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Texas healthcare

Lavi Oud
BACKGROUND The demand for critical care services among elderly with dementia outpaces that of their non-dementia elderly counterparts. However, there are scarce data on the corresponding attributes among ICU-managed patients with dementia. MATERIAL AND METHODS We used the Texas Inpatient Public Use Data File to examine temporal trends of the demographics, burden of comorbidities, measures of severity of illness, use of healthcare resources, and short-term outcomes among hospitalizations aged 65 years or older with a reported diagnosis of dementia, who were admitted to ICU (D-ICU hospitalizations) between 2001 and 2010...
October 20, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Melody Tran, Pin Xiang, Karen L Rascati, Eileen M Stock, Paul J Godley, Amber Coleman, Michael R Bogart, Richard H Stanford
BACKGROUND: Suboptimal treatment of exacerbations is a major concern in management of chronic obstructive pulmonary disease (COPD). The Pharmacotherapy Management of COPD Exacerbation (PCE) Healthcare Effectiveness Data and Information Set (HEDIS) measure is a quality measure included by the National Committee for Quality Assurance that focuses on appropriate use of steroids and bronchodilators during an acute COPD exacerbation. There is limited evidence evaluating predictors of this quality measure, as well as its association with hospital readmission and cost outcomes...
October 2016: Journal of Managed Care & Specialty Pharmacy
Vivian Ho, Timothy K Allen, Urie Kim, William P Keenan, Meei-Hsiang Ku-Goto, Mark Sanderson
OBJECTIVES: We analyzed changes in healthcare spending associated with the implementation of Cigna's Collaborative Accountable Care (CAC) initiative in a large multi-clinic physician practice. STUDY DESIGN: We compared claims from 2009, prior to the CAC initiative, against claims for 2010 to 2011, contrasting the patients covered by Cigna's CAC initiative with patients in other practices in the same geographic area covered by Cigna's medical plan. METHODS: We used a propensity weighted difference-in-differences approach, adjusting for age, sex, health status, and secular trends to isolate the treatment effect of the CAC...
2016: American Journal of Managed Care
Laura N Medford-Davis, Rohan Shah, Danielle Kennedy, Emilie Becker
OBJECTIVES: The objective of this study was to determine characteristics associated with potentially preventable pediatric admissions as defined by the Agency for Healthcare Research and Quality. METHODS: The Texas Inpatient Public Use Data File, an administrative database of hospital admissions, identified 747 040 pediatric admissions ages 0 to 17 years to acute care facilities between 2005 and 2008. Potentially preventable admissions included 5 diagnoses: asthma, perforated appendicitis, diabetes, gastroenteritis, and urinary tract infection...
October 2016: Hospital Pediatrics
Lee Revere, Adele Semaan, Nicole Lievsay, Jessica Hall, Zheng M Wang, Charles Begley
The Texas Medicaid 1115 Transformation Waiver reforms the state's safety net systems by creating a Delivery System Reform Incentive Payment incentive pool for innovative healthcare delivery. The Waiver supports the design and implementation of transformative projects. As part of the Waiver requirements, regions created Learning Collaboratives to collaborate on project implementation and outcomes. This paper describes the experience of one region in adapting the Institute for Healthcare Improvement Breakthrough Series (IHI BTS) model, as a framework for their Learning Collaborative...
September 13, 2016: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
Mariana Arevalo, Natalia I Heredia, Sarah Krasny, Maria L Rangel, Leticia A Gatus, Lorna H McNeill, Maria E Fernandez
Clinical trials are essential to advancing knowledge to reduce disease morbidity and mortality; however, ethnic and racial minorities remain under-represented in those studies. We explored knowledge and perceptions of clinical trials among Mexican-Americans in Texas. We conducted focus groups (N = 128) stratified by gender, language preference, and geographical location. This paper presents four emergent, primary themes: 1) knowledge and understanding of clinical trials, 2) fears and concerns about participating, 3) perceived benefits of participating, and 4) incentives to participate...
December 15, 2016: Contemporary Clinical Trials Communications
Krystal L Edwards, Ryan L Hadley, Nidhu Baby, Julianne C Yeary, Lisa M Chastain, Crystal D Brown
OBJECTIVE: To show that clinical pharmacy specialists (CPSs) can be utilized in remote facilities to provide appropriate diabetes outcomes along with potential cost savings. METHODS: A retrospective cohort chart review conducted at the Veterans Affairs North Texas Healthcare System (VANTHCS) evaluated outcomes in patients with type 2 diabetes mellitus referred to CPSs at Fort Worth Outpatient Clinic (FWOPC) or the endocrinologist-managed specialty clinic at the Dallas VA Medical Center (DVAMC)...
August 27, 2016: Journal of Pharmacy Practice
Kate Russell, Sara E Oliver, Lillianne Lewis, Wanda D Barfield, Janet Cragan, Dana Meaney-Delman, J Erin Staples, Marc Fischer, Georgina Peacock, Titilope Oduyebo, Emily E Petersen, Sherif Zaki, Cynthia A Moore, Sonja A Rasmussen
CDC has updated its interim guidance for U.S. health care providers caring for infants born to mothers with possible Zika virus infection during pregnancy (1). Laboratory testing is recommended for 1) infants born to mothers with laboratory evidence of Zika virus infection during pregnancy and 2) infants who have abnormal clinical or neuroimaging findings suggestive of congenital Zika syndrome and a maternal epidemiologic link suggesting possible transmission, regardless of maternal Zika virus test results...
2016: MMWR. Morbidity and Mortality Weekly Report
Marcia G Ory, Samuel D Towne, Jaewoong Won, Samuel N Forjuoh, Chanam Lee
BACKGROUND: Regular physical activity (PA) is a major factor in maintaining health in aging populations. This study examines the influences of sociodemographic, health, and environmental characteristics on older adults' walking behaviors, and the role physicians can play in promoting physical activity. METHODS: Online and paper surveys (n = 272) were distributed to community-dwelling older (age ≥ 60) adults from a large integrated healthcare system in two counties in Central Texas...
2016: BMC Geriatrics
Mary T Austin, Emma Hamilton, Denna Zebda, Hoang Nguyen, Jan M Eberth, Yuchia Chang, Linda S Elting, David I Sandberg
OBJECTIVE Health disparities in access to care, early detection, and survival exist among adult patients with cancer. However, there have been few reports assessing how health disparities impact pediatric patients with malignancies. The objective in this study was to examine the impact of racial/ethnic and social factors on disease presentation and outcome for children with primary CNS solid tumors. METHODS The authors examined all children (age ≤ 18 years) in whom CNS solid tumors were diagnosed and who were enrolled in the Texas Cancer Registry between 1995 and 2009 (n = 2421)...
August 19, 2016: Journal of Neurosurgery. Pediatrics
G C Lee, R G Hall, N K Boyd, S D Dallas, L C DU, L B Treviño, C Retzloff, S B Treviño, K A Lawson, J P Wilson, R J Olsen, Y Wang, C R Frei
Skin and soft tissue infections (SSTIs) due to Staphylococcus aureus have become increasingly common in the outpatient setting; however, risk factors for differentiating methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) SSTIs are needed to better inform antibiotic treatment decisions. We performed a case-case-control study within 14 primary-care clinics in South Texas from 2007 to 2015. Overall, 325 patients [S. aureus SSTI cases (case group 1, n = 175); MRSA SSTI cases (case group 2, n = 115); MSSA SSTI cases (case group 3, n = 60); uninfected control group (control, n = 150)] were evaluated...
November 2016: Epidemiology and Infection
Jad A Dandashi, Damir Nizamutdinov, Samantha Dayawansa, Ekokobe Fonkem, Jason H Huang
Today, Lyme disease is the most commonly reported tick-borne disease in the United States and Europe. The culprits behind Lyme disease are the Borrelia species of bacteria. In the USA, Borrelia burgdorferi causes the majority of cases, while in Europe and Asia Borrelia afzelii and Borrelia garinii carry the greatest burden of disease. The clinical manifestations of Lyme disease have been identified as early localized, early disseminated, and late chronic. The neurological effects of Lyme disease include both peripheral and central nervous systems involvement, including focal nerve abnormalities, cranial neuropathies, painful radiculoneuritis, meningitis, and/or toxic metabolic encephalopathy, known as Lyme encephalopathy...
June 2016: Journal of Neuroinfectious Diseases
Mehwish Javaid, Dana Ashrawi, Rachel Landgren, Lori Stevens, Rosalind Bello, Lewis Foxhall, Melissa Mims, Lois Ramondetta
The purpose of this study was to identify barriers to and facilitators of human papillomavirus (HPV) vaccination in children aged 9-17 years across Texas. A literature review informed the development of a web-based survey designed for people whose work involves HPV vaccination in settings serving pediatric patients. The survey was used to examine current HPV vaccine recommendation practices among healthcare providers, barriers to HPV vaccination, reasons for parent/caregiver vaccine refusal, staff and family education practices, utilization of reminder and recall systems and status of vaccine administration (payment, ordering and stocking)...
July 29, 2016: Journal of Community Health
Trudy Millard Krause, Elifnur Yay Donderici, Cecilia Ganduglia Cazaban, Luisa Franzini
BACKGROUND: Silent-members are members of a medical health plan who submit no claims for healthcare services in a benefit year despite 12 months of continuous-enrollment. This study was conducted to evaluate the future expenditure risk of commercial-insured members who avoid all medical care despite coverage. In order to determine if the silent-members were at greater risk, we compared them to members who received care in the anchor year (2009) but had low-expenditures. The low-expenditure members were assumed to represent persons without significant medical conditions and without care-avoidance behaviors...
2016: BMC Health Services Research
Roberta Romero, Lisa Campbell, Huaxin Song, Marc J Zuckerman, Ogechika Alozie
The incidence and prevalence of hepatitis C virus (HCV) is steadily increasing across the world. Increasing morbidity and mortality rates associated with HCV are influencing research on treatment outcomes. The purpose of this project was to examine the effect of health insurance status and office visit compliance on sustained virologic response (SVR) in adult patients living along the Texas-Mexico border treated for HCV and who received dual or triple medication therapy between January 2010 and August 2013...
July 2016: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
Darpan I Patel, Paula Winkler, Jorge Botello, Jocelin Villarreal, Frank Puga
OBJECTIVE: To describe the effectiveness of engaging patient partners as "citizen scientists" in the research process to boost patient centered outcomes research in underrepresented populations. METHODS: Translational Advisory Boards in South Texas have effectively collaborated with University researchers to develop community-based patient centered research. Here we describe innovative approaches in research to engage patients and offer practical methods to enhance partnerships between patients and researchers to facilitate patient engagement...
July 5, 2016: Patient Education and Counseling
Chanunya Srihawan, Rodrigo Lopez Castelblanco, Lucrecia Salazar, Susan H Wootton, Elizabeth Aguilera, Luis Ostrosky-Zeichner, David I Sandberg, HuiMahn A Choi, Kiwon Lee, Ryan Kitigawa, Nitin Tandon, Rodrigo Hasbun
Background.  Healthcare-associated meningitis or ventriculitis is a serious and life-threatening complication of invasive neurosurgical procedures or penetrating head trauma. Methods.  We performed a retrospective study of adults and children with the diagnosis of healthcare-associated meningitis or ventriculitis, as defined by the 2015 Centers of Disease Control and Prevention case definition, at 2 large tertiary care hospitals in Houston, Texas from July 2003 to November 2014. Patients were identified by infection control practitioners and by screening cerebrospinal fluid samples sent to the central laboratory...
April 2016: Open Forum Infectious Diseases
Debajyoti Pati, Kristi Gaines, Shabboo Valipoor
OBJECTIVES: An exploratory examination of rural hospital staff experiences to determine whether the physical state of rural healthcare facilities influence the healthcare experience and perception of care quality. BACKGROUND: Rural hospitals have served as the backbone of rural communities in the United States. Over time, these facilities have witnessed enhanced expectations, expanding their scope of operations from acute care to diversified services through linked provider networks and disaster management...
October 2016: HERD
Sally W Gillam, Andrew R Gillam, Tricia L Casler, Katelyn Curcio
AIM: A nursing study aimed to increase patient understanding of new medications and their side effects, and positively impact Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey scores for medications communication. BACKGROUND: Hospital patients' understanding of new medications and side effects is a major satisfaction indicator when formal surveys serve as quality measures. Medical/surgical unit survey scores at a 328-bed Texas hospital were below average...
August 2016: Applied Nursing Research: ANR
Lesli Biediger-Friedman, Sylvia H Crixell, Monica Silva, Brittany R Markides, Kenneth S Smith
OBJECTIVE: The purpose of this research was to conduct the first stages of a user-centered design of a smartphone app designed to improve health behaviors among participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Texas. METHODS: Focus groups explored facilitators and barriers to health behaviors, current use of apps, and desired features in a WIC app. RESULTS: Facilitators to improve health behaviors included access to information, support from healthcare practitioners and family, and implementation of strategies...
July 2016: American Journal of Health Behavior
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