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https://www.readbyqxmd.com/read/29332504/changes-in-distress-measured-by-the-distress-thermometer-as-reported-by-patients-in-home-palliative-care-in-germany
#1
Stefanie Ohnhäuser, Johannes Wüller, Ann Christina Foldenauer, Tania Pastrana
AIM: To identify changes in distress as reported by patients in a home palliative care program over a 2-week period. METHODS: Prospective study in West Germany with consecutive patients cared for at home by a palliative care specialty team. Exclusion criteria were patients under 18 years of age, mentally or physically not able to complete the assessment questionnaires, or unable to comprehend German language. Distress was measured using the distress thermometer (DT); sociodemographic and medical data were collected from the patients' records...
January 1, 2018: Journal of Palliative Care
https://www.readbyqxmd.com/read/29330238/changing-patterns-of-mental-health-care-use-the-role-of-integrated-mental-health-services-in-veteran-affairs-primary-care
#2
Lucinda B Leung, Jean Yoon, Lisa V Rubenstein, Edward P Post, Maureen E Metzger, Kenneth B Wells, Catherine A Sugar, José J Escarce
OBJECTIVE: Aiming to foster timely, high-quality mental health care for Veterans, VA's Primary Care-Mental Health Integration (PC-MHI) embeds mental health specialists in primary care and promotes care management for depression. PC-MHI and patient-centered medical home providers work together to provide the bulk of mental health care for primary care patients with low-to-moderate-complexity mental health conditions. This study examines whether increasing primary care clinic engagement in PC-MHI services is associated with changes in patient health care utilization and costs...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29238810/correlation-between-24-hour-predischarge-opioid-use-and-amount-of-opioids-prescribed-at-hospital-discharge
#3
Eric Y Chen, Andrew Marcantonio, Paul Tornetta
Importance: The United States is experiencing an opioid abuse epidemic. Opioid overprescription by physicians may contribute to this epidemic. Objectives: To determine if there was a correlation between a postoperative patient's 24-hour predischarge opioid use and the amount of opioids prescribed at hospital discharge and to determine the number of patients who used no opioids prior to discharge but were still prescribed opioids after hospital discharge. Design, Setting, and Participants: This cross-sectional study performed a retrospective record review of 18 343 postoperative patients at Boston Medical Center and Lahey Hospital and Medical Center-Burlington Campus who were discharged home after a postoperative inpatient admission of at least 24 hours...
December 13, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29226050/determinants-of-computed-tomography-head-scan-ordering-for-patients-with-low-risk-headache-in-the-emergency-department
#4
Meaghan J Mackenzie, Rashi Hiranandani, Dongmei Wang, Tak Fung, Eddy Lang
Background Many specialty societies have found that neuroimaging in headache is a low-value intervention for benign presentations. This study describes factors that influence Emergency Room (ER) physicians' adherence to Choosing Wisely (CW) recommendations for low-risk headache patients presenting to Calgary's Emergency Departments (EDs). Emergency medicine has yet to address imaging in headache as a CW topic; however, this study may inform that decision. Methods Data were retrospectively collected for all patients presenting to Calgary EDs with headaches from April 1, 2014 to March 31, 2016...
October 9, 2017: Curēus
https://www.readbyqxmd.com/read/29196486/multiple-and-multidimensional-transitions-from-trainee-to-trained-doctor-a-qualitative-longitudinal-study-in-the-uk
#5
Lisi Gordon, Divya Jindal-Snape, Jill Morrison, Janine Muldoon, Gillian Needham, Sabina Siebert, Charlotte Rees
OBJECTIVES: To explore trainee doctors' experiences of the transition to trained doctor, we answer three questions: (1) What multiple and multidimensional transitions (MMTs) are experienced as participants move from trainee to trained doctor? (2) What facilitates and hinders doctors' successful transition experiences? (3) What is the impact of MMTs on trained doctors? DESIGN: A qualitative longitudinal study underpinned by MMT theory. SETTING: Four training areas (health boards) in the UK...
December 1, 2017: BMJ Open
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/29151009/risk-stratification-triage-and-implementation-of-an-expedited-hip-fracture-treatment-protocol-is-it-safe-and-effective
#7
William Zelenty, Richard Yoon, Lorraine Hutzler, Nirmal Tejwani, Joseph Bosco
INTRODUCTION: The population of patients in the USA over the age of 65 is expected to significantly increase over the next 40 years. These patients are at increased risk for hip fractures and will pose a burden to providers in the near future. In order to provide high value care, providers will need to maintain positive outcomes, mitigate complications, and reduce overall cost burdens. This study was designed to investigate the safety and efficacy of a patient transfer protocol between a large academic medical center and a single specialty orthopaedic institution...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29144719/real-world-health-plan-claims-analysis-of-differences-in-healthcare-utilization-and-total-cost-in-patients-suffering-from-cluster-headaches-and-those-without-headache-related-conditions
#8
Michael Polson, Todd C Lord, Themmi M Evangelatos, Maria Lopes, Briana L Santaniello
BACKGROUND: According to the World Health Organization, headache disorders are underappreciated by many health systems. These disorders have a substantial impact on quality of life, yet the true correlation between headache conditions and increased total healthcare utilization is not well understood. This study further explores the impact of headache conditions on healthcare utilization. OBJECTIVES: To assess differences in healthcare utilization and total cost in patients suffering from cluster headaches (CH) compared with patients without headache-related conditions...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29137878/integration-of-medicare-and-medicaid-for-dually-eligible-beneficiaries-a-focus-group-study-examining-beneficiaries-early-experiences-in-california-s-dual-financial-alignment-demonstration
#9
Carrie L Graham, Holly C Stewart, Elaine Kurtovich, Pi-Ju Liu
BACKGROUND: In 2014 California implemented a federal dual alignment demonstration that used a capitated managed care health plans called Cal MediConnect (CMC) to integrate medical care and long term services and supports (LTSS) for beneficiaries with both Medicare and Medicaid. These beneficiaries often have complex care needs, including multiple chronic conditions and disabilities. By 2016, 120,000 eligible beneficiaries were enrolled in the program. OBJECTIVES: Focus groups with enrolled beneficiaries were conducted to gather rich data about their early experiences with quality of care, access to care, and coordination of care in CMC plans and to identify recommendations for program improvement...
July 21, 2017: Disability and Health Journal
https://www.readbyqxmd.com/read/29137666/utilization-of-the-behavior-change-wheel-framework-to-develop-a-model-to-improve-cardiometabolic-screening-for-people-with-severe-mental-illness
#10
Christina Mangurian, Grace C Niu, Dean Schillinger, John W Newcomer, James Dilley, Margaret A Handley
BACKGROUND: Individuals with severe mental illness (e.g., schizophrenia, bipolar disorder) die 10-25 years earlier than the general population, primarily from premature cardiovascular disease (CVD). Contributing factors are complex, but include systemic-related factors of poorly integrated primary care and mental health services. Although evidence-based models exist for integrating mental health care into primary care settings, the evidence base for integrating medical care into specialty mental health settings is limited...
November 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29080435/specialty-training-for-the-retention-of-malawian-doctors-a-cost-effectiveness-analysis
#11
Kate L Mandeville, Kara Hanson, Adamson S Muula, Titha Dzowela, Godwin Ulaya, Mylène Lagarde
Few medical schools and sustained emigration have led to low numbers of doctors in many sub-Saharan African countries. The opportunity to undertake specialty training has been shown to be particularly important in retaining doctors. Yet limited training capacity means that doctors are often sent to other countries to specialise, increasing the risk that they may not return. Expanding domestic training, however, may be constrained by the reluctance of doctors to accept training in their home country. We modelled different policy options in an example country, Malawi, to examine the cost-effectiveness of expanding specialty training to retain doctors in sub-Saharan Africa...
October 16, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/29040331/primary-care-models-for-treating-opioid-use-disorders-what-actually-works-a-systematic-review
#12
REVIEW
Pooja Lagisetty, Katarzyna Klasa, Christopher Bush, Michele Heisler, Vineet Chopra, Amy Bohnert
BACKGROUND: Primary care-based models for Medication-Assisted Treatment (MAT) have been shown to reduce mortality for Opioid Use Disorder (OUD) and have equivalent efficacy to MAT in specialty substance treatment facilities. OBJECTIVE: The objective of this study is to systematically analyze current evidence-based, primary care OUD MAT interventions and identify program structures and processes associated with improved patient outcomes in order to guide future policy and implementation in primary care settings...
2017: PloS One
https://www.readbyqxmd.com/read/29031914/bringing-the-medical-home-back-home-in-the-context-of-population-health-home-based-primary-care-and-home-based-palliative-care
#13
Christine S Ritchie, Bruce Leff
With the growth of value-based care, payers and health systems have begun to appreciate the need to provide enhanced services to homebound adults. Recent studies have shown that home-based medical services for this high-cost, high-need population reduce costs and improve outcomes. Home-based medical care services have two flavors that are related to historical context and specialty background-home-based primary care and home-based palliative care. While the type of services provided by home-based primary care and home-based palliative care (together termed "home-based medical care") overlap, home-based primary care tends to encompass longitudinal and preventive care, while home-based palliative care often provides services for shorter durations focused more on distress management and goals of care clarification...
October 11, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29027836/developing-macroindicators-of-palliative-care-development-in-africa-a-process-with-in-country-and-international-experts
#14
John Y Rhee, Eduardo Garralda, Eve Namisango, Emmanuel Luyirika, Liliana de Lima, Richard A Powell, Carlos Centeno
BACKGROUND: Indicators specific to the African context are important to measure palliative care (PC) development accurately. OBJECTIVE: To describe the process used to develop a set of PC macroindicators for Africa. DESIGN: Open-ended interviews on national PC development were conducted with five African Country Experts. Indicators were rated (1-4) by 14 Country Experts for validity and feasibility. An additional 11 interviews were conducted to ensure indicator saturation...
October 13, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29016982/burnout-in-belgian-physicians-and-nurses
#15
S Vandenbroeck, E Van Gerven, H De Witte, K Vanhaecht, L Godderis
Background: Burnout in healthcare is a worldwide problem. However, most studies focus narrowly on work-related factors and outcomes in one health profession or speciality. Aims: To investigate the prevalence of burnout and its association with job demands, job resources, individual well-being, work-related attitudes and behaviour in physicians and nurses across different specialties. Methods: Multi-centre cross-sectional study of physicians and nurses working in Belgian hospitals...
October 1, 2017: Occupational Medicine
https://www.readbyqxmd.com/read/28963077/payment-and-care-for-hematopoietic-cell-transplantation-patients-toward-a-specialized-medical-home-for-complex-care-patients
#16
James L Gajewski, Mark B McClellan, Navneet S Majhail, Parameswaran N Hari, Christopher N Bredeson, Richard T Maziarz, Charles F LeMaistre, Michael C Lill, Stephanie H Farnia, Krishna V Komanduri, Michael J Boo
Patient-centered medical home models are fundamental to the advanced alternative payment models defined in the Medicare Access and Children's Health Insurance Plan Reauthorization Act (MACRA). The patient-centered medical home is a model of healthcare delivery supported by alternative payment mechanisms and designed to promote coordinated medical care that is simultaneously patient-centric and population-oriented. This transformative care model requires shifting reimbursement to include a per-patient payment intended to cover services not previously reimbursed such as disease management over time...
September 28, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28962541/the-scientific-basis-of-medical-generalism
#17
Denis Pereira Gray
The scientific basis for the various specialties in medicine is strong and is well taught in UK medical schools. This is done by identifying and summarising for medical students the main research which describes and explains the principles of specialist practice. However, ever since 1948, general practice has been the one branch of medical practice which is not taught in this way. Many new doctors qualify believing that general practice is 'hospital medicine outside hospital' and ignorant of important research on general practice as a distinct specialty...
September 29, 2017: Education for Primary Care
https://www.readbyqxmd.com/read/28933240/long-term-follow-up-of-mind-body-medicine-practices-among-medical-school-graduates
#18
Andrew Staffaroni, Christina L Rush, Kristi D Graves, Kumudhnini Hendrix, Aviad Haramati, Nancy Harazduk
INTRODUCTION: We sought to determine the long-term use of mind-body medicine (MBM) skills after graduation from medical school. METHODS: An online survey was sent to Georgetown University School of Medicine (GUSOM) graduates who completed at least one semester of a MBM skills training course. Using a quantitative-qualitative mixed-methods approach, we assessed the personal and professional practices of graduates, and identified factors that may influence practice/training after graduation...
September 21, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28872535/the-opportunity-awaits-to-lead-orthopaedic-telehealth-innovation-aoa-critical-issues
#19
Montri D Wongworawat, Gary Capistrant, John M Stephenson
Telehealth is a way to provide health-care services to a patient from a provider who is at another location. The most common methods include a live interactive visit with the patient, interpretation of imaging, and monitoring of patient progress. Principally, telehealth is a way of providing a service rather than a type of service. It is about patient care, not data care.Examples of orthopaedic applications include conducting patient examinations, interpreting imaging studies, and providing postoperative care...
September 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28864710/principles-of-child-health-care-financing
#20
Mark L Hudak, Mark E Helm, Patience H White
After passage of the Patient Protection and Affordable Care Act, more children and young adults have become insured and have benefited from health care coverage than at any time since the creation of the Medicaid program in 1965. From 2009 to 2015, the uninsurance rate for children younger than 19 years fell from 9.7% to 5.3%, whereas the uninsurance rate for young adults 19 to 25 years of age declined from 31.7% to 14.5%. Nonetheless, much work remains to be done. The American Academy of Pediatrics (AAP) believes that the United States can and should ensure that all children, adolescents, and young adults from birth through the age of 26 years who reside within its borders have affordable access to high-quality and comprehensive health care, regardless of their or their families' incomes...
September 2017: Pediatrics
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