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https://www.readbyqxmd.com/read/28445806/patient-engagement-at-the-margins-health-care-providers-assessments-of-engagement-and-the-structural-determinants-of-health-in-the-safety-net
#1
Mark D Fleming, Janet K Shim, Irene Yen, Ariana Thompson-Lastad, Sara Rubin, Meredith Van Natta, Nancy J Burke
Increasing "patient engagement" has become a priority for health care organizations and policy-makers seeking to reduce cost and improve the quality of care. While concepts of patient engagement have proliferated rapidly across health care settings, little is known about how health care providers make use of these concepts in clinical practice. This paper uses 20 months of ethnographic and interview research carried out from 2015 to 2016 to explore how health care providers working at two public, urban, safety-net hospitals in the United States define, discuss, and assess patient engagement...
April 20, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28445024/an-economic-evaluation-of-the-enhanced-recovery-after-surgery-eras-multisite-implementation-program-for-colorectal-surgery-in-alberta
#2
Nguyen X. Thanh, Anderson W. Chuck, Tracy Wasylak, Jeannette Lawrence, Peter Faris, Olle Ljungqvist, Gregg Nelson, Leah M. Gramlich
BACKGROUND: In February 2013, Alberta Health Services established an Enhanced Recovery After Surgery (ERAS) implementation program for adopting the ERAS Society colorectal guidelines into 6 sites (initial phase) that perform more than 75% of all colorectal surgeries in the province. We conducted an economic evaluation of this initiative to not only determine its cost-effectiveness, but also to inform strategy for the spread and scale of ERAS to other surgical protocols and sites. METHODS: We assessed the impact of ERAS on patients’ health services utilization (HSU; length of stay [LOS], readmissions, emergency department visits, general practitioner and specialist visits) within 30 days of discharge by comparing pre- and post-ERAS groups using multilevel negative binomial regressions...
December 1, 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28444957/epidemiology-of-endometriosis-a-large-population-based-database-study-in-a-2-million-member-health-care-provider
#3
Vered H Eisenberg, Clara Weil, Gabriel Chodick, Varda Shalev
OBJECTIVE: Endometriosis constitutes a significant burden on the quality of life of women, their families, and health systems. The objective of this study is to describe the real-world epidemiology of endometriosis in an unselected low-risk population in Israel. DESIGN: Retrospective population-based study. SETTING AND POPULATION: The computerized databases of Maccabi Healthcare Services (MHS), a 2-million-member healthcare provider representing a quarter of the Israeli population...
April 26, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28444642/breast-self-exam-and-patient-interval-associate-with-advanced-breast-cancer-and-treatment-delay-in-mexican-women
#4
E Leon-Rodriguez, C Molina-Calzada, M M Rivera-Franco, A Campos-Castro
PURPOSE: The objective of this study was to compare treatment intervals in breast cancer patients according to the detection method (breast self-exam vs screening). PATIENTS AND METHODS: We conducted a retrospective analysis including 291 breast cancer patients at a Mexican tertiary referral hospital. RESULTS: Breast cancer detection method was mostly breast self-exam (60%). The median patient interval was 60.5 days, and was associated with marital status and socioeconomic level...
April 25, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28444458/the-potential-of-ehealth-in-otorhinolaryngology-head-and-neck-surgery-patients-perspectives
#5
Martin Holderried, C Ernst, F Holderried, M Rieger, G Blumenstock, A Tropitzsch
The use of modern information and communication technologies (ICT) in daily life has significantly increased during the last several years. These essential online technologies have also found their way into the healthcare system. The use of modern ICT for health reasons can be summarized by the term 'eHealth'. Despite the potential importance of eHealth in the field of otorhinolaryngology (ORL), there is little understanding of patients' attitudes towards the deeper integration of these technologies into intersectoral care...
April 25, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28444383/optimizing-drug-dose-alerts-using-commercial-software-throughout-an-integrated-health-care-system
#6
Salim M Saiyed, Peter J Greco, Glenn Fernandes, David C Kaelber
All default electronic health record and drug reference database vendor drug-dose alerting recommendations (single dose, daily dose, dose frequency, and dose duration) were silently turned on in inpatient, outpatient, and emergency department areas for pediatric-only and nonpediatric-only populations. Drug-dose alerts were evaluated during a 3-month period. Drug-dose alerts fired on 12% of orders (104 098/834 911). System-level and drug-specific strategies to decrease drug-dose alerts were analyzed. System-level strategies included: (1) turning off all minimum drug-dosing alerts, (2) turning off all incomplete information drug-dosing alerts, (3) increasing the maximum single-dose drug-dose alert threshold to 125%, (4) increasing the daily dose maximum drug-dose alert threshold to 125%, and (5) increasing the dose frequency drug-dose alert threshold to more than 2 doses per day above initial threshold...
April 24, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28444058/-quality-of-life-with-obsessive-compulsive-disorder-a-study-among-primary-care-users
#7
Carolina Coelho Scholl, Viviane Porto Tabeleão, Rafaelle Stark Stigger, Jéssica Puchalski Trettim, Mariana Bonati de Mattos, Andressa Jacondino Pires, Mariane Acosta Lopez Molina, Ricardo Azevedo da Silva, Elaine Tomasi, Luciana de Avila Quevedo
Quality of life (QOL) can be affected by the presence of mental disorders, like Obsessive-Compulsive Disorder (OCD). Thus, the evaluation and monitoring of QOL in patients with mental disorders enables the identification of priorities, making it possible to implement actions to improve QOL among health system users. The scope of this article is to measure QOL in OCD patients in primary health care. It involves a cross-sectional study with a convenience sample including all users of three Basic Health Units of Pelotas in the State of Rio Grande do Sul, Brazil...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28444056/care-for-young-victims-of-assault-in-public-emergency-services-in-2011-sex-differences
#8
Alice Cristina Medeiros Melo, Leila Posenato Garcia
This article aims to describe the characteristics of assaults among youth victims of violence treated in Public Emergency Departments, according to sex. This is a descriptive study using data from the Brazilian Violence and Accidents Surveillance System based on a multicenter survey conducted by the Ministry of Health in 71 public emergency departments, located in 24 state capitals and the Federal District in 2011. Male subjects predominated among the victims (75.1%) and also among aggressors (83.1% and 69...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28444052/healthcare-regions-and-their-care-networks-an-organizational-systemic-model-for-sus
#9
Lenir Santos
This paper describes a comprehensive effort to develop studies regarding Brazil's Unified Healthcare System (SUS), as a result of the combination of public services in a network that follows a region-based rationale (tripartite organization). The SUS emerges from such an integration and should be organized as such. The intention is to demonstrate that this type of organization is essential, given that Brazil is organized as a Federation, and all three governmental levels are, in a broad sense, equally responsible for healthcare...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28444050/ambulatory-municipal-regulation-of-the-unified-health-system-services-in-rio-de-janeiro-advances-limitations-and-challenges
#10
Luiz Felipe Pinto, Daniel Soranz, Mariana Tomasi Scardua, Iandara de Moura Silva
Federalism is basis of the Republic of Brazil which is made up of the union of states, municipalities and the Federal District, with the basic principle of political and administrative decentralization in all political, economic and social relations. In the health sector, the primary health care provider should be able to integrate all care that the patient receives through the coordination of health services. This article aims to evaluate the results of referrals for consultations and outpatient examinations in primary health care in the municipality of Rio de Janeiro, highlighting the advances, limitations and challenges for management at the local level...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28444048/state-health-managers-perceptions-of-the-public-health-action-organizational-contract-in-the-state-of-cear%C3%A3-brazil
#11
Neusa Goya, Luiz Odorico Monteiro de Andrade, Ricardo José Soares Pontes, Fábio Solon Tajra, Ivana Cristina de Holanda Cunha Barreto
The Public Health Action Organizational Contract (COAP) / Decree 7.508/2011 aimed to seal health agreements made between federated entities to promote the cooperative governance and management of Health Regions. A qualitative study was carried out adopting a hermeneutic approach to understand state health managers' perceptions of the elaboration and effects of the COAP in the State of Ceará. Open-ended interviewees and documental analysis were conducted. It was observed that the COAP led to the strengthening of regionalization in the government sphere; institutional gains through the implementation of ombudsmen and the National System of Pharmaceutical Care Management; increased information about the state health system's workforce; and health budget transparency...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28444043/challenges-for-ensuring-availability-and-accessibility-toin-health-care-services-under-brazil-s-unified-health-system-sus
#12
Ana Paula Cavalcante de Oliveira, Mariana Gabriel, Mario Roberto Dal Poz, Gilles Dussault
Shortages and imbalances in the distribution of the health workforce, are social and political problems that, along with the socio-economic inequality, reduce the access of the population to the health services. This study aims to understand the challenges of SUS policy-makers and managers to ensure the availability and geographical accessibility to health service providers. The analysis was guided by a framework of the health labour market and health policy interventions. Two main problems have been identified: shortage of doctors and maldistribution of professionals between levels of health care and between geographical areas...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28444041/primary-health-care-and-the-coordination-of-care-in-health-regions-managers-and-users-perspective
#13
Aylene Bousquat, Ligia Giovanella, Estela Márcia Saraiva Campos, Patty Fidelis de Almeida, Cleide Lavieri Martins, Paulo Henrique Dos Santos Mota, Maria Helena Magalhães de Mendonça, Maria Guadalupe Medina, Ana Luiza d'Ávila Viana, Márcia Cristina Rodrigues Fausto, Daniel Baffini de Paula
This paper aims to analyze the healthcare coordination by Primary Health Care (PHC), with the backdrop of building a Health Care Network (RAS) in a region in the state of São Paulo, Brazil. We conducted a case study with qualitative and quantitative approaches, proceeding to the triangulation of data between the perception of managers and experience of users. We drew analysis realms and variables from the three pillars of healthcare coordination - informational, clinical and administrative/organizational. Stroke was the tracer event chosen and therapeutic itineraries were conducted with users and questionnaires applied to the managers...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28444032/thoughts-on-the-development-of-active-regional-public-health-systems
#14
Ademar Arthur Chioro Dos Reis, Ana Paula Menezes Sóter, Lumena Almeida Castro Furtado, Silvana Souza da Silva Pereira
Decentralization and regionalization are strategic themes for reforms in the health system. This paper analyzes the complex process of health regionalization being developed in Brazil. This paper identifies that the normative framework from the Brazilian National Health System, SUS has made advances with respect to its institutionalization and overcoming the initial centrality involved in municipalization. This has strengthened the development of regionalization and the intergovernmental agreement on health but the evidence points to the need to promote a revision...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28444025/risk-of-misinterpretation-of-trends-in-hospital-admissions-for-primary-care-sensitive-conditions-in-local-contexts-itabora%C3%A3-rio-de-janeiro-state-brazil-2006-2011
#15
Janaina Furtado Botelho, Margareth Crisóstomo Portela
The study's objectives were to describe hospital admissions for primary care sensitive conditions (PCSCs) among residents of Itaboraí, a municipality in Rio de Janeiro State, Brazil, with a high rate of such admissions, to identify associated factors, and to explore the impact from closing a hospital. The ultimate aim was to contribute to the debate on the indicator's indiscriminate use for inferences on the expansion and quality of primary care. The study was based on data from the Hospital Information System of the Brazilian Unified National Health System...
April 20, 2017: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/28444008/from-guidelines-to-local-realities-evaluation-of-oral-rehydration-therapy-and-zinc-supplementation-in-guatemala
#16
Rachel Hall-Clifford, Roxanne Amerson
Objective: Diarrhea remains a leading cause of morbidity and mortality for children in low- and middle-income countries throughout the Americas. The World Health Organization (WHO) has developed guidelines on incorporating zinc supplementation (ZS) with traditional oral rehydration therapy (ORT) in order to shorten the duration of diarrheal episodes and to reduce poor health outcomes. Guatemala adopted these guidelines in 2011, but they have not yet been fully implemented at the community level...
April 20, 2017: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28443522/legal-and-organisational-innovation-in-the-italian-pharmacy-system-commercial-vs-public-interest
#17
Alceste Santuari
Pharmacy services are undoubtedly an important part of primary care. Pharmacists are entrepreneurs and simultaneously they are entrusted with a public mission in the health care sector. Pharmacies then reflect a contrast between a commercial/economic objective and public interest, which is to be identified with citizens' universal right to health care services. This is the reason why in Italy, as in many other EU countries, pharmacies supply their services according to a prior authorisation granted by public authorities...
April 26, 2017: Health Economics, Policy, and Law
https://www.readbyqxmd.com/read/28443488/socioeconomic-status-social-capital-and-self-reported-unmet-health-care-needs-a-population-based-study
#18
Christine Lindstrӧm, Maria Rosvall, Martin Lindstrӧm
AIMS: The aim of this study was to investigate the associations between socioeconomic status (SES) and self-reported unmet health care needs, taking economic stress, generalized trust in other people and trust in the health care system into account. METHODS: The 2012 public health survey in Scania was conducted using a postal questionnaire and included 28,029 participants aged 18-80 years. The study was cross-sectional. Associations between SES and unmet health care needs were investigated, adjusting for economic stress and trust in logistic regressions...
May 2017: Scandinavian Journal of Public Health
https://www.readbyqxmd.com/read/28443354/optimization-of-intelligent-infusion-pump-technology-to-minimize-vasopressor-pump-programming-errors
#19
Nina Vadiei, Carrie A Shuman, Manasa S Murthy, Mitchell J Daley
STUDY OBJECTIVE: To determine if incorporation of vasopressor upper hard limits (UHL) into intelligent infusion pump technology (IIPT) increases efficacy of alerts by preventing pump programming errors. DESIGN & METHODS: Retrospective review from five hospitals within a single healthcare network between April 1, 2013 and May 31, 2014. A total of 65,680 vasopressor data entries were evaluated; 19,377 prior to hard limit implementation and 46,303 after hard limit implementation...
April 26, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28443278/saliva-liquid-biopsy-for-point-of-care-applications
#20
REVIEW
Katri Aro, Fang Wei, David T Wong, Michael Tu
Saliva is a non-invasive biofluid, which is easy to collect, transport, and store. Because of its accessibility and connection to systemic diseases, saliva is one of the best candidates for the advancement of point-of-care medicine, where individuals are able to easily monitor their health status by using portable convenient tools such as smartphones. There are a variety of scenarios with which saliva can be used: studies have been conducted on using saliva to measure stress hormones, enzyme levels, developmental disease biomarkers, and even cancer mutations...
2017: Frontiers in Public Health
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