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Ambulatory sensitive admissions

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https://www.readbyqxmd.com/read/28502866/what-is-inappropriate-hospital-use-for-elderly-people-near-the-end-of-life-a-systematic-review
#1
REVIEW
Magnolia Cardona-Morrell, James C H Kim, Mikkel Brabrand, Blanca Gallego-Luxan, Ken Hillman
BACKGROUND: Older people with advance chronic illness use hospital services repeatedly near the end of life. Some of these hospitalizations are considered inappropriate. AIM: To investigate extent and causes of inappropriate hospital admission among older patients near the end of life. METHODS: English language publications in Medline, EMBASE, PubMed, Cochrane library, and the grey literature (January 1995-December 2016) covering community and nursing home residents aged ≥60years admitted to hospital...
May 11, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28486980/task-shifting-of-triage-to-peer-expert-informal-care-providers-at-a-tertiary-referral-hiv-clinic-in-malawi-a-cross-sectional-operational-evaluation
#2
Megan Landes, Courtney Thompson, Edson Mwinjiwa, Edith Thaulo, Chrissie Gondwe, Harriet Akello, Adrienne K Chan
BACKGROUND: HIV treatment models in Africa are labour intensive and require a high number of skilled staff. In this context, task-shifting is considered a feasible alternative for ART service delivery. In 2006, a lay health cadre of expert patients (EPs) at a tertiary referral HIV clinic in Zomba, Malawi was capacitated. There are few evaluations of EP program efficacy in this setting. Triage is the process of prioritizing patients in terms of the severity of their condition and ensures that no harmful delays occur to treatment and care...
May 9, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28467010/hospital-admissions-for-physical-health-conditions-for-people-with-intellectual-disabilities-systematic-review
#3
REVIEW
Kirsty Dunn, Laura Hughes-McCormack, Sally-Ann Cooper
BACKGROUND: People with intellectual disabilities may have inequalities in hospital admissions compared with the general population. The present authors aimed to investigate admissions for physical health conditions in this population. METHODS: The present authors conducted a systematic review, searching six databases using terms on intellectual disabilities and hospital admission. Papers were selected based on pre-defined inclusion/exclusion criteria, data extracted, tabulated and synthesized and quality assessed...
May 3, 2017: Journal of Applied Research in Intellectual Disabilities: JARID
https://www.readbyqxmd.com/read/28429977/are-some-areas-more-equal-than-others-socioeconomic-inequality-in-potentially-avoidable-emergency-hospital-admissions-within-english-local-authority-areas
#4
Jessica Sheringham, Miqdad Asaria, Helen Barratt, Rosalind Raine, Richard Cookson
Objectives Reducing health inequalities is an explicit goal of England's health system. Our aim was to compare the performance of English local administrative areas in reducing socioeconomic inequality in emergency hospital admissions for ambulatory care sensitive chronic conditions. Methods We used local authority area as a stable proxy for health and long-term care administrative geography between 2004/5 and 2011/12. We linked inpatient hospital activity, deprivation, primary care, and population data to small area neighbourhoods (typical population 1500) within administrative areas (typical population 250,000)...
April 2017: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/28388857/inappropriate-utilization-in-fee-for-service-medicare-and-medicare-advantage-plans
#5
Shriram Parashuram, Seung Kim, Bryan Dowd
This study uses a national multi-payer claims database to test for differences in potentially inappropriate emergency department (ED) visits and ambulatory care sensitive (ACS) admissions in fee-for-service (FFS) Medicare and Medicare Advantage (MA) plans. Rates of ACS admissions for MA enrollees were approximately one third those of FFS beneficiaries, controlling for covariates, which included the beneficiary's health status as represented by their risk score. This study then compared FFS and MA beneficiaries when they moved from one type of health plan to another...
April 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28349858/potentially-preventable-hospitalizations-in-dementia-family-caregiver-experiences
#6
Tatiana Sadak, Susan Foster Zdon, Emily Ishado, Oleg Zaslavsky, Soo Borson
BACKGROUND: Health crises in persons living with dementia challenge their caregivers to make pivotal decisions, often under pressure, and to act in new ways on behalf of their care recipient. Disruption of everyday routines and heightened stress are familiar consequences of these events. Hospitalization for acute illness or injury is a familiar health crisis in dementia. The focus of this study is to describe the lived experience of dementia family caregivers whose care recipients had a recent unplanned admission, and to identify potential opportunities for developing preventive interventions...
March 28, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28320329/external-validation-of-the-vulnerable-elder-s-survey-for-predicting-mortality-and-emergency-admission-in-older-community-dwelling-people-a-prospective-cohort-study
#7
Emma Wallace, Ronald McDowell, Kathleen Bennett, Tom Fahey, Susan M Smith
BACKGROUND: Prospective external validation of the Vulnerable Elder's Survey (VES-13) in primary care remains limited. The aim of this study is to externally validate the VES-13 in predicting mortality and emergency admission in older community-dwelling adults. METHODS: Design: Prospective cohort study with 2 years follow-up (2010-2012). SETTING: 15 General Practices (GPs) in the Republic of Ireland. PARTICIPANTS: n = 862, aged ≥70 years, community-dwellers Exposure: VES-13 calculated at baseline, where a score of ≥3 denoted high risk...
March 20, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28254128/a-multisensor-algorithm-predicts-heart%C3%A2-failure-events-in-patients-with-implanted-devices-results-from-the-multisense-study
#8
John P Boehmer, Ramesh Hariharan, Fausto G Devecchi, Andrew L Smith, Giulio Molon, Alessandro Capucci, Qi An, Viktoria Averina, Craig M Stolen, Pramodsingh H Thakur, Julie A Thompson, Ramesh Wariar, Yi Zhang, Jagmeet P Singh
OBJECTIVES: The aim of this study was to develop and validate a device-based diagnostic algorithm to predict heart failure (HF) events. BACKGROUND: HF involves costly hospitalizations with adverse impact on patient outcomes. The authors hypothesized that an algorithm combining a diverse set of implanted device-based sensors chosen to target HF pathophysiology could detect worsening HF. METHODS: The MultiSENSE (Multisensor Chronic Evaluation in Ambulatory Heart Failure Patients) study enrolled patients with investigational chronic ambulatory data collection via implanted cardiac resynchronization therapy defibrillators...
March 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28253856/evaluation-of-ambulatory-geriatric-rehabilitation-eager-study-protocol-of-a-matched-cohort-study-based-on-claims-data
#9
Simone Kiel, Carolin Zimak, Jean-François Chenot, Carsten Oliver Schmidt
BACKGROUND: Ambulatory geriatric rehabilitation (AGR) is a community based outpatient intervention which aims to improve physical function, maintain independent living of geriatric patients, avoiding hospitalisation and institutionalisation. It should therefore reduce health care costs. The objective of our study is to evaluate the effectiveness of AGR for frail elderly patients insured by the statutory health insurance AOK Nordost compared to care as usual. Outcome variables are progression to higher nursing care levels, admission to nursing home, incident fractures, hospital admission, ambulatory care sensitive hospital admissions, days spent in hospital, and health care costs...
March 2, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28148478/association-between-continuity-of-care-in-general-practice-and-hospital-admissions-for-ambulatory-care-sensitive-conditions-cross-sectional-study-of-routinely-collected-person-level-data
#10
Isaac Barker, Adam Steventon, Sarah R Deeny
OBJECTIVE:  To assess whether continuity of care with a general practitioner is associated with hospital admissions for ambulatory care sensitive conditions for older patients. DESIGN:  Cross sectional study. SETTING:  Linked primary and secondary care records from 200 general practices participating in the Clinical Practice Research Datalink in England. PARTICIPANTS:  230 472 patients aged between 62 and 82 years and who experienced at least two contacts with a general practitioner between April 2011 and March 2013...
February 1, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28125178/the-epidemiology-of-emergency-in-patient-hospitalisations-among-those-with-no-fixed-abode-homeless-2005-2014-what-lessons-can-be-learnt
#11
A O'Farrell, D S Evans, M Allen
Estimates show that homelessness is increasing in Ireland. This study analysed the epidemiology of emergency hospitalisations among those experiencing homelessness between 2005-2014. All in-patient admissions to acute hospitals classified with 'no fixed abode' were extracted from the Hospital In-patient Enquiry System. Data were analysed using JMP. There were 2,051 in-patient emergency admissions of people classified with 'no fixed abode' during the study period, an increase of 406% since 2005 (78 in 2005 vs...
October 12, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/28119410/emergency-department-use-among-patients-with-ckd-a-population-based-analysis
#12
Paul E Ronksley, Marcello Tonelli, Braden J Manns, Robert G Weaver, Chandra M Thomas, Jennifer M MacRae, Pietro Ravani, Robert R Quinn, Matthew T James, Richard Lewanczuk, Brenda R Hemmelgarn
BACKGROUND AND OBJECTIVES: Although prior studies have observed high resource use among patients with CKD, there is limited exploration of emergency department use in this population and the proportion of encounters related to CKD care specifically. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We identified all adults (≥18 years old) with eGFR<60 ml/min per 1.73 m(2) (including dialysis-dependent patients) in Alberta, Canada between April 1, 2010 and March 31, 2011...
February 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27924622/racial-and-ethnic-disparities-in-preventable-hospitalizations-for-chronic-disease-prevalence-and-risk-factors
#13
Riddhi P Doshi, Robert H Aseltine, Alyse B Sabina, Garth N Graham
BACKGROUND: Hospitalizations due to ambulatory care sensitive conditions (ACSCs) result in high morbidity and economic burden on the American healthcare system. Admissions due to chronic ACSCs, in particular, cost the American healthcare system over 30 billion dollars annually. OBJECTIVES AND METHODS: This paper presents the current research on racial and ethnic disparities in the burden of hospitalizations due to chronic ACSCs. For this narrative review, we evaluated over 800 abstracts from MEDLINE and Google Scholar and cited 62 articles...
December 6, 2016: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/27837359/emergency-department-visits-and-hospitalizations-for-the-uninsured-in-illinois-before-and-after-affordable-care-act-insurance-expansion
#14
Aabha I Sharma, Scott M Dresden, Emilie S Powell, Raymond Kang, Joe Feinglass
We describe changes in emergency department (ED) visits and the proportion of patients with hospitalizations through the ED classified as Ambulatory Care Sensitive Hospitalization (ACSH) for the uninsured before (2011-2013) and after (2014-2015) Affordable Care Act (ACA) health insurance expansion in Illinois. Hospital administrative data from 201 non-federal Illinois hospitals for patients age 18-64 were used to analyze ED visits and hospitalizations through the ED. ACSH was defined using Agency for Healthcare Research and Quality (AHRQ) Prevention Quality Indicators (PQIs)...
November 12, 2016: Journal of Community Health
https://www.readbyqxmd.com/read/27827306/using-geographic-variation-in-unplanned-ambulatory-care-sensitive-condition-admission-rates-to-identify-commissioning-priorities-an-analysis-of-routine-data-from-england
#15
John Busby, Sarah Purdy, William Hollingworth
OBJECTIVES: To use geographic variation in unplanned ambulatory care sensitive condition admission rates to identify the clinical areas and patient subgroups where there is greatest potential to prevent admissions and improve the quality and efficiency of care. METHODS: We used English Hospital Episode Statistics data from 2011/2012 to describe the characteristics of patients admitted for ambulatory care sensitive condition care and estimated geographic variation in unplanned admission rates...
November 8, 2016: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/27777230/opportunities-for-primary-care-to-reduce-hospital-admissions-a-cross-sectional-study-of-geographical-variation
#16
John Busby, Sarah Purdy, William Hollingworth
BACKGROUND: Reducing unplanned hospital admissions is a key priority within the UK. Substantial interpractice variation in admission rates for ambulatory care sensitive conditions (ACSC) suggests that decreases might be possible. AIM: To identify the clinical areas and patient subgroups where the greatest opportunities exist for GPs to improve ACSC care. DESIGN AND SETTING: Cross-sectional study using routine hospital data from patients registered at 8123 English GP practices during 2011 and 2012...
January 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27766628/physician-ehr-adoption-and-potentially-preventable-hospital-admissions-among-medicare-beneficiaries-panel%C3%A2-data-evidence-2010-2013
#17
Eric J Lammers, Catherine G McLaughlin, Michael Barna
OBJECTIVE: To test for correlation between the growth in adoption of ambulatory electronic health records (EHRs) in the United States during 2010-2013 and hospital admissions and readmissions for elderly Medicare beneficiaries with at least one of four common ambulatory care-sensitive conditions (ACSCs). DATA SOURCES: SK&A Information Services Survey of Physicians, American Hospital Association General Survey and Information Technology Supplement; and the Centers for Medicare & Medicaid Services Chronic Conditions Data Warehouse Geographic Variation Database for 2010 through 2013...
December 2016: Health Services Research
https://www.readbyqxmd.com/read/27745857/evaluating-the-impact-of-an-enhanced-primary-care-diabetes-service-on-diabetes-outcomes-a-before-after-study
#18
S Seidu, D H Bodicoat, M J Davies, H Daly, B Stribling, A Farooqi, E M Brady, K Khunti
Diabetes is an ambulatory care-sensitive condition and a high quality primary care or risk factor control can lead to a decrease in the risk of non-elective hospitalisations while ensuring continuity of care with usual primary care teams. AIMS AND METHODS: In this before and after study, eight primary care practices providing a newer enhanced diabetes model of care in Leicester UK, were compared with matched neighbouring practices with comparable demographic features providing a more expensive integrated specialist-community care diabetes service...
April 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/27716250/the-impact-of-reimbursement-systems-on-equity-in-access-and-quality-of-primary-care-a-systematic-literature-review
#19
Wenjing Tao, Janne Agerholm, Bo Burström
BACKGROUND: Reimbursement systems provide incentives to health care providers and may drive physician behaviour. This review assesses the impact of reimbursement system on socioeconomic and racial inequalities in access, utilization and quality of primary care. METHODS: A systematic search was performed in Web of Science and PubMed for English language studies published between 1980 and 2013, supplemented by reference tracking. Articles were selected based on inclusion criteria, and data extraction and critical appraisal were performed by two authors independently...
October 4, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27650770/comparison-of-count-based-multimorbidity-measures-in-predicting-emergency-admission-and-functional-decline-in-older-community-dwelling-adults-a-prospective-cohort-study
#20
Emma Wallace, Ronald McDowell, Kathleen Bennett, Tom Fahey, Susan M Smith
OBJECTIVES: Multimorbidity, defined as the presence of 2 or more chronic medical conditions in an individual, is associated with poorer health outcomes. Several multimorbidity measures exist, and the challenge is to decide which to use preferentially in predicting health outcomes. The study objective was to compare the performance of 5 count-based multimorbidity measures in predicting emergency hospital admission and functional decline in older community-dwelling adults attending primary care...
2016: BMJ Open
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