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https://www.readbyqxmd.com/read/28107250/evaluating-excessive-burden-of-depression-on-health-status-and-health-care-utilization-among-patients-with-hypertension-in-a-nationally-representative-sample-from-the-medial-expenditure-panel-survey-meps-2012
#1
Hui Shao, Mir Umer Mohammed, Nick Thomas, Saleh Babazadeh, Shuang Yang, Qian Shi, Lizheng Shi
Depression and hypertension frequently present together in clinical practice. Evaluating the interaction between depression and hypertension would help stakeholders better understand the value of depression prevention in primary care. This retrospective study aimed to evaluate the excessive burden of depression on overall health and on health care utilization expenditure among hypertensive patients. A total of 7019 hypertensive patients (ICD-9-CM: 401) were identified from the 2012 Medical Expenditure Panel Survey (MEPS 2012) data, of which 936 patients had depression (ICD-9-CM: 311)...
January 18, 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/28106625/long-term-hearing-results-after-ossiculoplasty
#2
Matthew D Cox, Aaron Trinidade, James Shep Russell, John L Dornhoffer
OBJECTIVES: To determine if the OOPS index is predictive of long-term hearing results after ossiculoplasty. STUDY DESIGN: Case series with retrospective chart review. SETTING: Tertiary care otology practice. PATIENTS: Adult and pediatric patients (3-88 years of age). INTERVENTIONS: Ossiculoplasty with cartilage tympanoplasty, with or without mastoidectomy. OUTCOME MEASURES: Primary outcome measures included short-term hearing results (pure-tone average air-bone gap [PTA-ABG] measured between 60 days and 1 year after surgery), long-term hearing results (PTA-ABG measured ≥5 years after surgery), and the rate of successful ABG closure to ≤20 dB...
January 18, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28106518/a-case-report-cornerstone-health-care-reduced-the-total-cost-of-care-through-population-segmentation-and-care-model-redesign
#3
Dale E Green, Bruce H Hamory, Grace E Terrell, Jasmine O'Connell
Over the course of a single year, Cornerstone Health Care, a multispecialty group practice in North Carolina, redesigned the underlying care models for 5 of its highest-risk populations-late-stage congestive heart failure, oncology, Medicare-Medicaid dual eligibles, those with 5 or more chronic conditions, and the most complex patients with multiple late-stage chronic conditions. At the 1-year mark, the results of the program were analyzed. Overall costs for the patients studied were reduced by 12.7% compared to the year before enrollment...
January 20, 2017: Population Health Management
https://www.readbyqxmd.com/read/28106511/telementoring-primary-care-clinicians-to-improve-geriatric-mental-health-care
#4
Elisa Fisher, Michael Hasselberg, Yeates Conwell, Linda Weiss, Norma A Padrón, Erin Tiernan, Jurgis Karuza, Jeremy Donath, José A Pagán
Health care delivery and payment systems are moving rapidly toward value-based care. To be successful in this new environment, providers must consistently deliver high-quality, evidence-based, and coordinated care to patients. This study assesses whether Project ECHO(®) (Extension for Community Healthcare Outcomes) GEMH (geriatric mental health)-a remote learning and mentoring program-is an effective strategy to address geriatric mental health challenges in rural and underserved communities. Thirty-three teleECHO clinic sessions connecting a team of specialists to 54 primary care and case management spoke sites (approximately 154 participants) were conducted in 10 New York counties from late 2014 to early 2016...
January 20, 2017: Population Health Management
https://www.readbyqxmd.com/read/28105878/understanding-performance-management-in-primary-care
#5
Lisa Rogan, Ruth Boaden
Purpose Principal-agent theory (PAT) has been used to understand relationships among different professional groups and explain performance management between organisations, but is rarely used for research within primary care. The purpose of this paper is to explore whether PAT can be used to attain a better understanding of performance management in primary care. Design/methodology/approach Purposive sampling was used to identify a range of general practices in the North-west of England. Interviews were carried out with directors, managers and clinicians in commissioning and regional performance management organisations and within general practices, and the data analysed using matrix analysis techniques to produce a case study of performance management...
February 13, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28105767/investigations-and-referral-for-suspected-cancer-in-primary-care-in-new-zealand-a-survey-linked-to-the-international-cancer-benchmarking-partnership
#6
H W Htun, J M Elwood, S J Ioannides, T Fishman, R Lawrenson
A national internet-based survey of New Zealand (NZ) primary care physicians (n = 192) used the survey instrument developed by the International Cancer Benchmarking Partnership (ICBP). Practitioners were recruited by a range of methods assisted by NZ general practice networks and contacts. Compared to 11 other ICBP jurisdictions, direct access to diagnostic tests was more limited and took more time than in most other areas; the average wait for a test to be done and reported was 3.0 weeks for X-rays and 8...
January 20, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28104470/a-cluster-randomized-trial-of-a-primary-palliative-care-intervention-connect-for-patients-with-advanced-cancer-protocol-and-key-design-considerations
#7
Claire L Becker, Robert M Arnold, Seo Young Park, Margaret Rosenzweig, Thomas J Smith, Douglas B White, Kenneth J Smith, Yael Schenker
BACKGROUND: The addition of specialty palliative care to standard oncology care improves outcomes for patients with advanced cancer and their caregivers, but many lack access to specialty care services. Primary palliative care-meaning basic palliative care services provided by clinicians who are not palliative care specialists-is an alternative approach that has not been rigorously evaluated. METHODS: A cluster randomized, controlled trial of the CONNECT (Care management by Oncology Nurses to address supportive care needs) intervention, an oncology nurse-led care management approach to providing primary palliative care for patients with advanced cancer and their family caregivers, is currently underway at 16 oncology practices in Western Pennsylvania...
January 16, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28103923/risk-adjustment-methods-for-all-payer-comparative-performance-reporting-in-vermont
#8
Karl Finison, MaryKate Mohlman, Craig Jones, Melanie Pinette, David Jorgenson, Amy Kinner, Tim Tremblay, Daniel Gottlieb
BACKGROUND: As the emphasis in health reform shifts to value-based payments, especially through multi-payer initiatives supported by the U.S. Center for Medicare & Medicaid Innovation, and with the increasing availability of statewide all-payer claims databases, the need for an all-payer, "whole-population" approach to facilitate the reporting of utilization, cost, and quality measures has grown. However, given the disparities between the different populations served by Medicare, Medicaid, and commercial payers, risk-adjustment methods for addressing these differences in a single measure have been a challenge...
January 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28103918/the-effects-of-asking-a-fertility-intention-question-in-primary-care-settings-a-systematic-review-protocol
#9
Paul A Henning, Carolyne K Burgess, Heidi E Jones, Wendy V Norman
BACKGROUND: Planning for pregnancy has been associated with reduced unwanted pregnancies and improved pregnancy outcomes. Despite the benefits of planned pregnancy, there are no guideline recommendations on routine counseling regarding pregnancy intention in primary care settings. The objective of the systematic review is to determine the effectiveness of incorporating questions of pregnancy intention into primary care. METHODS: A systematic search of the literature will be conducted for any studies comparing questions of pregnancy intention in primary care settings with no intervention or a control intervention...
January 19, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28103871/a-descriptive-survey-study-of-violence-management-and-priorities-among-psychiatric-staff-in-mental-health-services-across-seventeen-european-countries
#10
Seamus Cowman, Anna Björkdahl, Eric Clarke, Georgina Gethin, Jim Maguire
BACKGROUND: In mental health services what is commonplace across international frontiers is that to prevent aggressive patients from harming themselves, other patients or staff, coercive measures and foremost, violence management strategies are required. There is no agreement, recommendations or direction from the EU on which measures of coercion should be practiced across EU countries, and there is no overall one best practice approach. METHODS: The project was conceived through an expert group, the European Violence in Psychiatry Research Group (EViPRG)...
January 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28103848/the-crisp-colorectal-cancer-risk-prediction-tool-an-exploratory-study-using-simulated-consultations-in-australian-primary-care
#11
Jennifer G Walker, Adrian Bickerstaffe, Nadira Hewabandu, Sanjay Maddumarachchi, James G Dowty, Mark Jenkins, Marie Pirotta, Fiona M Walter, Jon D Emery
BACKGROUND: In Australia, screening for colorectal cancer (CRC) with colonoscopy is meant to be reserved for people at increased risk, however, currently there is a mismatch between individuals' risk of CRC and the type of CRC screening they receive. This paper describes the development and optimisation of a Colorectal cancer RISk Prediction tool ('CRISP') for use in primary care. The aim of the CRISP tool is to increase risk-appropriate CRC screening. METHODS: CRISP development was informed by previous experience with developing risk tools for use in primary care and a systematic review of the evidence...
January 19, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28102924/current-practices-related-to-family-presence-during-acute-deterioration-in-adult-emergency-department-patients
#12
Megan J Youngson, Judy Currey, Julie Considine
AIMS: To explore the characteristics and interactions of clinicians, patients and family members during management of the deteriorating adult patient in the Emergency Department. BACKGROUND: Previous research into family presence during resuscitation has identified many positive outcomes when families are included. However, over that last three decades the epidemiology of acute clinical deterioration has changed, with a decrease in in-hospital cardiac arrests and an increase in acute clinical deterioration...
January 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28102792/a-study-exploring-the-protean-responses-of-nurses-transitioning-to-primary-healthcare
#13
Christine Ashley, Elizabeth Halcomb, Angela Brown
Background Healthcare systems are faced with changing community health profiles and ageing populations. Together with economic considerations, these factors have influenced the increase in provision of care in primary rather than other healthcare settings. Many nurses are electing to move from acute care to meet demands for a skilled primary healthcare workforce. However, little is reported about these nurses' experiences of transition. Aim To describe how role theory provides a theoretical framework to inform the design of a mixed-methods study exploring the transition of acute care nurses to roles in primary health care...
January 23, 2017: Nurse Researcher
https://www.readbyqxmd.com/read/28100562/healthcare-organisation-and-delivery-for-people-with-dementia-and-comorbidity-a-qualitative-study-exploring-the-views-of-patients-carers-and-professionals
#14
Frances Bunn, Anne-Marie Burn, Louise Robinson, Marie Poole, Greta Rait, Carol Brayne, Johan Schoeman, Sam Norton, Claire Goodman
OBJECTIVES: People living with dementia (PLWD) have a high prevalence of comorbidty. The aim of this study was to explore the impact of dementia on access to non-dementia services and identify ways of improving service delivery for this population. DESIGN: Qualitative study involving interviews and focus groups. Thematic content analysis was informed by theories of continuity of care and access to care. SETTING: Primary and secondary care in the South and North East of England...
January 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28100559/what-is-involved-in-medicines-management-across-care-boundaries-a-qualitative-study-of-healthcare-practitioners-experiences-in-the-case-of-acute-kidney-injury
#15
Denham L Phipps, Rebecca L Morris, Tom Blakeman, Darren M Ashcroft
OBJECTIVES: To examine the role of individual and collective cognitive work in managing medicines for acute kidney injury (AKI), this being an example of a clinical scenario that crosses the boundaries of care organisations and specialties. DESIGN: Qualitative design, informed by a realist perspective and using semistructured interviews as the data source. The data were analysed using template analysis. SETTING: Primary, secondary and intermediate care in England...
January 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28100440/it-s-about-me-patients-experiences-of-patient-participation-in-the-web-behavior-change-program-for-activity-in-combination-with-multimodal-pain-rehabilitation
#16
Catharina Nordin, Peter Michaelson, Margareta K Eriksson, Gunvor Gard
BACKGROUND: Patients' participation in their health care is recognized as a key component in high-quality health care. Persons with persistent pain are recommended treatments with a cognitive approach from a biopsychosocial explanation of pain, in which a patient's active participation in their rehabilitation is in focus. Web-based interventions for pain management have the potential to increase patient participation by enabling persons to play a more active role in rehabilitation. However, little is known about patients' experiences of patient participation in Web-based interventions in clinical practice...
January 18, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28100439/considerations-for-an-access-centered-design-of-the-fever-thermometer-in-low-resource-settings-a-literature-review
#17
REVIEW
Rikako Iwamoto, Ana Laura Rodrigues Santos, Niels Chavannes, Ria Reis, Jan Carel Diehl
BACKGROUND: The lack of adequate information about fever in low-resource settings, its unreliable self-assessment, and poor diagnostic practices may result in delayed care and under-or-overdiagnosis of diseases such as malaria. The mismatches of existing fever thermometers in the context of use imply that the diagnostic tools and connected services need to be studied further to address the challenges of fever-related illnesses and their diagnostics. OBJECTIVE: This study aims to inform a product-service system approach to design a reliable and accessible fever thermometer and connected services, as well as contribute to the identification of innovative opportunities to improve health care in low-resource settings...
January 18, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/28099282/risk-factors-for-acanthamoeba-keratitis-a-multistate-case-control-study-2008-2011
#18
Allison C Brown, Jonathan Ross, Daniel B Jones, Sarah A Collier, Tracy L Ayers, Robert M Hoekstra, Bryon Backensen, Sharon L Roy, Michael J Beach, Jonathan S Yoder
OBJECTIVE: To identify modifiable risk factors contributing to Acanthamoeba keratitis (AK) infection. METHODS: A case-control investigation was conducted. Case patients were soft contact lens wearers with laboratory-confirmed AK. Control were soft contact lens wearers ≥12 years of age, with no history of AK. Case patients were recruited from 14 ophthalmology referral centers and a clinical laboratory. Control were matched on state of residence and type of primary eye care provider (ophthalmologist or optometrist)...
January 17, 2017: Eye & Contact Lens
https://www.readbyqxmd.com/read/28099065/exploring-variation-in-transformation-of-primary-care-practices-to-patient-centered-medical-homes-a-mixed-methods-approach
#19
Robert D Lieberthal, Tom Karagiannis, Evan Bilheimer, Manisha Verma, Colleen Payton, Mona Sarfaty, George Valko
The objective was to quantify the activities required for patient-centered medical home (PCMH) transformation in a sample of small to medium-sized National Committee for Quality Assurance (NCQA) recognized practices, and explore barriers and facilitators to transformation. Eleven small to medium-sized PCMH practices in Southeastern Pennsylvania completed a survey, which was adapted from the 2011 NCQA standards. Semistructured follow-up interviews were conducted, descriptive statistics were computed for the quantitative analysis, and a process of thematic coding was deployed for the qualitative analysis...
January 18, 2017: Population Health Management
https://www.readbyqxmd.com/read/28099046/death-notification-someone-needs-to-call-the-family
#20
Rachel Ombres, Lauren Montemorano, Daniel Becker
BACKGROUND: The death notification process can affect family grief and bereavement. It can also affect the well-being of involved physicians. There is no standardized process for making death notification phone calls. We assumed that residents are likely to be unprepared before and troubled after. OBJECTIVE: We investigated current death notification practices to develop an evidence-based template for standardizing this process. DESIGN: We used results of a literature review and open-ended interviews with faculty, residents, and widows to develop a survey regarding resident training and experience in death notification by phone...
January 18, 2017: Journal of Palliative Medicine
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