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https://www.readbyqxmd.com/read/28340247/usability-testing-of-the-iphone-app-to-improve-pain-assessment-for-older-adults-with-cognitive-impairment-prehospital-setting-a-qualitative-study
#1
Rachael E Docking, Matthew Lane, Pat A Schofield
Objectives. : Pain assessment in older adults with cognitive impairment is often challenging, and paramedics are not given sufficient tools/training to assess pain. The development of a mobile app may improve pain assessment and management in this vulnerable population. We conducted usability testing of a newly developed iPhone pain assessment application with potential users, in this case as a tool for clinical paramedic practice to improve pain assessment of older adults with cognitive impairment...
March 15, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340229/meaningful-use-in-the-safety-net-a-rapid-ethnography-of-patient-portal-implementation-at-five-community-health-centers-in-california
#2
Sara L Ackerman, Urmimala Sarkar, Lina Tieu, Margaret A Handley, Dean Schillinger, Kenneth Hahn, Mekhala Hoskote, Gato Gourley, Courtney Lyles
Objective: US health care institutions are implementing secure websites (patient portals) to achieve federal Meaningful Use (MU) certification. We sought to understand efforts to implement portals in "safety net" health care systems that provide services for low-income populations. Materials and Methods: Our rapid ethnography involved visits at 4 California safety net health systems and in-depth interviews at a fifth. Visits included interviews with clinicians and executives ( n  = 12), informal focus groups with front-line staff ( n  = 35), observations of patient portal sign-up procedures and clinic work, review of marketing materials and portal use data, and a brief survey ( n  = 45)...
March 15, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28340208/health-care-on-equal-terms-assessing-horizontal-equity-in-health-care-use-in-northern-sweden
#3
Miguel San Sebastián, Paola A Mosquera, Nawi Ng, Per E Gustafsson
The Swedish health care system has successively moved toward increased market-orientation, which has raised concerns as to whether Sweden still offers health on equal terms. To explore this issue, this study aimed (i) to assess if the principles of horizontal equity (equal access for equal need regardless of socio-economic factors) are met in Northern Sweden 2006-14; and (ii) to explore the contribution of different factors to the inequalities in access along the same period. Data came from cross sectional surveys known in 2006, 2010 and 2014 targeting 16-84-year-old residents in the four northern-most counties in Sweden...
March 18, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/28340126/association-between-socioeconomic-status-and-access-to-care-and-quitting-smoking-with-and-without-assistance
#4
Sarah A Edwards, Russell C Callaghan, Robert E Mann, Susan J Bondy
Introduction: Socio-economic disparities in smoking rates persist, in Ontario, despite public health care and universal tobacco control policies. Mechanisms for continuing disparities are not fully understood. Unequal access or utilization of assistance for cessation may contribute. The objective of this research was to use longitudinal data on smokers to examine the associations between socioeconomic status (SES) and access to care measures and assisted and unassisted quit attempts. Methods: Data were taken from 3578 smokers with at least one follow-up interview participating in the Ontario Tobacco Survey (OTS)...
March 10, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/28340092/community-based-effectiveness-trials-as-a-means-to-disseminate-evidence-based-and-culturally-responsive-behavioral-health-interventions
#5
Flavio F Marsiglia, Patricia Dustman, Mary Harthun, Chelsea Coyne Ritland, Adriana Umaña-Taylor
This article adds to the existing knowledge about innovative community-based approaches used to reduce and eliminate behavioral health disparities. Special attention is given to culturally appropriate interventions that increase access to care and that improve the quality of behavioral health services across different geographic regions and communities. Effectiveness trials are presented as appropriate tools to translate existing efficacious interventions into real-world settings. This article describes how to transition from efficacy to effectiveness, including factors essential to consider from the perspectives of university-based research teams and community-based organizations (CBOs)...
March 14, 2017: Health & Social Work
https://www.readbyqxmd.com/read/28339932/utilizing-patient-geographic-information-system-data-to-plan-telemedicine-service-locations
#6
Neelkamal Soares, Joseph Dewalle, Ben Marsh
Objective: To understand potential utilization of clinical services at a rural integrated health care system by generating optimal groups of telemedicine locations from electronic health record (EHR) data using geographic information systems (GISs). Methods: This retrospective study extracted nonidentifiable grouped data of patients over a 2-year period from the EHR, including geomasked locations. Spatially optimal groupings were created using available telemedicine sites by calculating patients' average travel distance (ATD) to the closest clinic site...
March 3, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339895/does-parental-health-mediate-the-relationship-between-parental-uninsurance-and-insured-children-s-health-outcomes-evidence-from-a-u-s-national-survey
#7
Ilhom Akobirshoev, Diana Bowser, Susan L Parish, Cindy Thomas, Sara S Bachman
Although the United States has made great strides in ensuring near universal health care access for children, the health insurance coverage gap between children and their parents remains high. This study analyzed aggregated data from the 2006-2013 National Health Interview Survey to investigate the direct relationships between parental uninsurance and children's health outcomes. Authors explored how parental health mediates the relationship between parents' health and children's health outcomes. Results suggest that insured children of uninsured parents have worse health status and are at higher risk of asthma, attention-deficit/hyperactivity disorder, developmental delays, learning disabilities, and mental disabilities compared with insured children of insured parents...
March 2, 2017: Health & Social Work
https://www.readbyqxmd.com/read/28339847/telephone-delivered-exercise-advice-and-behavior-change-support-by-physical-therapists-for-people-with-knee-osteoarthritis-protocol-for-the-telecare-randomized-controlled-trial
#8
Rana S Hinman, Belinda J Lawford, Penny K Campbell, Andrew M Briggs, Janette Gale, Caroline Bills, Simon D French, Jessica Kasza, Andrew Forbes, Anthony Harris, Stephen J Bunker, Clare M Delany, Kim L Bennell
Background.: Exercise and physical activity are a core component of knee osteoarthritis (OA) care, yet access to physical therapists is limited for many people. Telephone service delivery models may increase access. Objective.: Determine the effectiveness of incorporating exercise advice and behaviour change support by physical therapists into an existing Australian nurse-led musculoskeletal telephone service for adults with knee OA. Design.: Randomized controlled trial with nested qualitative studies...
March 1, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28339771/implementing-patient-reported-outcome-surveys-as-part-of-routine-care-lessons-from-an-academic-radiation-oncology-department
#9
Lisa S Rotenstein, Ankit Agarwal, Kelly O'Neil, Andrea Kelly, Maureen Keaty, Colleen Whitehouse, Barbara Kalinowski, Peter F Orio, Neil Wagle, Neil E Martin
Patient reported outcomes (PROs) are reports of health conditions that come directly from patients. Use of PROs has been associated with improved patient outcomes, enhanced quality of life, and reduced end-of-life spending. Yet there are still outstanding questions regarding the process of implementing PRO collection in routine practice. In this article, we describe the experience of selecting and implementing PROs in a multisite, multidisease academic medical center-based radiation oncology practice and demonstrate that such large-scale rollout is feasible...
March 2, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339494/facility-type-and-primary-care-performance-in-sub-district-health-promotion-hospitals-in-northern-thailand
#10
Nithra Kitreerawutiwong, Sue Jordan, David Hughes
BACKGROUND: Poor and middle-income Thai people rely heavily on primary care health services. These are staffed by a range of professionals. However, it is unknown whether the performance of primary care varies according to the staffing and organization of local service delivery units. Tambon (sub-district) health promotion hospitals (THPHs) were introduced in 2009 to upgrade the services offered by the previous health centres, but were faced with continuing shortages of doctors and nurses...
2017: PloS One
https://www.readbyqxmd.com/read/28339427/a-critical-analysis-of-obamacare-affordable-care-or-insurance-for-many-and-coverage-for-few
#11
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
The Affordable Care Act (ACA), of 2010, or Obamacare, was the most monumental change in US health care policy since the passage of Medicaid and Medicare in 1965. Since its enactment, numerous claims have been made on both sides of the aisle regarding the ACA's success or failure; these views often colored by political persuasion. The ACA had 3 primary goals: increasing the number of the insured, improving the quality of care, and reducing the costs of health care. One point often lost in the discussion is the distinction between affordability and access...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28335011/understanding-public-perception-of-the-need-for-major-change-in-latin-american-healthcare-systems
#12
Ricardo Pérez-Cuevas, Frederico C Guanais, Svetlana V Doubova, Leonardo Pinzón, Luis Tejerina, Diana Pinto Masis, Marcia Rocha, Donna O Harris, James Macinko
The opinions and experiences of the public regarding health services are valuable insights into identifying opportunities to improve healthcare systems. We analyzed the 2012-2013 Public Opinion Health Policy Survey carried out in Brazil (n = 1486), Colombia (n = 1485), El Salvador (n = 1460), Jamaica (n = 1480), México (n = 1492) and Panama (n = 1475). In these countries between 82 and 96% of participants perceived that their health systems needed fundamental changes. The most frequent barrier to access to healthcare was lack of the primary medical home, difficulties in obtaining medical care during the weekends and financial barriers...
March 17, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28335004/barriers-and-facilitators-for-institutional-delivery-among-poor-mesoamerican-women-a-cross-sectional-study
#13
Bernardo Hernandez, Danny V Colombara, Marielle C Gagnier, Sima S Desai, Annie Haakenstad, Casey Johanns, Claire R McNellan, Jennifer Nelson, Erin B Palmisano, Diego Ríos-Zertuche, Alexandra Schaefer, Paola Zúñiga-Brenes, Emma Iriarte, Ali H Mokdad
Professional skilled care has shown to be one of the most promising strategies to reduce maternal mortality, and in-facility deliveries are a cost-effective way to ensure safe births. Countries in Mesoamerica have emphasized in-facility delivery care by professionally skilled attendants, but access to good-quality delivery care is still lacking for many women. We examined the characteristics of women who had a delivery in a health facility and determinants of the decision to bypass a closer facility and travel to a distant one...
March 15, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28334653/the-impact-of-transitions-in-insurance-coverage-on-gp-visiting-among-children-in-ireland
#14
Anne Nolan, Richard Layte
The use of direct out-of-pocket payments to finance general practitioner (GP) care by the majority of the population in Ireland is unusual in a European context. Currently, approximately 40 per cent of the population have means-tested access to free GP care, while the remainder must pay the full out-of-pocket cost. In this paper, we use nationally representative data from the Growing up in Ireland (GUI) study to examine the impact of transitions in insurance coverage on GP utilisation among children. GUI surveys two cohorts of nearly 20,000 children (aged 9 months and 9 years at baseline); we use data from the first two waves of each cohort (which covers the period 2007-2012)...
March 16, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28334581/a-gap-analysis-needs-assessment-tool-to-drive-a-care-delivery-and-research-agenda-for-integration-of-care-and-sharing-of-best-practices-across-a-health-system
#15
Sherita Hill Golden, Daniel Hager, Lois J Gould, Nestoras Mathioudakis, Peter J Pronovost
BACKGROUND: In a complex health system, it is important to establish a systematic and data-driven approach to identifying needs. The Diabetes Clinical Community (DCC) of Johns Hopkins Medicine's Armstrong Institute for Patient Safety and Quality developed a gap analysis tool and process to establish the system's current state of inpatient diabetes care. METHODS: The collectively developed tool assessed the following areas: program infrastructure; protocols, policies, and order sets; patient and health care professional education; and automated data access...
January 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28333734/changing-health-care-delivery-one-company-at-a-time
#16
Roxanne Nelson
Improving access to comprehensive primary care in the workplace.
April 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28333538/health-care-contact-and-suicide-risk-documentation-prior-to-suicide-death-results-from-the-army-study-to-assess-risk-and-resilience-in-servicemembers-army-starrs
#17
Jessica D Ribeiro, Peter M Gutierrez, Thomas E Joiner, Ronald C Kessler, Maria V Petukhova, Nancy A Sampson, Murray B Stein, Robert J Ursano, Matthew K Nock
OBJECTIVE: Prior research has shown that a substantial portion of suicide decedents access health care in the weeks and months before their death. We examined whether this is true among soldiers. METHOD: The sample included the 569 Regular Army soldiers in the U.S. Army who died by suicide on active duty between 2004 and 2009 compared to 5,690 matched controls. Analyses examined the prevalence and frequency of health care contacts and documentation of suicide risk (i...
April 2017: Journal of Consulting and Clinical Psychology
https://www.readbyqxmd.com/read/28333519/-doctor-are-you-listening-communication-about-children-s-mental-health-and-psychosocial-concerns
#18
Anne E Pidano, Madhavi M Padukkavidana, Lisa Honigfeld
Effective communication is critical, including in the pediatric primary care setting. Pediatric primary care providers (PPCPs) are in a unique position to address psychosocial and mental health concerns during office visits, and effective communication skills play a crucial role in providing an opportunity for parents and patients to disclose and discuss such concerns. In this article, the authors encourage two relatively simple strategies that have shown potential for enhancing effective communication in pediatric primary care regarding mental health and psychosocial issues: (a) ensure that pediatric residents and practicing providers have access to brief, targeted communications training and (b) strongly promote the use of screening tools both to encourage discussion and to assist in identifying children who may benefit from further assessment and/or treatment...
March 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28332943/effects-of-different-models-of-dialysis-care-on-patient-important-outcomes-a-systematic-review-and-meta-analysis
#19
Priya Ramar, Ahmed T Ahmed, Zhen Wang, Sagar S Chawla, Maria Lourdes Gonzalez Suarez, LaTonya J Hickson, Ann Farrell, Amy W Williams, Nilay D Shah, M Hassan Murad, Bjorg Thorsteinsdottir
Ongoing payment reform in dialysis necessitates better patient outcomes and lower costs. Suggested improvements to processes of care for maintenance dialysis patients are abundant; however, their impact on patient-important outcomes is unclear. This systematic review included comparative randomized controlled trials or observational studies with no restriction on language, published from 2000 to 2014, involving at least 5 adult dialysis patients who received a minimum of 6 months of follow-up. The effect size was pooled and stratified by intervention strategy (multidisciplinary care [MDC], home dialysis, alternate dialysis settings, and electronic health record implementation)...
March 23, 2017: Population Health Management
https://www.readbyqxmd.com/read/28332939/pediatric-asthma-hospitalizations-among-urban-minority-children-and-the-continuity-of-primary-care
#20
Levon H Utidjian, Alexander G Fiks, A Russell Localio, Lihai Song, Mark J Ramos, Ron Keren, Louis M Bell, Robert W Grundmeier
OBJECTIVE: To examine the effect of ambulatory health care processes on asthma hospitalizations. METHODS: A retrospective cohort study using electronic health records was completed. Patients aged 2-18 years receiving health care from 1 of 5 urban practices between Jan 1, 2004 and Dec 31, 2008 with asthma documented on their problem list were included. Independent variables were modifiable health care processes in the primary care setting: (1) use of asthma controller medications; (2) regular assessment of asthma symptoms; (3) use of spirometry; (4) provision of individualized asthma care plans; (5) timely influenza vaccination; (6) access to primary healthcare; and (7) use of pay for performance physician incentives...
February 25, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
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