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https://www.readbyqxmd.com/read/29159844/incidence-and-predictors-of-30-day-postoperative-readmission-in-children
#1
Daniel Vo, David Zurakowski, David Faraoni
BACKGROUND: Hospital readmissions are being used as a quality metric for hospital reimbursement without a clear understanding of the factors that contribute to readmission. OBJECTIVE: The objective of this study was to report the incidence of 30-day postsurgical readmission in children, identify the predictors for readmission, and create an algorithm to identify high-risk children. METHODS: Data from the 2012-2014 Pediatric database of the American College of Surgeons National Surgical Quality Improvement Program were analyzed using univariable and multivariable logistical regression analysis...
November 20, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29159676/the-posterior-anterior-flexed-view-is-better-than-the-anterior-posterior-view-for-assessing-osteoarthritis-of-the-knee
#2
Kilian Rueckl, Friedrich Boettner, Noor Maza, Armin Runer, Ulrich Bechler, Peter Sculco
OBJECTIVE: The aim of this study is to determine whether the posterior-anterior (PA)-flexed view improves the radiographic assessment of patients with knee pain compared with the standard standing anterior-posterior radiograph. MATERIALS AND METHODS: Three hundred and sixty-five patients with knee pain underwent anterior-posterior (AP), PA flexed, lateral, and Merchant radiographs of the knee. Knees were grouped as mild (Kellgren and Lawrence [K-L] 1-2) or severe (K-L 3-4) osteoarthritis (OA) and either varus (medial compartment), valgus (lateral compartment), or patellofemoral OA...
November 20, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/29157785/history-of-breast-cancer-increases-90-day-pulmonary-embolism-rates-and-reimbursements-after-total-hip-arthroplasty-a-national-matched-pair-analysis
#3
Samuel Rosas, Alejandro Marquez-Lara, Daniel N Bracey, Jennifer Kurowicki, Martin W Roche, Cynthia L Emory
BACKGROUND: Rates of total hip arthroplasty (THA) are projected to increase in the coming decades. Multiple studies have focused on identifying risk factors for adverse events after joint arthroplasty, and recent attention has been directed toward cancer. Very limited data have been published examining the effects of history of malignancy on outcomes after THA. With a concomitant increase in breast cancer diagnosis and treatments in recent years, it is expected that orthopedic surgeons will likely see more breast cancer survivors in clinic...
October 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29157739/office-based-spirometry-a-new-model-of-care-in-preoperative-assessment-for-low-risk-lung-resections
#4
Jessica L Hudson, Jennifer M Bell, Traves D Crabtree, Daniel Kreisel, G Alexander Patterson, Bryan F Meyers, Varun Puri
BACKGROUND: Formal pulmonary function testing with laboratory spirometry (LS) is the standard of care for risk stratification before lung resection. LS and handheld office spirometry (OS) are clinically comparable for forced expiratory volume in 1 second and forced vital capacity. We investigated the safety of preoperative risk stratification based solely on OS. METHODS: Patients at low-risk for cardiopulmonary complications were enrolled in a single-center prospective study and underwent preoperative OS...
November 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29155929/pan-asian-adapted-esmo-consensus-guidelines-for-the-management-of-patients-with-metastatic-colorectal-cancer-a-jsmo-esmo-initiative-endorsed-by-csco-kaco-mos-sso-and-tos
#5
T Yoshino, D Arnold, H Taniguchi, G Pentheroudakis, K Yamazaki, R-H Xu, T W Kim, F Ismail, I B Tan, K-H Yeh, A Grothey, S Zhang, J B Ahn, D Chong, L-T Chen, S Kopetz, T Eguchi-Nakajima, H Ebi, A Ohtsu, A Cervantes, K Muro, J Tabernero, H Minami, F Ciardiello, J-Y Douillard
The most recent version of the European Society for Medical Oncology (ESMO) consensus guidelines for the treatment of patients with metastatic colorectal cancer (mCRC) was published in 2016, identifying both a more strategic approach to the administration of the available systemic therapy choices, and a greater emphasis on the use of ablative techniques, including surgery. At the 2016 ESMO Asia Meeting, in December 2016, it was decided by both ESMO and the Japanese Society of Medical Oncology (JSMO) to convene a special guidelines meeting, endorsed by both ESMO and JSMO, immediately after the JSMO 2017 Annual Meeting...
November 16, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29153853/community-pharmacist-collaboration-with-a-patient-centered-medical-home-establishment-of-a-patient-centered-medical-neighborhood-and-payment-model
#6
Heidi R Luder, Pam Shannon, James Kirby, Stacey M Frede
OBJECTIVES: To determine the feasibility of a partnership between a community pharmacy and a patient-centered medical home (PCMH) by measuring the impact on office- and patient-level clinical outcomes. SETTING: Kroger Pharmacy and a PCMH practice in Cincinnati, OH. PRACTICE DESCRIPTION: The Kroger Co. is a large grocery store chain that operates 102 pharmacies in the Cincinnati-Dayton marketing area. The PCMH practice is an accredited PCMH office serving more than 9000 patients in the Cincinnati area...
November 15, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/29153633/opioids-consumed-in-the-immediate-post-operative-period-does-not-influence-how-patients-rate-their-experience-of-care-after-total-hip-arthroplasty
#7
Jennifer I Etcheson, Chukwuweike U Gwam, Nicole E George, Sana Virani, Michael A Mont, Ronald E Delanois
BACKGROUND: Patient perception of care, commonly measured with Press Ganey (PG) surveys, is an important metric used to determine hospital and provider reimbursement. However, post-operative pain following total hip arthroplasty (THA) may negatively affect patient satisfaction. As a result, over-administration of opioids may occur, even without marked evidence of pain. Therefore, this study evaluated whether opioid consumption in the immediate postoperative period bears any influence on satisfaction scores after THA...
November 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29151818/lifetime-cost-effectiveness-analysis-of-intraoperative-radiation-therapy-versus-external-beam-radiation-therapy-for-early-stage-breast-cancer
#8
Rakesh Patel, Olga Ivanov, Jeff Voigt
Background: To date no one has examined the quality of life and direct costs of care in treating early stage breast cancer with adjunct intraoperative radiation therapy (IORT) versus external beam radiation therapy (EBRT) over the life of the patient. As well no one has examined the effects of radiation exposure with both therapies on the longer term sequelae. The purpose of this analysis was to examine the cost-effectiveness of IORT vs. EBRT over the life of the patient. Methods: A Markov decision-analytic model evaluated these treatment strategies in terms of the direct costs in treating patients over their lifetime (including the downstream costs associated with radiation exposure) and the resultant quality of life of these patients...
2017: Cost Effectiveness and Resource Allocation: C/E
https://www.readbyqxmd.com/read/29151390/reflections-on-the-nice-decision-to-reject-patient-production-losses
#9
James Shearer, Sarah Byford, Steve Birch
OBJECTIVES: Patient production losses occur when individuals' capacities to work, whether paid or unpaid, are impaired by illness, treatment, disability, or death. There is controversy about whether and how to include patient production losses in economic evaluations in health care. Patient production losses have not previously been considered when evaluating medications for reimbursement under the U.K. National Health Service. Proposals for value-based assessment of health technologies in the United Kingdom created renewed interest in whether and how to include costs from a wider societal perspective, such as patient production losses, within economic evaluation of healthcare interventions...
November 20, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/29151010/same-day-discharge-after-total-joint-arthroplasty-the-future-may-be-now
#10
Vinay Aggarwal, Savyasachi Thakkar, Kristopher Collins, Jonathan Vigdorchik
Total joint arthroplasty has traditionally been performed as an inpatient procedure to mitigate the risks of perioperative complications, limited mobility, and pain control issues. Reducing readmissions and complications is increasingly important with the push toward outcomes based reimbursement. Nonetheless, there is a definite trend toward not only shortening postoperative length of stay but also toward considering a same day discharge arthroplasty model in appropriately selected patients. In this review, we outline the literature evidence regarding same day discharge in total joint arthroplasty and discuss our own institutional guidelines for appropriate patient selection as well as contraindications...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29150533/disparity-between-indications-for-and-utilization-of-implantable-cardioverter-defibrillators-in-asian-patients-with-heart-failure
#11
Yvonne May Fen Chia, Tiew-Hwa Katherine Teng, Eugene S J Tan, Wan Ting Tay, A Mark Richards, Calvin Woon Loong Chin, Wataru Shimizu, Sang Weon Park, Chung-Lieh Hung, Lieng H Ling, Tachapong Ngarmukos, Razali Omar, Bambang B Siswanto, Calambur Narasimhan, Eugene B Reyes, Cheuk-Man Yu, Inder Anand, Michael R MacDonald, Jonathan Yap, Shu Zhang, Eric A Finkelstein, Carolyn S P Lam
BACKGROUND: Implantable cardioverter defibrillators (ICDs) are lifesaving devices for patients with heart failure (HF) and reduced ejection fraction. However, utilization and determinants of ICD insertion in Asia are poorly defined. We determined the utilization, associations of ICD uptake, patient-perceived barriers to device therapy and, impact of ICDs on mortality in Asian patients with HF. METHODS AND RESULTS: Using the prospective ASIAN-HF (Asian Sudden Cardiac Death in Heart Failure) registry, 5276 patients with symptomatic HF and reduced ejection fraction (HFrEF) from 11 Asian regions and across 3 income regions (high: Hong Kong, Japan, Korea, Singapore, and Taiwan; middle: China, Malaysia, and Thailand; and low: India, Indonesia, and Philippines) were studied...
November 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29149853/cost-of-delivering-health-care-services-at-primary-health-facilities-in-ghana
#12
Maxwell Ayindenaba Dalaba, Paul Welaga, Chieko Matsubara
BACKGROUND: There is limited knowledge on the cost of delivering health services at primary health care facilities in Ghana which is posing a challenge in resource allocations. This study therefore estimated the cost of providing health care in primary health care facilities such as Health Centres (HCs) and Community-based Health Planning and Services (CHPS) in Ghana. METHODS: The study was cross-sectional and quantitative data was collected from the health provider perspective...
November 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29148326/understanding-professional-jurisdiction-changes-in-the-field-of-anesthesiology
#13
Scott Feyereisen, Joseph P Broschak, Beth Goodrick
We further our understanding of jurisdictional disputes between established professional groups through a 10-year longitudinal analysis of the differential adoption by U.S. states of policies expanding Certified Registered Nurse Anesthetists' (CRNAs) autonomy. In the United States, CRNAs are trained to deliver anesthetics to patients in the same way as physician anesthesiologists but have more restrictions in practice. Following a 2001 federal decision regarding Medicare reimbursement, states were permitted but not required to allow CRNAs to practice without physician supervision, potentially reducing health care costs...
January 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148258/influence-of-medical-insurance-schemes-and-charity-assistance-projects-on-regular-prophylaxis-treatment-of-the-boys-with-severe-haemophilia-a-in-china
#14
Z Li, J Wu, Y Zhao, R Liu, K Li, Y Zhou, R Wu, R Yang, X Zhang, S Lian, Q Hu, X Li, J Gu, R Zhou, J Sun, C Li, W Xu, M-C Poon, J Xiao
OBJECTIVE: To explore the influence of medical insurance policy and charity assistance projects on the uptake and discontinuation of regular prophylaxis treatment in Chinese severe haemophilia A children. METHODOLOGY: This retrospective study was conducted on children with severe haemophilia A, who received FVIII prophylaxis treatment at 12 haemophilia centres in China from 1 November 2007 to 31 May 2013. RESULTS: The average duration of prophylaxis treatment received by haemophilia children significantly increased from 16...
November 17, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29146289/off-label-treatments-were-not-consistently-better-or-worse-than-approved-drug-treatments-in-randomized-trials
#15
Aviv Ladanie, John P A Ioannidis, Randall S Stafford, Hannah Ewald, Heiner C Bucher, Lars G Hemkens
BACKGROUND: Off-label drug use is highly prevalent, but controversial and often discouraged assuming generally inferior medical effects associated with off-label use. METHODS: We searched Medline, PubMed Health and the Cochrane Library up to May 2015 for systematic reviews including meta-analyses of randomized clinical trials (RCTs) comparing off-label and approved drugs head-to-head in any population and on any medical outcome. We combined the comparative effects in meta-analyses providing summary odds ratios (sOR) for each treatment comparison and outcome, and then calculated an overall summary of the sOR across all comparisons (ssOR)...
November 13, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/29144718/the-emerging-role-of-gammacore%C3%A2-in-the-management-of-cluster-headache-expert-panel-recommendations
#16
Stephen D Silberstein, Anne H Calhoun, Christina Treppendahl, David W Dodick, Alan M Rapoport, Avinash Mamidi, Peter Vargas, Thomas H Ebert, Stewart J Tepper
A panel of 9 experts, including neurologists, other headache specialists, and medical and pharmacy directors, from 4 health plans (1 integrated delivery network and 3 plans with commercial, Medicare, and Medicaid lines of business), convened to discuss cluster headache (CH). Topics covered included the current treatment landscape, treatment challenges, economic impact of disease, and gaps in care for patients with CH. One major challenge in the management of CH is that it is underrecognized and frequently misdiagnosed, leading to delays in and suboptimal treatment for patients who suffer from this painful and disabling condition...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29144717/review-of-non-invasive-vagus-nerve-stimulation-gammacore-efficacy-safety-potential-impact-on-comorbidities-and-economic-burden-for-episodic-and-chronic-cluster-headache
#17
Mkaya Mwamburi, Eric J Liebler, Andrew T Tenaglia
The FDA has cleared gammaCore (non-invasive vagus nerve stimulator [nVNS]) for the treatment of episodic cluster headache (eCH). With the exception of subcutaneous sumatriptan, all other treatments are used off label and have many limitations. The FDA approval process for devices differs from that of drugs. We performed a review of the literature to evaluate new evidence on various aspects of gammaCore treatment and impact. The ACute Treatment of Cluster Headache Studies (ACT1 and ACT2), both double-blind sham-controlled randomized trials, did not meet the primary endpoints of the trials but each demonstrated significant superiority of gammaCore among patients with eCH...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29143859/socioeconomic-risk-factors-for-hospital-admittance-due-to-a-suicide-attempt-in-belgium-a-population-based-study-using-administrative-data
#18
Marc Roelands, Johan Vanoverloop, Leila Maron, Johan Bilsen
PURPOSE: This population-based study aims to investigate socio-economic factors, depression and psychosis as independent risk factors for a suicide attempt that requires hospitalization, and estimate the incidence of suicide attempts. METHODS: Individual-level administrative data were analysed that were collected for all members of the Socialist Health Insurance Schemes in Belgium during the period 2011-2013 (N = 3,156,030) in the context of the financing of the health care services provided...
November 16, 2017: Social Psychiatry and Psychiatric Epidemiology
https://www.readbyqxmd.com/read/29143367/risk-of-death-associated-with-new-benzodiazepine-use-among-persons-with-alzheimer-disease-a-matched-cohort-study
#19
Laura Saarelainen, Anna-Maija Tolppanen, Marjaana Koponen, Antti Tanskanen, Jari Tiihonen, Sirpa Hartikainen, Heidi Taipale
OBJECTIVE: To investigate the risk of death associated with new benzodiazepine and related drug (BZDR) use in a nationwide cohort of persons with Alzheimer disease (AD). METHODS: The register-based MEDALZ cohort, including all community-dwelling Finns diagnosed with AD during 2005 to 2011 (n = 70 718), was used. Clinically verified AD diagnoses were obtained from the Special Reimbursement Register. Drug use periods were modeled from BZDR purchases, derived from the Prescription Register...
November 15, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/29141787/the-five-things-we-all-need-to-know-about-macra-and-alternative-payment-systems-to-compete-and-flourish
#20
REVIEW
Michael C Dalsing
Changes in how patient care will be reimbursed in the future are being determined right now. The law has changed to eliminate the past method of fee for service funded by the sustainable growth rate formula to payment based on quality. You need to know how the system functions to prevent a 4% reduction in Medicare reimbursement in 2019. You need to know this now because data collected today in 2017 will determine your rate for 2019. This review provides you knowledge of how the system has changed, what is required of you right now to be successful, and how you can succeed in the future...
November 12, 2017: Journal of Vascular Surgery
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