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https://www.readbyqxmd.com/read/29786024/needs-assessment-of-ophthalmology-education-for-undergraduate-medical-students-a-study-from-a-medical-college-in-south-india
#1
Karuppannasamy Divya, Kannappan Suvetha, Alo Sen, Devisundaram Sundar
Background: Adequate ophthalmic diagnostic and clinical skills are essential for practitioners in primary care settings as well as specialty care physicians. The objectives of this study were to assess the adequacy of ophthalmology teaching in undergraduate medical education and to evaluate the comfort of medical students in diagnosing common eye problems and performing ophthalmic skills. Methods: A questionnaire based, cross-sectional survey was conducted among third-year undergraduate students from a medical college in South India at the end of ophthalmology training from February 2014 to December 2014...
September 2017: Education for Health: Change in Training & Practice
https://www.readbyqxmd.com/read/29783031/a-unique-all-payer-rate-setting-system-controls-the-cost-but-not-the-racial-disparity-in-lower-extremity-revascularization-procedures
#2
Besma Nejim, Robert J Beaulieu, Husain Alshaikh, Mohammed Hamouda, Joseph Canner, Mahmoud B Malas
BACKGROUND: Patients with peripheral arterial disease (PAD) often have high comorbidity burden that may complicate post-interventional course and drive increased healthcare expenditures. Racial disparity had been observed in lower extremity revascularization (LER) patterns and outcomes. In 2014, Maryland adopted an all-payer rate setting system to limit the rising hospitalization costs. This resulted in an aggregate payment system in which hospital compensation takes place as an overall per capita expenditure for hospital services...
May 18, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29781557/supplier-induced-demand-for-urgent-after-hours-primary-care-services
#3
Thomas Longden, Jane Hall, Kees van Gool
Australia is one of nine Organisation for Economic Co-operation and Development (OECD) countries that utilise deputising services to provide after-hours primary care. While the provision of this service is supposed to be on behalf of regular general practitioners, businesses have adapted to the financial incentives on offer and are directly advertising their services to consumers emphasising patient convenience and no copayments. The introduction of corporate entities has changed the way that deputising services operate...
May 21, 2018: Health Economics
https://www.readbyqxmd.com/read/29780760/has-the-janani-suraksha-yojana-a-conditional-maternity-benefit-transfer-scheme-succeeded-in-reducing-the-economic-burden-of-maternity-in-rural-india-evidence-from-the-varanasi-district-of-uttar-pradesh
#4
Saradiya Mukherjee, Aditya Singh
Background: One of the constraints in the utilisation of maternal healthcare in India is the out-of-pocket expenditure. To improve the utilisation and to reduce the out-of-pocket expenditure, India launched a cash incentive scheme, Janani Suraksha Yojana (JSY), which provides monetary incentive to the mothers delivering in public facility. However, no study has yet examined the extent to which the JSY payments reduce the maternal healthcare induced catastrophic out-of-pocket expenditure burden of the households...
February 5, 2018: Journal of Public Health Research
https://www.readbyqxmd.com/read/29779967/a-comparison-of-the-united-states-and-international-perspective-on-chronic-urticaria-guidelines
#5
REVIEW
Torsten Zuberbier, Jonathan A Bernstein
Urticaria is a heterogeneous skin disorder that may be acute or chronic and is defined by the appearance of wheals, angioedema, or both. The European perspective is expressed in a recent international guideline and the American perspective has been based on the US Joint Task Force chronic urticaria practice parameter published in 2014. Both the international guideline (initiated by the European societies European Academy of Allergology and Clinical Immunology [EAACI]/Global Allergy and Asthma European Network [GA2 LEN]/European Dermatology Forum [EDF] in collaboration with the World Allergy Organization [WAO]) and the US (American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma and Immunology) guideline have been developed to help direct primary care physicians and specialists in the management of their patients with urticaria...
May 18, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29779714/self-monitoring-induced-savings-on-type-2-diabetes-patients-travel-and-healthcare-costs
#6
Aapeli Leminen, Markku Tykkyläinen, Tiina Laatikainen
BACKGROUND: Type 2 diabetes (T2DM) is a major health concern in most regions. In addition to direct healthcare costs, diabetes causes many indirect costs that are often ignored in economic analyses. Patients' travel and time costs associated with the follow-up of T2DM patients have not been previously calculated systematically over an entire healthcare district. The aim of the study was to develop a georeferenced cost model that could be used to measure healthcare accessibility and patient travel and time costs in a sparsely populated healthcare district in Finland...
July 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29779300/coroners-recommendations-for-prevention-of-resident-deaths-in-aged-care-the-role-of-primary-care-providers
#7
Georgia Aitken, Athena Demosthenous, Lyndal Bugeja, Melissa Willoughby, Carmel Young, Joseph E Ibrahim
BACKGROUND AND OBJECTIVES: Currently, very little is known about how coroners consider a role for general practitioners (GPs) and registered nurses (RNs) in recommendations for the prevention of premature death. Involving these professions in recommendations generally directed towards government organisations or residential aged care providers and management may contribute to more successful broader policy changes. The aim of this article was to examine whether coroners' recommendations describe a specific role for GPs and RNs in the prevention of premature death in residential aged care settings and, if so, what domains of practice were considered...
May 2018: Australian journal of general practice
https://www.readbyqxmd.com/read/29778331/goal-directed-perfusion-to-reduce-acute-kidney-injury-a-randomized-trial
#8
Marco Ranucci, Ian Johnson, Timothy Willcox, Robert A Baker, Christa Boer, Andreas Baumann, George A Justison, Filip de Somer, Paul Exton, Seema Agarwal, Rachael Parke, Richard F Newland, Renard G Haumann, Dirk Buchwald, Nathaen Weitzel, Rajamiyer Venkateswaran, Valeria Pistuddi
OBJECTIVE: To determine whether a goal-directed perfusion (GDP) strategy aimed at maintaining oxygen delivery (DO2 ) at ≥280 mL·min-1 ·m-2 reduces the incidence of acute kidney injury (AKI). METHODS: This multicenter randomized trial enrolled a total of 350 patients undergoing cardiac surgery in 9 institutions. Patients were randomized to receive either GDP or conventional perfusion. A total of 326 patients completed the study and were analyzed. Patients in the treatment arm were treated with a GDP strategy during cardiopulmonary bypass (CPB) aimed to maintain DO2 at ≥280 mL·min-1 ·m-2 ...
April 18, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29778258/new-treatments-have-changed-the-game-hepatitis-c-treatment-in-primary-care
#9
REVIEW
Shelley N Facente, Katie Burk, Kelly Eagen, Elise S Mara, Aaron A Smith, Colleen S Lynch
In the pre-direct-acting antiviral era, hepatitis C virus (HCV) treatments were complex and largely managed by hepatologists, gastroenterologists, and infectious disease physicians. As direct-acting antivirals have driven up demand for treatment, the relative scarcity of these specialists has created a bottleneck effect, resulting in only a fraction of HCV-infected individuals offered treatment. The San Francisco Health Network is a safety net system of care. Its intervention was designed to be sustainable and scalable; with minimal time commitments for training providers, primary care-based HCV treatment increased 3-fold in a period of just over 3 years...
June 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/29777782/financial-analysis-of-pediatric-resident-physician-primary-care-longitudinal-outpatient-experience
#10
Carole H Stipelman, Brad Poss, Laura Anne Stetson, Luca Boi, Michael Rogers, Caleb Puzey, Sri Koduri, Robert Kaplan, Vivian S Lee, Edward B Clark
PURPOSE: To determine whether residency training represents a net positive or negative cost to academic medical centers, we analyzed the cost of a residency program and clinical productivity of residents and faculty in outpatient primary care practice with or without residents. METHOD: Patient volume and revenue data (Current Procedural Terminology codes) from an academic primary care general pediatric clinic were evaluated for faculty clinics (faculty only) and resident teaching clinics (Longitudinal Outpatient Experience [LOE]) with 1-4 residents/faculty...
May 16, 2018: Academic Pediatrics
https://www.readbyqxmd.com/read/29777373/safety-and-feasibility-of-pulmonary-artery-pressure-guided-heart-failure-therapy-rationale-and-design-of-the-prospective-cardiomems-monitoring-study-for-heart-failure-mems-hf
#11
Christiane E Angermann, Birgit Assmus, Stefan D Anker, Johannes Brachmann, Georg Ertl, Friedrich Köhler, Stephan Rosenkranz, Carsten Tschöpe, Philip B Adamson, Michael Böhm
BACKGROUND: Wireless monitoring of pulmonary artery (PA) pressures with the CardioMEMS HF™ system is indicated in patients with New York Heart Association (NYHA) class III heart failure (HF). Randomized and observational trials have shown a reduction in HF-related hospitalizations and improved quality of life in patients using this device in the United States. OBJECTIVE: MEMS-HF is a prospective, non-randomized, open-label, multicenter study to characterize safety and feasibility of using remote PA pressure monitoring in a real-world setting in Germany, The Netherlands and Ireland...
May 19, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29777372/cardiac-surgery-2017-reviewed
#12
REVIEW
Torsten Doenst, Hristo Kirov, Alexandros Moschovas, David Gonzalez-Lopez, Rauf Safarov, Mahmoud Diab, Steffen Bargenda, Gloria Faerber
For the year 2017, more than 21,000 published references can be found in PubMed when entering the search term "cardiac surgery". This review focusses on conventional cardiac surgery, considering the new interventional techniques only if they were directly compared to classic techniques but also entails aspects of perioperative intensive care management. The publications last year provided a plethora of new and interesting information that helped to quantify classic surgical treatment effects and provided new guidelines for the management of structural heart disease, which made comparisons to interventional techniques easier...
May 17, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29776663/barriers-and-facilitators-to-diabetes-self-management-in-a-primary-care-setting-patient-perspectives
#13
Rahul Khairnar, Khalid M Kamal, Vincent Giannetti, Nilanjana Dwibedi, Jamie McConaha
BACKGROUND: Diabetes self-management (DSM) is a key element in the overall management of type-2 diabetes (T2DM). Identifying barriers and facilitators to DSM and addressing them is a critical step in achieving improved health outcomes in this population. OBJECTIVE: To assess patient reported barriers and facilitators to self-management of T2DM in a primary care setting. METHODS: This cross sectional study combined patient survey data with electronic medical record (EMR) data...
May 9, 2018: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29774749/excess-costs-of-non-infectious-comorbidities-among-people-living-with-hiv-estimates-from-denmark-and-sweden
#14
Frida Hjalte, Paul S Calara, Anders Blaxhult, Marie Helleberg, Karoline Wallace, Peter Lindgren
People living with HIV have an increased risk of comorbidities with non-communicable diseases such as cardiovascular disease, chronic kidney disease and osteoporotic fractures, compared to the general population. The burden of these comorbidities is expected to rise as the HIV-infected population ages. This development may require additional health care resources and it is relevant to ascertain the costs associated with these comorbidities. The population attributed risk approach was applied to estimate excess costs associated with the higher rates of comorbidities among HIV patients in Denmark and Sweden compared to their respective general populations...
May 18, 2018: AIDS Care
https://www.readbyqxmd.com/read/29772928/a-clinical-carepath-for-obese-pregnant-women-a-pragmatic-pilot-cluster-randomized-controlled-trial
#15
Sarah D McDonald, Kristen A Viaje, Rebecca A Rooney, Alexander Jarde, Lucia Giglia, Cynthia V Maxwell, David Small, Tracy Pearce Kelly, B H Sc Midwifery, Lisa Sabatino, Lehana Thabane
OBJECTIVES: Obese women are at increased risks for complications during pregnancy, birth and in their infants. Although guidelines have been established for the clinical care of obese pregnant women, management is sometimes suboptimal. Our goal was to determine the feasibility of implementing and testing a clinical carepath for obese pregnant women compared to standard care, in a pilot cluster randomized controlled trial (RCT). METHODS: A pragmatic pilot cluster RCT was conducted, randomly allocating eight clinics to the carepath or standard care for obese pregnant women...
May 17, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29771873/community-based-services-to-improve-testing-and-linkage-to-care-among-non-u-s-born-persons-with-chronic-hepatitis-b-virus-infection-three-u-s-programs-october-2014-september-2017
#16
Aaron M Harris, Ruth Link-Gelles, Karen Kim, Edwin Chandrasekar, Su Wang, Nicole Bannister, Perry Pong, Eric Chak, Moon S Chen, Christopher Bowlus, Noele P Nelson
Among an estimated 850,000 to 2.2 million persons with chronic hepatitis B virus (HBV) infection in the United States, 70% are non-U.S.-born (1,2). All patients require linkage to care, and approximately 20%-40% require antiviral treatment (3). Without treatment, one in four persons chronically infected with HBV will die prematurely from liver failure, liver cirrhosis, or hepatocellular carcinoma (4). To mitigate morbidity and mortality, CDC funded a cooperative agreement to develop hepatitis B testing and linkage-to-care programs serving non-U...
May 18, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29771868/the-use-of-technology-for-std-partner-services-in-the-united-states-a-structured-review
#17
Rachel Kachur, Wendasha Hall, Alexandra Coor, Jennine Kinsey, Dayne Collins, F V Strona
BACKGROUND: Since the late 1990s, health departments and STD programs throughout the U.S. have used technologies, such as the internet and mobile phones, to provide services to persons with a sexually transmitted infection, including HIV, and their sex partners, also known as partner services. This study reviewed the published literature to assess and compare partner services outcomes as a result of using technology and to calculate cost savings through cases averted. METHODS: We conducted a structured literature review of all U...
May 1, 2018: Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/29771722/detection-of-deteriorating-patients-on-surgical-wards-outside-the-icu-by-an-automated-mews-based-early-warning-system-with-paging-functionality
#18
Axel R Heller, Sören T Mees, Benjamin Lauterwald, Christian Reeps, Thea Koch, Jürgen Weitz
BACKGROUND: The establishment of early warning systems in hospitals was strongly recommended in recent guidelines to detect deteriorating patients early and direct them to adequate care. Upon reaching predefined trigger criteria, Medical Emergency Teams (MET) should be notified and directed to these patients. The present study analyses the effect of introducing an automated multiparameter early warning score (MEWS)-based early warning system with paging functionality on 2 wards hosting patients recovering from highly complex surgical interventions...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29771205/organizational-health-management-through-metaphor-a-mission-based-approach
#19
Joseph M Woodside
Purpose The purpose of this paper is to identify the underlying metaphors that hospitals use to establish their organizational mission. Metaphors impact the direction and managerial decision making of organizations, and provide a method to more easily communicate to a variety of stakeholders. Design/methodology/approach A text analytics process is run to evaluate the mission statements from the largest hospitals by revenue in each of the 50 states of the USA and District of Columbia to identify the types of metaphor-based organizational health management methods...
May 21, 2018: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/29769026/cost-effectiveness-of-a-multicomponent-primary-care-program-targeting-frail-elderly-people
#20
Franca G H Ruikes, Eddy M Adang, Willem J J Assendelft, Henk J Schers, Raymond T C M Koopmans, Sytse U Zuidema
BACKGROUND: Over the last 20 years, integrated care programs for frail elderly people aimed to prevent functional dependence and reduce hospitalization and institutionalization. However, results have been inconsistent and merely modest. To date, evidence on the cost-effectiveness of these programs is scarce. We evaluated the cost-effectiveness of the CareWell program, a multicomponent integrated care program for frail elderly people. METHODS: Economic evaluation from a healthcare perspective embedded in a cluster controlled trial of 12 months in 12 general practices in (the region of) Nijmegen...
May 16, 2018: BMC Family Practice
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