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https://www.readbyqxmd.com/read/28346948/putting-patients-first-by-reducing-administrative-tasks-in-health-care-a-position-paper-of-the-american-college-of-physicians
#1
Shari M Erickson, Brooke Rockwern, Michelle Koltov, Robert McLean
This American College of Physicians (ACP) position paper, initiated and written by ACP's Medical Practice and Quality Committee and approved by the Board of Regents on 21 January 2017, reports policy recommendations to address the issue of administrative tasks to mitigate or eliminate their adverse effects on physicians, their patients, and the health care system as a whole. The paper outlines a cohesive framework for analyzing administrative tasks through several lenses to better understand any given task that a clinician and his or her staff may be required to perform...
March 28, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28345439/primary-nonadherence-to-overactive-bladder-medications-in-an-integrated-managed-care-health-care-system
#2
Nazia Rashid, Maria Vassilakis, Kathy J Lin, Rita Kristy, Daniel B Ng
BACKGROUND: Treatment for overactive bladder (OAB) remains suboptimal, in part because of patient nonadherence to medications. Primary nonadherence is when patients fail to pick up their initial prescriptions. OBJECTIVE: To measure primary nonadherence to OAB medications within 30 days of a first OAB prescription order using electronic medical records from a U.S. managed care health care system METHODS: A retrospective cohort study was conducted using electronic medical records from the Kaiser Permanente Southern California (KPSC) database to identify patients with new OAB prescriptions between January 1, 2007, and December 31, 2013...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28345434/effect-of-diabetes-treatment-related-attributes-on-costs-to-type-2-diabetes-patients-in-a-real-world-population
#3
Jie Meng, Roman Casciano, Yi-Chien Lee, Lee Stern, Dmitry Gultyaev, Liyue Tong, Brice Kitio-Dschassi
BACKGROUND: Type 2 diabetes mellitus (T2DM) results in a substantial economic burden on patients, health care systems, and society. Most literature assessing the cost of T2DM focuses on the long-term complications of the disease, the association between glucose control and cost, and patient characteristics resulting in poor and costly outcomes. However, it is likely that attributes specific to diabetes therapy can affect the use of costly resources. OBJECTIVE: To estimate the effect of diabetes treatment-related attributes, such as improved efficacy, adherence, and reduced risk for hypoglycemia, on costs to T2DM patients...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28345371/ewma-document-negative-pressure-wound-therapy
#4
Jan Apelqvist, Christian Willy, Ann-Mari Fagerdahl, Marco Fraccalvieri, Malin Malmsjö, Alberto Piaggesi, Astrid Probst, Peter Vowden
1. Introduction Since its introduction in clinical practice in the early 1990's negative pressure wounds therapy (NPWT) has become widely used in the management of complex wounds in both inpatient and outpatient care.(1) NPWT has been described as a effective treatment for wounds of many different aetiologies(2,3) and suggested as a gold standard for treatment of wounds such as open abdominal wounds,(4-6) dehisced sternal wounds following cardiac surgery(7,8) and as a valuable agent in complex non-healing wounds...
March 1, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28345258/locus-of-control-and-frequency-of-physician-visits-results-of-a-population-based-longitudinal-study-in-germany
#5
André Hajek, Hans-Helmut König
OBJECTIVES: To examine the role of internal and external locus of control (LOC) in the frequency of physician visits longitudinally. DESIGN: A nationally representative, longitudinal cohort study of German households. Data were used from the years 2005 and 2010. METHODS: Data were gathered from the German Socio-Economic Panel (GSOEP). The ten internal and external LOC items in the SOEP are based on a scale by Krampen. The number of physician visits in the last 3 months was used as outcome variable...
March 27, 2017: British Journal of Health Psychology
https://www.readbyqxmd.com/read/28343782/lifestyle-socioeconomic-characteristics-and-medical-history-of-elderly-persons-who-receive-seasonal-influenza-vaccination-in-a-tax-supported-healthcare-system
#6
Maja Hellfritzsch, Reimar Wernich Thomsen, Lisbeth Munksgård Baggesen, Finn Breinholt Larsen, Henrik Toft Sørensen, Christian Fynbo Christiansen
BACKGROUND: Observational studies on effectiveness of influenza vaccination in the elderly are thought to be biased by healthier lifestyles and higher socioeconomic status among vaccinated vs. unvaccinated persons. We examined this hypothesis in a uniform tax-supported health care system with free-of-charge influenza vaccination to the elderly. METHODS: We conducted a cross-sectional study among Danes aged 65-79years participating in a survey. We compared elderly persons with and without a recent (within six months) influenza vaccination in terms of (i) lifestyle and socioeconomic characteristics obtained from the survey and (ii) health factors including medical history provided by Danish registries...
March 23, 2017: Vaccine
https://www.readbyqxmd.com/read/28343559/hospital-associated-costs-of-chronic-pelvic-pain-in-canada-a-population-based-descriptive-study
#7
Innie Chen, Kednapa Thavorn, Minxue Shen, Yvette Goddard, Paul Yong, George S MacRae, Corrine Nishi, Ayah Matar, Catherine Allaire
OBJECTIVE: To determine the hospital-related costs incurred by women requiring surgery or inpatient admission for chronic pelvic pain in Canada. METHODS: We conducted a population-based, cross-sectional study, focusing on women ages 15-59 with a most responsible International Classification of Diseases diagnosis of pelvic and perineal pain, dysmenorrhea, or dyspareunia who had surgery or inpatient admission with a discharge date between April 1, 2008 and March 31, 2012...
March 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28342917/science-of-health-care-delivery-as-a-first-step-to-advance-undergraduate-medical-education-a-multi-institutional-collaboration
#8
Stephanie R Starr, Darcy A Reed, Alison Essary, William Hueston, C Daniel Johnson, Natalie Landman, John Meurer, Bonnie Miller, Greg Ogrinc, Elizabeth M Petty, John Raymond, William Riley, Sherine Gabriel, Cheryl Maurana
Physicians must possess knowledge and skills to address the gaps facing the US health care system. Educators advocate for reform in undergraduate medical education (UME) to align competencies with the Triple Aim. In 2014, five medical schools and one state university began collaborating on these curricular gaps. The authors report a framework for the Science of Health Care Delivery (SHCD) using six domains and highlight curricular examples from each school. They describe three challenges and strategies for success in implementing SHCD curricula...
March 22, 2017: Healthcare
https://www.readbyqxmd.com/read/28342688/in-hospital-mortality-30-day-readmission-and-length-of-hospital-stay-after-surgery-for-primary-colorectal-cancer-a-national-population-based-study
#9
S Pucciarelli, M Zorzi, N Gennaro, G Gagliardi, A Restivo, M Saugo, A Barina, M Rugge, M Zuin, I Maretto, D Nitti
INTRODUCTION: The simultaneous assessment of multiple indicators for quality of care is essential for comparisons of performance between hospitals and health care systems. The aim of this study was to assess the rates of in-hospital mortality and 30-day readmission and length of hospital stay (LOS) in patients who underwent surgical procedures for colorectal cancer between 2005 and 2014 in Italy. METHODS: All patients in the National Italian Hospital Discharge Dataset who underwent a surgical procedure for colorectal cancer during the study period were included...
March 16, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28341271/obesity-and-kidney-disease-from-population-to%C3%A2-basic-science-and-the-search-for-new-therapeutic%C3%A2-targets
#10
REVIEW
Adam Whaley-Connell, James R Sowers
The global burden of kidney disease is increasing strikingly in parallel with increases in obesity and diabetes. Indeed, chronic kidney disease (CKD) and end-stage renal disease (ESRD) coupled with comorbidities such as obesity, diabetes, and hypertension cost the health care system hundreds of billions of dollars in the US alone. The progression to ESRD in patients with obesity and diabetes continues despite widespread use of inhibitors of the renin-angiotensin-aldosterone system (RAAS) along with aggressive blood pressure and glycemic control in these high-risk populations...
March 21, 2017: Kidney International
https://www.readbyqxmd.com/read/28340544/understanding-challenges-strategies-and-the-role-of-support-networks-in-medication-self-management-among-patients-with-type-2-diabetes
#11
Gerda Bernhard, Dominik Ose, Ines Baudendistel, Hanna M Seidling, Marion Stützle, Joachim Szecsenyi, Michel Wensing, Cornelia Mahler
Purpose The purpose of this qualitative study was to investigate the challenges and strategies of patients with type 2 diabetes mellitus (T2DM) regarding daily management of their medication regimen focusing on the role of their support networks. Methods A purposeful sample of 25 patients with T2DM was recruited from local self-help groups, general practitioner practices, and a university hospital in southwestern Germany. Four semi-structured focus groups were conducted to identify the challenges patients experienced, the strategies they used, and their collaboration with support networks to assist them in self-managing their medication regimen...
April 2017: Diabetes Educator
https://www.readbyqxmd.com/read/28340241/pragmatic-trial-informatics-a-perspective-from-the-nih-health-care-systems-research-collaboratory
#12
Rachel L Richesson, Beverly B Green, Reesa Laws, Jon Puro, Michael G Kahn, Alan Bauck, Michelle Smerek, Erik G Van Eaton, Meredith Zozus, W Ed Hammond, Kari A Stephens, Greg E Simon
Pragmatic clinical trials (PCTs) are research investigations embedded in health care settings designed to increase the efficiency of research and its relevance to clinical practice. The Health Care Systems Research Collaboratory, initiated by the National Institutes of Health Common Fund in 2010, is a pioneering cooperative aimed at identifying and overcoming operational challenges to pragmatic research. Drawing from our experience, we present 4 broad categories of informatics-related challenges: (1) using clinical data for research, (2) integrating data from heterogeneous systems, (3) using electronic health records to support intervention delivery or health system change, and (4) assessing and improving data capture to define study populations and outcomes...
March 14, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28340229/meaningful-use-in-the-safety-net-a-rapid-ethnography-of-patient-portal-implementation-at-five-community-health-centers-in-california
#13
Sara L Ackerman, Urmimala Sarkar, Lina Tieu, Margaret A Handley, Dean Schillinger, Kenneth Hahn, Mekhala Hoskote, Gato Gourley, Courtney Lyles
Objective: US health care institutions are implementing secure websites (patient portals) to achieve federal Meaningful Use (MU) certification. We sought to understand efforts to implement portals in "safety net" health care systems that provide services for low-income populations. Materials and Methods: Our rapid ethnography involved visits at 4 California safety net health systems and in-depth interviews at a fifth. Visits included interviews with clinicians and executives ( n  = 12), informal focus groups with front-line staff ( n  = 35), observations of patient portal sign-up procedures and clinic work, review of marketing materials and portal use data, and a brief survey ( n  = 45)...
March 15, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28340208/health-care-on-equal-terms-assessing-horizontal-equity-in-health-care-use-in-northern-sweden
#14
Miguel San Sebastián, Paola A Mosquera, Nawi Ng, Per E Gustafsson
The Swedish health care system has successively moved toward increased market-orientation, which has raised concerns as to whether Sweden still offers health on equal terms. To explore this issue, this study aimed (i) to assess if the principles of horizontal equity (equal access for equal need regardless of socio-economic factors) are met in Northern Sweden 2006-14; and (ii) to explore the contribution of different factors to the inequalities in access along the same period. Data came from cross sectional surveys known in 2006, 2010 and 2014 targeting 16-84-year-old residents in the four northern-most counties in Sweden...
March 18, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/28340128/crossing-the-health-it-chasm-considerations-and-policy-recommendations-to-overcome-current-challenges-and-enable-value-based-care
#15
Julia Adler-Milstein, Peter J Embi, Blackford Middleton, Indra Neil Sarkar, Jeff Smith
While great progress has been made in digitizing the US health care system, today's health information technology (IT) infrastructure remains largely a collection of systems that are not designed to support a transition to value-based care. In addition, the pursuit of value-based care, in which we deliver better care with better outcomes at lower cost, places new demands on the health care system that our IT infrastructure needs to be able to support. Provider organizations pursuing new models of health care delivery and payment are finding that their electronic systems lack the capabilities needed to succeed...
March 15, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28340108/cigarette-smoking-and-musculoskeletal-pain-severity-among-male-and-female-afghanistan-iraq-era-veterans
#16
Kimberly T Green, Sarah M Wilson, Paul A Dennis, Jennifer J Runnals, Rebecca A Williams, Lori A Bastian, Jean C Beckham, Eric A Dedert, Harold S Kudler, Kristy Straits-Tröster, Jennifer M Gierisch, Patrick S Calhoun
Objective.:  Cigarette smoking and musculoskeletal pain are prevalent among Department of Veterans Affairs (VA) health care system users. These conditions frequently co-occur; however, there is limited empirical information specific to Afghanistan/Iraq era veterans. The present study sought to examine gender differences in the association between cigarette smoking and moderate to severe musculoskeletal pain in US veterans with Afghanistan/Iraq era service. Methods.:  A random sample of 5,000 veterans with service after November 11, 2001, participated in a survey assessing health care needs and barriers to care...
March 14, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339932/utilizing-patient-geographic-information-system-data-to-plan-telemedicine-service-locations
#17
Neelkamal Soares, Joseph Dewalle, Ben Marsh
Objective: To understand potential utilization of clinical services at a rural integrated health care system by generating optimal groups of telemedicine locations from electronic health record (EHR) data using geographic information systems (GISs). Methods: This retrospective study extracted nonidentifiable grouped data of patients over a 2-year period from the EHR, including geomasked locations. Spatially optimal groupings were created using available telemedicine sites by calculating patients' average travel distance (ATD) to the closest clinic site...
March 3, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339159/differences-in-survival-outcome-for-severely-injured-paediatric-trauma-by-type-of-trauma-centre
#18
Rebecca J Mitchell, Kate Curtis, Luke Testa, Andrew Ja Holland, Soundappan Sv Soundappan, Sarah Adams
AIM: Whether treatment at paediatric trauma centres (PTCs) provides a survival advantage for injured children over treatment at adult trauma centres (ATCs) remains inconclusive. This study examines the association between trauma centre type and in-hospital mortality for severely injured paediatric trauma patients in New South Wales, Australia. METHODS: A retrospective examination of paediatric patient characteristics (aged ≤15 years), treatment and injury outcome was conducted using data from the New South Wales Trauma Registry for 2009-2014...
March 24, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28337689/managing-chronic-pain-in-primary-care-it-really-does-take-a-village
#19
Karen Seal, William Becker, Jennifer Tighe, Yongmei Li, Tessa Rife
Some healthcare systems are relieving primary care providers (PCPs) of "the burden" of managing chronic pain and opioid prescribing, instead offloading chronic pain management to pain specialists. Last year the Centers for Disease Control and Prevention recommended a biopsychosocial approach to pain management that discourages opioid use and promotes exercise therapy, cognitive behavioral therapy and non-opioid medications as first-line patient-centered, multi-modal treatments best delivered by an interdisciplinary team...
March 23, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28336506/using-ehealth-technologies-interests-preferences-and-concerns-of-older-adults
#20
Patrick Ware, Susan J Bartlett, Guy Paré, Iphigenia Symeonidis, Cara Tannenbaum, Gillian Bartlett, Lise Poissant, Sara Ahmed
BACKGROUND: The Internet and eHealth technologies represent new opportunities for managing health. Age, sex, socioeconomic status, and current technology use are some of the known factors that influence individuals' uptake of eHealth; however, relatively little is known about facilitators and barriers to eHealth uptake specific to older adults, particularly as they relate to their experiences in accessing health care. OBJECTIVE: The aim of our study was to explore the interests, preferences, and concerns of older adults in using the Internet and eHealth technologies for managing their health in relation to their experiences with the current health care system...
March 23, 2017: Interactive Journal of Medical Research
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