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https://www.readbyqxmd.com/read/28550706/st-michael-s-improvement-program-a-collaborative-approach-to-sustainable-cost-savings
#1
Anne Trafford, Danielle Jane
In response to a challenging financial environment and increasing patient demand, St. Michael's Hospital needed to find long-term sustainable solutions to continue to provide high-quality patient care and invest in key priorities. By conducting Operational Reviews in focused areas, the hospital achieved $7.4 million of in-year savings in the first year, found standardizations, process efficiencies and direct cost savings that positioned itself for success in future funding models. Initiatives were grounded in evidence and relied heavily on the effective execution by the leadership, front-line staff and physicians...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28550692/improving-health-system-efficiency-perspectives-of-decision-makers
#2
Sara Allin, Sara Guilcher, Dana Riley, Yu Janice Zhang
While improving health system efficiency, or value for money, is a priority in Canada, there is little information about optimal approaches for improvement in the Canadian context. Through interviews with senior health system decision-makers from two provinces, this study conducted by the Canadian Institute for Health Information identified the following five main themes along with actions that can be taken to improve health system efficiency in Canada: performance monitoring for accountability and decision-making, system-level integration in governance and care delivery, partnerships outside the health sector to improve population health, physician engagement and remuneration and flexible funding...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28550145/paediatric-innovation-in-pakistan-our-experience-and-a-call-to-action
#3
Walid Farooqi, Faysal Subhani, Asad Mian
Standardisation in paediatric medicine may have the unintended effect of stifling innovation. Thinking outside the box becomes even more important in low-income to middle-income countries like Pakistan, where a large paediatric population requires healthcare. In addition, there is always a lack of funds, making an innovative, low-cost and high impact solution all the more necessary. While regulation and formal research is an integral part of the process, the local synthesis of a solution must start with a creative idea...
May 26, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28550006/virtual-visits-and-patient-centered-care-results-of-a-patient-survey-and-observational-study
#4
Kimberlyn Marie McGrail, Megan Alyssa Ahuja, Chad Andrew Leaver
BACKGROUND: Virtual visits are clinical interactions in health care that do not involve the patient and provider being in the same room at the same time. The use of virtual visits is growing rapidly in health care. Some health systems are integrating virtual visits into primary care as a complement to existing modes of care, in part reflecting a growing focus on patient-centered care. There is, however, limited empirical evidence about how patients view this new form of care and how it affects overall health system use...
May 26, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28549805/immunization-requirements-of-the-top-200-universities-implications-for-vaccine-hesitant-families
#5
Allison Noesekabel, Ada M Fenick
BACKGROUND: The majority of pediatricians encounter vaccine hesitancy in their practices. As part of a broad discussion about vaccination, school requirements arise as a topic yet providers may lack information about the effects of immunization on university matriculation. METHODS: We surveyed the top-ranked 200 universities regarding required immunizations, medical, religious, and philosophical exemptions, and noncompliance policies. We examined the legal requirements for involved jurisdictions...
May 23, 2017: Vaccine
https://www.readbyqxmd.com/read/28549706/long-term-effectiveness-of-a-multifactorial-fall-and-fracture-prevention-program-in-bavarian-nursing-homes-an-analysis-based-on-health-insurance-claims-data
#6
Claudia Schulz, Ivonne Lindlbauer, Kilian Rapp, Clemens Becker, Hans-Helmut König
OBJECTIVE: Femoral fractures are frequently consequences of falls in nursing homes and are associated with considerable costs and unfavorable outcomes such as immobility and mortality. The purpose of this study was to examine the long-term effectiveness of a multifactorial fall and fracture prevention program in nursing homes in terms of reducing femoral fractures. DESIGN: Retrospective cohort study. SETTING: Nursing homes. PARTICIPANTS: Health insurance claims data for 2005-2013 including 85,148 insurants of a sickness fund (Allgemeine Ortskrankenkasse Bayern), aged 65 years or older and living in 802 nursing homes in Bavaria, Germany...
June 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28549640/industry-funding-for-neurosurgery-research
#7
Vikram C Prabhu, Russ P Nockels, Douglas E Anderson
No abstract text is available yet for this article.
May 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28549479/engaging-the-canadian-public-on-reimbursement-decision-making-for-drugs-for-rare-diseases-a-national-online-survey
#8
Julie Polisena, Michael Burgess, Craig Mitton, Larry D Lynd
BACKGROUND: Funding of drugs for rare diseases (DRDs) requires decisions that balance fairness for all individuals within the healthcare system with compassion for affected individuals. Our study objective was to conduct a national online survey to determine the Canadian public's perspective, including regional variations, associated with DRD decision-making. METHODS: The survey collected responses from 1631 Canadians. Respondents were asked to rank at least three and up to five DRD decision-making priorities, out of a total of eight priorities presented...
May 26, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28548543/systematic-review-of-clinical-guidance-documents-for-autism-spectrum-disorder-diagnostic-assessment-in-select-regions
#9
Melanie Penner, Evdokia Anagnostou, Lana Y Andoni, Wendy J Ungar
Clinical guidance documents play an important role in ensuring access to high-quality autism spectrum disorder diagnostic assessment practices. The objective was to perform a systematic review of professional association and government clinical guidance documents for autism spectrum disorder diagnostic assessment, analyzing their quality and content. The government search was limited to English-speaking, single-payer, publicly funded health systems. A quality appraisal was conducted by two appraisers using the Appraisal of Guidelines Research and Evaluation, second edition tool...
May 1, 2017: Autism: the International Journal of Research and Practice
https://www.readbyqxmd.com/read/28548227/changing-the-risk-threshold-for-surgical-prevention-of-ovarian-cancer
#10
Ranjit Manchanda, Rosa Legood, Antonis C Antoniou, Leigh Pearce, Usha Menon
Ovarian cancer (OC) remains a lethal disease and a major cause of deaths from gynaecological cancer particularly in western countries. Despite advances in treatment, there have been only marginal improvements in survival rates over the last 30years. Additionally, the number of OC cases in the UK is estimated to increase by 27-45%, which translates to a 15% rise in the incidence rate by 2035.(1) A national OC screening programme is unavailable as this has not yet shown a conclusive mortality benefit.(2) Hence, primary prevention continues to be the cornerstone in reducing the burden of OC and improving health outcomes...
May 26, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28547724/costs-associated-with-community-acquired-pneumonia-in-france
#11
Grèce Saba, Luiz Flavio Andrade, Jacques Gaillat, Pierre Bonnin, Christian Chidiac, Hajnal-Gabriela Illes, Henri Laurichesse, Jonathan Messika, Jean-Damien Ricard, Bruno Detournay, Patrick Petitpretz, Gérard de Pouvourville
OBJECTIVES: Pneumocost is a prospective study that aimed at documenting the costs of the management of patients hospitalized with a pneumococcal pneumonia and the post-discharge costs during a 6-month period in the French context. METHODS: Billing data were used to document hospital costs. Resource use during the follow-up period was collected through phone interviews at month 1, 3 and 6. Descriptive statistics and multivariate analyses were performed. We used generalized linear models with log-link functions to estimate parameters associated with hospital and follow-up costs of patients...
May 25, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28546591/the-healthcare-system-and-the-provision-of-oral-healthcare-in-european-union-member-states-part-8-italy
#12
M Bindi, C Paganelli, K A Eaton, E Widström
In Italy healthcare is provided for all Italian citizens and residents and it is delivered mainly by public providers, with some private or private-public entities. Italy's public healthcare system - the Servizio Sanitario Nazionale (SSN) - is organised by the Ministry of Health and administered on a devolved regional basis. It is financed by general taxation that provides universal coverage, largely free of charge at the point of service. The central government establishes the basic national health benefits package, which must be uniformly provided throughout the country, through services guaranteed under the NHS provision called LEA - (Livelli Essenziali di Assistenza [Essential Level of Assistance]) and allocates national funds to the regions...
May 26, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28546055/the-long-way-of-implementing-patient-centered-care-and-shared-decision-making-in-germany
#13
Martin Härter, Jörg Dirmaier, Isabelle Scholl, Norbert Donner-Banzhoff, Marie-Luise Dierks, Wolfgang Eich, Hardy Müller, David Klemperer, Klaus Koch, Christiane Bieber
The main focus of the paper is on the description of the development and current state of research and implementation of patient-centered care (PCC) and shared decision-making (SDM) after fifteen years of substantial advances in health policy and health services research. What is the current state of SDM in health policy? The "Law on Patients' Rights" from 2013 standardizes all rights and responsibilities within the framework of medical treatment for German citizens and legal residents. This comprises the right to informed decisions, comprehensive and comprehensible information for patients, and decisions based on a clinician-patient-partnership...
May 22, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28546050/shared-decision-making-in-argentina-in-2017
#14
Mariela Barani, Karin Kopitowski, Carolina Carrara, María Victoria Ruiz Yanzi
Argentina is a high-middle income country located in Southern South America with an estimated population of 44 million inhabitants. The epidemiological profile of the population is characterised by an increase of non-communicable diseases. The health system is heterogeneous, fragmented and loosely integrated. There are no unified research agenda or government initiatives encouraging the implementation of and research on Shared Decision-Making (SDM). Progress has been made lately to respect patient autonomy through the enactment of the 'Patients' Rights Act', which expressly enshrines the right of patients to get information as a key element of decision-making...
May 22, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28545906/optimizing-diet-and-nutrition-for-cancer-survivors-a-review
#15
REVIEW
Niki Mourouti, Demosthenes B Panagiotakos, Elias A Kotteas, Konstantinos N Syrigos
The number of cancer survivors is increasing and they are often highly motivated to search for information about nutrition and about physical activity in order to try to improve their treatment outcomes, quality of life and overall survival. In the light of these concerns, the World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) as well as the American Cancer Society recommend a largely plant-based diet with limited consumption of red and processed meat, and limited consumption of alcohol, as well as the maintenance of a healthy weight throughout life and regular engagement in physical activity...
May 19, 2017: Maturitas
https://www.readbyqxmd.com/read/28545846/is-diabetes-self-management-education-still-the-cinderella-of-diabetes-care
#16
Lorna Hurley, Máire O'Donnell, Mary Clare O'Hara, Marian E Carey, Ingrid Willaing, Heather Daly, Seán F Dinneen
This paper reflects on the status of diabetes self-management education (DSME) as a branch of diabetology in Europe and discusses some opportunities for better supporting DSME delivery. DSME (also commonly known as Therapeutic Patient Education) has been evolving as a therapy for diabetes for decades. As a continent, Europe is fortunate to have nurtured many pioneers in DSME, and currently has many experts in the field progressing the knowledge base and striving to improve access to DSME for people with diabetes...
May 17, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28545823/novel-molecular-subgroups-for-clinical-classification-and-outcome-prediction-in-childhood-medulloblastoma-a-cohort-study
#17
Edward C Schwalbe, Janet C Lindsey, Sirintra Nakjang, Stephen Crosier, Amanda J Smith, Debbie Hicks, Gholamreza Rafiee, Rebecca M Hill, Alice Iliasova, Thomas Stone, Barry Pizer, Antony Michalski, Abhijit Joshi, Stephen B Wharton, Thomas S Jacques, Simon Bailey, Daniel Williamson, Steven C Clifford
BACKGROUND: International consensus recognises four medulloblastoma molecular subgroups: WNT (MBWNT), SHH (MBSHH), group 3 (MBGrp3), and group 4 (MBGrp4), each defined by their characteristic genome-wide transcriptomic and DNA methylomic profiles. These subgroups have distinct clinicopathological and molecular features, and underpin current disease subclassification and initial subgroup-directed therapies that are underway in clinical trials. However, substantial biological heterogeneity and differences in survival are apparent within each subgroup, which remain to be resolved...
May 22, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28545798/sleep-disturbances-in-fibromyalgia-a-meta-analysis-of-case-control-studies
#18
REVIEW
Yu-Lin Wu, Ling-Yin Chang, Hsin-Chien Lee, Su-Chen Fang, Pei-Shan Tsai
OBJECTIVE: Sleep disturbances are common in fibromyalgia, but the features of sleep disturbances are not well understood. We performed a systematic review and meta-analysis of case-control studies to compare the sleep outcomes of individuals with fibromyalgia and healthy controls. METHODS: We systematically searched eight databases (PubMed, Ovid MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, Airiti Library and Wanfang Data) for articles published before April 2016...
May 2017: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/28545551/identifying-and-reducing-disparities-in-successful-addiction-treatment-completion-testing-the-role-of-medicaid-payment-acceptance
#19
Erick G Guerrero, Bryan R Garner, Benjamin Cook, Yinfei Kong, William A Vega, Lillian Gelberg
BACKGROUND: Medicaid has become the largest payer of substance use disorder treatment and may enhance access to quality care and reduce disparities. We tested whether treatment programs' acceptance of Medicaid payments was associated with reduced disparities between Mexican Americans and non-Latino Whites. METHODS: We analyzed client and program data from 122 publicly funded treatment programs in 2010 and 112 programs in 2013. These data were merged with information regarding 15,412 adult clients from both periods, of whom we selected only Mexican Americans (n = 7130, 46...
May 25, 2017: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/28545332/a-nationwide-uk-survey-of-female-fertility-preservation-prior-to-cancer-treatment
#20
Yazan Abdallah, Jonathan Briggs, Joshua Jones, Gregory Horne, Cheryl Fitzgerald
This survey examined the provision of fertility preservation for female oncology patients prior to cancer treatments, given their well-established gonadotoxic effects. Questionnaires were sent to all assisted conception units in the UK enquiring about the provision of oocyte or embryo cryopreservation, as well as funding for female oncology patients. In addition, data were obtained from the Human Fertilisation and Embryology Authority (HFEA) on the number of cryopreservation cycles in 2013-2014. Of the 60 responding units, 53 (88%) offered fertility preservation...
May 26, 2017: Human Fertility: Journal of the British Fertility Society
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