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https://www.readbyqxmd.com/read/28110510/access-equity-and-costs-of-induced-abortion-services-in-australia-a-cross-sectional-study
#1
Mridula Shankar, Kirsten I Black, Philip Goldstone, Safeera Hussainy, Danielle Mazza, Kerry Petersen, Jayne Lucke, Angela Taft
OBJECTIVES: To examine access and equity to induced abortion services in Australia, including factors associated with presenting beyond nine weeks gestation. METHODS: Cross-sectional survey of 2,326 women aged 16+ years attending for an abortion at 14 Dr Marie clinics. Associations with later presentation assessed using multivariate logistic regression. RESULTS: Over a third of eligible women opted for a medical abortion. More than one in 10 (11...
January 22, 2017: Australian and New Zealand Journal of Public Health
https://www.readbyqxmd.com/read/28110486/spectra-optia-%C3%A2-for-automated-red-blood-cell-exchange-in-patients-with-sickle-cell-disease-a-nice-medical-technology-guidance
#2
REVIEW
Iain Willits, Helen Cole, Roseanne Jones, Kimberley Carter, Mick Arber, Michelle Jenks, Joyce Craig, Andrew Sims
The Spectra Optia(®) automated apheresis system, indicated for red blood cell exchange in people with sickle cell disease, underwent evaluation by the National Institute for Health and Care Excellence, which uses its Medical Technologies Advisory Committee to make recommendations. The company (Terumo Medical Corporation) produced a submission making a case for adoption of its technology, which was critiqued by the Newcastle and York external assessment centre. Thirty retrospective observational studies were identified in their clinical submission...
January 21, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/28110420/the-availability-and-marginal-costs-of-dependent-employer-sponsored-health-insurance
#3
G Edward Miller, Jessica Vistnes, Matthew Buettgens, Lisa Dubay
In this study, we examine differences by firm size in the availability of dependent coverage and the incremental cost of such coverage. We use data from the Medical Expenditure Panel Survey - Insurance Component (MEPS-IC) to show that among employees eligible for single coverage, dependent coverage was almost always available for employees in large firms (100 or more employees) but not in smaller firms, particularly those with fewer than 10 employees. In addition, when dependent coverage was available, eligible employees in smaller firms were more likely than employees in large firms to face two situations that represented the extremes of the incremental cost distribution: (1) they paid nothing for single or family coverage or (2) they paid nothing for single coverage but faced a high contribution for family coverage...
January 21, 2017: Int J Health Econ Manag
https://www.readbyqxmd.com/read/28110290/guided-and-unguided-internet-based-vestibular-rehabilitation-versus-usual-care-for-dizzy-adults-of-50%C3%A2-years-and-older-a-protocol-for-a-three-armed-randomised-trial
#4
Vincent A van Vugt, Johannes C van der Wouden, Judith E Bosmans, Martin Smalbrugge, Willianne van Diest, Rosie Essery, Lucy Yardley, Henriëtte E van der Horst, Otto R Maarsingh
INTRODUCTION: Dizziness is a common symptom in general practice with a high prevalence among older adults. The most common cause of dizziness in general practice is peripheral vestibular disease. Vestibular rehabilitation (VR) is a safe and effective treatment for peripheral vestibular disease that entails specific exercises to maximise the central nervous system compensation for the effects of vestibular pathology. An internet-based VR intervention has recently been shown to be safe and effective...
January 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28110283/estimated-generic-prices-of-cancer-medicines-deemed-cost-ineffective-in-england-a-cost-estimation-analysis
#5
Andrew Hill, Christopher Redd, Dzintars Gotham, Isabelle Erbacher, Jonathan Meldrum, Ryo Harada
OBJECTIVES: The aim of this study was to estimate lowest possible treatment costs for four novel cancer drugs, hypothesising that generic manufacturing could significantly reduce treatment costs. SETTING: This research was carried out in a non-clinical research setting using secondary data. PARTICIPANTS: There were no human participants in the study. Four drugs were selected for the study: bortezomib, dasatinib, everolimus and gefitinib. These medications were selected according to their clinical importance, novel pharmaceutical actions and the availability of generic price data...
January 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28109939/peripheral-venous-catheter-insertion-simulation-training-a-randomized-controlled-trial-comparing-performance-after-instructor-led-teaching-versus-peer-assisted-learning
#6
Sophie Pelloux, Arnaud Grégoire, Patrice Kirmizigul, Sandrine Maillot, Bernard Bui-Xuan, Guy Llorca, Sylvain Boet, Jean-Jacques Lehot, Thomas Rimmelé
INTRODUCTION: Peripheral venous catheter insertion is a procedural skill that every medical student should master. Training is often limited to a small number of students and is poorly evaluated. The objective of this study was to evaluate the performance of peer-assisted learning in comparison to instructor-led teaching for peripheral venous catheter insertion training. METHODS: Students were randomized to the control group attending a traditional instructor-led training session (slideshow and demonstration by an anaesthetist instructor, followed by training on a procedural simulator) or to the test group attending a peer-assisted training session (slideshow and demonstration video-recorded by the same instructor, followed by training on a procedural simulator...
January 18, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28109281/evaluation-of-a-program-to-strengthen-general-practice-care-for-patients-with-chronic-disease-in-germany
#7
Michel Wensing, Joachim Szecsenyi, Christian Stock, Petra Kaufmann Kolle, Gunter Laux
BACKGROUND: A program to strengthen general practice care for patients with chronic disease was offered in Germany. Enrollment was a free individual choice for both patients and physicians. This study aimed to examine the long-term impact of this program. METHODS: Two comparative evaluations were done, at 4 and 5 years (T1 and T2) after start of the program. In each year, patients in the program were compared with patients in usual care. Measures were based on routinely collected data and concerned 11 aspects of primary care and hospital care...
January 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28108941/factors-associated-with-emergency-department-useamong-veteran-psychiatric-patients
#8
Daniel M Blonigen, Kathryn S Macia, Xiaoyu Bi, Paola Suarez, Luisa Manfredi, Todd H Wagner
Frequent utilization of emergency department (ED) services contributes substantially to the cost of healthcare nationally and is often driven by psychiatric factors. Using national-level data from the Veterans Health Administration (VHA), the present study examined patient-level factors associated with ED use among veteran psychiatric patients. Veterans who had at least one ED visit with a psychiatric diagnosis in fiscal years 2011-2012 (n = 226,122) were identified in VHA administrative records. Andersen's behavioral model of healthcare utilization was used to identify need, enabling, and predisposing factors associated with frequency of ED use (primary outcome) in multivariate regression models...
January 21, 2017: Psychiatric Quarterly
https://www.readbyqxmd.com/read/28108823/which-clinical-and-patient-factors-influence-the-national-economic-burden-of-hospital-readmissions-after-total-joint-arthroplasty
#9
Steven M Kurtz, Edmund C Lau, Kevin L Ong, Edward M Adler, Frank R Kolisek, Michael T Manley
BACKGROUND: The Affordable Care Act of 2010 advanced the economic model of bundled payments for total joint arthroplasty (TJA), in which hospitals will be financially responsible for readmissions, typically at 90 days after surgery. However, little is known about the financial burden of readmissions and what patient, clinical, and hospital factors drive readmission costs. QUESTIONS/PURPOSES: (1) What is the incidence, payer mix, and demographics of THA and TKA readmissions in the United States? (2) What patient, clinical, and hospital factors are associated with the cost of 30- and 90-day readmissions after primary THA and TKA? (3) Are there any differences in the economic burden of THA and TKA readmissions between payers? (4) What types of THA and TKA readmissions are most costly to the US hospital system? METHODS: The recently developed Nationwide Readmissions Database from the Healthcare Cost and Utilization Project (2006 hospitals from 21 states) was used to identify 719,394 primary TJAs and 62,493 90-day readmissions in the first 9 months of 2013 based on International Classification of Diseases, 9th Revision, Clinical Modification codes...
January 20, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28108799/the-economics-of-stone-disease
#10
Noah E Canvasser, Peter Alken, Michael Lipkin, Stephen Y Nakada, Hiren S Sodha, Abdulkadir Tepeler, Yair Lotan
The rising prevalence of kidney stone disease is associated with significant costs to healthcare systems worldwide. This is in part due to direct procedural and medical management costs, as well as indirect costs to health systems, patients, and families. A number of manuscripts evaulating the economics of stone disease have been published since the 2008s International Consultation on Stone Disease. These highlight costs associated with stone disease, including acute management, surgical management, and medical management...
January 20, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28108747/national-guidelines-for-smoking-cessation-in-primary-care-a-literature-review-and-evidence-analysis
#11
Marjolein Verbiest, Evelyn Brakema, Rianne van der Kleij, Kate Sheals, Georgia Allistone, Siân Williams, Andy McEwen, Niels Chavannes
: National guidelines for smoking cessation in primary care can be effective in improving clinical practice. This study assessed which parties are involved in the development of such guidelines worldwide, which national guidelines address primary care, what recommendations are made for primary care settings, and how these recommendations correlate with each other and with current evidence. We identified national guidelines using an online resource. Only the most recent version of a guideline was included...
December 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28108324/the-circle-nephrostomy-tube-an-attractive-nephrostomy-drainage-system-following-complex-percutaneous-nephrolithotomy
#12
Marawan M El Tayeb, Michael S Borofsky, James E Lingeman
OBJECTIVE: To describe our experience with the circle NT (Cook® Medical), a drainage system uniquely designed for use after multiple access PNL. MATERIALS AND METHODS: A retrospective review of 1317 consecutive patients undergoing 1599 PNLs at IU Health Methodist Hospital was performed. All multiple access cases utilizing circle NTs were reviewed and analyzed. The method of insertion of circle NT is demonstrated. RESULTS: A total of 1843 accesses were obtained in 1599 renal units RUs: 380 upper, 129 mid, and 1334 lower...
January 17, 2017: Urology
https://www.readbyqxmd.com/read/28107301/implementation-of-a-pediatric-orthopaedic-bundle-to-reduce-surgical-site-infections
#13
Jan Schriefer, James Sanders, Julie Michels, Kori Wolcott, Connor Ruddy, Jenna Hanson
Surgical site infections (SSIs) cost an estimated $27,288 per case. An analysis of the National Surgical Quality Improvement Program data at the University of Rochester Medical Center suggested that rates of SSIs could be lowered in comparison with both peers and baseline. The aim of this study was to reduce the number of SSIs to zero through the implementation of a "bundle" or a combination of practices. Meetings were held with the multidisciplinary care team that includes surgeons and staff from pediatric pharmacy, pediatric infectious diseases, anesthesia, and nursing to create a care bundle for all pediatric orthopaedic surgery patients...
January 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28107295/healthcare-transformation-and-changing-roles-for-nursing
#14
Susan W Salmond, Mercedes Echevarria
Factors driving healthcare transformation include fragmentation, access problems, unsustainable costs, suboptimal outcomes, and disparities. Cost and quality concerns along with changing social and disease-type demographics created the greatest urgency for the need for change. Caring for and paying for medical treatments for patients suffering from chronic health conditions are a significant concern. The Affordable Care Act includes programs now led by the Centers for Medicare & Medicaid Services aiming to improve quality and control cost...
January 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28105877/academic-detailing-among-psychiatrists-feasibility-and-acceptability
#15
Kamini Vasudev, Joel Lamoure, Michael Beyaert, Varinder Dua, David Dixon, Jason Eadie, Larissa Husarewych, Ragu Dhir, Jatinder Takhar
Purpose Research has shown that academic detailing (AD), which includes repeated in-person educational messages in an interactive format in a physician's office, is among the most effective continuing medical education (CME) forms for improving prescribing practices and reducing drug costs. The purpose of this paper is to investigate AD's feasibility and acceptability as an educational tool among psychiatrists and its ability to facilitate positive changes in antipsychotic prescribing. Design/methodology/approach All psychiatrists practicing in Southwestern Ontario, Canada were invited to participate...
February 13, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28105778/psychosocial-screening-and-management-of-young-people-aged-18-25-years-with-diabetes
#16
Helen d'Emden, Brett McDermott, Neisha D'Silva, Tom Dover, Tatjana Ewais, Kristen Gibbons, Trisha O'Moore-Sullivan
BACKGROUND: Routine psychosocial screening and management of people with diabetes is recommended. AIMS: To profile demographic, medical and psychosocial characteristics of young people with diabetes, and to develop a screening tool and care pathway for routine use. METHODS: Indices of diabetes control and recorded diabetes complications were complimented by psychosocial screening tools assessing psychological, diabetes specific, and perceived stress (K10, PAID, PSS), well-being (WHO-5), disordered eating ((EDI-3RC), compensatory behaviour questionnaire, social support (MSPSS), resilience (CD-2) and financial concerns...
January 20, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28105620/-effect-of-a-clinical-pathway-in-patients-with-crohn-s-disease-complicated-with-intestinal-obstruction
#17
Zhen Guo, Lei Cao, Jianfeng Gong, Yi Li, Lili Gu, Weiming Zhu, Jieshou Li
OBJECTIVE: To evaluate the effect of a clinical pathway for Crohn disease (CD) complicated with intestinal obstruction. METHODS: CD patients complicated with intestinal obstruction in Inflammatory Bowel Disease(IBD) Center of Jinling Hospital were enrolled. One hundred and nineteen CD patients from March 2014 to September 2015 received treatment with the clinical pathway (CP), which was developed based on medical evidence and experience of the IBD center in February 2014, as CP group...
January 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28104154/cost-analysis-of-transplantation-in-japan-performed-with-the-use-of-the-national-database
#18
T Kitazawa, K Matsumoto, S Fujita, K Seto, T Hasegawa
BACKGROUND: When assessing the cost of transplants in Japan, earlier studies have been limited to case series that investigated inpatient cost alone. Few studies have evaluated total cost, which includes inpatient, outpatient, and pharmaceutical costs, or compared costs before and after transplantation. Using the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB), we investigated the total cost of major transplantation and contributing factors. METHODS: We analyzed the cost and complications of patients who underwent a cadaveric renal transplantation (CRT), living renal transplantation (LRT), living-donor liver transplantation (LDLT), allogeneic bone marrow transplantation, autologous bone marrow transplantation, allogeneic peripheral blood stem cell transplantation, or autologous peripheral blood stem cell transplantation (auto-PBSCT) from April 2009 to March 2010...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28103987/-four-awareness-of-clinical-lean-management
#19
L Z Xiong, C F Zhang
Along with changes of medical model, hospitals need to provide best outcome with lowest cost and best patient's experience rather than merely medical treatments. It is the cultivation of lean awareness to the doctors that could acquire such outcome. The healthcare lean awareness can be summarized as responsibility awareness, digitalized awareness, detail awareness, and outstanding awareness. Through the cultivation of lean awareness, humanism can immerse into the doctors'practice, which is conducive to train for the great masters of the medicine...
January 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28103948/the-cost-effectiveness-of-a-patient-tailored-intervention-programme-to-enhance-adherence-to-antihypertensive-medication-in-community-pharmacies-study-protocol-of-a-randomised-controlled-trial
#20
Danielle M van der Laan, Petra J M Elders, Christel C L M Boons, Judith E Bosmans, Giel Nijpels, Jacqueline G Hugtenburg
BACKGROUND: Medication non-adherence is a complex health care problem. Due to non-adherence, substantial numbers of cardiovascular patients benefit from their medication to only a limited extent. In order to improve adherence, a variety of pharmacist-led interventions have been developed. However, even the most effective interventions achieved only a modest positive effect. To be effective, interventions should be targeted at underlying barriers to adherence, developed in a systematic manner and tailored to specific features of a target group and setting...
January 19, 2017: Trials
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