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https://www.readbyqxmd.com/read/29769026/cost-effectiveness-of-a-multicomponent-primary-care-program-targeting-frail-elderly-people
#1
Franca G H Ruikes, Eddy M Adang, Willem J J Assendelft, Henk J Schers, Raymond T C M Koopmans, Sytse U Zuidema
BACKGROUND: Over the last 20 years, integrated care programs for frail elderly people aimed to prevent functional dependence and reduce hospitalization and institutionalization. However, results have been inconsistent and merely modest. To date, evidence on the cost-effectiveness of these programs is scarce. We evaluated the cost-effectiveness of the CareWell program, a multicomponent integrated care program for frail elderly people. METHODS: Economic evaluation from a healthcare perspective embedded in a cluster controlled trial of 12 months in 12 general practices in (the region of) Nijmegen...
May 16, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29764796/predicting-the-reasons-of-customer-complaints-a-first-step-toward-anticipating-quality-issues-of-in-vitro-diagnostics-assays-with-machine-learning
#2
Stephane Aris-Brosou, James Kim, Li Li, Hui Liu
BACKGROUND: Vendors in the health care industry produce diagnostic systems that, through a secured connection, allow them to monitor performance almost in real time. However, challenges exist in analyzing and interpreting large volumes of noisy quality control (QC) data. As a result, some QC shifts may not be detected early enough by the vendor, but lead a customer to complain. OBJECTIVE: The aim of this study was to hypothesize that a more proactive response could be designed by utilizing the collected QC data more efficiently...
May 15, 2018: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29764330/factors-influencing-the-provision-of-fertility-counseling-and-impact-on-quality-of-life-in-adolescents-and-young-adults-with-cancer
#3
Gemma Skaczkowski, Victoria White, Kate Thompson, Helen Bibby, Michael Coory, Lisa M Orme, Rachel Conyers, Marianne B Phillips, Michael Osborn, Rosemary Harrup, Antoinette Anazodo
PURPOSE: This study investigated the impact of fertility-related discussions on Adolescent and Young Adult (AYA) cancer patients' quality of life (QoL) and the factors influencing provision of these discussions. METHODS: Recruitment was conducted through population-based state cancer registries. Eligible AYAs were 15-24 years at diagnosis, 3-24 months postdiagnosis, with any cancer (except early stage melanoma). As part of a larger survey, AYAs were asked about their experiences of fertility-related discussions and QoL (FACT-G)...
May 15, 2018: Journal of Psychosocial Oncology
https://www.readbyqxmd.com/read/29759285/value-proposition-and-anesthesiology
#4
REVIEW
Joseph W Szokol, Keith J Chamberlin
Health care in general and anesthesia in particular have seen dramatic changes in the economic landscape. It is vital if anesthesia groups wish to survive and prosper in this new environment to understand the changes occurring in health care and be flexible and proactive in taking on these challenges. More than ever anesthesia groups must be good corporate citizens and seek ways in which to enhance their value to the organization, whether in the operating room or out of operating room locations, and be a proactive partner with the hospital...
June 2018: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29757929/transitioning-bodies-the-case-of-self-prescribing-sexual-hormones-in-gender-affirmation-in-individuals-attending-psychiatric-services
#5
Antonio Metastasio, Attilio Negri, Giovanni Martinotti, Ornella Corazza
Self-prescribing of sexual hormones for gender affirmation is a potentially widespread and poorly studied phenomenon that many clinicians are unaware of. The uncontrolled use of hormones poses significant health hazards, which have not been previously reported in the literature. We have collected seven clinical cases in general adult psychiatry settings (both inpatient and outpatients), describing transgender and gender non-conforming individuals' (TGNC) self-prescribing and self-administering hormones bought from the Internet without any medical consultation...
May 14, 2018: Brain Sciences
https://www.readbyqxmd.com/read/29756676/impact-of-serious-mental-illness-on-surgical-patient-outcomes
#6
Kate E McBride, Michael J Solomon, Jane M Young, Daniel Steffens, Tim J Lambert, Nick Glozier, Paul G Bannon
BACKGROUND: People with comorbid mental illness have poorer health status and disparate access to healthcare. Several studies internationally have reported mixed findings regarding the association between mental illness and surgical patient outcomes. This study examines the surgical outcomes in people with decompensated serious mental illness (SMI) within the setting of the Australian universal healthcare system. METHODS: Retrospective cohort study involving elective overnight surgical patients aged 18 years and above who attended a large public tertiary referral hospital in Sydney, Australia, between 2010 and 2014...
May 14, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29743230/proactive-strategies-to-address-health-equity-and-disparities-recommendations-from-a-bi-national-symposium
#7
Jeannie Haggerty, Marshall H Chin, Alan Katz, Kue Young, Jonathan Foley, Antoine Groulx, Eliseo J Pérez-Stable, Jeff Turnbull, Jennifer E DeVoe, Uche Uchendo
INTRODUCTION: Health inequities persist in Canada and the United States. Both countries show differential health status and health care quality by social characteristics, making zip or postal code a greater predictor of health than genetics. Many social determinants of health overlap in the same individuals or communities, exacerbating their vulnerability. Many of the contributing factors and problems are structural and evade simple solutions. METHODS: In March 2017 a binational Canada-US symposium was held in Washington DC involving 150 primary care thought leaders, including clinicians, researchers, patients, and policy makers to address transformation in integrated primary care...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29743033/knowledge-practices-and-expectations-of-preventive-care-a-qualitative-study-of-patients-attending-government-general-outpatient-clinics-in-hong-kong
#8
Denise Y S Tam, Yvonne Y C Lo, Wendy Tsui
BACKGROUND: Evidence-based preventive care recommendations have been well established, but studies have persistently reported gaps between these recommendations and general practitioners' practices in providing preventive care. Many studies have explored factors that affect the delivery of preventive care from the perspectives of the practitioners, but relatively few have evaluated the patients' point of view. The purpose of this study was to explore patients' understanding of preventive care, the actions they were taking in terms of preventive health and their expectations from family doctors in providing preventive care...
May 9, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29743030/keys-to-success-of-a-community-of-clinical-practice-in-primary-care-a-qualitative-evaluation-of-the-ecopih-project
#9
David Lacasta Tintorer, Josep Maria Manresa Domínguez, Enriqueta Pujol-Rivera, Souhel Flayeh Beneyto, Xavier Mundet Tuduri, Francesc Saigí-Rubió
BACKGROUND: The current reality of primary care (PC) makes it essential to have telemedicine systems available to facilitate communication between care levels. Communities of practice have great potential in terms of care and education, and that is why the Online Communication Tool between Primary and Hospital Care was created. This tool enables PC and non-GP specialist care (SC) professionals to raise clinical cases for consultation and to share information. The objective of this article is to explore healthcare professionals' views on communities of clinical practice (CoCPs) and the changes that need to be made in an uncontrolled real-life setting after more than two years of use...
May 9, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29739735/effectiveness-of-a-blended-multidisciplinary-intervention-for-patients-with-moderate-medically-unexplained-physical-symptoms-parasol-protocol-for-a-cluster-randomized-clinical-trial
#10
Paula Elisabeth van Westrienen, Martijn F Pisters, Suze Aj Toonders, Marloes Gerrits, Cindy Veenhof, Niek J de Wit
BACKGROUND: Medically unexplained physical symptoms are an important health problem in primary care, with a spectrum from mild to chronic. The burden of chronic medically unexplained physical symptoms is substantial for patients, health care professionals, and society. Therefore, early identification of patients with moderate medically unexplained physical symptoms is needed in order to prevent chronicity. The preventive screening of medically unexplained physical symptoms (PRESUME) screening method was developed using data from the electronic medical record of the patients' general practitioner and demonstrated its prognostic accuracy to identify patients with moderate medically unexplained physical symptoms...
May 8, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29735931/the-delivery-of-health-promotion-and-environmental-health-services-public-health-or-primary-care-settings
#11
Lene Bjørn Jensen, Irena Lukic, Gabriel Gulis
The WHO Regional Office for Europe developed a set of public health functions resulting in the ten Essential Public Health Operations (EPHO). Public health or primary care settings seem to be favorable to embrace all actions included into EPHOs. The presented paper aims to guide readers on how to assign individual health promotion and environmental health services to public health or primary care settings. Survey tools were developed based on EPHO 2, 3 and 4; there were six key informant surveys out of 18 contacted completed via e-mails by informants working in Denmark on health promotion and five face-to-face interviews were conducted in Australia (Melbourne and Victoria state) with experts from environmental health, public health and a physician...
May 7, 2018: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/29733102/breastfeeding-and-risk-for-ceasing-in-mothers-of-preterm-infants-long-term-follow-up
#12
Jenny Ericson, Mats Eriksson, Pat Hoddinott, Lena Hellström-Westas, Renée Flacking
Breastfeeding is challenging for mothers of preterm infants. The aim of this paper is to describe risk factors for ceasing breastfeeding and methods of feeding until 12 months postnatal age in mothers who breastfed their preterm infants at discharge from neonatal intensive care units (NICUs). The data come from a randomised controlled trial, which evaluated the effectiveness on exclusive breastfeeding at 8 weeks of proactive telephone support compared with reactive support offered to mothers of preterm infants following discharge from NICU...
May 7, 2018: Maternal & Child Nutrition
https://www.readbyqxmd.com/read/29726958/proactive-therapeutic-drug-monitoring-of-tnf-antagonists-in-inflammatory-bowel-disease
#13
Xavier Roblin, Pauline Riviere, Mathurin Flamant, Pauline Veyrard, Fabien Poullenot, S Paul, David Laharie
Background: Proactive therapeutic drug monitoring (TDM) to titrate tumor necrosis factor (TNF) antagonists has emerged recently as a tool to routinely monitor drug concentration to achieve target levels in patients with quiescent inflammatory bowel disease (IBD). Methods: The purpose of the present review article was to present available data exploring the concept of proactive TDM. Results: While several observational studies have identified an association between proactive TDM and better IBD outcomes, 2 randomized controlled studies did not confirm this advantage...
May 3, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29720395/pulmonary-arterial-hypertension-in-adult-congenital-heart-disease
#14
REVIEW
Margarita Brida, Michael A Gatzoulis
Pulmonary arterial hypertension (PAH) is commonly associated with congenital heart disease (CHD) and relates to type of the underlying cardiac defects and repair history. Large systemic to pulmonary shunts may develop PAH if untreated or repaired late. PAH, when present, markedly increases morbidity and mortality in patients with CHD. Significant progress has been made for patients with Eisenmenger syndrome in pathophysiology, prognostication and disease-targeting therapy (DTT), which needs to be applied to routine patient care...
May 2, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29720099/skill-mix-change-between-general-practitioners-nurse-practitioners-physician-assistants-and-nurses-in-primary-healthcare-for-older-people-a-qualitative-study
#15
Marleen H Lovink, Anneke J A H van Vught, Anke Persoon, Lisette Schoonhoven, Raymond T C M Koopmans, Miranda G H Laurant
BACKGROUND: More and more older adults desire to and are enabled to grow old in their own home, regardless of their physical and mental capabilities. This change, together with the growing number of older adults, increases the demand for general practitioners (GPs). However, care for older people lacks prestige among medical students and few medical students are interested in a career in care for older people. Innovative solutions are needed to reduce the demand for GPs, to guarantee quality of healthcare and to contain costs...
May 2, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29717949/managing-health-it-risks-reflections-and-recommendations
#16
Mark Sujan
Health information technology (IT) offers exciting opportunities for providing novel services to patients, and for improving the quality and safety of care.  However, the introduction of IT can lead to unintended consequences, and create opportunities for failure, which can have significant effects on patient safety.  In this paper I argue that many health IT patient safety risks are probably quite predictable, but are often not considered at the time.  This puts patients at risk, and it threatens the successful adoption of health IT...
March 15, 2018: Journal of Innovation in Health Informatics
https://www.readbyqxmd.com/read/29710108/association-of-a-proactive-swallowing-rehabilitation-program-with-feeding-tube-placement-in-patients-treated-for-pharyngeal-cancer
#17
Gaurav S Ajmani, Cheryl C Nocon, Bruce E Brockstein, Nicholas P Campbell, Amy B Kelly, Jamie Allison, Mihir K Bhayani
Importance: A proactive speech and language pathology (SLP) program is an important component of the multidisciplinary care of patients with head and neck squamous cell carcinoma (HNSCC). Swallowing rehabilitation can reduce the rate of feeding tube placement, thereby significantly improving quality of life. Objective: To evaluate the initiation of a proactive SLP rehabilitation program at a single institution and its association with rates of feeding tube placement and dietary intake in patients with HNSCC...
April 19, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29709530/beliefs-influencing-community-pharmacists-interventions-with-chronic-kidney-disease-patients-a-theory-based-qualitative-study
#18
Patricia Quintana-Bárcena, Lyne Lalonde, Sophie Lauzier
BACKGROUND: Drug-related problems (DRPs) are highly prevalent in chronic kidney disease (CKD) patients. Community pharmacists are ideally positioned to manage these DRPs. However, little is known about the factors influencing their interventions with CKD patients. OBJECTIVES: Using the theory of planned behavior (TPB), this qualitative study sought to: (1) explore the behavioral beliefs (perceived advantages and disadvantages), normative beliefs (perceived expectations of significant others) and control beliefs (perceived barriers and facilitators) influencing community pharmacists' interventions related to identifying and managing DRPs in CKD; and (2) compare these beliefs among three DRPs prevalent in CKD patients...
April 6, 2018: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29708764/human-milk-biomarkers-of-secretory-activation-in-breast-pump-dependent-mothers-of-premature-infants
#19
Rebecca Hoban, Aloka L Patel, Clarisa Medina Poeliniz, Ching Tat Lai, Judy Janes, Donna Geddes, Paula P Meier
OBJECTIVE: Mothers of premature infants confront barriers to coming to volume (CTV; ≥500 mL/day mother's own milk [MOM] by postpartum day 14), a strong predictor of continued MOM provision at neonatal intensive care unit (NICU) discharge. We sought to determine concentrations of secretory activation biomarkers (MOM sodium, total protein, lactose, and citrate) during the first 14 postpartum days and to describe relationships among these biomarkers, pumped MOM volume, CTV, and pumping frequency...
April 30, 2018: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
https://www.readbyqxmd.com/read/29707957/a-health-plan-s-journey-to-identifying-meaningful-quality-measures
#20
Misty Roberts, Faith Green, Worthe Holt
The number of quality measures in health care is overwhelming, and reporting requirements are inconsistent. Value-based payments emphasize the need to prioritize quality measures and align across organizations. This article describes the process Humana undertook to reduce the quality measurement burden, refine measure consistency across the organization, ensure alignment with national standards, and relate quality measures to improved health outcomes within the health plan. Of the 1100 measures identified in use at Humana, 699 were duplicative or inconsistent...
April 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
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