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https://www.readbyqxmd.com/read/29189477/remaining-financially-viable-in-a-time-of-healthcare-transition
#1
Barry P Ronan
In an unstable healthcare environment, Western Maryland Health System has been demonstrating stability. We have responded to the many challenges that hospitals face and managed to thrive in the new, value-based world.We made the transition to value-based payment and care delivery models through innovations in Maryland's payment system. In 2010, we recognized that becoming a demonstration project for value-based care would benefit our health system as we dealt with an aging and shrinking regional population...
January 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/29188069/simultaneous-isolation-of-chryseobacterium-gleum-from-bloodstream-and-respiratory-tract-first-case-report-from-india
#2
Vidhi Jain, Nayani Amrin Fatema Afzal Hussain, Tasneem Siddiqui, Chinmoy Sahu, Malay Ghar, Kashi Nath Prasad
Introduction. Species of the genus Chryseobacterium are emerging healthcare-associated pathogens, often colonizing the hospital environment. There are no clear guidelines available for antimicrobial susceptibility of this organism. In this report we present the first case, to our knowledge, of simultaneous central-line-associated bloodstream infection (CLABSI) and ventilator-associated pneumonia (VAP) due to Chryseobacterium gleum from India. Case presentation. A 62 years old man with a history of a road traffic accident 1 month previously was referred to our center for further management...
October 2017: JMM Case Reports
https://www.readbyqxmd.com/read/28968409/a-brief-intervention-for-preparing-icu-families-to-be-proxies-a-phase-i-study
#3
Alison E Turnbull, Caroline M Chessare, Rachel K Coffin, Dale M Needham
BACKGROUND: Family members of critically ill patients report high levels of conflict with clinicians, have poor understanding of prognosis, struggle to make decisions, and experience substantial symptoms of anxiety, depression, and post-traumatic stress regardless of patient survival status. Efficient interventions are needed to prepare these families to act as patient proxies. OBJECTIVES: To assess a brief "patient activation" intervention designed to set expectations and prepare families of adult intensive care unit (ICU) patients to communicate effectively with the clinical team...
2017: PloS One
https://www.readbyqxmd.com/read/28917951/a-spatial-analysis-of-race-local-health-promoting-resources-and-preventable-hospitalizations
#4
Caryn N Bell, Janice V Bowie, Roland J Thorpe, David M Levine
INTRODUCTION: Preventable hospitalizations (PHs) for chronic conditions could have been avoided if treated with primary healthcare. PH rates are higher among African Americans, and in areas with less healthcare. Little is known about the effects of non-healthcare local health-promoting resources (LHPRs). The objective of this study is to determine associations between LHPRs and chronic PH rates in Maryland, and to assess spatial clustering of areas with high PH rates. METHODS: Hospitalizations in 2010 were obtained from the Maryland Health Services Cost Review Commission by zip code of residence...
December 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28858967/applying-decision-science-to-the-prioritization-of-healthcare-associated-infection-initiatives
#5
Terry H Tsai, Michael D Gerst, Cyrus Engineer, Harold P Lehmann
OBJECTIVES: Improving patient quality remains a top priority from the perspectives of both patient outcomes and cost of care. The continuing threat to patient safety has resulted in an increasing number of options for patient safety initiatives, making choices more difficult because of competing priorities. This study provides a proof of concept for using low-cost decision science methods for prioritizing initiatives. METHODS: Using multicriteria decision analysis, we developed a decision support model for aiding the prioritization of the four most common types of healthcare-associated infections: surgical site infections, central line-associated bloodstream infections, ventilator-associated events, and catheter-associated urinary tract infections...
August 30, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28820507/hematopoietic-stem-cell-transplantation-recipient-and-caregiver-factors-affecting-length-of-stay-and-readmission
#6
Thiruppavai Sundaramurthi, Leslie Wehrlen, Erika Friedman, Sue Thomas, Margaret Bevans
PURPOSE/OBJECTIVES: To evaluate the contributions of patient and caregiver factors to length of stay (LOS) and 30-day readmission status for recipients of allogeneic hematopoietic stem cell transplantation (HSCT).
. DESIGN: Secondary data analysis from a phase 2 clinical trial.
. SETTING: National Institutes of Health Clinical Center in Bethesda, Maryland.
. SAMPLE: 68 dyads (N = 136) comprised of patients receiving HSCT and their caregivers...
September 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/28780533/nursing-home-facebook-reviews-who-has-them-and-how-do-they-relate-to-other-measures-of-quality-and-experience
#7
Jennifer Gaudet Hefele, Yue Li, Lauren Campbell, Adrita Barooah, Joyce Wang
BACKGROUND: The growing use of social media creates opportunities for patients and families to provide feedback and rate individual healthcare providers. Whereas previous studies have examined this emerging trend in hospital and physician settings, little is known about user ratings of nursing homes (NHs) and how these ratings relate to other measures of quality. OBJECTIVE: To examine the relationship between Facebook user-generated NH ratings and other measures of NH satisfaction/experience and quality...
August 5, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28770189/racial-disparities-in-emergency-department-utilization-for-dental-oral-health-related-conditions-in-maryland
#8
Natalia I Chalmers
OBJECTIVES: Hospital emergency departments (EDs) are a place where many Americans seek treatment of dental conditions. Racial and ethnic minorities consistently have higher rates of ED utilization than whites for dental conditions. The reasons for these disparities and significant public health concerns are investigated less often. In this paper, we measure trends in racial disparities in ED discharges for dental conditions in Maryland from 2010 to 2013. To understand these disparities, we also describe differences between racial groups in age, gender, income, location, payer, comorbidities, and the availability of dental care...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28736796/longitudinal-research-on-aging-drivers-longroad-study-design-and-methods
#9
Guohua Li, David W Eby, Robert Santos, Thelma J Mielenz, Lisa J Molnar, David Strogatz, Marian E Betz, Carolyn DiGuiseppi, Lindsay H Ryan, Vanya Jones, Samantha I Pitts, Linda L Hill, Charles J DiMaggio, David LeBlanc, Howard F Andrews
BACKGROUND: As an important indicator of mobility, driving confers a host of social and health benefits to older adults. Despite the importance of safe mobility as the population ages, longitudinal data are lacking about the natural history and determinants of driving safety in older adults. METHODS: The Longitudinal Research on Aging Drivers (LongROAD) project is a multisite prospective cohort study designed to generate empirical data for understanding the role of medical, behavioral, environmental and technological factors in driving safety during the process of aging...
December 2017: Injury Epidemiology
https://www.readbyqxmd.com/read/28735371/identifying-symptoms-of-distress-in-youth-living-with-neurofibromatosis-type-1-nf1
#10
Lori Wiener, Haven Battles, Sima Zadeh Bedoya, Andrea Baldwin, Brigitte C Widemann, Maryland Pao
Children and adolescents with Neurofibromatosis type 1 (NF1) are at increased risk for wide-ranging behavioral, developmental, and cognitive impairments and decreased quality of life. To date, no psychosocial screening tool has been developed to quickly assess the symptoms that 1) can be addressed during routine medical appointments in children with NF1, 2) can produce interpretable and actionable results, 3) can be integrated into medical care, and 4) can quickly identify patients at risk in order to better address that the provision of appropriate care are available...
July 23, 2017: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/28625170/indirect-versus-direct-standardization-methods-for-reporting-healthcare-associated-infections-an-analysis-of-central-line-associated-bloodstream-infections-in-maryland
#11
Lyndsay M O'Hara, Max Masnick, Surbhi Leekha, Sarah S Jackson, Natalia Blanco, Anthony D Harris
Whether healthcare-associated infection data should be presented using indirect (current CMS/CDC methodology) or direct standardization remains controversial. We applied both methods to central-line-associated bloodstream infection data from 45 acute-care hospitals in Maryland from 2012 to 2014. We found that the 2 methods generate different hospital rankings with payment implications. Infect Control Hosp Epidemiol 2017;1-4.
June 19, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28599062/pediatric-cochlear-implantation-variation-in-income-race-payer-and-charges-across-five-states
#12
Zhen Huang, Heather Gordish-Dressman, Diego Preciado, Brian K Reilly
OBJECTIVES/HYPOTHESIS: Our objectives were to investigate pediatric cochlear implantation (PCI) across representative states within the United States and analyze any geographical differences in age, median household income, race, insurance, and total medical charges. STUDY DESIGN: Cross-sectional. METHODS: Data from children (aged 0.5-18 years) who received cochlear implantation surgery were collected from the 2011 State Ambulatory Surgery and Services Databases from California (CA), Florida (FL), Maryland (MD), New York (NY), and Kentucky (KY) as a part of the Healthcare Cost and Utilization Project...
June 9, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28535103/value-frameworks-for-the-patient-provider-interaction-a-comparison-of-the-asco-value-framework-versus-nccn-evidence-blocks-in-determining-value-in-oncology
#13
Bijal Shah-Manek, Joseph S Galanto, Huong Nguyen, Robert Ignoffo
BACKGROUND: To address the rising concern about oncology drug costs, the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) recently developed unique tools to help providers and patients make informed decisions about the value of an anticancer regimen. The ASCO Value Framework (AVF) allows users to generate a net health benefit (NHB) score along with drug acquisition costs for oncology regimens that have been compared in a prospective randomized clinical trial...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28448318/two-state-collaborative-study-of-a-multifaceted-intervention-to-decrease-ventilator-associated-events
#14
MULTICENTER STUDY
Nishi Rawat, Ting Yang, Kisha J Ali, Mary Catanzaro, Mariah D Cohen, Donna O Farley, Lisa H Lubomski, David A Thompson, Bradford D Winters, Sara E Cosgrove, Michael Klompas, Kathleen A Speck, Sean M Berenholtz
OBJECTIVES: Ventilator-associated events are associated with increased mortality, prolonged mechanical ventilation, and longer ICU stay. Given strong national interest in improving ventilated patient care, the National Institute of Health and Agency for Healthcare Research and Quality funded a two-state collaborative to reduce ventilator-associated events. We describe the collaborative's impact on ventilator-associated event rates in 56 ICUs. DESIGN: Longitudinal quasi-experimental study...
July 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28445566/variation-in-outcomes-at-bariatric-surgery-centers-of-excellence
#15
Andrew M Ibrahim, Amir A Ghaferi, Jyothi R Thumma, Justin B Dimick
Importance: In the United States, reports about perioperative complications associated with bariatric surgery led to the establishment of accreditation criteria for bariatric centers of excellence and many bariatric centers obtaining accreditation. Currently, most bariatric procedures occur at these centers, but to what extent they uniformly provide high-quality care remains unknown. Objective: To describe the variation in surgical outcomes across bariatric centers of excellence and the geographic availability of high-quality centers...
July 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28435485/impact-of-health-policy-changes-on-emergency-medicine-in-maryland-stratified-by-socioeconomic-status
#16
Laura Pimentel, David Anderson, Bruce Golden, Edward Wasil, Fermin Barrueto, Jon M Hirshon
INTRODUCTION: On January 1, 2014, the financing and delivery of healthcare in the state of Maryland (MD) profoundly changed. The insurance provisions of the Patient Protection and Affordable Care Act (ACA) began implementation and a major revision of MD's Medicare waiver ushered in a Global Budget Revenue (GBR) structure for hospital reimbursement. Our objective was to analyze the impact of these policy changes on emergency department (ED) utilization, hospitalization practices, insurance profiles, and professional revenue...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28216442/a-seven-day-course-of-tmp-smx-may-be-as-effective-as-a-seven-day-course-of-ciprofloxacin-for-the-treatment-of-pyelonephritis
#17
MULTICENTER STUDY
Miriam T Fox, Michael T Melia, Rebecca G Same, Anna T Conley, Pranita D Tamma
BACKGROUND: The Infectious Diseases Society of America guidelines recommend either 14 days of trimethoprim-sulfamethoxazole (TMP-SMX) or 7 days of ciprofloxacin for the treatment of pyelonephritis. Antibiotic courses of 7 days of TMP-SMX vs 7 days of ciprofloxacin for pyelonephritis have not been previously compared. We evaluated the odds of a subsequent, symptomatic urinary tract infection (UTI) for women with Escherichia coli pyelonephritis receiving a 7-day course of TMP-SMX vs a 7-day course of ciprofloxacin...
July 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28195959/treatment-charges-for-traumatic-brain-injury-among-older-adults-at-a-trauma-center
#18
Jennifer S Albrecht, Julia F Slejko, Deborah M Stein, Gordon S Smith
OBJECTIVE: To provide charge estimates of treatment for traumatic brain injury (TBI), including both hospital and physician charges, among adults 65 years and older treated at a trauma center. METHODS: We identified older adults treated for TBI during 2008-2012 (n = 1843) at Maryland's Primary Adult Resource Center and obtained hospital and physician charges separately. Analyses were stratified by sex and all charges were inflated to 2012 dollars. Total TBI charges were modeled as a function of covariates using a generalized linear model...
November 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28064401/the-national-cancer-institute-r25-cancer-education-grants-program-a-workshop-report
#19
REVIEW
Jeannette F Korczak, Davyd W Chung, Erica Rosemond, Daniel D Von Hoff, Richard L Haspel, John W Waterbor, Shine Chang, Amelie G Ramirez, Susan Perkins, Jonathan Wiest, Ming Lei
Through the R25 Cancer Education Grants Program (CEGP), the National Cancer Institute (NCI) has been supporting the broad educational needs of the cancer research and cancer healthcare communities since 1974. NCI sponsored a workshop on September 13, 2016 in Bethesda, Maryland, with the objectives of sharing best practices in cancer education, communicating R25 CEGP programmatic information, and gathering ideas to strengthen the R25 CEGP to better meet the emerging needs in cancer education in the face of a rapidly changing landscape in cancer research and cancer care...
March 2017: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/28034651/patient-surgeon-and-hospital-disparities-associated-with%C3%A2-benign-hysterectomy-approach-and-perioperative-complications
#20
Ambar Mehta, Tim Xu, Susan Hutfless, Martin A Makary, Abdulrahman K Sinno, Edward J Tanner, Rebecca L Stone, Karen Wang, Amanda N Fader
BACKGROUND: Hysterectomy is among the most common major surgical procedures performed in women. Approximately 450,000 hysterectomy procedures are performed each year in the United States for benign indications. However, little is known regarding contemporary US hysterectomy trends for women with benign disease with respect to operative technique and perioperative complications, and the association between these 2 factors with patient, surgeon, and hospital characteristics. OBJECTIVE: We sought to describe contemporary hysterectomy trends and explore associations between patient, surgeon, and hospital characteristics with surgical approach and perioperative complications...
May 2017: American Journal of Obstetrics and Gynecology
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