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https://www.readbyqxmd.com/read/27913266/cost-utility-of-video-electroencephalography-monitoring-followed-by-surgery-in-adults-with-drug-resistant-focal-epilepsy-in-thailand
#1
Pimprapa Kitwitee, Kanjana Unnwongse, Teeradej Srikijvilaikul, Tinonkorn Yadee, Chulaporn Limwattananon
OBJECTIVES: This study assessed, whether video-electroencephalography (VEEG) monitoring followed by surgery was cost-effective in adult patients with drug-resistant focal epilepsy under Thai healthcare context, as compared to continued medical treatment without VEEG. METHODS: Total cost (in Thai Baht, THB) and effectiveness (in quality-adjusted life years, QALYs) were estimated over a lifetime horizon, using a decision tree and a Markov model. Data on short-term surgical outcomes, direct health care costs, and utilities, were collected from Thai patients in a specialized hospital...
November 29, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27912043/palliative-care-interventions-for-patients-with-heart-failure-a-systematic-review-and-meta-analysis
#2
Michelle S Diop, James L Rudolph, Kristin M Zimmerman, Mary A Richter, L Michal Skarf
OBJECTIVE: To systematically characterize interventions and effectiveness of palliative care for advanced heart failure (HF) patients. BACKGROUND: Patients with advanced heart failure experience a high burden of distressing symptoms and diminished quality of life. Palliative care expertise with symptom management and healthcare decision-making benefits HF patients. METHODS: A systematic PubMed search was conducted from inception to June 2016 for studies of palliative care interventions for HF patients...
December 2, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27911935/the-impact-of-healthcare-insurance-on-the-utilisation-of-facility-based-delivery-for-childbirth-in-the-philippines
#3
Hebe N Gouda, Andrew Hodge, Raoul Bermejo, Willibald Zeck, Eliana Jimenez-Soto
OBJECTIVES: In recent years, the government of the Philippines embarked upon an ambitious Universal Health Care program, underpinned by the rapid scale-up of subsidized insurance coverage for poor and vulnerable populations. With a view of reducing the stubbornly high maternal mortality rates in the country, the program has a strong focus on maternal health services and is supported by a national policy of universal facility-based delivery (FBD). In this study, we examine the impact that recent reforms expanding health insurance coverage have had on FBD...
2016: PloS One
https://www.readbyqxmd.com/read/27911347/smartphone-applications-for-immersive-virtual-reality-therapy-for-internet-addiction-and-internet-gaming-disorder
#4
Melvyn W B Zhang, Roger C M Ho
There have been rapid advances in technologies over the past decade and virtual reality technology is an area which is increasingly utilized as a healthcare intervention in many disciplines including that of Medicine, Surgery and Psychiatry. In Psychiatry, most of the current interventions involving the usage of virtual reality technology is limited to its application for anxiety disorders. With the advances in technology, Internet addiction and Internet gaming disorders are increasingly prevalent. To date, these disorders are still being treated using conventional psychotherapy methods such as cognitive behavioural therapy...
November 25, 2016: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/27909581/expansion-of-health-insurance-in-moldova-and-associated-improvements-in-access-and-reductions-in-direct-payments
#5
Thomas Hone, Jarno Habicht, Silviu Domente, Rifat Atun
BACKGROUND: Moldova is the poorest country in Europe. Economic constraints mean that Moldova faces challenges in protecting individuals from excessive costs, improving population health and securing health system sustainability. The Moldovan government has introduced a state benefit package and expanded health insurance coverage to reduce the burden of health care costs for citizens. This study examines the effects of expanded health insurance by examining factors associated with health insurance coverage, likelihood of incurring out-of-pocket (OOP) payments for medicines or services, and the likelihood of forgoing health care when unwell...
December 2016: Journal of Global Health
https://www.readbyqxmd.com/read/27909482/the-cost-effectiveness-of-laa-exclusion
#6
REVIEW
Bahij Kreidieh, Moisés Rodríguez-Mañero, Sergio H Ibarra-Cortez, Paul Schurmann, Miguel Valderrábano
Left atrial appendage (LAA) exclusion strategies are increasingly utilized for stroke prevention in lieu of oral anticoagulants. Reductions in bleeding risk and long-term compliance issues bundled with comparable stroke prevention benefits have made these interventions increasingly attractive. Unfortunately, healthcare funding remains limited. Comparative cost economic analyses are therefore critical in optimizing resource allocation. In this review we seek to discourse the cost economics analysis of LAA exclusion over available therapeutic alternatives (warfarin and the new oral anticoagulants (NOACs))...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27908502/centralized-capacity-building-training-of-lichtenstein-hernioplasty-in-brazil
#7
Alexandra M Moore, Néha Datta, Justin P Wagner, Alexander D Schroeder, Wolfgang Reinpold, Maurice Y Franciss, Rodrigo A Silva, David C Chen, Charles J Filipi, Sergio Roll
BACKGROUND: In Brazil, access to healthcare varies widely by community. Options for repair of surgically correctable conditions, such as inguinal hernias, are limited. A training program was instituted to expand access to Lichtenstein hernioplasty. METHODS: Between September, 2014 and September, 2015, 3 orders of training series took place in São Paulo, Brazil. Participating surgeons received training and assessments from expert trainers using the Operative Performance Rating Scale (OPRS)...
November 22, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27908165/a-comparison-of-two-prospective-risk-analysis-methods-traditional-fmea-and-a-modified-healthcare-fmea
#8
Jeong-Eun Rah, Ryan P Manger, Adam D Yock, Gwe-Ya Kim
PURPOSE: To examine the abilities of a traditional failure mode and effects analysis (FMEA) and modified healthcare FMEA (m-HFMEA) scoring methods by comparing the degree of congruence in identifying high risk failures. METHODS: The authors applied two prospective methods of the quality management to surface image guided, linac-based radiosurgery (SIG-RS). For the traditional FMEA, decisions on how to improve an operation were based on the risk priority number (RPN)...
December 2016: Medical Physics
https://www.readbyqxmd.com/read/27906759/development-of-a-disease-based-hernia-program-and-the-impact-on-cost-for-a-hospital-system
#9
David M Krpata, Ivy N Haskins, Steven Rosenblatt, Sharon Grundfest, Ajita Prabhu, Michael J Rosen
OBJECTIVE: The aim of this study was to assess the impact of developing a hernia program on mesh utilization. BACKGROUND: With the ongoing changes in healthcare, the value of all interventions will see increased scrutiny. Hernia mesh can be one of the most costly components of hernia repairs. A disease-based institutional hernia program that defines roles for mesh utilization and measures outcomes has the potential to add significant value to hospital systems. METHODS: In August 2014, a disease-based hernia program was initiated across a hospital system...
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27906698/ige-and-eosinophils-as-therapeutic-targets-in-asthma
#10
Tanvi R Patel, Sanjiv Sur
PURPOSE OF REVIEW: Asthma is a chronic inflammatory disorder characterized by reversible airflow obstruction, which is being more widely recognized as a broad-spectrum disease that encompasses multiple patient characteristics and pathophysiologic mechanisms. Suboptimal asthma control leads to increasing burden of healthcare costs and loss of productivity to society. Biologic therapies targeted at IgE and eosinophils can be used in poorly controlled allergic and eosinophilic asthma, respectively...
November 30, 2016: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27906011/prevalence-of-hiv-and-hepatitis-b-coinfection-in-ghana-a-systematic-review-and-meta-analysis
#11
REVIEW
Akosua Adom Agyeman, Richard Ofori-Asenso
BACKGROUND: Human immunodeficiency virus (HIV) and hepatitis B virus (HBV) coinfection has been associated with higher morbidity and mortality and may impact significantly on healthcare resource utilization. However, in Ghana, accurate estimates of the prevalence of HIV/HBV coinfection needed to inform policy decisions and the design of public health interventions are currently lacking. In this study, our aim was to determine the HIV/HBV coinfection prevalence rate in Ghana. METHODS: Primary studies reporting prevalence of HIV/HBV coinfection in Ghana were retrieved through searches conducted in PubMed, science direct, Google scholar and Africa journals online (AJOL) databases...
May 17, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27905829/post-traumatic-stress-disorder-dimensions-and-asthma-morbidity-in-world-trade-center-rescue-and-recovery-workers
#12
Irina Mindlis, Esperanza Morales-Raveendran, Emily Goodman, Kevin Xu, Clara Vila-Castelar, Kristine Keller, Ginger Crawford, Shynah James, Craig Katz, Laura E Crowley, Rafael E de la Hoz, Steven Markowitz, Juan P Wisnivesky
Objective Using data from a cohort of World Trade Center (WTC) rescue and recovery workers with asthma, we assessed whether meeting criteria for post-traumatic stress disorder (PTSD), sub- PTSD and for specific PTSD symptom dimensions are associated with increased asthma morbidity. Methods Participants underwent a Structured Clinical Interview for Diagnostic and Statistical Manual to assess presence of PTSD following DSM-IV criteria during in-person interviews between December 2013 and April 2015. We defined sub-threshold PTSD as meeting criteria for two of three symptom dimensions: re-experiencing, avoidance, or hyper-arousal...
December 1, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27902661/assessment-of-clinical-alarms-influencing-nurses-perceptions-of-alarm-fatigue
#13
Emalie M Petersen, Cindy L Costanzo
BACKGROUND: Excessive clinical alarms have inundated health care for years. Multiple governing bodies, organizations, and facilities have deemed alarm management a priority. Alarm management is a multifaceted problem that affects all health care organizations and clinical staff, especially those in critical care units. Ultimately, the lack of knowledge regarding nurses' perceptions to alarm management and alarm fatigue creates patient safety chiasms. OBJECTIVES: The purpose of this quality improvement project was to understand nurses' perceptions of alarm fatigue (utilizing the Healthcare Technology Foundation's Clinical Alarms Committee Survey) while implementing interventions that improve patient safety...
January 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/27902648/incidence-and-burden-of-pertussis-among-infants-less-than-1-year-of-age
#14
Cristina Masseria, Carolyn K Martin, Girishanthy Krishnarajah, Laura K Becker, Ami Buikema, Tina Q Tan
BACKGROUND: Infant-specific pertussis data, especially among neonates, are limited and variable. This study (NCT01890850) provides overall and age-specific pertussis incidence and associated healthcare utilization and costs among commercially insured infants in the United States. METHODS: Nearly 1.2 million infants born from 2005-2010 with commercial health plan coverage were followed during their first 12 months of life. Pertussis cases were identified from medical claims (ICD-9-CM 033...
November 28, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27902568/health-utilities-in-people-with-chronic-pain-using-a-population-level-survey-and-linked-healthcare-administrative-data
#15
Mary-Ellen Hogan BScPhm, Anna Taddio BScPhm, Joel Katz, Vibhuti Shah, Murray Krahn
Health utilities are a preference-based measure of health-related quality of life that facilitates comparison of disease burden across conditions. We estimated utilities using a population-based, matched sample of adolescents and adults with and without chronic pain, controlling for comorbidity.Ontarians aged ≥12 years with and without chronic pain were identified from the Canadian Community Health Survey (CCHS) 2000-01 and 2009-10 and linked to their provincial healthcare administrative data. Individuals with chronic pain were matched to those without using age, sex, survey year, and a propensity score for having chronic pain estimated from a rurality index, income quintile and comorbidity...
November 24, 2016: Pain
https://www.readbyqxmd.com/read/27901333/fractional-flow-reserve-lessons-from-platform-and-future-perspectives
#16
Gianluca Pontone, Patrizia Carità, Massimo Verdecchia, Dario Buccheri, Daniele Andreini, Andrea I Guaricci, Mark Rabbat, Mauro Pepi
In the treatment of stable coronary artery disease (CAD) the identification of patients who may gain the highest benefit from further invasive treatments is of pivotal importance for the healthcare system. In this setting, it has been established that an ischemia-guided revascularization strategy yields improved clinical outcomes in a cost- effective fashion compared with anatomy-guided revascularization alone. Invasive fractional flow reserve (FFR) is considered the gold standard, especially in the intermediate-range atherosclerotic lesions, for assessing lesion specific ischemia at the time of invasive coronary angiography and has now become the standard of reference for studies assessing the diagnostic performance of the various non-invasive stress tests...
November 30, 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27900514/process-evaluation-of-a-community-garden-at-an-urban-outpatient-clinic
#17
Brandy-Joe Milliron, Mara Z Vitolins, Elizabeth Gamble, Robert Jones, Margaret C Chenault, Janet A Tooze
In addition to expediting patient recovery, community gardens that are associated with medical facilities can provide fresh produce to patients and their families, serve as a platform for clinic-based nutrition education, and help patients develop new skills and insights that can lead to positive health behavior change. While community gardening is undergoing resurgence, there is a strong need for evaluation studies that employ valid and reliable measures. The objective of this study was to conduct a process evaluation of a community garden program at an urban medical clinic to estimate the prevalence of patient awareness and participation, food security, barriers to participation, and personal characteristics; garden volunteer satisfaction; and clinic staff perspectives in using the garden for patient education/treatment...
November 29, 2016: Journal of Community Health
https://www.readbyqxmd.com/read/27897108/diagnostic-validity-and-clinical-utility-of-hba1c-tests-for-type-2-diabetes-mellitus
#18
Arthur Hamie Owora
Individual and population level inference about risk and burden of diabetes is often made using diagnostic tests that are imperfect and prone to misclassification error (i.e. false positives and negatives). These errors or biases are rarely accounted for and could lead to inappropriate clinical decisions, inefficient allocation of scarce resources, and poor planning of disease prevention and treatment interventions. The objective of this article is to describe how misclassification error due to imperfect diagnostic tests affects individual and population level inference, particularly involving the role of hemoglobin HbA1c in diagnosing Type 2 diabetes mellitus...
November 29, 2016: Current Diabetes Reviews
https://www.readbyqxmd.com/read/27896982/predictive-modeling-of-hospital-readmission-rates-using-electronic-medical-record-wide-machine-learning-a-case-study-using-mount-sinai-heart-failure-cohort
#19
Khader Shameer, Kipp W Johnson, Alexandre Yahi, Riccardo Miotto, L I Li, Doran Ricks, Jebakumar Jebakaran, Patricia Kovatch, Partho P Sengupta, Sengupta Gelijns, Alan Moskovitz, Bruce Darrow, David L David, Andrew Kasarskis, Nicholas P Tatonetti, Sean Pinney, Joel T Dudley
Reduction of preventable hospital readmissions that result from chronic or acute conditions like stroke, heart failure, myocardial infarction and pneumonia remains a significant challenge for improving the outcomes and decreasing the cost of healthcare delivery in the United States. Patient readmission rates are relatively high for conditions like heart failure (HF) despite the implementation of high-quality healthcare delivery operation guidelines created by regulatory authorities. Multiple predictive models are currently available to evaluate potential 30-day readmission rates of patients...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27896880/a-community-based-cross-sectional-survey-of-medication-utilization-among-chronic-disease-patients-in-china
#20
Mark A Strand, Kirstin Gramith, Macy Royston, Xiaoxi Wang, Judith Perry, Curt Elliott
OBJECTIVES: To determine medication use patterns and associated health outcomes in Chinese individuals with diabetes, hypertension or hyperlipidaemia. METHODS: This community-based cross-sectional study was done in a north China city of 300 000 people. Participants were recruited by poster and phone call through Community Health Centres. Data were collected on 638 Chinese individuals. Interviews were done to screen for disease and health behaviours. Fasting blood was collected and analyzed...
November 29, 2016: International Journal of Pharmacy Practice
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