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Healthcare outcomes

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https://www.readbyqxmd.com/read/27926663/the-impact-of-value-based-healthcare-for-inflammatory-bowel-diseases-on-healthcare-utilization-a-pilot-study
#1
Welmoed K van Deen, Arlen Spiro, A Burak Ozbay, Martha Skup, Adriana Centeno, Natalie E Duran, Precious N Lacey, Darius Jatulis, Eric Esrailian, Martijn G H van Oijen, Daniel W Hommes
BACKGROUND AND OBJECTIVES: Value-based healthcare (VBHC) is considered to be the solution that will improve quality and decrease costs in healthcare. Many hospitals are implementing programs on the basis of this strategy, but rigorous scientific reports are still lacking. In this pilot study, we present the first-year outcomes of a VBHC program for inflammatory bowel disease (IBD) management that focuses on highly coordinated care, task differentiation of providers, and continuous home monitoring...
December 6, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27926563/truth-in-reporting-how-data-capture-methods-obfuscate-actual-surgical-site-infection-rates-within-a-health-care-network-system
#2
Liliana Bordeianou, Christy E Cauley, Donna Antonelli, Sarah Bird, David Rattner, Matthew Hutter, Sadiqa Mahmood, Deborah Schnipper, Marc Rubin, Ronald Bleday, Pardon Kenney, David Berger
BACKGROUND: Two systems measure surgical site infection rates following colorectal surgeries: the American College of Surgeons National Surgical Quality Improvement Program and the Centers for Disease Control and Prevention National Healthcare Safety Network. The Centers for Medicare & Medicaid Services pay-for-performance initiatives use National Healthcare Safety Network data for hospital comparisons. OBJECTIVE: This study aimed to compare database concordance...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27926555/avoiding-radical-surgery-in-elderly-patients-with-rectal-cancer-is-cost-effective
#3
Christopher Rao, Arthur Sun Myint, Thanos Athanasiou, Omar Faiz, Antony Paul Martin, Brendan Collins, Fraser McLean Smith
BACKGROUND: Radical surgery is associated with significant perioperative mortality in elderly and comorbid populations. Emerging data suggest for patients with a clinical complete response after neoadjuvant chemoradiotherapy that a watch-and-wait approach may provide equivalent survival and oncological outcomes. OBJECTIVE: The purpose of this study was to compare the cost-effectiveness of watch and wait and radical surgery for patients with rectal cancer after a clinical complete response following chemoradiotherapy...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27925425/preventing-acute-care-associated-venous-thromboembolism-in-adult-and-pediatric-patients-across-a-large-healthcare-system
#4
REVIEW
Timothy I Morgenthaler, Vilmarie Rodriguez
BACKGROUND: Although effective methods for venous thromboembolism prophylaxis (VTE-P) have been known for decades, reliable implementation has been challenging. OBJECTIVE: Develop reliable VTE-P systems for adult and for pediatric patients to reduce preventable venous thromboembolism (VTE). DESIGN: We used a discovery and diffusion system to first develop an effective system in 1 hospital location, and then spread the principle best practices across the entire 22-hospital system...
December 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27925424/evaluation-of-an-institutional-project-to-improve-venous-thromboembolism-prevention
#5
REVIEW
Christina A Minami, Anthony D Yang, Mila Ju, Eckford Culver, Kathryn Seifert, Lindsey Kreutzer, Terri Halverson, Kevin J O'Leary, Karl Y Bilimoria
BACKGROUND: Northwestern Memorial Hospital (NMH) was historically a poor performer on the venous thromboembolism (VTE) outcome measure. As this measure has been shown to be flawed by surveillance bias, NMH embraced process-of-care measures to ensure appropriate VTE prophylaxis to assess healthcare-associated VTE prevention efforts. OBJECTIVE: To evaluate the impact of an institution-wide project aimed at improving hospital performance on VTE prophylaxis measures...
December 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27925382/moving-beyond-not-enough-time-factors-influencing-paediatric-clinicians-participation-in-research
#6
Simon Paul Paget, Patrina Hy Caldwell, Joyce Murphy, Kimberley J Lilischkis, Angie M Morrow
BACKGROUND: Increasing the amount of clinical research that occurs in healthcare settings has been identified as an important mechanism to improve healthcare outcomes. While clinicians are key persons in achieving this aim, research participation amongst clinicians is generally limited. AIMS: To identify the factors (barriers and facilitators) influencing clinician research participation and determine how professional culture impacts on these factors. METHODS: Forty clinicians working at a tertiary children's hospital participated in six discipline-specific focus groups...
December 7, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27925149/behavioural-interventions-to-promote-workers-use-of-respiratory-protective-equipment
#7
REVIEW
Bao Yen Luong Thanh, Malinee Laopaiboon, David Koh, Pornpun Sakunkoo, Hla Moe
BACKGROUND: Respiratory hazards are common in the workplace. Depending on the hazard and exposure, the health consequences may include: mild to life-threatening illnesses from infectious agents, acute effects ranging from respiratory irritation to chronic lung conditions, or even cancer from exposure to chemicals or toxins. Use of respiratory protective equipment (RPE) is an important preventive measure in many occupational settings. RPE only offers protection when worn properly, when removed safely and when it is either replaced or maintained regularly...
December 7, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27924674/work-load-and-management-in-the-delivery-room-changing-the-direction-of-healthcare-policy
#8
Gianfranco Sfregola, Antonio Simone Laganà, Roberta Granese, Pamela Sfregola, Angela Lopinto, Onofrio Triolo
Nurse staffing, increased workload and unstable nursing unit environments are linked to negative patient outcomes including falls and medication errors on medical/surgical units. Considering this evidence, the aim of our study was to overview midwives' workload and work setting. We created a questionnaire and performed an online survey. We obtained information about the type and level of hospital, workload, the use of standardised procedures, reporting of sentinel and 'near-miss' events. We reported a severe understaffing in midwives' work settings and important underuse of standard protocols according to the international guidelines, especially in the South of Italy...
December 7, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27924653/healthcare-resource-use-comorbidity-treatment-and-clinical-outcomes-for-patients-with-primary-intracranial-tumors-a-swedish-population-based-register-study
#9
Jenny Bergqvist, Hanna Iderberg, Johan Mesterton, Nils Bengtsson, Björn Wettermark, Roger Henriksson
BACKGROUND: Primary intracranial tumors are relatively uncommon and heterogeneous, which make them challenging to study. We coupled data from unique Swedish population-based registries in order to deeper analyze the most common intracranical tumor types. Patient characteristics (e.g. comorbidities), care process measures like adherence to national guidelines, healthcare resource use and clinical outcome was evaluated. MATERIALS AND METHODS: A register-based study including several population-based registries for all patients living in Stockholm-Gotland, diagnosed with primary intracranial tumor between 2001 and 2013 was performed...
December 7, 2016: Acta Oncologica
https://www.readbyqxmd.com/read/27924429/cyp2c19-lof-and-gof-guided-antiplatelet-therapy-in-patients-with-acute-coronary-syndrome-a-cost-effectiveness-analysis
#10
Minghuan Jiang, Joyce H S You
PURPOSE: This study aimed to examine the cost-effectiveness of CYP2C19 loss-of-function and gain-of-function allele guided (LOF/GOF-guided) antiplatelet therapy in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). METHODS: A life-long decision-analytic model was designed to simulate outcomes of three strategies: universal clopidogrel (75 mg daily), universal alternative P2Y12 inhibitor (prasugrel 10 mg daily or ticagrelor 90 mg twice daily), and LOF/GOF-guided therapy (LOF/GOF allele carriers receiving alternative P2Y12 inhibitor, wild-type patients receiving clopidogrel)...
December 7, 2016: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/27924187/evaluating-outcomes-in-patients-with-overactive-bladder-within-an-integrated-healthcare-delivery-system-using-a-treatment-patterns-analyzer
#11
Daniel B Ng, Melissa McCart, Christopher Klein, Chelsey Campbell, Robert Schoenhaus, Todd Berner
BACKGROUND: Overactive bladder (OAB) is a relatively common disease that has been linked to a variety of comorbidities, reductions in quality of life, and increased healthcare costs. Antimuscarinic agents are the standard of care among pharmacologic treatments for OAB, but these drugs are linked to high levels of anticholinergic burden, especially in the elderly. OBJECTIVE: To demonstrate how efficient data analysis can be used to identify gaps in care as a result of improvement strategies for OAB within an integrated healthcare delivery system setting...
September 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/27924186/treatment-of-chronic-hepatitis-c-infection-with-sofosbuvir-based-regimens-in-a-commercially-insured-patient-population
#12
John Barron, Yiqiong Xie, Sze-Jung Wu, Jeff White, Joseph Singer, Bernard Tulsi, Alan Rosenberg
BACKGROUND: The response to treatment with direct-acting antiviral agents in patients with chronic hepatitis C virus (HCV) is not well-characterized in the real-world setting. OBJECTIVE: To describe patients' response to 3 sofosbuvir-based treatment regimens among commercially insured patients with chronic HCV. METHODS: In this observational study, we identified patients with HCV who started sofosbuvir treatment with 1 of 3 sofosbuvir-based regimens between December 1, 2013, and April 30, 2014, in the HealthCore Integrated Research Database, a large managed care repository...
September 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/27924139/outcome-of-a-four-hour-smoking-cessation-counselling-workshop-for-medical-students
#13
Kurosch Purkabiri, Valentina Steppacher, Kathrin Bernardy, Nikola Karl, Verena Vedder, Michèle Borgmann, Anja Rogausch, Uz Stammberger, Robert Bals, Tobias Raupach, Volker Koellner, Jürg Hamacher
BACKGROUND: Lack of smoking cessation education in undergraduate medical training hinders healthcare professionals in providing adequate tobacco cessation counselling. We developed a comprehensive 4-h smoking cessation counselling course for medical students that is easy to incorporate in a medical school curriculum, and assessed its short-term outcome for knowledge, skills, and attitudes. METHODS: Eighty-eight medical students (53f, 35 m) were educated by a doctoral student in five identical 4-h courses...
2016: Tobacco Induced Diseases
https://www.readbyqxmd.com/read/27924107/newborn-healthcare-in-urban-india
#14
REVIEW
J Sharma, D Osrin, B Patil, S B Neogi, M Chauhan, R Khanna, R Kumar, V K Paul, S Zodpey
The rapid population growth in urban India has outpaced the municipal capacity to build essential infrastructures that make life in cities safe and healthy. Local and national governments alike are grappling with the challenges of urbanization with thousands migrating from villages to cities. Thus, urbanization in India has been accompanied by a concentration of poverty and urban public healthcare has emerged as one of the most pressing priorities facing our country. Newborn mortality rates in urban settings are lower than rural areas, early neonatal deaths account for greater proportion than late neonatal deaths...
December 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27923916/a-structured-review-of-chronic-care-model-components-supporting-transition-between-healthcare-service-delivery-types-for-older-people-with-multiple-chronic-diseases
#15
Marguerite Sendall, Laura McCosker, Kristie Crossley, Ann Bonner
OBJECTIVE: Older people with chronic diseases often have complex and interacting needs and require treatment and care from a wide range of professionals and services concurrently. This structured review will identify the components of the chronic care model (CCM) required to support healthcare that transitions seamlessly between hospital and ambulatory settings for people over 65 years of age who have two or more chronic diseases. METHOD: A structured review was conducted by searching six electronic databases combining the terms 'hospital', 'ambulatory', 'elderly', 'chronic disease' and 'integration/seamless'...
December 5, 2016: HIM Journal
https://www.readbyqxmd.com/read/27923553/anxiety-and-depression-in-caregivers-of-individuals-with-celiac-disease-a-population-based-study
#16
Jonas F Ludvigsson, Abhik Roy, Benjamin Lebwohl, Peter H R Green, Louise Emilsson
BACKGROUND & AIMS: Partner burden is common in celiac disease (CD), but it is unclear if parents of children with CD have increased burden, and if this may translate into depression and anxiety meriting healthcare. METHODS: Nationwide population-based study of 41,753 parents and spouses ("caregivers") to 29,096 celiac patients and 215,752 caregivers to 144,522 matched controls. Caregivers were identified from the Swedish Total Population Register, and linked to data on psychiatric disease in the National Patient Registry...
November 16, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/27923381/economic-evaluation-of-artesunate-and-three-quinine-regimens-in-the-treatment-of-severe-malaria-in-children-at-the-ebolowa-regional-hospital-cameroon-a-cost-analysis
#17
Daniel Ethe Maka, Andreas Chiabi, Bolaji Obadeyi, Evelyn Mah, Séraphin Nguefack, Pamela Nana, Wilfred Mbacham, Elie Mbonda
BACKGROUND: Severe malaria is a leading cause of morbidity and mortality in under-fives in sub-Saharan Africa. Recently quinine has been replaced by artesunate as the first-line drug in the treatment of severe malaria in Cameroon. Artesunate has been shown to be cost-effective in African children, but whether these findings are transferable to Cameroonian children remains to be explored. OBJECTIVES: To conduct a cost-analysis of four different regimens used in the treatment from the perspective of the healthcare payer...
December 7, 2016: Malaria Journal
https://www.readbyqxmd.com/read/27922998/hiring-and-retaining-home-care-nurses
#18
Leslie Jo Mitchell, Marilyn Oermann
Home care agencies are tasked with finding increasingly cost-efficient care processes to improve the quality of patient care outcomes. Hiring and retaining nurses who are well suited for home care are important factors that can influence the cost and provision of quality care in the home. The purpose of this article is to identify characteristics of home healthcare nurses that enable them to be successful home healthcare team members and leaders. A search of the literature was conducted to compile a list of questions with which to screen home healthcare nurse applicants for the required knowledge and skills as well as to improve retention rates of nurses hired...
January 2017: Home Healthcare Now
https://www.readbyqxmd.com/read/27922727/measuring-learning-gain-comparing-anatomy-drawing-screencasts-and-paper-based-resources
#19
James D Pickering
The use of technology-enhanced learning (TEL) resources is now a common tool across a variety of healthcare programs. Despite this popular approach to curriculum delivery there remains a paucity in empirical evidence that quantifies the change in learning gain. The aim of the study was to measure the changes in learning gain observed with anatomy drawing screencasts in comparison to a traditional paper-based resource. Learning gain is a widely used term to describe the tangible changes in learning outcomes that have been achieved after a specific intervention...
December 6, 2016: Anatomical Sciences Education
https://www.readbyqxmd.com/read/27922167/cost-effectiveness-of-primarily-surgical-versus-primarily-conservative-treatment-of-acute-and-subacute-radiculopathies-due-to-intervertebral-disc-herniation-from-the-swiss-perspective
#20
Zanfina Ademi, Viktoria Gloy, Dominik Glinz, Heike Raatz, Joris Van Stiphout, Heiner C Bucher, Matthias Schwenkglenks
AIMS OF THE STUDY: To assess the cost-effectiveness of primarily surgical treatment (PST) versus primarily conservative treatment (PCT) in adults with intermediate severity, acute or subacute, lumbar radicular syndrome due to intervertebral disc herniation. METHODS: A decision analytic model from healthcare system and societal perspectives was used to compare outcomes and costs of PST with those of PCT (physiotherapy, epidural injection and medication). Treatment pathways and quality of life were obtained from published clinical trials...
2016: Swiss Medical Weekly
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