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https://www.readbyqxmd.com/read/28692071/-charges-and-convictions-of-psychiatrists-for-the-violent-behavior-of-the-patient-psychiatric-forensic-remarks
#1
Giancarlo Nivoli, Liliana Lorettu, Bernardo Carpiniello, Paolo Milia, Federica Pinna, Andrea Lepretti, Cristiano Depalmas, Alessandra M A Nivoli
Purpose of the present study is to point-out a number of psychiatric-forensic remarks about the management of violent behavior against the person (VBP) amongst psychiatric patients. The study is the authors' personal contribution based on clinical and forensic experience as experts in the management of psychiatric patients with VBP. Twelve psychiatric-forensic remarks have been highlighted in the present study: 1) VBP is a multifactorial event; 2) the risk of VBP against the person may change rapidly over time in quantity and quality; 3) there are no methods for reliable prediction of VBP in a single clinical-case; 4) there are no medications with an indication of "heal" the VBP; 5) there are no therapeutic measures that neutralize always, quickly and without recurrences VBP; 6) there exist clinical hypotheses to assess VBP; 7) there exist principles of victimology to assess VBP; 8) there are emotional reactions that can affect the evaluation and clinical and forensic management of VBP; 9) the responsibility of the psychiatrist has to be evaluated at the moment of the events; 10) the responsibility of the psychiatrist must be contextualized in the single clinical-case; 11) there is the need to clarify the individual professional responsibility of psychiatrists who treated a patient; 12) there is the need to clarify the criteria for the definition of the guarantee role...
May 2017: Rivista di Psichiatria
https://www.readbyqxmd.com/read/28579517/early-regional-wall-distension-is-strongly-associated-with-vulnerability-to-ventricular-fibrillation-but-not-arrhythmia-triggers-following-coronary-occlusion-in-vivo
#2
José A Barrabés, Javier Inserte, Antonio Rodríguez-Sinovas, Marisol Ruiz-Meana, David Garcia-Dorado
Wall stress may favor ischemic ventricular arrhythmias, yet its association with ventricular fibrillation (VF) or ventricular ectopy has been inconsistent among studies and its potential arrhythmogenicity across the cardiac cycle is unclear. In 91 open-chest pigs undergoing 40-50 min left anterior descending artery occlusion, we assessed the association between diastolic or systolic distension of the ischemic area and the incidence of ventricular premature beats (VPBs) and VF. End-diastolic segment length (EDL) and systolic bulging ([maximum systolic length-EDL] × 100/EDL) were measured by ultrasonic crystals...
June 1, 2017: Progress in Biophysics and Molecular Biology
https://www.readbyqxmd.com/read/28562306/statement-of-the-problem-health-reform-value-based-purchasing-alternative-payment-strategies-and-children-and-youth-with-special-health-care-needs
#3
Sara S Bachman, Meg Comeau, Thomas F Long
There is increasing interest in maximizing health care purchasing value by emphasizing strategies that promote cost-effectiveness while achieving optimal health outcomes. These value-based purchasing (VBP) strategies have largely focused on adult health, and little is known about the impact of VBP program development and implementation on children, especially children and youth with special health care needs (CYSHCN). With the increasing emphasis on VBP, policymakers must critically analyze the potential impact of VBP for CYSCHN, because this group of children, by definition, uses more health care services than other children and inevitably incurs higher per person costs...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28558604/hospitals-known-for-nursing-excellence-perform-better-on-value-based-purchasing-measures
#4
Karen B Lasater, Hayley D Germack, Dylan S Small, Matthew D McHugh
It is well-established that hospitals recognized for good nursing care - Magnet hospitals - are associated with better patient outcomes. Less is known about how Magnet hospitals compare to non-Magnets on quality measures linked to Medicare reimbursement. The purpose of this study was to determine how Magnet hospitals perform compared to matched non-Magnet hospitals on Hospital Value Based Purchasing (VBP) measures. A cross-sectional analysis of three linked data sources was performed. The sample included 3,021 non-federal acute care hospitals participating in the VBP program (323 Magnets; 2,698 non-Magnets)...
November 2016: Policy, Politics & Nursing Practice
https://www.readbyqxmd.com/read/28448211/prevalence-and-geographic-distribution-of-vector-borne-pathogens-in-apparently-healthy-dogs-in-croatia
#5
Vladimir Mrljak, Josipa Kuleš, Željko Mihaljević, Marin Torti, Jelena Gotić, Martina Crnogaj, Tatjana Živičnjak, Iva Mayer, Iva Šmit, Mangesh Bhide, Renata Barić Rafaj
Vector-borne pathogens (VBPs) are a group of globally extended and quickly spreading pathogens that are transmitted by various arthropod vectors. The aim of the present study was to investigate the seroprevalence against Babesia canis, Anaplasma phagocytophilum, Borrelia burgdorferi sensu lato, Leishmania infantum, Dirofilaria immitis, and Ehrlichia canis in dogs in Croatia. We investigated 435 randomly selected apparently healthy dogs in 13 different locations of Croatia for antibodies to B. canis by indirect immunofluorescence using a commercial IFA IgG Antibody Kit...
June 2017: Vector Borne and Zoonotic Diseases
https://www.readbyqxmd.com/read/28367375/the-hospital-score-and-lace-index-as-predictors-of-30-day-readmission-in-a-retrospective-study-at-a-university-affiliated-community-hospital
#6
Robert Robinson, Tamer Hudali
INTRODUCTION: Hospital readmissions are common, expensive, and a key target of the Medicare Value Based Purchasing (VBP) program. Validated risk assessment tools such as the HOSPITAL score and LACE index have been developed to identify patients at high risk of hospital readmission so they can be targeted for interventions aimed at reducing the rate of readmission. This study aims to evaluate the utility of HOSPITAL score and LACE index for predicting hospital readmission within 30 days in a moderate-sized university affiliated hospital in the midwestern United States...
2017: PeerJ
https://www.readbyqxmd.com/read/28285583/molecular-detection-of-vector-borne-pathogens-in-blood-and-splenic-samples-from-dogs-with-splenic-disease
#7
Rebeca Movilla, Laura Altet, Lorena Serrano, María-Dolores Tabar, Xavier Roura
BACKGROUND: The spleen is a highly perfused organ involved in the immunological control and elimination of vector-borne pathogens (VBP), which could have a fundamental role in the pathogenesis of splenic disease. This study aimed to evaluate certain VBP in samples from dogs with splenic lesions. METHODS: Seventy-seven EDTA-blood and 64 splenic tissue samples were collected from 78 dogs with splenic disease in a Mediterranean area. Babesia spp., Bartonella spp., Ehrlichia/Anaplasma spp...
March 13, 2017: Parasites & Vectors
https://www.readbyqxmd.com/read/28141930/value-based-payment-in-implementing-evidence-based-care-the-mental-health-integration-program-in-washington-state
#8
Yuhua Bao, Thomas G McGuire, Ya-Fen Chan, Ashley A Eggman, Andrew M Ryan, Martha L Bruce, Harold Alan Pincus, Erin Hafer, Jürgen Unützer
OBJECTIVES: To assess the role of value-based payment (VBP) in improving fidelity and patient outcomes in community implementation of an evidence-based mental health intervention, the Collaborative Care Model (CCM). STUDY DESIGN: Retrospective study based on a natural experiment. METHODS: We used the clinical tracking data of 1806 adult patients enrolled in a large implementation of the CCM in community health clinics in Washington state. VBP was initiated in year 2 of the program, creating a natural experiment...
January 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28122873/rising-stakes-for-health-care-associated-infection-prevention-implications-for-the-clinical-microbiology-laboratory
#9
Daniel J Diekema
Health care-associated infection (HAI) rates are subject to public reporting and are linked to hospital reimbursement from the Centers for Medicare and Medicaid Services (CMS). The increasing pressure to lower HAI rates comes at a time when advances in the clinical microbiology laboratory (CML) provide more-precise and -sensitive tests, altering HAI detection in ways that may increase reported HAI rates. I review how changing CML practices can impact HAI rates and how the financial implications of HAI metrics may produce pressure to change diagnostic testing practices...
April 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28089185/joint-replacement-volume-positively-correlates-with-improved-hospital-performance-on-centers-for-medicare-and-medicaid-services-quality-metrics
#10
Rachel A Sibley, Vanessa Charubhumi, Lorraine H Hutzler, Albit R Paoli, Joseph A Bosco
BACKGROUND: The Center for Medicare and Medicaid Services (CMS) is transitioning Medicare from a fee-for-service program into a value-based pay-for-performance program. In order to accomplish this goal, CMS initiated 3 programs that attempt to define quality and seek to reward high-performing hospitals and penalize poor-performing hospitals. These programs include (1) penalties for hospital-acquired conditions (HACs), (2) penalties for excess readmissions for certain conditions, and (3) performance on value-based purchasing (VBP)...
May 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28072793/merit-based-incentive-payment-system-meaningful-changes-in-the-final-rule-brings-cautious-optimism
#11
Laxmaiah Manchikanti, Standiford Helm Ii, Aaron K Calodney, Joshua A Hirsch
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) eliminated the flawed Sustainable Growth Rate (SGR) act formula - a longstanding crucial issue of concern for health care providers and Medicare beneficiaries. MACRA also included a quality improvement program entitled, "The Merit-Based Incentive Payment System, or MIPS." The proposed rule of MIPS sought to streamline existing federal quality efforts and therefore linked 4 distinct programs into one. Three existing programs, meaningful use (MU), Physician Quality Reporting System (PQRS), value-based payment (VBP) system were merged with the addition of Clinical Improvement Activity category...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28069856/patient-hospital-experience-improved-modestly-but-no-evidence-medicare-incentives-promoted-meaningful-gains
#12
Irene Papanicolas, José F Figueroa, E John Orav, Ashish K Jha
The Centers for Medicare and Medicaid Services (CMS) has played a leading role in efforts to improve patients' experiences with hospital care. Yet little is known about how much patient experience has changed over the past decade, and even less is known about the impact of CMS's most recent strategy: tying payments to performance under the Value-Based Purchasing (VBP) program. We examined trends in multiple measures of patient satisfaction in the period 2008-14. We found that patient experience has improved modestly at US hospitals-both those participating in the VBP program and others-with the majority of improvement concentrated in the period before the program was implemented...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/27906530/medicare-program-hospital-outpatient-prospective-payment-and-ambulatory-surgical-center-payment-systems-and-quality-reporting-programs-organ-procurement-organization-reporting-and-communication-transplant-outcome-measures-and-documentation-requirements-electronic
#13
(no author information available yet)
This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2017 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system...
November 14, 2016: Federal Register
https://www.readbyqxmd.com/read/27858564/preparing-for-value-based-payment-a-stepwise-approach-for-cancer-centers
#14
Kerin B Adelson, Salimah Velji, Kavita Patel, Basit Chaudhry, Catherine Lyons, Rogerio Lilenbaum
Most cancer centers are ill-equipped to pursue value-based payment (VBP) because of limited information on their population's cost of care. Herein, we outline the stepwise approach used by Smilow Cancer Hospital at Yale-New Haven in our pursuit of better value care. First, we addressed institutional barriers. A move toward value required demonstration to Yale-New Haven Health System leadership that OCM would improve patient care, fund new infrastructure, and provide the opportunity to gain experience with VBP without a major threat to the financial stability of the health system...
October 2016: Journal of Oncology Practice
https://www.readbyqxmd.com/read/27723613/malignant-extra-cranial-germ-cell-tumors-in-children-and-adolescents-results-following-the-guidelines-of-sfop-sfce-95-protocol
#15
Pedro Zubizarreta, Ana Rossa, Marcela Bailez, Silvia Gil, Adriana Rose, Walter Cacciavillano
Between September 1995 and December 2010, 99 new consecutive assessable patients with extra-cranial MGCT were treated according to SFOP/SFCE TGM95 Protocol. A "watch and wait" strategy for completely resected stage I-II was observed in cases with preoperative high tumor markers levels. Metastatic disease or alpha fetoprotein levels > 15 000 ng/ml cases were treated by VIP chemotherapy (etoposide, ifosfamide and CDDP) 4-6-courses. All other cases were treated by VBP (vinblastine, bleomycin, and CDDP) 3-5 courses...
2016: Medicina
https://www.readbyqxmd.com/read/27697566/hospice-value-based-purchasing-program-a-model-design
#16
Bryan P Nowak
With the implementation of the Affordable Care Act, the U.S. government committed to a transition in payment policy for health care services linking reimbursement to improved health outcomes rather than the volume of services provided. To accomplish this goal, the Department of Health and Human Services is designing and implementing new payment models intended to improve the quality of health care while reducing its cost. Collectively, these novel payment models and programs have been characterized under the moniker of value-based purchasing (VBP), and although many of these models retain a fundamental fee-for-service (FFS) structure, they are seen as essential tools in the evolution away from volume-based health care financing toward a health system that provides "better care, smarter spending, and healthier people...
December 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/27696009/does-drug-price-regulation-affect-healthcare-expenditures
#17
Omer Ben-Aharon, Oren Shavit, Racheli Magnezi
BACKGROUND: Increasing health costs in developed countries are a major concern for decision makers. A variety of cost containment tools are used to control this trend, including maximum price regulation and reimbursement methods for health technologies. Information regarding expenditure-related outcomes of these tools is not available. OBJECTIVE: To evaluate the association between different cost-regulating mechanisms and national health expenditures in selected countries...
September 30, 2016: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/27676686/merit-based-incentive-payment-system-mips-harsh-choices-for-interventional-pain-management-physicians
#18
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
UNLABELLED: The Merit-based Incentive Payment System (MIPS) was created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) to improve the health of all Americans by providing incentives and policies to improve patient health outcomes. MIPS combines 3 existing programs, Meaningful Use (MU), now called Advancing Care Information (ACI), contributing 25% of the composite score; Physician Quality Reporting System (PQRS), changed to Quality, contributing 50% of the composite score; and Value-based Payment (VBP) system to Resource Use or cost, contributing 10% of the composite score...
September 2016: Pain Physician
https://www.readbyqxmd.com/read/27651999/the-hospital-score-as-a-predictor-of-30-day-readmission-in-a-retrospective-study-at-a-university-affiliated-community-hospital
#19
Robert Robinson
INTRODUCTION: Hospital readmissions are common, expensive, and a key target of the Medicare Value Based Purchasing (VBP) program. Risk assessment tools have been developed to identify patients at high risk of hospital readmission so they can be targeted for interventions aimed at reducing the rate of readmission. One such tool is the HOSPITAL score that uses seven readily available clinical variables to predict the risk of readmission within 30 days of discharge. The HOSPITAL score has been internationally validated in large academic medical centers...
2016: PeerJ
https://www.readbyqxmd.com/read/27618668/independent-practice-associations-advantages-and-disadvantages-of-an-alternative-form-of-physician-practice-organization
#20
Lawrence P Casalino, Norman Chenven
BACKGROUND: Value-based purchasing (VBP) favors provider organizations large enough to accept financial risk and develop care management infrastructure. Independent Practice Associations (IPAs) are a potential alternative for physicians to becoming employed by a hospital or large medical group. But little is known about IPAs. METHODS: We selected four IPAs that vary in location, structure, and strategy, and conducted interviews with their president and medical director, as well as with a hospital executive and health plan executive familiar with that IPA...
March 2017: Healthcare
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