Lafeuille, Rhiannon Kamstra, Bruno Emond, Patrick Lefebvre, Kruti Joshi
PURPOSE: Second-generation long-acting injectable therapies (SGA-LAIs) may reduce health care resource utilization (HRU) and health care costs compared with daily oral atypical antipsychotics (OAAs) in patients with schizophrenia due to reduced dosing frequency, delivery/monitoring by a health care provider, and improved adherence. The aim of the present study was to compare treatment patterns, HRU, and Medicaid spending in patients with schizophrenia initiated on SGA-LAIs (overall and according to agent) versus OAAs...
September 14, 2017: Clinical Therapeutics
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