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https://www.readbyqxmd.com/read/28743173/improvement-and-persistent-disparities-in-completion-lymph-node-dissection-lessons-from-the-national-cancer-database
#1
Brian S Chu, Wima Koffi, Richard S Hoehn, Audrey Ertel, Shimul A Shah, Syed A Ahmad, Jeffrey J Sussman, Heather B Neuman, Daniel E Abbott
BACKGROUND: Completion lymph node dissection (CLND) is recommended for melanoma patients with positive sentinel lymph node biopsies (SLNB); however, 50% do not undergo CLND. We sought to determine CLND trends over time, and factors contributing to variability. METHODS: The NCDB was queried for patients undergoing wide local excision (WLE), with or without SLNB and CLND. Cohorts were created based on demographic/socioeconomic variables and era of treatment (Era 1: 2003-07, Era 2: 2008-12)...
July 25, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28742924/geocoding-to-manage-missing-data-in-a-secondary-analysis-of-community-dwelling-low-income-older-adults
#2
Kathy Wright, Shirley M Moore, Diana Lynn Morris, Susan Hazelett
Managing missing data in a secondary analysis is daunting, particularly if the data of interest were not included in the parent study design. The current study describes the use of geocoding to replace missing data from a parent study for a secondary analysis of socioeconomic and neighborhood characteristics in community-dwelling older adults who are dually eligible for Medicare and Medicaid. Geocoding was used to link participants' addresses to data from the American Community Survey to replace missing income and neighborhood data...
July 1, 2017: Research in Gerontological Nursing
https://www.readbyqxmd.com/read/28741101/bundled-payments-in-total-joint-replacement-keeping-our-care-affordable-and-high-in-quality
#3
REVIEW
Alexander S McLawhorn, Leonard T Buller
PURPOSE OF REVIEW: The purpose of this review was to evaluate the literature regarding bundle payment reimbursement models for total joint arthroplasty (TJA). RECENT FINDINGS: From an economic standpoint, TJA are cost-effective, but they represent a substantial expense to the Centers for Medicare & Medicaid Services (CMS). Historically, fee-for-service payment models resulted in highly variable cost and quality. CMS introduced Bundled Payments for Care Improvement (BPCI) in 2012 and subsequently the Comprehensive Care for Joint Replacement (CJR) reimbursement model in 2016 to improve the value of TJA from the perspectives of both CMS and patients, by improving quality via cost control...
July 24, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28740620/use-and-cost-comparison-of-clobazam-to-other-antiepileptic-drugs-for-treatment-of-lennox-gastaut-syndrome
#4
Clément François, John M Stern, Augustina Ogbonnaya, Tasneem Lokhandwala, Pamela Landsman-Blumberg, Amy Duhig, Vivienne Shen, Robin Tan
Background: Lennox-Gastaut syndrome (LGS) is a severe form of childhood-onset epilepsy associated with serious injuries due to frequent and severe seizures. Of the antiepileptic drugs (AEDs) approved for LGS, clobazam is a more recent market entrant, having been approved in October 2011. Recent AED budget impact and cost-effectiveness analyses for LGS suggest that adding clobazam to a health plan formulary may result in decreased medical costs; however, research on clinical and economic outcomes and treatment patterns with these AED treatments in LGS is limited...
2017: Journal of Market Access & Health Policy
https://www.readbyqxmd.com/read/28739479/emergency-department-visits-after-lumbar-spine-surgery-are-associated-with-lower-hcahps-scores
#5
Jay M Levin, Robert D Winkelman, Gabriel A Smith, Joseph E Tanenbaum, Roy Xiao, Thomas E Mroz, Michael P Steinmetz
BACKGROUND: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys are used to assess the quality of the patient experience following an inpatient stay. HCAHPS scores are used to determine reimbursement for hospital systems and incentivize spine surgeons nationwide. There are conflicting data detailing whether early readmission or other post-discharge complications are associated with patient responses on the HCAHPS survey. Currently, the association between post-discharge ED visits and HCAHPS scores following lumbar spine surgery is unknown...
July 21, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28739386/from-silos-to-an-innovative-health-care-delivery-and-patient-engagement-model-for-children-in-medicaid
#6
Jennifer May, Nicole Kazee, Sheila Castillo, Neil Bahroos, Scott Kennedy, Amparo Castillo, William Frese, Monika Marko-Holguin, T J Crawford, Benjamin W Van Voorhees
No abstract text is available yet for this article.
July 21, 2017: Healthcare
https://www.readbyqxmd.com/read/28738897/food-assistance-is-associated-with-decreased-nursing-home-admissions-for-maryland-s-dually-eligible-older-adults
#7
Sarah L Szanton, Laura J Samuel, Rachel Cahill, Ginger Zielinskie, Jennifer L Wolff, Roland J Thorpe, Charles Betley
BACKGROUND: Although it has long been known that a broad range of factors beyond medical diagnoses affect health and health services use, it has been unclear whether additional income can decrease health service use. We examined whether Supplemental Nutrition Assistance Program (SNAP) receipt is associated with subsequent nursing home entry among low income older adults. METHODS: We examined the 77,678 older adults dually eligible for Medicaid and Medicare in Maryland, 2010-2012...
July 24, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28738726/weighing-obligations-to-home-care-workers-and-medicaid-recipients
#8
Paul C Treacy, Douglas MacKay
In June 2016, a US Department of Labor rule extending minimum wage and overtime pay protections to home care workers such as certified nursing assistants and home health aides survived its final legal challenge and became effective. However, Medicaid officials in certain states reported that during the intervening decades when these protections were not in place, their states had developed a range of innovative services and programs providing home care to people with disabilities-services and programs that would be at risk if workers were newly owed minimum wage and overtime pay...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28738686/disparities-in-diabetes-and-hypertension-care-for-individuals-with-serious-mental-illness
#9
Junqing Liu, Jonathan Brown, Suzanne Morton, D E B Potter, Lisa Patton, Milesh Patel, Rita Lewis, Sarah Hudson Scholle
OBJECTIVES: People with serious mental illnesses (SMI), including schizophrenia, bipolar disorder, and major depression, experience early mortality, partly due to comorbid physical health conditions such as diabetes and hypertension. This study examined the quality of diabetes and hypertension care for Medicaid and Medicare enrollees with SMI. STUDY DESIGN: We conducted a retrospective analysis of medical records and claims data from 3 health plans: a Medicaid plan for disabled adults, a Medicaid plan for low-income adults, and a Special Needs Plan for individuals dually enrolled in Medicaid and Medicare...
May 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28737992/temporal-trends-in-use-of-biologic-dmards-for-rheumatoid-arthritis-in-the-united-states-a-cohort-study-of-publicly-and-privately-insured-patients
#10
Rishi J Desai, Daniel H Solomon, Yinzhu Jin, Jun Liu, Seoyoung C Kim
BACKGROUND: Ten biologic disease-modifying antirheumatic drugs (bDMARDs) are available as treatment for rheumatoid arthritis (RA), but relatively little is known about population-level time trends in the use of these agents. OBJECTIVE: To describe time trends in the use of bDMARDs in RA patients with private or public insurance in the United States. METHODS: Claims data from private (Optum Clinformatics, 2004-2015) and public (Medicaid Analytic eXtract [MAX], 2000-2010) insurance programs were used...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28737989/incremental-effect-of-the-addition-of-prescriber-restrictions-on-a-state-medicaid-s-pharmacy-only-patient-review-and-restriction-program
#11
Shellie L Keast, Timothy Pham, Ashley Teel, Nancy J Nesser
BACKGROUND: Patient review and restriction programs (PRRPs), used by state Medicaid programs to limit potential abuse and misuse of opioids and related controlled medications, often restrict members to a single pharmacy for controlled medications. While most states use a restricted pharmacy access model, not all states include restricted prescriber access. Oklahoma Medicaid (MOK) added a restricted prescriber access feature to its PRRP in July 2014. OBJECTIVE: To evaluate the incremental effect that the addition of a prescriber restriction to MOK's pharmacy-only PRRP had on the pharmacy and resource utilization of the enrolled members...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28736045/comparative-effectiveness-of-high-dose-versus-standard-dose-influenza-vaccination-on-numbers-of-us-nursing-home-residents-admitted-to-hospital-a-cluster-randomised-trial
#12
Stefan Gravenstein, H Edward Davidson, Monica Taljaard, Jessica Ogarek, Pedro Gozalo, Lisa Han, Vincent Mor
BACKGROUND: Immune responses to influenza vaccines decline with age, reducing clinical effectiveness. We compared the effect of the more immunogenic high-dose trivalent influenza vaccine with a standard-dose vaccine to identify the effect on reducing hospital admissions of nursing home residents in the USA. METHODS: We did a single-blind, pragmatic, comparative effectiveness, cluster-randomised trial with a 2 × 2 factorial design. Medicare-certified nursing homes in the USA located within 50 miles of a Centers for Disease Control and Prevention influenza reporting city were recruited, so long as the facilities were not located in a hospital, had more than 50 long-stay residents, had less than 20% of the population aged under 65 years, and were not already planning to administer the high-dose influenza vaccine to residents...
July 20, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28735693/concomitant-use-of-atypical-antipsychotics-with-other-psychotropic-medication-classes-and-the-risk-of-type-2-diabetes-mellitus
#13
Mehmet Burcu, Julie M Zito, Daniel J Safer, Laurence S Magder, Susan dosReis, Fadia T Shaya, Geoffrey L Rosenthal
OBJECTIVE: More than half of youth treated with atypical antipsychotic (AAP) medications are also treated with concomitant antidepressants or stimulants. This study assessed the association between antidepressant or stimulant use concomitant with AAPs and the risk of incident type 2 diabetes mellitus (T2DM). METHOD: Medicaid Analytic eXtract data were used to conduct a retrospective cohort study of youth (aged 5-20 years) who initiated AAP treatment. In AAP-treated youth, concomitant antidepressant (selective serotonin reuptake inhibitors [SSRI]/serotonin-norepinephrine reuptake inhibitors [SNRIs], tricyclic/other cyclic antidepressants [TCAs], and other antidepressants) or stimulant use was assessed...
August 2017: Journal of the American Academy of Child and Adolescent Psychiatry
https://www.readbyqxmd.com/read/28735567/policy-research-challenges-in-comparing-care-models-for-dual-eligible-beneficiaries
#14
Janet H Van Cleave, Brian L Egleston, Sarah Brosch, Elizabeth Wirth, Molly Lawson, Eileen M Sullivan-Marx, Mary D Naylor
Providing affordable, high-quality care for the 10 million persons who are dual-eligible beneficiaries of Medicare and Medicaid is an ongoing health-care policy challenge in the United States. However, the workforce and the care provided to dual-eligible beneficiaries are understudied. The purpose of this article is to provide a narrative of the challenges and lessons learned from an exploratory study in the use of clinical and administrative data to compare the workforce of two care models that deliver home- and community-based services to dual-eligible beneficiaries...
January 1, 2017: Policy, Politics & Nursing Practice
https://www.readbyqxmd.com/read/28734782/the-adapt-online-education-program-a-tool-for-practicing-pharmacists-delivering-patient-centered-care
#15
Leticia R Moczygemba, Andrea L Pierce, Aziza Dang, Philip Emberley, Michael J Czar, Gary R Matzke
OBJECTIVES: The ADapting pharmacists' skills and Approaches to maximize Patient's drug Therapy effectiveness (ADAPT) e-learning program was developed by a consortium of Canadian pharmacy educators and researchers to prepare practicing pharmacists for patient-centered care. We selected this education program to provide training for pharmacists as the workforce transformation component of a Center for Medicare and Medicaid Innovation project. In this report we share our experiences with this educational program...
July 19, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28732590/cost-utility-of-evaluation-for-posterior-vitreous-detachment-and-prophylaxis-of-retinal-detachment
#16
Nicolas A Yannuzzi, Jonathan S Chang, Gary C Brown, William E Smiddy
PURPOSE: To evaluate the costs and cost-utility of examination for posterior vitreous detachment (PVD) and treatment of associated pathology, and of managing various other peripheral retinal disorders to prevent retinal detachment (RD). DESIGN: A decision analysis model of cost-utility. PARTICIPANTS: There were no participants. METHODS: Published retrospective data on the natural course of PVD, retinal tears, and lattice degeneration were used to quantitate the visual benefits of examination and treatment...
July 18, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28732455/comparison-of-births-by-provider-place-and-payer-in-new-hampshire
#17
Lynette Hamlin
This study examines maternity care in a rural state by birth attendant, place of birth, and payer of birth. It is a secondary analysis of birth certificate data in New Hampshire between the years 2005 and 2012. Results revealed that in New Hampshire, the majority of births occurred in the hospital setting (98.6%). Physicians attended 75.8% of births, certified nurse midwives attended 17%, and certified professional midwives attended 1%. Medicaid coverage was the payer source for 28% of all births, compared with 44...
January 1, 2017: Policy, Politics & Nursing Practice
https://www.readbyqxmd.com/read/28731497/the-effect-of-frailty-on-short-term-outcomes-after-head-and-neck-cancer-surgery
#18
Carrie L Nieman, Karen T Pitman, Anthony P Tufaro, David W Eisele, Kevin D Frick, Christine G Gourin
OBJECTIVE: To determine the relationship between frailty and comorbidity, in-hospital mortality, postoperative complications, length of hospital stay (LOS), and costs in head and neck cancer (HNCA) surgery. STUDY DESIGN: Cross-sectional analysis. METHODS: Discharge data from the Nationwide Inpatient Sample for 159,301 patients who underwent ablative surgery for a malignant oral cavity, laryngeal, hypopharyngeal, or oropharyngeal neoplasm in 2001 to 2010 was analyzed using cross-tabulations and multivariate regression modeling...
July 21, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28730629/emergency-department-use-for-acute-rhinosinusitis-insurance-dependent-for-children-and-adults
#19
Regan W Bergmark, Stacey L Ishman, Katie M Phillips, Michael J Cunningham, Ahmad R Sedaghat
OBJECTIVES/HYPOTHESIS: Patients with Medicaid or self-pay insurance status are more likely to present to the emergency department (ED) for uncomplicated acute rhinosinusitis (ARS). Our aim was to determine if this pattern holds true for both pediatric and adult visits. STUDY DESIGN: Cross-sectional study using the 2005 to 2012 National Hospital Ambulatory Medical Care Surveys and National Ambulatory Medical Care Surveys. METHODS: We included all visits with International Classification of Diseases, Ninth Revision codes for ARS and without codes for ARS complications...
July 21, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28730279/potentially-inappropriate-antidepressant-prescriptions-among-older-adults-in-office-based-outpatient-settings-national-trends-from-2002-to-2012
#20
Taeho Greg Rhee, Jon C Schommer, Benjamin D Capistrant, Ronald L Hadsall, Donald L Uden
Using data from 2002 to 2012 National Ambulatory Medical Care Survey, we estimated that the prevalence of overall antidepressant prescriptions increased almost twofold from 5.2% in 2002 to 10.1% in 2012 in office-based outpatient visits made by older adults. In addition, older adults were exposed to the risk of potentially avoidable adverse drug events in approximately one in ten antidepressant-related visits, or 2.2 million visits annually. Amitriptyline and doxepin were the two most frequent disease-independent potentially inappropriate antidepressants...
July 20, 2017: Administration and Policy in Mental Health
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