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maryland healthcare

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
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...
February 16, 2017: American Journal of Medicine
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...
February 10, 2017: Journal of Head Trauma Rehabilitation
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
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...
December 26, 2016: American Journal of Obstetrics and Gynecology
Marcelo Cerullo, Faiz Gani, Sophia Y Chen, Joseph K Canner, Timothy M Pawlik
BACKGROUND: Although uncoordinated postdischarge care has been associated with poor clinical outcomes, the effect of discharge to a low healthcare resource area (LHRA) on readmission remains undetermined. We sought to assess how the quality of discharge area health resources impact readmission following major surgery. METHODS: This cross-sectional study was performed by linking Maryland state data for 2012-2015 to the Agency for Healthcare Research and Quality Area Health-Resource File...
October 2016: Journal of Surgical Research
Katherine Treiman, Lauren McCormack, Murrey Olmsted, Nancy Roach, Bryce B Reeve, Christa E Martens, Rebecca R Moultrie, Hanna Sanoff
BACKGROUND: Patient-centered communication (PCC) is an essential component of patient-centered care and contributes to patient satisfaction, health-related quality of life, and other important patient outcomes. OBJECTIVE: The aim of this study was to develop and test survey questions to assess patients' experiences with PCC in cancer care. METHODS: We used a conceptual model developed by the National Cancer Institute as our framework. The survey questions align with the six core functions of PCC defined in the model: Exchanging Information, Managing Uncertainty, Enabling Patient Self-Management, Fostering Healing Relationships, Making Decisions, and Responding to Emotions...
September 23, 2016: Patient
Parul Agarwal, Thomas K Bias, Suresh Madhavan, Nethra Sambamoorthi, Stephanie Frisbee, Usha Sambamoorthi
OBJECTIVE: The objective of this study was to examine the association of patient- and county-level factors with the emergency department (ED) visits among adult fee-for-service (FFS) Medicaid beneficiaries residing in Maryland, Ohio, and West Virginia. METHODS: A cross-sectional design using retrospective observational data was implemented. Patient-level data were obtained from 2010 Medicaid Analytic eXtract files. Information on county-level health-care resources was obtained from the Area Health Resource file and County Health Rankings file...
April 27, 2016: Health Services Research and Managerial Epidemiology
David Schnabel, Douglas H Esposito, Joanna Gaines, Alison Ridpath, M Anita Barry, Katherine A Feldman, Jocelyn Mullins, Rachel Burns, Nina Ahmad, Edith N Nyangoma, Duc B Nguyen, Joseph F Perz, Heather A Moulton-Meissner, Bette J Jensen, Ying Lin, Leah Posivak-Khouly, Nisha Jani, Oliver W Morgan, Gary W Brunette, P Scott Pritchard, Adena H Greenbaum, Susan M Rhee, David Blythe, Mark Sotir
During 2013, the Maryland Department of Health and Mental Hygiene in Baltimore, MD, USA, received report of 2 Maryland residents whose surgical sites were infected with rapidly growing mycobacteria after cosmetic procedures at a clinic (clinic A) in the Dominican Republic. A multistate investigation was initiated; a probable case was defined as a surgical site infection unresponsive to therapy in a patient who had undergone cosmetic surgery in the Dominican Republic. We identified 21 case-patients in 6 states who had surgery in 1 of 5 Dominican Republic clinics; 13 (62%) had surgery at clinic A...
August 2016: Emerging Infectious Diseases
Yukyan Lam, Ryan Westergaard, Gregory Kirk, Azal Ahmadi, Andrew Genz, Jeanne Keruly, Heidi Hutton, Pamela J Surkan
Despite the existence of highly active antiretroviral therapy, HIV/AIDS morbidity and mortality continue to be public health burdens in the United States due to difficulties in engaging people living with HIV/AIDS (PLWHA) in continuous, effective care. In comparison to studies investigating patient-level characteristics associated with starting and remaining in care, there is relatively little research on how structural factors, such as those pertaining to healthcare providers and the infrastructure for delivery of health services, influence patients' engagement in HIV care...
2016: PloS One
Elizabeth Cutting, Meghan Banchero, Amber L Beitelshees, James J Cimino, Guilherme Del Fiol, Ayse P Gurses, Mark A Hoffman, Linda Jo Bone Jeng, Kensaku Kawamoto, Mark Kelemen, Harold Alan Pincus, Alan R Shuldiner, Marc S Williams, Toni I Pollin, Casey Lynnette Overby
The objective of this study was to develop a high-fidelity prototype for delivering multi-gene sequencing panel (GS) reports to clinicians that simulates the user experience of a final application. The delivery and use of GS reports can occur within complex and high-paced healthcare environments. We employ a user-centered software design approach in a focus group setting in order to facilitate gathering rich contextual information from a diverse group of stakeholders potentially impacted by the delivery of GS reports relevant to two precision medicine programs at the University of Maryland Medical Center...
October 2016: Journal of Biomedical Informatics
Sarah S Jackson, Surbhi Leekha, Lisa Pineles, Laurence S Magder, Kerri A Thom, Yuan Wang, Anthony D Harris
OBJECTIVE To identify comorbid conditions associated with surgical site infection (SSI) among patients undergoing renal transplantation and improve existing risk adjustment methodology used by the Centers for Disease Control and Prevention National Healthcare Safety Network (NHSN). PATIENTS Patients (≥18 years) who underwent renal transplantation at University of Maryland Medical Center January 1, 2010-December 31, 2011. METHODS Trained infection preventionists reviewed medical records to identify surgical site infections that developed within 30 days after transplantation, using NHSN criteria...
October 2016: Infection Control and Hospital Epidemiology
Martin L Stephens, Kellyn Betts, Nancy B Beck, Vincent Cogliano, Kay Dickersin, Suzanne Fitzpatrick, James Freeman, George Gray, Thomas Hartung, Jennifer McPartland, Andrew A Rooney, Roberta W Scherer, Didier Verloo, Sebastian Hoffmann
The Evidence-based Toxicology Collaboration hosted a workshop on "The Emergence of Systematic Review and Related Evidence-based Approaches in Toxicology," on November 21, 2014 in Baltimore, Maryland. The workshop featured speakers from agencies and organizations applying systematic review approaches to questions in toxicology, speakers with experience in conducting systematic reviews in medicine and healthcare, and stakeholders in industry, government, academia, and non-governmental organizations. Based on the workshop presentations and discussion, here we address the state of systematic review methods in toxicology, historical antecedents in both medicine and toxicology, challenges to the translation of systematic review from medicine to toxicology, and thoughts on the way forward...
July 2016: Toxicological Sciences: An Official Journal of the Society of Toxicology
Tim Xu, Martin A Makary, Elie Al Kazzi, Mo Zhou, Timothy M Pawlik, Susan M Hutfless
BACKGROUND: Variation in surgical outcomes is often attributed to patient comorbidities and the severity of underlying disease, but little is known about the extent of variation in outcomes by surgeon and the surgeon factors that are associated with quality. METHODS: Using the Maryland Health Services Cost Review Commission database, we evaluated risk-adjusted postoperative events by surgeon. Operations studied were elective laparoscopic and open colectomy procedures for colon cancer performed over a 2-year period (July 2012-September 2014)...
July 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Scott P Grytdal, Emilio DeBess, Lore E Lee, David Blythe, Patricia Ryan, Christianne Biggs, Miriam Cameron, Mark Schmidt, Umesh D Parashar, Aron J Hall
Noroviruses and other viral pathogens are increasingly recognized as frequent causes of acute gastroenteritis (AGE). However, few laboratory-based data are available on the incidence of AGE caused by viral pathogens in the U.S. This study examined stool specimens submitted for routine clinical diagnostics from patients enrolled in Kaiser Permanente (KP) health plans in metro Portland, OR, and the Maryland, District of Columbia, and northern Virginia geographic areas to estimate the incidence of viral enteropathogens in these populations...
2016: PloS One
Dzifa Dordunoo, Sue A Thomas, Erika Friedmann, Stuart D Russell, Robin P Newhouse, Bim Akintade
BACKGROUND: All-cause 30-day hospital readmission is a heart failure (HF) quality of care metric. Readmission costs the healthcare system $30.7 million annually. Specific structure, process, or patient factors that predispose patients to readmission are unclear. OBJECTIVE: The aim of this study is to determine whether the addition of unit-level structural factors (attending medical service, patient-to-nurse ratio, and unit HF volume) predicts readmission beyond patient factors...
May 2017: Journal of Cardiovascular Nursing
Tyler E Mains, Mark V Wilcox, Scott M Wright
BACKGROUND: Less than 6% of U.S. medical school applicants are African-American. The lack of diversity among physicians, by race as well as other measures, confers a negative impact on the American healthcare system because underrepresented minority (URM) physicians are more likely to practice in underserved communities and deliver more equitable, culturally competent care. METHODS: MERIT (Medical Education Resources Initiative for Teens) is a nonprofit organization based in Baltimore, Maryland, USA...
January 2016: Education for Health: Change in Training & Practice
Erik H Hoyer, Charles A Odonkor, Sumit N Bhatia, Curtis Leung, Amy Deutschendorf, Daniel J Brotman
OBJECTIVE: Hospital discharge summaries can provide valuable information to future providers and may help to prevent hospital readmissions. We sought to examine whether the number of days to complete hospital discharge summaries is associated with 30-day readmission rate. PATIENTS AND METHODS: This was a retrospective cohort study conducted on 87,994 consecutive discharges between January 1, 2013 and December 31, 2014, in a large urban academic hospital. We used multivariable logistic regression models to examine the association between days to complete the discharge summary and hospital readmissions while controlling for age, gender, race, payer, hospital service (gynecology-obstetrics, medicine, neurosciences, oncology, pediatrics, and surgical sciences), discharge location, length of stay, expected readmission rate in Maryland based on diagnosis and illness severity, and the Agency for Healthcare Research and Quality Comorbidity Index...
June 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Grant R Martsolf, Teresa B Gibson, Richele Benevent, H Joanna Jiang, Carol Stocks, Emily D Ehrlich, Ryan Kandrack, David I Auerbach
OBJECTIVE: To study the association between hospital nurse staffing and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. DATA SOURCES: State hospital financial and utilization reports, Healthcare Cost and Utilization Project State Inpatient Databases, HCAHPS survey, and American Hospital Association Annual Survey of Hospitals. STUDY DESIGN: Retrospective study using cross-sectional and longitudinal models to estimate the effect of nurse staffing levels and skill mix on seven HCAHPS measures...
December 2016: Health Services Research
Laura W Koo, Alice M Horowitz, Sarah D Radice, Min Q Wang, Dushanka V Kleinman
OBJECTIVES: We examined nurse practitioners' use and opinions of recommended communication techniques for the promotion of oral health as part of a Maryland state-wide oral health literacy assessment. Use of recommended health-literate and patient-centered communication techniques have demonstrated improved health outcomes. METHODS: A 27-item self-report survey, containing 17 communication technique items, across 5 domains, was mailed to 1,410 licensed nurse practitioners (NPs) in Maryland in 2010...
2016: PloS One
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