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accountable care act

Christina Krudy, Kavita Shah Arora
The United States, along with other resource-rich countries, leads global health care by advancing medical care through randomized controlled trials (RCTs). While most medical research is conducted in these resource-rich areas, RCTs, including replications of previous trials, are additionally carried out in low- and middle-income countries. On the basis of positive findings from several RCTs conducted in high-income countries, the Antenatal Corticosteroids Trial (ACT) evaluated the effectiveness of antenatal corticosteroids in reducing neonatal mortality in low- and middle-income countries...
March 1, 2018: AMA Journal of Ethics
Marianne Bracconi, Christian Hervé, Philippe Pirnay
In a world open to the movement of people, medical ethics is today associated with the area of loyal behavior of the practitioner and oriented in the patient's interest and accountability of each. The universal vision of respect for the dignity of the sick person progresses. Yet, many behaviours are sometimes illegitimate, but not in principle legally reprehensible. One of the main principles marking the observance of patient consent is based on the autonomy given to the patient to decide for himself what appears to be adapted to his or her care...
March 5, 2018: Eastern Mediterranean Health Journal, la Revue de Santé de la Méditerranée Orientale
Grace Awantang, Stella Babalola, Hannah Koenker, Kathleen Fox, Michael Toso, Nan Lewicky, Daniel Somah, Victor Koko
BACKGROUND: In 2010, malaria was responsible for an estimated 41% of deaths among children under the age of five years in Liberia. The same year, the Rebuilding Basic Health Services Project launched "Healthy Baby, Happy Mother," a social and behavior change communication campaign. The campaign encouraged caregivers to take children under the age of five years to a health facility as soon as children developed fever. This study investigated correlates of two case management outcomes: care-seeking for children under five with fever during the past two weeks and administration of an artemisinin-based combination therapy (ACT) the same or next day as fever onset...
March 7, 2018: Malaria Journal
Lilit Karapetyan, Om Dawani, Heather S Laird-Fick
The immigrant population in the United States has grown over the past years. Undocumented immigrants account for 14.6% of the uninsured population in the United States. Decisions about end-of-life treatment are often difficult to reach in the best of situations. We present a 43-year-old undocumented Mexican female immigrant with metastatic sarcomatoid squamous cell cervical cancer and discuss the barriers that she faced during her treatment. Limited English proficiency, living below the poverty line, low level of education, and lack access to Medicare, Medicaid, or other insurance coverage under the Affordable Care Act are major causes of decreased health-care access and service utilization by the immigrant population...
January 1, 2018: Journal of Palliative Care
Thomas A Thornhill, Anne C Black, Marc I Rosen
INTRODUCTION: Adults with mental health disorders whose ability to work is sufficiently impeded are entitled to financial supports from the Social Security Administration. Beneficiaries determined to be incapable of managing these funds are supposed to be assigned a representative payee to assist beneficiaries in meeting their needs. However, patterns of payee assignment suggest that payee assignment is impacted by factors other than those the Social Security Administration instructs clinicians to consider...
March 5, 2018: Journal of Dual Diagnosis
Niam Yaraghi, Ram D Gopal
Policy Points: Frequent data breaches in the US health care system undermine the privacy of millions of patients every year-a large number of which happen among business associates of the health care providers that continue to gain unprecedented access to patients' data as the US health care system becomes digitally integrated. Implementation of the HIPAA Omnibus Rules in 2013 has led to a significant decrease in the number of privacy breach incidents among business associates. CONTEXT: Frequent data breaches in the US health care system undermine the privacy of millions of patients every year...
March 2018: Milbank Quarterly
Michelle M Mello, Julia Adler-Milstein, Karen L Ding, Lucia Savage
Policy Points: Historically, in addition to economic and technical hurdles, state and federal health information privacy laws have been cited as a significant obstacle to expanding electronic health information exchange (HIE) in the United States. Our review finds that over the past decade, several helpful developments have ameliorated the legal barriers to HIE, although variation in states' patient consent requirements remains a challenge. Today, health care providers' complaints about legal obstacles to HIE may be better understood as reflecting concerns about the economic and competitive risks of information sharing...
March 2018: Milbank Quarterly
Martin Widschwendter, Allison Jones, Iona Evans, Daniel Reisel, Joakim Dillner, Karin Sundström, Ewout W Steyerberg, Yvonne Vergouwe, Odette Wegwarth, Felix G Rebitschek, Uwe Siebert, Gaby Sroczynski, Inez D de Beaufort, Ineke Bolt, David Cibula, Michal Zikan, Line Bjørge, Nicoletta Colombo, Nadia Harbeck, Frank Dudbridge, Anne-Marie Tasse, Bartha M Knoppers, Yann Joly, Andrew E Teschendorff, Nora Pashayan
The incidence of cancer is continuing to rise and risk-tailored early diagnostic and/or primary prevention strategies are urgently required. The ideal risk-predictive test should: integrate the effects of both genetic and nongenetic factors and aim to capture these effects using an approach that is both biologically stable and technically reproducible; derive a score from easily accessible biological samples that acts as a surrogate for the organ in question; and enable the effectiveness of risk-reducing measures to be monitored...
February 27, 2018: Nature Reviews. Clinical Oncology
Chien-Jung Lin, Eric Novak, Michael W Rich, Joseph J Billadello
BACKGROUND: Adults with congenital heart disease (ACHD) have traditionally been viewed as an underinsured population. Whether this is true in the Affordable Care Act era is unknown. We determined insurance patterns in ACHD patients compared to the non-ACHD cardiology population in a contemporary cohort. METHODS: All cardiology outpatient visits between July 2016 and February 2017 to a large referral center in the United States were reviewed. The primary payer was categorized as health maintenance organization (HMO), preferred provider organization (PPO), Medicare, Medicaid, self-pay, or other...
February 26, 2018: Congenital Heart Disease
Sarah Petite
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is the third-leading cause of death in the United States. Guideline recommendations for medication therapy include the use of inhaled medications for management of stable COPD. There are limited data available describing prescribing percentages of medications in patients with COPD. AIM: To determine the prescribing percentages of medications for COPD in a national, cross-sectional study. METHODS: This was a national, cross-sectional study using data from the National Ambulatory Medical Care Survey (NAMCS) in 2013...
February 15, 2018: Pulmonary Pharmacology & Therapeutics
Michael W King
Despite the U.S. substantially outspending peer high income nations with almost 18% of GDP dedicated to health care, on any number of statistical measurements from life expectancy to birth rates to chronic disease, 1 the U.S. achieves inferior health outcomes. In short, Americans receive a very disappointing return on investment on their health care dollars, causing economic and social strain. 2 Accordingly, the debates rage on: what is the top driver of health care spending? Among the culprits: poor communication and coordination among disparate providers, paperwork required by payors and regulations, well-intentioned physicians overprescribing treatments, drugs and devices, outright fraud and abuse, and medical malpractice litigation...
November 2017: American Journal of Law & Medicine
Stanislas Pol, Lucia Parlati
BACKGROUND & AIMS: The recommended combination of pangenotypic direct-acting antivirals (DAAs) for the treatment of hepatitis C virus (HCV) associates the co-formulation of 2 or 3 second-generation DAAs. In the so-called "special populations" defined as patients with chronic kidney disease (CKD), HCV/HIV co-infection, HCV/HBV co-infection and an unsuccessful previous DAA regimen, these combinations have a high antiviral potency (sustained virologic response (SVR) > 95%), fair tolerance and a reduced pill burden...
February 2018: Liver International: Official Journal of the International Association for the Study of the Liver
Soo Downe, Theresa A Lawrie, Kenny Finlayson, Olufemi T Oladapo
BACKGROUND: Several studies have identified how mistreatment during labour and childbirth can act as a barrier to the use of health facilities. Despite general agreement that respectful maternity care (RMC) is a fundamental human right, and an important component of quality intrapartum care that every pregnant woman should receive, the effectiveness of proposed policies remains uncertain. We performed a systematic review to assess the effectiveness of introducing RMC policies into health facilities providing intrapartum services...
February 6, 2018: Reproductive Health
Juliana Onwumere, Grace Parkyn, Stephanie Learmonth, Elizabeth Kuipers
OBJECTIVES: Informal caregiving relationships play an important role in facilitating recovery outcomes in psychosis. The relationship can serve as a source of positive experiences that co-exist alongside common challenges typically associated with mental health problems. People with psychosis, when compared to the general population, are more likely to perpetrate acts of violence, a relationship that is particularly evident during the first psychosis episode. Although victims of service user violence are typically people already known to them, such as informal carers, there remains a lack of understanding about their caring experiences and needs...
February 5, 2018: Psychology and Psychotherapy
M E Bazzuri, N A Gabellone, L C Solari
Man-made activities exert great influences on fluvial ecosystems, with lowland rivers being substantially modified through agricultural land use and populations. The recent construction of drainage canals in the upper stretch of the Salado-River basin caused the mobilization of huge amounts of salts formerly stored in the groundwater. The main aim of this work was to analyze the effect of the discharges of those canals into the Salado-River water, under different hydrologic conditions, and the role of the wetlands and shallow lakes placed along the canals' system...
January 26, 2018: Environmental Monitoring and Assessment
Eric M Mafuta, Tjard De Cock Buning, Didier L Lolobi, Papy M Mayala, Thérèse N M Mambu, Patrick K Kayembe, Marjolein A Dieleman
BACKGROUND: This paper aims to identify factors that influence the capacity of women to voice their concerns regarding maternal health services at the local level. METHODS: A secondary analysis was conducted of the data from three studies carried out between 2013 and 2015 in the Democratic Republic of the Congo (DRC) in the context of a WOTRO initiative to improve maternal health services through social accountability mechanisms in the DRC. The data processing and analysis focused on data related to factors that influence the capacity of women to voice their concerns and on the characteristics of women that influence their ability to identify, and address specific problems...
January 25, 2018: BMC Health Services Research
Toufik Sadi, Adnan Mehonic, Luca Montesi, Mark Buckwell, Anthony Kenyon, Asen Asenov
We employ an advanced three-dimensional (3D) electro-thermal simulator to explore the physics and potential of oxide-based resistive random-access memory (RRAM) cells. The physical simulation model has been developed recently, and couples a kinetic Monte Carlo study of electron and ionic transport to the self-heating phenomenon while accounting carefully for the physics of vacancy generation and recombination, and trapping mechanisms. The simulation framework successfully captures resistance switching, including the electroforming, set and reset processes, by modeling the dynamics of conductive filaments in the 3D space...
January 15, 2018: Journal of Physics. Condensed Matter: An Institute of Physics Journal
Janet K Sluggett, Esa Y H Chen, Jenni Ilomäki, Megan Corlis, Sarah N Hilmer, Jan Van Emden, Choon Ean Ooi, Kim-Huong Nguyen, Tracy Comans, Michelle Hogan, Tessa Caporale, Susan Edwards, Lyntara Quirke, Allan Patching, J Simon Bell
BACKGROUND: Complex medication regimens are highly prevalent in residential aged care facilities (RACFs). Strategies to reduce unnecessary complexity may be valuable because complex medication regimens can be burdensome for residents and are costly in terms of nursing time. The aim of this study is to investigate application of a structured process to simplify medication administration in RACFs. METHODS: SImplification of Medications Prescribed to Long-tErm care Residents (SIMPLER) is a non-blinded, matched-pair, cluster randomised controlled trial of a single multidisciplinary intervention to simplify medication regimens...
January 12, 2018: Trials
Christina Galstian, Larry Hearld, Stephen J O'Connor, Nancy Borkowski
Efforts by hospitals to improve patient experience continue as changes in policy such as the Affordable Care Act of 2010 have made patient experience a cornerstone of promoting greater value in the United States. Hospital CEOs play an important role in promoting positive patient experiences as they set the organizational vision and strategic goals and can execute change to support positive experiences.This study assessed whether three CEO characteristics-education, tenure with the organization, and gender-were associated with patient experience scores of California hospitals in 2013 and 2014...
January 2018: Journal of Healthcare Management / American College of Healthcare Executives
Elena D Dimova, Ashleigh Ward, Vivien Swanson, Josie Mm Evans
BACKGROUND: People's personal perceptions, or illness representations, of type 2 diabetes can act as barriers to successful self-management. INTRODUCTION: Understanding patients' subjective perceptions of type 2 diabetes can aid the design of evidence-based care and appropriate educational programmes. This scoping review provides a narrative account of previous knowledge of patients' illness representations of type 2 diabetes. METHOD: Quantitative and qualitative studies that explored patients' illness representations of type 2 diabetes, as defined by Leventhal's Common Sense Model, were included...
December 27, 2017: Current Diabetes Reviews
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