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https://www.readbyqxmd.com/read/28108823/which-clinical-and-patient-factors-influence-the-national-economic-burden-of-hospital-readmissions-after-total-joint-arthroplasty
#1
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/28108765/score-study-quality-indicators-for-rheumatology-nursing-clinics
#2
Santiago Muñoz-Fernández, Ma Dolores Aguilar, Raquel Almodóvar, Laura Cano-García, Sandra Fortea, Cristina Patricia Alcañiz-Escandell, José R Rodríguez, Laura Cebrián, Pablo Lázaro
Nursing clinics in rheumatology (NCR) are organizational care models that provide care centred within the scope of nurses abilities. To analyse patients differences in the knowledge of the disease, adherence to the treatment, quality indicators of the Rheumatology Departments included quality perceived by the patients with and without NCR. National multicenter observational prospective cohort study 1 year follow-up, comparing patients attending rheumatology services with and without NCR. NCR was defined by the presence of: (1) office itself; (2) at least one dedicated nurse; (3) its own appointment schedule, and (4) phone...
January 20, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28108581/reduced-emergency-department-utilization-by-patients-with-epilepsy-using-qi-methodology
#3
Anup D Patel, Eric G Wood, Daniel M Cohen
BACKGROUND: Epilepsy or seizure care is the most common neurologic condition that presents to an emergency department (ED) and accounts for a large number of annual cases. Our aim was to decrease seizure-related ED visits from our baseline of 17 ED visits per month per 1000 patients to 13.6 ED visits per month per 1000 patients (20%) by July 2014. METHODS: Our strategy was to develop a quality improvement (QI) project utilizing the Institute for Healthcare Improvement model...
January 20, 2017: Pediatrics
https://www.readbyqxmd.com/read/28108529/does-charging-different-user-fees-for-primary-and-secondary-care-affect-first-contacts-with-primary-healthcare-a-systematic-review
#4
Thomas Hone, John Tayu Lee, Azeem Majeed, Lesong Conteh, Christopher Millett
Policy-makers are increasingly considering charging users different fees between primary and secondary care (differential user charges) to encourage utilisation of primary health care in health systems with limited gate keeping. A systematic review was conducted to evaluate the impact of introducing differential user charges on service utilisation. We reviewed studies published in MEDLINE, EMBASE, the Cochrane library, EconLIT, HMIC, and WHO library databases from January 1990 until June 2015. We extracted data from the studies meeting defined eligibility criteria and assessed study quality using an established checklist...
January 20, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28108380/the-taste-of-heat-how-humoral-qualities-act-as-a-cultural-filter-for-chemosensory-properties-guiding-herbal-medicine
#5
Matthias S Geck, Stefano Cabras, Laura Casu, Alberto J Reyes García, Marco Leonti
ETHNOPHARMACOLOGICAL RELEVANCE: Organoleptic properties, and more specifically chemosensory cues, have been shown to guide therapeutic applications of medicinal plants. Humoral qualities, on the other hand, are widely believed to be an abstract concept, mainly applied post hoc to validate therapy. However, the nexus between humoral qualities, chemosensory properties, and medicinal plant uses has never been systematically assessed. AIM OF THE STUDY: To systematically analyse the correlations between chemosensory properties, humoral qualities, and medicinal uses of selected botanical drugs...
January 17, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28108271/comparative-effectiveness-of-busulfan-and-fludarabine-versus-fludarabine-and-400-cgy-total-body-irradiation-conditioning-regimens-for-aml-mds
#6
Moaath Mustafa Ali, Donna M Abounader, Lisa A Rybicki, Melissa A Yurch, Jamie Starn, Christina Ferraro, Victoria Winslow, Betty K Hamilton, Aaron T Gerds, Hien Liu, Robert Dean, Brian T Hill, Brad Pohlman, Steven Andresen, Rabi Hanna, Matt Kalaycio, Brian J Bolwell, Navneet S Majhail, Ronald Sobecks
Allogeneic hematopoietic cell transplantation (alloHCT) conditioning regimen intensity has varied for patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). A comparative effectiveness analysis was performed to assess outcomes of busulfan and fludarabine (BuFlu) versus fludarabine and 400 cGy total body irradiation (FluTBI) conditioning. Thirty-three subjects received BuFlu and 38 had FluTBI. The BuFlu group received more red blood cell transfusions (P=0.02) and had a longer time to platelet recovery (P=0...
January 17, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28108085/learning-curve-of-laparoscopic-roux-en-y-gastric-bypass-in-an-asian-low-volume-bariatric-unit
#7
Shih-Chiang Shen, Chun-Yi Tsai, Chien-Hung Liao, Yu-Yin Liu, Ta-Sen Yeh, Keng-Hao Liu
BACKGROUND: Obesity has become a healthcare burden in Taiwan and the rest of Asia. Laparoscopic Roux-en-Y gastric bypass (LRYGB) provides good weight loss outcome, and improves comorbidity as well as quality of life. We present our experience of the learning curve for LRYGB in a low-volume bariatric unit. METHODS: From March 2009 to August 2011, 60 consecutive patients who underwent LRYGB were included. They were separated into two groups, with the first 30 cases in Group 1 and the remaining 30 cases in Group 2...
January 17, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28107335/aromatherapy-using-essential-oils-as-a-supportive-therapy%C3%A2
#8
Debra Reis, Tisha Jones
Essential oils can be a great adjunct to cancer care, aiding in the management of side effects, such as insomnia and nausea. Healthcare professionals should be knowledgeable about the quality and safety of essential oils when using them for clinical purposes. Using lesser quality essential oils and not understanding safety guidelines can negatively affect clinical outcomes. This article provides an overview of how nurses can help patients with cancer safely use essential oils as a supportive therapy.
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February 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28107295/healthcare-transformation-and-changing-roles-for-nursing
#9
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/28107251/internet-delivered-self-management-support-for-improving-coronary-heart-disease-and-self-management-related-outcomes-a-systematic-review
#10
Jorge Palacios, Geraldine A Lee, Maria Duaso, Abigail Clifton, Ian J Norman, Derek Richards, Elizabeth Alexandra Barley
INTRODUCTION: Coronary heart disease (CHD) is associated with significant morbidity and mortality, including mental health comorbidity, which is associated with poor outcomes. Self-management is key, but there is limited access to self-management support. Internet-delivered interventions may increase access. OBJECTIVE: The aim of this study was to conduct a systematic review to (1) determine the effectiveness of Internet-delivered CHD self-management support for improving CHD, mood, and self-management related outcomes and (2) identify and describe essential components for effectiveness...
January 20, 2017: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28106853/significant-change-spotting-for-periodic-human-motion-segmentation-of-cleaning-tasks-using-wearable-sensors
#11
Kai-Chun Liu, Chia-Tai Chan
The proportion of the aging population is rapidly increasing around the world, which will cause stress on society and healthcare systems. In recent years, advances in technology have created new opportunities for automatic activities of daily living (ADL) monitoring to improve the quality of life and provide adequate medical service for the elderly. Such automatic ADL monitoring requires reliable ADL information on a fine-grained level, especially for the status of interaction between body gestures and the environment in the real-world...
January 19, 2017: Sensors
https://www.readbyqxmd.com/read/28106661/swallowing-after-transoral-surgery-for-oropharyngeal-cancer-comparison-with-primary-chemoradiotherapy-outcomes
#12
Nicholas Dawe, James O'Hara
PURPOSE OF REVIEW: Survival equipoise is recognized between the contemporary surgical and oncological approaches to oropharyngeal squamous cell carcinoma treatment. Primary transoral surgery (TOS) options have emerged that utilize either laser or robotic techniques. Our review presents an overview of the evidence available for swallowing outcomes following TOS approaches and compares these with outcomes following primary oncological management. RECENT FINDINGS: Meta-analysis of swallow outcomes following TOS or (chemo)radiotherapy is not possible given the heterogeneity of the available data...
January 18, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28106617/determinants-of-health-knowledge-and-health-perceptions-from-the-perspective-of-health-related-education-of-patients-with-spinal-cord-injury-a-systematic-review
#13
Piotr Tederko, Tomasz Krasuski, Marek Krasuski, Alicja Długołęcka, Beata Tarnacka
Appropriate health knowledge (HK) and health perceptions (HP) of patients with spinal cord injury (SCI) are linked to health-related behaviors, compliance, the involvement of caregivers and efficacy of prophylaxis, and management of secondary conditions. The significance of factors determining the efficacy of educational interventions in patients with SCI is underestimated. This systematic literature review aims at identification of determinants of HK and HP among patients with SCI. We identified 16 papers with quantitative HK and HP measurements conclusive in the identification of HK and HP determinants in individuals with SCI...
January 18, 2017: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
https://www.readbyqxmd.com/read/28106511/telementoring-primary-care-clinicians-to-improve-geriatric-mental-health-care
#14
Elisa Fisher, Michael Hasselberg, Yeates Conwell, Linda Weiss, Norma A Padrón, Erin Tiernan, Jurgis Karuza, Jeremy Donath, José A Pagán
Health care delivery and payment systems are moving rapidly toward value-based care. To be successful in this new environment, providers must consistently deliver high-quality, evidence-based, and coordinated care to patients. This study assesses whether Project ECHO(®) (Extension for Community Healthcare Outcomes) GEMH (geriatric mental health)-a remote learning and mentoring program-is an effective strategy to address geriatric mental health challenges in rural and underserved communities. Thirty-three teleECHO clinic sessions connecting a team of specialists to 54 primary care and case management spoke sites (approximately 154 participants) were conducted in 10 New York counties from late 2014 to early 2016...
January 20, 2017: Population Health Management
https://www.readbyqxmd.com/read/28105884/framework-for-establishing-records-control-in-hospitals-as-an-iso-9001-requirement
#15
Lina Al-Qatawneh
Purpose The purpose of this paper is to present the process followed to control records in a Jordanian private community hospital as an ISO 9001:2008 standard requirement. Design/methodology/approach Under the hospital quality council's supervision, the quality management and development office staff were responsible for designing, planning and implementing the quality management system (QMS) using the ISO 9001:2008 standard. A policy for records control was established. An action plan for establishing the records control was developed and implemented...
February 13, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28105880/nursing-home-care-quality-a-cluster-analysis
#16
Vigdis Abrahamsen Grøndahl, Liv Berit Fagerli
Purpose The purpose of this paper is to explore potential differences in how nursing home residents rate care quality and to explore cluster characteristics. Design/methodology/approach A cross-sectional design was used, with one questionnaire including questions from quality from patients' perspective and Big Five personality traits, together with questions related to socio-demographic aspects and health condition. Residents ( n=103) from four Norwegian nursing homes participated (74.1 per cent response rate)...
February 13, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28105730/geography-not-health-system-affiliations-determines-patients-revisits-to-the-emergency-department
#17
Kristin L Rising, David N Karp, Rhea E Powell, Timothy W Victor, Brendan G Carr
OBJECTIVES: To determine how frequently patients revisit the emergency department after an initial encounter, and to describe revisit capture rates for the same hospital, health system, and geographic region. DATA SOURCES/STUDY SETTING: Florida state data from January 1, 2010, to June 30, 2011, from the Healthcare Cost and Utilization Project. STUDY DESIGN: This is a retrospective cohort study of emergency department return visits among Florida adults over an 18-month period...
January 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28104694/patient-perceptions-of-continuity-of-health-care-and-associated-factors-cross-sectional-study-in-municipalities-of-central-colombia-and-north-eastern-brazil
#18
Ingrid Vargas, Irene Garcia-Subirats, Amparo Susana Mogollón-Pérez, Pierre De Paepe, Maria Rejane Ferreira da Silva, Jean-Pierre Unger, M B Aller, María Luisa Vázquez
Despite the fragmentation of healthcare provision being considered one of the main obstacles to attaining effective health care in Latin America, very little is known about patients' perceptions. This paper analyses the level of continuity of health care perceived by users and explores influencing factors in two municipalities of Colombia and Brazil, by means of a cross-sectional study based on a survey of a multistage probability sample of people who had suffered at least one health problem within the previous three months (2163 in Colombia; 2167 in Brazil)...
January 18, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28104624/youtube-are-parent-uploaded-videos-of-their-unwell-children-a-useful-source-of-medical-information-for-other-parents
#19
Katie Knight, Dorothy M van Leeuwen, Damian Roland, Henriette A Moll, Rianne Oostenbrink
AIMS: YouTube is a vast source of freely accessible user-uploaded medical information. To our knowledge no study has analysed the quality of parent-uploaded videos which depict illness in their children. We aimed to investigate the quality and quantity of videos representing two common conditions, croup and dehydration. METHOD: YouTube was searched using the search terms 'croup+child' and 'dehydration+child'. The first 400 videos of each search were screened. Videos created by doctors or by educational institutions were excluded...
January 19, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28104470/a-cluster-randomized-trial-of-a-primary-palliative-care-intervention-connect-for-patients-with-advanced-cancer-protocol-and-key-design-considerations
#20
Claire L Becker, Robert M Arnold, Seo Young Park, Margaret Rosenzweig, Thomas J Smith, Douglas B White, Kenneth J Smith, Yael Schenker
BACKGROUND: The addition of specialty palliative care to standard oncology care improves outcomes for patients with advanced cancer and their caregivers, but many lack access to specialty care services. Primary palliative care-meaning basic palliative care services provided by clinicians who are not palliative care specialists-is an alternative approach that has not been rigorously evaluated. METHODS: A cluster randomized, controlled trial of the CONNECT (Care management by Oncology Nurses to address supportive care needs) intervention, an oncology nurse-led care management approach to providing primary palliative care for patients with advanced cancer and their family caregivers, is currently underway at 16 oncology practices in Western Pennsylvania...
January 16, 2017: Contemporary Clinical Trials
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