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https://www.readbyqxmd.com/read/28441685/stagnant-physical-therapy-referral-rates-alongside-rising-opioid-prescription-rates-in-patients-with-low-back-pain-in-the-united-states-1997-2010
#1
Patricia Zheng, Ming-Chih Kao, Nicholas V Karayannis, Matthew Smuck
STUDY DESIGN: A cross-sectional observational study utilizing the National Ambulatory and National Hospital Ambulatory Medical Care Surveys between 1997 and 2010. OBJECTIVE: The aim of this study was to characterize national physical therapy (PT) referral trends during primary care provider (PCP) visits in the United States. SUMMARY OF BACKGROUND DATA: Despite guidelines recommending PT for the initial management of low back pain (LBP), national PT referral rates remain low...
May 1, 2017: Spine
https://www.readbyqxmd.com/read/28441676/transitioning-from-volume-to-value-one-academic-medical-center-s-approach-to-improving-population-health
#2
Stephanie A C Halvorson, Mary E Tanski, Thomas R Yackel
PROBLEM: The U.S. health care system is undergoing a major transformation. Clinical delivery systems are now being paid according to the value of the care they provide, in accordance with the Triple Aim, which incorporates improving the quality and cost of care and the patient experience. Increasingly, financial risk is being transferred from insurers to clinical delivery systems that become responsible for both episode-based clinical care and the longitudinal care of patients. Thus, these delivery systems need to develop strategies to manage the health of populations...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28439751/development-of-a-streamlined-work-flow-for-handling-patients-genetic-testing-insurance-authorizations
#3
Wendy R Uhlmann, Katie Schwalm, Victoria M Raymond
Obtaining genetic testing insurance authorizations for patients is a complex, time-involved process often requiring genetic counselor (GC) and physician involvement. In an effort to mitigate this complexity and meet the increasing number of genetic testing insurance authorization requests, GCs formed a novel partnership with an industrial engineer (IE) and a patient services associate (PSA) to develop a streamlined work flow. Eight genetics clinics and five specialty clinics at the University of Michigan were surveyed to obtain benchmarking data...
April 24, 2017: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/28439739/medical-mistrust-and-colorectal-cancer-screening-among-african-americans
#4
REVIEW
Leslie B Adams, Jennifer Richmond, Giselle Corbie-Smith, Wizdom Powell
Despite well-documented benefits of colorectal cancer (CRC) screening, African Americans are less likely to be screened and have higher CRC incidence and mortality than Whites. Emerging evidence suggests medical mistrust may influence CRC screening disparities among African Americans. The goal of this systematic review was to summarize evidence investigating associations between medical mistrust and CRC screening among African Americans, and variations in these associations by gender, CRC screening type, and level of mistrust...
April 24, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28439350/transgender-related-education-in-plastic-surgery-and-urology-residency-programs
#5
Shane D Morrison, Geolani W Dy, H Jonathan Chong, Sarah K Holt, Nicholas B Vedder, Mathew D Sorensen, Byron D Joyner, Jeffrey B Friedrich
BACKGROUND: With increasing public awareness of and greater coverage for gender-confirming surgery by insurers, more transgender patients are likely to seek surgical transition. The degree to which plastic surgery and urology trainees are prepared to treat transgender patients is unknown. OBJECTIVE: We assessed the number of hours dedicated to transgender-oriented education in plastic surgery and urology residencies, and the impact of program director (PD) attitudes on provision of such training...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28438048/the-impact-of-infant-well-child-care-compliance-and-social-risks-on-emergency-department-utilization
#6
Nikki R Lawson, Melissa D Klein, Nicholas J Ollberding, Victoria Wurster Ovalle, Andrew F Beck
Deployment of medical and social services at well-child visits promotes child health. A retrospective review of the electronic health record was conducted for infants presenting for their "newborn" visit over a 2-year period at an urban, academic primary care center. Primary outcomes were time to first emergency department (ED) visit, number of ED visits (emergent or nonemergent), and number of nonemergent ED visits by 2 years of life. Records from 212 consecutive newborns were evaluated-59.9% were black/African American and 84...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28437472/socioeconomic-status-and-type-2-diabetes-complications-among-young-adult-patients-in-japan
#7
Mitsuhiko Funakoshi, Yasushi Azami, Hisashi Matsumoto, Akemi Ikota, Koichi Ito, Hisashi Okimoto, Nobuaki Shimizu, Fumihiro Tsujimura, Hiroshi Fukuda, Chozi Miyagi, Sayaka Osawa, Ryo Osawa, Jiro Miura
OBJECTIVE: To assess the relationship between socioeconomic status (SES) and complications of type 2 diabetes among young adults in Japan. DESIGN: A cross-sectional study. SETTING: Outpatient wards of 96 member hospitals and clinics of the Japan Federation of Democratic Medical Institutions. PARTICIPANTS: A total of 782 outpatients with type 2 diabetes (525 males, 257 females), aged 20-40 years as of March 31, 2012. After excluding 110 participants whose retinopathy diagnosis was in question, 672 participants were analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/28436256/clinical-and-economic-impact-of-hyperkalemia-in-patients-with-chronic-kidney-disease-and-heart-failure
#8
Michael Polson, Todd C Lord, Anne Kangethe, Lindsay Speicher, Carolyn Farnum, Melanie Brenner, Nina Oestreicher, Paula Alvarez
BACKGROUND: Hyperkalemia (HK) is a concern for patients with chronic kidney disease (CKD) and heart failure (HF), and for those receiving treatments that inhibit the renin-angiotensin-aldosterone system (RAASi). An analysis of 1.7 million medical records of patients in the United States revealed that among individuals with more than 2 potassium values during 2007 to 2012, HK was detected in 34.6% of patients with CKD and 30.0% of patients with HF. OBJECTIVE: To evaluate the association of HK and use of RAASi therapies at optimal and suboptimal doses in patients with CKD and/or HF with health care resource utilization and overall cost of care in a diverse cohort of commercially insured patients...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28436189/medication-appropriateness-for-patients-with-dementia-approaching-the-end-of-their-life
#9
Hsien-Yeh Chuang, Yu-Wen Wen, Liang-Kung Chen, Fei-Yuan Hsiao
AIM: To examine medication use among patients with dementia towards the end of their life and to evaluate the appropriateness of medication use by using a nationwide database. METHODS: Using Taiwan's National Health Insurance Research Database, we identified 6532 people with dementia that died between 2008 and 2012. For each person with dementia, data of medication use in the last month of outpatient setting (vs -12th month [baseline]) and last hospitalization (vs -3rd hospitalization [baseline]) before death were retrieved for study...
April 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28433120/additional-cost-because-of-pneumonia-in-nursing-home-residents-results-from-the-incidence-of-pneumonia-and-related-consequences-in-nursing-home-resident-study
#10
Nadège Costa, Emiel O Hoogendijk, Michael Mounié, Robert Bourrel, Yves Rolland, Bruno Vellas, Laurent Molinier, Matteo Cesari
OBJECTIVES: Pneumonia is a frequent condition in older people. Our aim was to examine the total healthcare cost related to pneumonia in nursing home (NH) residents over a 1-year follow-up period. DESIGN: This was a prospective, longitudinal, observational, and multicenter study that was a part of the Incidence of Pneumonia and related Consequences in Nursing Home Resident study. SETTING: Thirteen NHs located in Languedoc Roussillon and Midi-Pyrénées regions in France were included...
May 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28432756/high-rate-of-systemic-corticosteroid-prescription-among-outpatient-visits-for-psoriasis-a-population-based-epidemiological-study-using-the-korean-national-health-insurance-database
#11
Sang Jun Eun, Sihyeok Jang, Jin Yong Lee, Young Kyung Do, Seong Jin Jo
The use of systemic corticosteroids (SC) for the treatment of psoriasis is not recommended according to textbooks and guidelines. In clinical practise, however, many physicians frequently prescribe SC for patients with psoriasis. To determine the magnitude of SC prescription for outpatients with psoriasis in Korea and identify factors associated with the use of SC, we used the 2010-2014 nationwide claims data of the Health Insurance Review and Assessment Service of Korea. In frequency analysis for the full scale of prescribed SC, oral methylprednisolone was the most frequently prescribed SC, followed by dexamethasone and betamethasone injections...
April 22, 2017: Journal of Dermatology
https://www.readbyqxmd.com/read/28432402/predictors-of-missed-appointments-in-patients-referred-for-congenital-or-pediatric-cardiac-magnetic-resonance
#12
Jimmy C Lu, Ray Lowery, Sunkyung Yu, Maryam Ghadimi Mahani, Prachi P Agarwal, Adam L Dorfman
BACKGROUND: Congenital cardiac magnetic resonance is a limited resource because of scanner and physician availability. Missed appointments decrease scheduling efficiency, have financial implications and represent missed care opportunities. OBJECTIVE: To characterize the rate of missed appointments and identify modifiable predictors. MATERIALS AND METHODS: This single-center retrospective study included all patients with outpatient congenital or pediatric cardiac MR appointments from Jan...
April 21, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28429976/reimbursement-changes-and-drug-switching-are-severe-patients-more-affected
#13
Shou-Hsia Cheng, Chi-Chen Chen, Hung-Chih Kuo, Chi-Chuan Wang
Objectives To examine the long-term effects of drug reimbursement adjustments on drug-switching decisions and to investigate whether patients with complicated or severe conditions are more affected. Methods A population-based, longitudinal study with a before-and-after design. Analysis of 141,703 patients with type 2 diabetes covered by the universal health insurance program in Taiwan. Observation of five 6-month phases before and after a drug reimbursement adjustment implemented in October 2009. Drug switching was defined as a brand change within the same anatomical therapeutic chemical group between two consecutive physician visits...
April 2017: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/28429667/sex-based-disparities-in-venous-thromboembolism-outcomes-a-national-inpatient-sample-nis-based-analysis
#14
Ariela L Marshall, Adam C Bartley, Aneel A Ashrani, Rajiv K Pruthi, Urshila Durani, Wilson I Gonsalves, Prashant Kapoor, Shahrukh K Hashmi, Mustaqeem A Siddiqui, Ronald S Go
Venous thromboembolism (VTE) contributes to significant morbidity, mortality, and socioeconomic burden. There is a paucity of literature regarding sex-based sociodemographic differences in VTE presentation and short-term outcomes. We aimed to compare clinical outcomes between men and women hospitalized for VTE management. We performed a retrospective analysis using data from the National Inpatient Sample (NIS) database from 2012 to 2013. Inclusion criteria were age 18 years and older and a primary discharge diagnosis of VTE...
April 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28427793/contribution-of-health-care-factors-to-the-burden-of-skin-disease-in-the-united-states
#15
Henry W Lim, Scott A B Collins, Jack S Resneck, Jean L Bolognia, Julie A Hodge, Thomas A Rohrer, Marta J Van Beek, David J Margolis, Arthur J Sober, Martin A Weinstock, David R Nerenz, Wendy Smith Begolka, Jose V Moyano
The American Academy of Dermatology has developed an up-to-date national Burden of Skin Disease Report on the impact of skin disease on patients and on the US population. In this second of 3 manuscripts, data are presented on specific health care dimensions that contribute to the overall burden of skin disease. Through the use of data derived from medical claims in 2013 for 24 skin disease categories, these results indicate that skin disease health care is delivered most frequently to the aging US population, who are afflicted with more skin diseases than other age groups...
April 17, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28427124/-contemporary-use-of-ticagrelor-in-patients-with-acute-coronary-syndrome-after-discharge
#16
J Liu, H B Yan, L Song, Y H Hua, H J Zhao, C Liu, P Zhou, J N Li, Y Tan, Y M Yang, Y Wu
Objective: To investigate the degree and determinants of using ticagrelor among discharged patients with acute coronary syndrome (ACS). Methods: Patients with ACS in Fuwai hospital who were given ticagrelor after discharge between Jan. 2015 to Jun. 2015 were analyzed.The clinical characteristics and adherence to ticagrelor of these patients were collected by reviewing the electronic medical records and telephone interview.Date were statistically-analyzed. Results: Among all screened 404 patients, 158 (39.1%) patients prematurely stopped ticagrelor within 12 months, while 119(29...
April 18, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28426677/information-ranks-highest-expectations-of-female-adolescents-with-a-rare-genital-malformation-towards-health-care-services
#17
Elisabeth Simoes, Alexander N Sokolov, Andrea Kronenthaler, Hanna Hiltner, Norbert Schaeffeler, Katharina Rall, Esther Ueding, Monika A Rieger, Anke Wagner, Leonie S Poesch, Marie-Christin Baur, Judith Kittel, Sara Y Brucker
BACKGROUND: Access to highly specialized health care services and support to meet the patient's specific needs is critical for health outcome, especially during age-related transitions within the health care system such as with adolescents entering adult medicine. Being affected by an orphan disease complicates the situation in several important respects. Long distances to dedicated institutions and scarcity of knowledge, even among medical doctors, may present major obstacles for proper access to health care services and health chances...
2017: PloS One
https://www.readbyqxmd.com/read/28426477/incidence-of-adhesive-bowel-obstruction-after-colon-cancer-surgery-and-its-risk-factors-a-nationwide-claim-study
#18
Gi Hyeon Seo, Eun Kyung Choe, Kyu Joo Park, Young Jun Chai
OBJECTIVE: To elucidate the incidence of adhesive postoperative bowel obstruction (PBO) after colon cancer surgery and its risk factors using nationwide claim data. BACKGROUND: PBO has a significant impact on quality of life and medical costs after colectomy, though most of the literature consists of single-institution analyses. METHODS: Data from 24,645 patients who underwent regional colectomy for colon cancer from 2010 to 2012 and had at least 3 years of follow up were obtained from the Health Insurance Review and Assessment Service database...
April 19, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28426313/substance-use-criteria-to-restrict-medicaid-coverage-of-hepatitis-c-treatment-cost-versus-ethics
#19
Joshua M Liao, Michael A Fischer
Medicaid programs provide health insurance coverage for many patients with hepatitis C, a public health problem for which effective but very expensive treatments are now available. Facing constrained budgets, most states adopted prior authorization criteria for sofosbuvir, the first of these agents. Using fee-for-service utilization data from 42 Medicaid programs in 2014, we found that strict behavioral criteria-those that limited coverage on the basis of drug or alcohol use and included specific abstinence or treatment requirements-were associated with significantly less spending on sofosbuvir...
April 20, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28422923/a-cross-sectional-study-of-emergency-care-utilization-and-associated-costs-of-violent-related-assault-injuries-in-the-united-states
#20
Michael C Monuteaux, Eric W Fleegler, Lois K Lee
BACKGROUND: Violent-related (assault) injuries are a leading cause of death and disability in the United States. Many violent injury victims seek treatment in the emergency department (ED). Our objectives were to: (1) estimate rates of violent-related injuries evaluated in United States EDs; (2) estimate linear trends in ED visits for violent-related injuries from 2000 to 2010; and (3) to determine the associated healthcare and work-loss costs. METHODS: We examined adults 18 years of age and older from a nationally representative survey (the National Hospital Ambulatory Medical Care Survey) of ED visits, from 2000 to 2010...
April 18, 2017: Journal of Trauma and Acute Care Surgery
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