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https://www.readbyqxmd.com/read/28434466/cost-effectiveness-of-acupuncture-in-an-employee-population-a-retrospective-analysis
#1
Bijan J Borah, James M Naessens, Amy E Glasgow, Brent A Bauer, Tony Y Chon
OBJECTIVES: To determine whether acupuncture is a cost-effective adjunct to usual care for Mayo Clinic employees and their dependents experiencing pain symptoms. DESIGN: Retrospective review of the medical and billing records of 466 employee-patients and their dependents who had received acupuncture as part of their care and 466 propensity score-matched control patients. INTERVENTIONS: Usual care in combination with acupuncture compared with usual care alone...
April 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28433453/attending-documentation-contribution-to-billing-at-an-academic-emergency-department-with-an-electronic-health-record
#2
Brian J Yun, Stephen C Dorner, Brian M Baccari, John Brennan, Karen Smith, Ali S Raja, Benjamin A White
INTRODUCTION: In emergency medicine (EM), patient care documentation serves many functions, including supporting reimbursement. In addition, many electronic health record systems facilitate automatically populating certain data fields. As a result, in the academic model, the attending's note may now more often recapitulate many of the same elements found in the resident's or physician assistant's (PA) note. We sought to determine the value of additional attending documentation, and how often the attending documentation prevented a downcoding event...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28418524/evaluating-testing-strategies-for-identifying-youths-with-hiv-infection-and-linking-youths-to-biomedical-and-other-prevention-services
#3
Robin Lin Miller, Cherrie B Boyer, Danielle Chiaramonte, Peter Lindeman, Kate Chutuape, Bendu Cooper-Walker, Bill G Kapogiannis, Craig M Wilson, J Dennis Fortenberry
Importance: Most human immunodeficiency virus (HIV)-infected youths are unaware of their serostatus (approximately 60%) and therefore not linked to HIV medical or prevention services. The need to identify promising and scalable approaches to promote uptake of HIV testing among youths at risk is critical. Objective: To evaluate a multisite HIV testing program designed to encourage localized HIV testing programs focused on self-identified sexual minority males and to link youths to appropriate prevention services after receipt of their test results...
April 17, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28365373/marijuana-and-acute-health-care-contacts-in-colorado
#4
George Sam Wang, Katelyn Hall, Daniel Vigil, Shireen Banerji, Andrew Monte, Mike VanDyke
Over 22 million Americans are current users of marijuana; half of US states allow medical marijuana, and several allow recreational marijuana. The objective of this study was to evaluate the impact marijuana has on hospitalizations, emergency department (ED) visits, and regional poison center (RPC) calls in Colorado, a medical and recreational marijuana state. This is a retrospective review using Colorado Hospital Association hospitalizations and ED visits with marijuana-related billing codes, and RPC marijuana exposure calls...
March 29, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28339812/spending-on-hospital-care-and-pediatric-psychology-service-use-among-adolescents-and-young-adults-with-cancer
#5
Meghan E McGrady, James L Peugh, Gabriella A Brown, Ahna L H Pai
To examine the relationship between need-based pediatric psychology service use and spending on hospital care among adolescents and young adults (AYAs) with cancer. Billing data were obtained from 48 AYAs with cancer receiving need-based pediatric psychology services and a comparison cohort of 48 AYAs with cancer not receiving services. A factorial analysis of covariance examined group differences in spending for hospital care. Pending significant findings, a multivariate analysis of covariance was planned to examine the relationship between need-based pediatric psychology service use and spending for inpatient admissions, emergency department (ED) visits, and outpatient visits...
February 26, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/28324108/hypoparathyroidism-less-severe-hypocalcemia-with-treatment-with-vitamin-d2-compared-to-calcitriol
#6
Elizabeth A Streeten, Yasaman Mohtasebi, Manige Konig, Lisa Davidoff, Kathleen Ryan
Context: Options for chronic treatment of hypoparathyroidism include calcitriol, recombinant human parathyroid hormone and high dose vitamin D (D2). D2 is used in a minority because of fear of prolonged hypercalcemia and renal toxicity. There is a paucity of recent data about D2 use in hypoparathyroidism. Objective: Compare renal function, hypercalcemia and hypocalcemia in patients with hypoparathyroidism treated chronically with either D2 or calcitriol. Design, setting, patients: A retrospective study of patients with hypoparathyroidism treated at University of Maryland Hospital...
January 23, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28301213/academic-radiologist-subspecialty-identification-using-a-novel-claims-based-classification-system
#7
Andrew B Rosenkrantz, Wenyi Wang, Danny R Hughes, Luke A Ginocchio, David A Rosman, Richard Duszak
OBJECTIVE: The objective of the present study is to assess the feasibility of a novel claims-based classification system for payer identification of academic radiologist subspecialties. MATERIALS AND METHODS: Using a categorization scheme based on the Neiman Imaging Types of Service (NITOS) system, we mapped the Medicare Part B services billed by all radiologists from 2012 to 2014, assigning them to the following subspecialty categories: abdominal imaging, breast imaging, cardiothoracic imaging, musculoskeletal imaging, nuclear medicine, interventional radiology, and neuroradiology...
March 16, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28169978/analysis-of-patient-visits-and-collections-after-opening-a-satellite-pediatric-emergency-department
#8
Katherine M Nichols, Kerry Caperell, Keith Cross, Scott Duncan, Ben Foster, Gil Liu, Hank Pritchard, Gary Southard, Ben Shinabery, Brad Sutton, In K Kim
OBJECTIVE: Satellite pediatric emergency departments (PEDs) have emerged as a strategy to increase patient capacity. We sought to determine the impact on patient visits, physician fee collections, and value of emergency department (ED) time at the primary PED after opening a nearby satellite PED. We also illustrate the spatial distribution of patient demographics and overlapping catchment areas for the primary and satellite PEDs using geographical information system. METHODS: A structured, financial retrospective review was conducted...
February 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28159379/factors-affecting-visits-to-the-emergency-department-for-urgent-and-nonurgent-ocular-conditions
#9
Brian C Stagg, Muazzum M Shah, Nidhi Talwar, Dolly A Padovani-Claudio, Maria A Woodward, Joshua D Stein
PURPOSE: To determine the frequency of emergency department (ED) visits for nonurgent and urgent ocular conditions and risk factors associated with ED use for nonurgent and urgent ocular problems. DESIGN: Retrospective, longitudinal cohort analysis. PARTICIPANTS: All enrollees aged 21 years or older in a United States managed care network during 2001-2014. METHODS: We identified all enrollees visiting an ED for ocular conditions identified by International Classification of Diseases, billing codes...
May 2017: Ophthalmology
https://www.readbyqxmd.com/read/28150328/use-of-emergency-ultrasound-in-arizona-community-emergency-departments
#10
Richard Amini, Michael T Wyman, Nicholas C Hernandez, John A Guisto, Srikar Adhikari
OBJECTIVES: Despite the increased educational exposure to point-of-care ultrasound (US) at all levels of medical training, there are utilization gaps between academic and nonacademic emergency department (ED) settings. The purpose of this study was to assess the current practices and potential barriers to the use of point-of-care US in nonacademic EDs throughout the state of Arizona. METHODS: We conducted a cross-sectional study. An online questionnaire was electronically sent to all nonacademic EDs in Arizona...
May 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28116025/medical-student-documentation-in-the-electronic-medical-record-patterns-of-use-and-barriers
#11
Kathleen Wittels, Joshua Wallenstein, Rahul Patwari, Sundip Patel
INTRODUCTION: Electronic health records (EHR) have become ubiquitous in emergency departments. Medical students rotating on emergency medicine (EM) clerkships at these sites have constant exposure to EHRs as they learn essential skills. The Association of American Medical Colleges (AAMC), the Liaison Committee on Medical Education (LCME), and the Alliance for Clinical Education (ACE) have determined that documentation of the patient encounter in the medical record is an essential skill that all medical students must learn...
January 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28029490/factors-influencing-drainage-setting-and-cost-for-cutaneous-abscesses-among-pediatric-patients
#12
COMPARATIVE STUDY
Corrie E Chumpitazi, Chris A Rees, Elizabeth A Camp, Karina L Valdez, Benjamin Choi, Bruno P Chumpitazi, Faria Pereira
OBJECTIVE: To evaluate the clinical and microbiological factors associated with skin and soft tissue infections drained in the emergency department (ED) vs operative drainage (OD) in a tertiary care children's hospital. METHODS: This was a cross-sectional study among children aged 2 months to 17 years who required incision and drainage (I&D). Demographic information, signs and symptoms, abscess size and location, and wound culture/susceptibility were recorded. Patient-specific charges were collected from the billing database...
February 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27988262/impact-of-scribes-on-billed-relative-value-units-in-an-academic-emergency-department
#13
Heather A Heaton, David M Nestler, Derick D Jones, Rachelen S Varghese, Christine M Lohse, Eric S Williamson, Annie T Sadosty
BACKGROUND: Scribe use throughout health care is becoming more common. There is limited peer-reviewed literature supporting this emerging role in health care despite rapid uptake of the role. OBJECTIVES: Our study assesses impact of scribes on relative value units (RVUs) in adult and pediatric emergency departments (EDs). METHODS: A prospective cohort study was developed in a tertiary academic ED. Charts were coded by an external billing and coding company, then returned and mapped by International Classification of Diseases, 9th revision diagnostic codes...
March 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27974361/one-in-five-inpatient-emergency-department-cases-may-lead-to-surprise-bills
#14
Christopher Garmon, Benjamin Chartock
A surprise medical bill is a bill from an out-of-network provider that was not expected by the patient or that came from an out-of-network provider not chosen by the patient. In 2014, 20 percent of hospital inpatient admissions that originated in the emergency department (ED), 14 percent of outpatient visits to the ED, and 9 percent of elective inpatient admissions likely led to a surprise medical bill.
December 14, 2016: Health Affairs
https://www.readbyqxmd.com/read/27931303/a-comparison-of-seasonal-trends-in-asthma-exacerbations-among-children-from-geographic-regions-with-different-climates
#15
Julia A Wisniewski, Anne P McLaughlin, Philip J Stenger, James Patrie, Mark A Brown, Jane M El-Dahr, Thomas A E Platts-Mills, Nora J Byrd, Peter W Heymann
BACKGROUND: The fall peak in childhood asthma exacerbations is thought to be related to an increase in viral infections and allergen exposure when children return to school. Whether the seasonality of asthma attacks among children from different geographic regions follows similar trends is unclear. OBJECTIVE: To compare seasonal trends in asthma exacerbations among school-age children who lived in different geographic locations, with different climates, within the United States...
November 2016: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/27893295/medical-directors-of-breastfeeding-programs-at-academic-medical-centers-duties-and-challenges
#16
Casey B Rosen-Carole
INTRODUCTION: An emerging trend in Academic Medical Centers (AMCs) is to coordinate breastfeeding care, research, and trainee education through "medical director" positions. Little is known about their duties, supports, and challenges. OBJECTIVE: To determine the duties and challenges of directors of breastfeeding medicine in AMCs. METHODS: A survey was distributed four times over a 3-month period to three listservs with a total of 860 members...
November 28, 2016: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
https://www.readbyqxmd.com/read/27864915/identification-of-emergency-department-visits-in-medicare-administrative-claims-approaches-and-implications
#17
Arjun K Venkatesh, Hao Mei, Keith E Kocher, Michael Granovsky, Ziad Obermeyer, Erica S Spatz, Craig Rothenberg, Harlan M Krumholz, Zhenqui Lin
OBJECTIVES: Administrative claims data sets are often used for emergency care research and policy investigations of healthcare resource utilization, acute care practices, and evaluation of quality improvement interventions. Despite the high profile of emergency department (ED) visits in analyses using administrative claims, little work has evaluated the degree to which existing definitions based on claims data accurately captures conventionally defined hospital-based ED services. We sought to construct an operational definition for ED visitation using a comprehensive Medicare data set and to compare this definition to existing operational definitions used by researchers and policymakers...
April 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27836322/anemia-is-not-a-risk-factor-for-developing-pulmonary-embolism
#18
John B Harringa, Rebecca L Bracken, Scott K Nagle, Mark L Schiebler, Brian W Patterson, James E Svenson, Michael D Repplinger
OBJECTIVE: Our aim was to validate the previously published claim of a positive relationship between low blood hemoglobin level (anemia) and pulmonary embolism (PE). METHODS: This was a retrospective study of patients undergoing cross-sectional imaging to evaluate for PE at an academic medical center. Patients were identified using billing records for charges attributed to either magnetic resonance angiography or computed tomography angiography of the chest from 2008 to 2013...
January 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27818095/genetic-markers-associated-with-dihydroartemisinin-piperaquine-failure-in-plasmodium-falciparum-malaria-in-cambodia-a-genotype-phenotype-association-study
#19
Roberto Amato, Pharath Lim, Olivo Miotto, Chanaki Amaratunga, Dalin Dek, Richard D Pearson, Jacob Almagro-Garcia, Aaron T Neal, Sokunthea Sreng, Seila Suon, Eleanor Drury, Dushyanth Jyothi, Jim Stalker, Dominic P Kwiatkowski, Rick M Fairhurst
BACKGROUND: As the prevalence of artemisinin-resistant Plasmodium falciparum malaria increases in the Greater Mekong subregion, emerging resistance to partner drugs in artemisinin combination therapies seriously threatens global efforts to treat and eliminate this disease. Molecular markers that predict failure of artemisinin combination therapy are urgently needed to monitor the spread of partner drug resistance, and to recommend alternative treatments in southeast Asia and beyond. METHODS: We did a genome-wide association study of 297 P falciparum isolates from Cambodia to investigate the relationship of 11 630 exonic single-nucleotide polymorphisms (SNPs) and 43 copy number variations (CNVs) with in-vitro piperaquine 50% inhibitory concentrations (IC50s), and tested whether these genetic variants are markers of treatment failure with dihydroartemisinin-piperaquine...
February 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/27769219/advanced-practice-pharmacists-a-retrospective-evaluation-of-the-efficacy-and-cost-of-clinical-pharmacist-practitioners-managing-ambulatory-medicare-patients-in-north-carolina-apple-nc
#20
Michèle M Kislan, Adam T Bernstein, Loretta R Fearrington, Timothy J Ives
BACKGROUND: Clinical Pharmacist Practitioners are advanced practicing pharmacists in North Carolina that provide disease-specific management. The purpose of this retrospective cohort study was to compare the efficacy and charges from referrals to a Clinical Pharmacist Practitioner by the primary care provider, to those managed by a primary care provider alone. METHODS: Patients were separated into cohorts depending if they had at least two appointments with a Clinical Pharmacist Practitioner from November 2008 to November 2011...
October 21, 2016: BMC Health Services Research
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