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Consultation models

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https://www.readbyqxmd.com/read/29137632/descriptive-study-of-interprofessional-collaboration-between-physicians-and-osteopaths-for-the-pediatric-population-in-quebec-canada
#1
Chantal Morin, Johanne Desrosiers, Isabelle Gaboury
BACKGROUND: Osteopathy is an increasingly popular healthcare approach that uses a wide variety of therapeutic manual techniques to address pain and somatic dysfunction. In Quebec, Canada, osteopathy is the complementary medicine most often recommended by family physicians. However, factors fostering the development of interprofessional collaboration (IPC) between physicians and osteopaths are unknown. This study aimed to describe the current situation in terms of IPC among practitioners working with pediatric patients...
November 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29137558/testing-a-web-based-trained-peer-model-to-build-capacity-for-evidence-based-practices-in-community-mental-health-systems
#2
Ramaris E German, Abby Adler, Sarah A Frankel, Shannon Wiltsey Stirman, Paola Pinedo, Arthur C Evans, Aaron T Beck, Torrey A Creed
OBJECTIVE: Use of expert-led workshops plus consultation has been established as an effective strategy for training community mental health (CMH) clinicians in evidence-based practices (EBPs). Because of high rates of staff turnover, this strategy inadequately addresses the need to maintain capacity to deliver EBPs. This study examined knowledge, competency, and retention outcomes of a two-phase model developed to build capacity for an EBP in CMH programs. METHODS: In the first phase, an initial training cohort in each CMH program participated in in-person workshops followed by expert-led consultation (in-person, expert-led [IPEL] phase) (N=214 clinicians)...
November 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29137501/parkinsonnet-a-low-cost-health-care-innovation-with-a-systems-approach-from-the-netherlands
#3
Bas R Bloem, Lonneke Rompen, Nienke M de Vries, Ab Klink, Marten Munneke, Patrick Jeurissen
ParkinsonNet, a low-cost innovation to optimize care for patients with Parkinson disease, was developed in 2004 as a network of physical therapists in several regions in the Netherlands. Since that time, the network has achieved full national reach, with 70 regional networks and around 3,000 specifically trained professionals from 12 disciplines. Key elements include the empowerment of professionals who are highly trained and specialized in Parkinson disease, the empowerment of patients by education and consultation, and the empowerment of integrated multidisciplinary teams to better address and manage the disease...
November 2017: Health Affairs
https://www.readbyqxmd.com/read/29135698/associations-between-early-care-decisions-and-the-risk-for-long-term-opioid-use-for-patients-with-low-back-pain-with-a-new-physician-consultation-and-initiation-of-opioid-therapy
#4
Julie M Fritz, Jordan B King, Carrie McAdams-Marx
OBJECTIVE: Identify associations between early care decisions and long-term opioid use in opioid-naïve patients with a new physician consultation for low back pain at which an opioid was prescribed. METHODS: Retrospective study of claims data was used to identify opioid-naïve low back pain patients who were prescribed opioids at the index physician visit. Early care variables captured included additional non-opioid medications prescribed within 14 days, and provider visits or diagnostic imaging within 30 days of the index visit...
November 10, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29135568/dynamic-prediction-of-outcome-for-patients-with-ovarian-cancer-application-of-a-joint-model-for-longitudinal-cancer-antigen-125-values
#5
Yuting Cao, Yi Jiang, Xiao Lin, Jinsong Liu, Tao Lu, Wenjun Cheng, Fangrong Yan
OBJECTIVE: In clinical practice, gynecologic oncologists are interested in predicting the prognosis of patients through information from different sources. Recently, the overall survival (OS) of ovarian cancer patients has been widely and intensively researched, and a large number of risk factors have been determined, including the biomarker of cancer antigen 125 (CA-125). For newly diagnosed patients, it is critical to construct effective prognostic models to predict prognosis dynamically by combining their CA-125 values with adjusted clinical factors...
November 11, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/29135336/a-retrospective-observational-analysis-of-post-pandemic-influenza-related-outcomes-in-the-united-kingdom-2010-2014
#6
Sankarasubramanian Rajaram, Witold Wiecek, Richard Lawson, Betina Blak, Yanli Zhao, Judith Hackett, Robert Brody, Tehseen Salimi, Billy Amzal, Vishal Patel
This study set out to evaluate influenza- and respiratory-related illnesses recorded during primary care physician consultations in England following the H1N1 pandemic in 2009 and to enable the development of a dynamic disease model. Data were obtained from the Clinical Practice Research Datalink of primary care records over four influenza seasons (2010-2014). The primary outcome of the study was incidence of influenza- and respiratory-related diagnoses, calculated per practice and by season and age group. Upper respiratory tract infection diagnoses were most frequently recorded (mean seasonal practice level incidence; 3,762 consultations per 100,000 [SD = 1,989]), and influenza-related diagnoses were least frequently recorded across all seasons, except one...
November 14, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/29133496/factors-influencing-allopurinol-initiation-in-primary-care
#7
Lorna E Clarson, Samantha L Hider, John Belcher, Edward Roddy, Christian D Mallen
Despite guidance on appropriate initiation, urate-lowering therapy is prescribed for only a minority of patients with gout. Electronic health records for 8,142 patients with gout were used to investigate the effect of age, sex, comorbidities, number of consultations, and meeting internationally agreed eligibility criteria on time to allopurinol initiation. Time to first prescription was modeled using multilevel Cox proportional hazards regression. Allopurinol initiation was positively associated with meeting eligibility criteria at diagnosis of gout, but negatively associated with becoming eligible after diagnosis...
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29132619/a-statistical-analysis-based-recommender-model-for-heart-disease-patients
#8
Anam Mustaqeem, Syed Muhammad Anwar, Abdul Rashid Khan, Muhammad Majid
OBJECTIVES: An intelligent information technology based system could have a positive impact on the life-style of patients suffering from chronic diseases by providing useful health recommendations. In this paper, we have proposed a hybrid model that provides disease prediction and medical recommendations to cardiac patients. The first part aims at implementing a prediction model, that can identify the disease of a patient and classify it into one of the four output classes i.e., non-cardiac chest pain, silent ischemia, angina, and myocardial infarction...
December 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29132445/physician-remuneration-for-remote-consults-an-overview-of-approaches-across-canada
#9
Kelly Stanistreet, Jenn Verma, Kirby Kirvan, Neil Drimer, Clare Liddy
While lengthy waits for medical specialists remains a persistent problem across Canada, remote consult presents a strategy to address this issue. Connecting primary healthcare providers to specialists via electronic (eConsult) or telephone consult enables care providers to deliver appropriate, speciality-informed care for their patients in the primary care setting, reducing the time spent waiting for specialists and potentially preventing unnecessary referrals to specialty care. These remote consult models are the focus of a new pan-Canadian quality improvement collaborative delivered by the Canadian Foundation for Healthcare Improvement in partnership with Canada Health Infoway, the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/29132193/impact-of-supervised-student-optometry-consultations-on-the-patient-experience
#10
Sharon A Bentley, Jane E Trevaskis, Craig A Woods, Daryl Guest, Kathleen G Watt
BACKGROUND: Understanding patient perceptions of having students involved in their clinical care is important as we strive to develop optimal models of care that integrate teaching with the best possible experience for the patient. The aim was to ascertain the impact of supervised optometry student consultations on the patient experience. METHODS: A survey comprising 45 questions was mailed to consecutive adult patients who had undergone a comprehensive eye examination at the Australian College of Optometry over a four-week period...
November 13, 2017: Clinical & Experimental Optometry: Journal of the Australian Optometrical Association
https://www.readbyqxmd.com/read/29127227/protocol-for-hospital-based-surveillance-of-cerebral-palsy-cp-in-hanoi-using-the-paediatric-active-enhanced-disease-surveillance-mechanism-paeds-vietnam-a-study-towards-developing-hospital-based-disease-surveillance-in-vietnam
#11
Gulam Khandaker, Nguyen Van Bang, Trịnh Quang Dũng, Nguyen Thi Huong Giang, Cao Minh Chau, Nguyen Thi Van Anh, Nguyen Van Thuong, Nadia Badawi, Elizabeth J Elliott
INTRODUCTION: The epidemiology, pathogenesis, management and outcomes of cerebral palsy (CP) in low-income and middle-income countries including Vietnam are unknown because of the lack of mechanisms for standardised collection of data. In this paper, we outline the protocol for developing a hospital-based surveillance system modelled on the Paediatric Active Enhanced Disease Surveillance (PAEDS) system in Australia. Using PAEDS-Vietnam we will define the aetiology, motor function and its severity, associated impairments, and nutritional and rehabilitation status of children with CP in Hanoi, Vietnam...
November 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/29126454/an-analysis-on-intersectional-collaboration-on-non-communicable-chronic-disease-prevention-and-control-in-china-a-cross-sectional-survey-on-main-officials-of-community-health-service-institutions
#12
Xing-Ming Li, Alon Rasooly, Bo Peng, JianWang, Shu-Yu Xiong
BACKGROUND: Our study aimed to design a tool of evaluating intersectional collaboration on Non-communicable Chronic Disease (NCD) prevention and control, and further to understand the current status of intersectional collaboration in community health service institutions of China. METHODS: We surveyed 444 main officials of community health service institutions in Beijing, Tianjin, Hubei and Ningxia regions of China in 2014 by using a questionnaire. A model of collaboration measurement, including four relational dimensions of governance, shared goals and vision, formalization and internalization, was used to compare the scores of evaluation scale in NCD management procedures across community healthcare institutions and other ones...
November 10, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29125409/interdependence-in-decision-making-by-medical-consultants-implications-for-improving-the-efficiency-of-inpatient-physician-services
#13
Adam S Wilk, Lena M Chen
OBJECTIVES: Hospital administrators are seeking to improve efficiency in medical consultation services, yet whether consultants make decisions to provide more or less care is unknown. We examined how medical consultants account for prior consultants' care when determining whether to provide intensive consulting care or sign off in the treatment of complex surgical inpatients. We applied three distinct theoretical frameworks in the interpretation of our results. METHODS: We performed a retrospective cohort study of consultants' care intensity, measured alternately using a dummy variable for providing two or more days consulting (versus one) and a continuous measure of total days consulting, with 100% Medicare claims data from 2007-2010...
November 10, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29122806/diagnostic-utility-of-appetite-loss-in-addition-to-existing-prediction-models-for-community-acquired-pneumonia-in-the-elderly-a-prospective-diagnostic-study-in-acute-care-hospitals-in-japan
#14
Toshihiko Takada, Yosuke Yamamoto, Kazuhiko Terada, Mitsuyasu Ohta, Wakako Mikami, Hajime Yokota, Michio Hayashi, Jun Miyashita, Teruhisa Azuma, Shingo Fukuma, Shunichi Fukuhara
OBJECTIVE: Diagnosis of community-acquired pneumonia (CAP) in the elderly is often delayed because of atypical presentation and non-specific symptoms, such as appetite loss, falls and disturbance in consciousness. The aim of this study was to investigate the external validity of existing prediction models and the added value of the non-specific symptoms for the diagnosis of CAP in elderly patients. DESIGN: Prospective cohort study. SETTING: General medicine departments of three teaching hospitals in Japan...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29122505/mayo-clinic-care-network-a-collaborative-health-care-model
#15
John T Wald, Sherri Lowery-Schrandt, David L Hayes, Amy L Kotsenas
By leveraging its experience and expertise as a consultative clinical partner, the Mayo Clinic developed an innovative, scalable care model to accomplish several strategic goals: (1) create and sustain high-value relationships that benefit patients and providers, (2) foster relationships with like-minded partners to act as a strategy against the development of narrow health care networks, and (3) increase national and international brand awareness of Mayo Clinic. The result was the Mayo Clinic Care Network.
November 1, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29120225/descriptive-values-for-dancers-on-baseline-concussion-tools
#16
Lauren McIntyre, Marc Campo
CONTEXT:   Capturing baseline data before a concussion can be a valuable tool in individualized care. However, not all athletes, including dancers, have access to baseline testing. When baseline examinations were not performed, clinicians consult normative values. Dancers are unique athletes; therefore, describing values specific to dancers may assist those working with these athletes in making more informed decisions. OBJECTIVE:   To describe values for key concussion measures of dancers...
November 9, 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/29118053/international-variations-in-primary-care-physician-consultation-time-a-systematic-review-of-67-countries
#17
Greg Irving, Ana Luisa Neves, Hajira Dambha-Miller, Ai Oishi, Hiroko Tagashira, Anistasiya Verho, John Holden
OBJECTIVE: To describe the average primary care physician consultation length in economically developed and low-income/middle-income countries, and to examine the relationship between consultation length and organisational-level economic, and health outcomes. DESIGN AND OUTCOME MEASURES: This is a systematic review of published and grey literature in English, Chinese, Japanese, Spanish, Portuguese and Russian languages from 1946 to 2016, for articles reporting on primary care physician consultation lengths...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29117874/estimated-incidence-and-number-of-outpatient-visits-for-seasonal-influenza-in-2015-2016-in-beijing-china
#18
S Wu, L VAN Asten, L Wang, S A McDonald, Y Pan, W Duan, L Zhang, Y Sun, Y Zhang, X Zhang, E Pilot, T Krafft, W VAN DER Hoek, M A B VAN DER Sande, P Yang, Q Wang
Information on morbidity burden of seasonal influenza in China is limited. A multiplier model was used to estimate the incidence and number of outpatient visits for seasonal influenza by age group for the 2015-2016 season in Beijing, the capital of China, based on reported numbers of influenza-like illness consultations and proportions of positive cases from influenza surveillance systems in Beijing, general consultation rates and other parameters from previous studies, surveys and surveillance systems. An estimated total of 1 190 200 (95% confidence interval (CI) 830 400-1 549 900) cases of influenza virus infections occurred in Beijing, 2015-2016 season, with an attack rate of 5·5% (95% CI 3·9-7·2%)...
November 9, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/29117053/an-outcome-analysis-of-nurse-practitioners-in-acute-care-trauma-services
#19
Anna Holliday, Damayanti Samanta, Julie Budinger, Jessica Hardway, Audis Bethea
The department of trauma at a Level 1 trauma center sought to improve outcomes by enhancing the continuity of care for patients admitted to trauma services. Departmental leadership explored opportunities to improve this aspect of patient care through expansion of existing trauma nurse practitioner (NP) services. The restructured trauma NP service model was implemented in September 2013. A retrospective study was conducted with patients who presented at the trauma center between September 2012 and August 2015...
November 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29112975/referral-determinants-in-swiss-primary-care-with-a-special-focus-on-managed-care
#20
Ryan Tandjung, Seraina Morell, Andreas Hanhart, Andreas Haefeli, Fabio Valeri, Thomas Rosemann, Oliver Senn
Studies have shown large variation of referral probabilities in different countries, and many influencing factors have been described. This variation is most likely explained by different healthcare systems, particularly to which extent primary care physicians (PCPs) act as gatekeepers. In Switzerland no mandatory gatekeeping system exists, however insurance companies offer voluntary managed care plans with reduced insurance premiums. We aimed at investigating the role of managed care plans as a potential referral determinant in a non-gatekeeping healthcare system...
2017: PloS One
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