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https://www.readbyqxmd.com/read/28916294/characteristics-of-older-adults-in-primary-care-who-may-benefit-from-primary-palliative-care-in-the-united-states
#1
Nancy Dudley, Christine S Ritchie, Margaret I Wallhagen, Kenneth E Covinsky, Bruce A Cooper, Kanan Patel, Irena Stijacic-Cenzer, Susan A Chapman
CONTEXT: Older adults with advanced illness and associated symptoms may benefit from primary palliative care, but limited data exist to identify older adults in U.S. primary care to benefit from this care. OBJECTIVES: To describe U.S. primary care visits among adults 65 years and older with advanced illness. METHODS: Cross-sectional analysis of the National Ambulatory and Hospital Ambulatory Medical Care Surveys (2009-2011) was conducted using chi-square tests to compare visits without and with advanced illness to U...
September 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28916216/coronary-artery-bypass-grafting-bundled-payment-proposal-will-have-significant-financial-impact-on-hospitals
#2
Robert B Hawkins, J Hunter Mehaffey, Kenan W Yount, Leora T Yarboro, Clifford Fonner, Irving L Kron, Mohammed Quader, Alan Speir, Jeffrey Rich, Gorav Ailawadi
OBJECTIVES: The Centers for Medicare and Medicaid Services plans to institute a 5-year trial of bundled payments for coronary artery bypass grafting through 90 days after discharge. To investigate the impact, we reviewed actual inpatient costs for patients undergoing bypass surgery relative to the target price. METHODS: A total of 13,276 Medicare patients with estimated cost data underwent isolated coronary artery bypass grafting from 2008 to 2015 in 18 hospitals over 8 Medicare-defined regions within the Commonwealth of Virginia...
July 29, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28915854/medical-therapy-following-hospitalization-for-heart-failure-with-reduced-ejection-fraction-and-association-with-discharge-to-long-term-care-a-cross-sectional-analysis-of-the-reasons-for-geographic-and-racial-differences-in-stroke-regards-population
#3
Emily B Levitan, Melissa K Van Dyke, Ligong Chen, Raegan W Durant, Todd M Brown, J David Rhodes, Olusola Olubowale, Oluwole Muyiwa Adegbala, Meredith L Kilgore, Justin Blackburn, Karen C Albright, Monika M Safford
BACKGROUND: Less intensive treatment for heart failure with reduced ejection fraction (HFrEF) may be appropriate for patients in long-term care settings because of limited life expectancy, frailty, comorbidities, and emphasis on quality of life. METHODS: We compared treatment patterns between REasons for Geographic And Racial Differences in Stroke (REGARDS) study participants discharged to long-term care versus home following HFrEF hospitalizations. We examined medical records and Medicare pharmacy claims for 147 HFrEF hospitalizations among 80 participants to obtain information about discharge disposition and medication prescriptions and fills...
September 16, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28915166/factors-associated-with-hospital-participation-in-centers-for-medicare-and-medicaid-services-accountable-care-organization-programs
#4
Askar S Chukmaitov, David W Harless, Gloria J Bazzoli, Yangyang Deng
BACKGROUND: In 2012, the Centers for Medicare and Medicaid Services (CMS) initiated the Medicare Shared Savings Program (MSSP) and Pioneer Accountable Care Organization (ACO) programs. Organizations in the MSSP model shared cost savings they generated with CMS, and those in the Pioneer program shared both savings and losses. It is largely unknown what hospital and environmental characteristics are associated with the development of CMS ACOs with one- or two-sided risk models. PURPOSE: The aim of this study was to assess the organizational and environmental characteristics associated with hospital participation in the MSSP and Pioneer ACOs...
September 15, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28914683/primum-non-nocere-and-the-5-rights
#5
Gabriele Popp, Dick Clarke, Stephen Rothstein
Overutilization of hyperbaric oxygen therapy (HBOT) is commonplace and primarily associated with outpatient wound care. While the number of hospitals providing HBOT is at an all-time high, the number of those willing to treat patients in immediate need is at an all-time low. Huge areas of the country, including major population areas, are now completely devoid of 24/7 HBOT availability and inpatient access. Purchasers of healthcare, including the Centers for Medicare and Medicaid Services, have become increasingly concerned to the point that several strategies have been introduced to constructively deal with this issue...
October 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28914278/magnitude-of-potentially-inappropriate-thrombophilia-testing-in-the-inpatient-hospital-setting
#6
Eric Mou, Henry Kwang, Jason Hom, Lisa Shieh, Andre Kumar, Ilana Richman, Caroline Berube
Laboratory costs of thrombophilia testing exceed an estimated $650 million (in US dollars) annually. Quantifying the prevalence and financial impact of potentially inappropriate testing in the inpatient hospital setting represents an integral component of the effort to reduce healthcare expenditures. We conducted a retrospective analysis of our electronic medical record to evaluate 2 years' worth of inpatient thrombophilia testing measured against preformulated appropriateness criteria. Cost data were obtained from the Centers for Medicare and Medicaid Services 2016 Clinical Laboratory Fee Schedule...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28913649/improvement-in-diagnostic-and-therapeutic-arthrocentesis-via-constant-compression
#7
Tej B Bhavsar, Wilmer L Sibbitt, Philip A Band, Romy J Cabacungan, Timothy S Moore, Luis C Salayandia, Roderick A Fields, Scarlett K Kettwich, Luis P Roldan, N Suzanne Emil, Monthida Fangtham, Arthur D Bankhurst
We hypothesized that constant compression of the knee would mobilize residual synovial fluid and promote successful arthrocentesis. Two hundred and ten knees with grade II-III osteoarthritis were included in this paired design study: (1) conventional arthrocentesis was performed with manual compression and success and volume (milliliters) determined; and (2) the intra-articular needle was left in place, and a circumferential elastomeric brace was tightened on the knee to provide constant compression. Arthrocentesis was attempted again and additional fluid volume was determined...
September 14, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28910436/integrating-data-collection-into-office-work-flow-and-electronic-health-records-for-clinical-outcomes-research
#8
C Alessandra Colaianni, Patricia A Levesque, Robin W Lindsay
Meticulous collection of clinical outcomes metrics in patients undergoing elective surgery is important to ensure quality care; it is also increasing in importance as the Centers for Medicare & Medicaid Services moves to tie reimbursement to outcomes and insurance approval. This study assesses a systematic method for gathering preoperative and postoperative data on patients with nasal obstruction who undergo functional septorhinoplasty that was developed at the Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts...
September 14, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28906314/quality-of-care-in-the-united-states-territories-1999-2012
#9
Sudhakar V Nuti, Yun Wang, Frederick A Masoudi, Marcella Nunez-Smith, Sharon-Lise T Normand, Karthik Murugiah, Orlando Rodríguez-Vilá, Joseph S Ross, Harlan M Krumholz
BACKGROUND: Millions of Americans live in the US territories, but health outcomes and payments among Medicare beneficiaries in these territories are not well characterized. METHODS: Among Fee-for-Service Medicare beneficiaries aged 65 years and older hospitalized between 1999 and 2012 for acute myocardial infarction (AMI), heart failure (HF), and pneumonia, we compared hospitalization rates, patient outcomes, and inpatient payments in the territories and states...
October 2017: Medical Care
https://www.readbyqxmd.com/read/28906313/two-innovative-cancer-care-programs-have-potential-to-reduce-utilization-and-spending
#10
Erin M Colligan, Erin Ewald, Nancy L Keating, Shriram Parashuram, Michelle Spafford, Sarah Ruiz, Adil Moiduddin
BACKGROUND: Cancer patients often present to the emergency department (ED) and hospital for symptom management, but many of these visits are avoidable and costly. OBJECTIVE: We assessed the impact of 2 Health Care Innovation Awards that used an oncology medical home model [Community Oncology Medical Home (COME HOME)] or patient navigation model [Patient Care Connect Program (PCCP)] on utilization and spending. METHODS: Participants in COME HOME and PCCP models were matched to similar comparators using propensity scores...
October 2017: Medical Care
https://www.readbyqxmd.com/read/28906189/the-rehabilitation-continuum-from-hospital-to-cardiac-rehabilitation-a-study-of-147-000-medicare-beneficiaries
#11
Mary A Dolansky, Melissa D Zullo, Richard A Josephson
No abstract text is available yet for this article.
October 2017: Western Journal of Nursing Research
https://www.readbyqxmd.com/read/28906171/association-of-state-level-restrictions-in-nurse-practitioner-scope-of-practice-with-the-quality-of-primary-care-provided-to-medicare-beneficiaries
#12
Jennifer Perloff, Sean Clarke, Catherine M DesRoches, Monica O'Reilly-Jacob, Peter Buerhaus
CONTEXT: State scope of practice (SoP) laws impose significant restrictions on the services that a nurse practitioner (NP) may provide in some states, yet evidence about SoP limitations on the quality of primary care is very limited. METHOD: This study uses six different classifications of state regulations and bivariate and multivariate analyses to compare beneficiaries attributed to primary care nurse practitioners and primary care physicians in 2013 testing two hypotheses: (1) chronic disease management, cancer screening, preventable hospitalizations, and adverse outcomes of care provided by primary care nurse practitioners are better in reduced and restricted practice states compared to states without restrictions and (2) by decreasing access to care, SoP restrictions negatively affect the quality of primary care...
September 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/28905359/guideline-recommended-medications-and-physical-function-in-older-adults-with-multiple-chronic-conditions
#13
Gail McAvay, Heather G Allore, Andrew B Cohen, Danijela Gnjidic, Terrence E Murphy, Mary E Tinetti
BACKGROUND/OBJECTIVES: The benefit or harm of a single medication recommended for one specific condition can be difficult to determine in individuals with multiple chronic conditions and polypharmacy. There is limited information on the associations between guideline-recommended medications and physical function in older adults with multiple chronic conditions. The objective of this study was to estimate the beneficial or harmful associations between guideline-recommended medications and decline in physical function in older adults with multiple chronic conditions...
September 14, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28905305/a-systematic-review-of-promising-strategies-of-faith-based-cancer-education-and-lifestyle-interventions-among-racial-ethnic-minority-groups
#14
REVIEW
Su-I Hou, Xian Cao
Church-based interventions have been used to reach racial/ethnic minorities. In order to develop effective programs, we conducted a comprehensive systematic review of faith-based cancer prevention studies (2005~2016) to examine characteristics and promising strategies. Combination terms "church or faith-based or religion," "intervention or program," and "cancer education or lifestyle" were used in searching the five major databases: CINAHL; ERIC; Health Technology Assessments; MEDLINE; and PsycInfo. A total of 20 studies met study criteria...
September 13, 2017: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/28905179/overtreatment-and-deintensification-of-diabetic-therapy-among-medicare-beneficiaries
#15
Matthew L Maciejewski, Xiaojuan Mi, Jeremy Sussman, Melissa Greiner, Lesley H Curtis, Judy Ng, Samuel C Haffer, Eve A Kerr
BACKGROUND: Deintensification of diabetic therapy is often clinically appropriate for older adults, because the benefit of aggressive diabetes treatment declines with age, while the risks increase. OBJECTIVE: We examined rates of overtreatment and deintensification of therapy for older adults with diabetes, and whether these rates differed by medical, demographic, and socioeconomic characteristics. DESIGN, SUBJECTS, AND MAIN MEASURES: We analyzed Medicare claims data from 10 states, linked to outpatient laboratory values to identify patients potentially overtreated for diabetes (HbA1c < 6...
September 13, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28903802/can-national-healthcare-associated-infections-hais-data-differentiate-hospitals-in-the-united-states
#16
Max Masnick, Daniel J Morgan, John D Sorkin, Mark D Macek, Jessica P Brown, Penny Rheingans, Anthony D Harris
OBJECTIVE To determine whether patients using the Centers for Medicare and Medicaid Services (CMS) Hospital Compare website (http://medicare.gov/hospitalcompare) can use nationally reported healthcare-associated infection (HAI) data to differentiate hospitals. DESIGN Secondary analysis of publicly available HAI data for calendar year 2013. METHODS We assessed the availability of HAI data for geographically proximate hospitals (ie, hospitals within the same referral region) and then analyzed these data to determine whether they are useful to differentiate hospitals...
October 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28903137/nationwide-coverage-and-cost-sharing-for-pcsk9-inhibitors-among-medicare-part-d-plans
#17
Dhruv S Kazi, Christine Y Lu, Grace A Lin, Colette DeJong, R Adams Dudley, Randi Chen, Chien-Wen Tseng
No abstract text is available yet for this article.
September 13, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28902882/risk-of-myeloid-neoplasms-after-radiotherapy-among-older-women-with-localized-breast-cancer-a-population-based-study
#18
Amer M Zeidan, Jessica B Long, Rong Wang, Xin Hu, James B Yu, Scott F Huntington, Gregory A Abel, Sarah S Mougalian, Nikolai A Podoltsev, Steven D Gore, Cary P Gross, Xiaomei Ma, Amy J Davidoff
BACKGROUND: There are inconsistent and limited data regarding the risk of myeloid neoplasms (MN) among breast cancer survivors who received radiotherapy (RT) in the absence of chemotherapy. Concern about subsequent MN might influence the decision to use adjuvant RT for women with localized disease. As patients with therapy-related MN have generally poor outcomes, the presumption of subsequent MN being therapy-related could affect treatment recommendations. METHODS: We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database to study older women with in-situ or stage 1-3 breast cancer diagnosed 2001-2009 who received surgery...
2017: PloS One
https://www.readbyqxmd.com/read/28902769/factors-associated-with-financial-relationships-between-spine-surgeons-and-industry-an-analysis-of-the-open-payments-database
#19
Joseph A Weiner, Ralph W Cook, Sohaib Hashmi, Michael S Schallmo, Danielle S Chun, Kathryn A Barth, Sameer K Singh, Alpesh A Patel, Wellington K Hsu
STUDY DESIGN: A retrospective review of Centers for Medicare and Medicaid Services Database. OBJECTIVE: Utilizing Open Payments data, we aimed to determine the prevalence of industry payments to orthopedic and neurospine surgeons, report the magnitude of those relationships, and help outline the surgeon demographic factors associated with industry relationships. SUMMARY OF BACKGROUND DATA: Previous Open Payments data revealed that orthopedic surgeons receive the highest value of industry payments...
September 15, 2017: Spine
https://www.readbyqxmd.com/read/28902741/the-influence-of-geography-time-and-payer-type-on-the-utilization-of-bone-morphogenetic-protein-bmp-between-2005-and-2015
#20
Sohrab S Virk, Frank M Phillips, Safdar N Khan
Bone morphogenetic protein (BMP) is a critical compound for endochondral bone formation and is used as a bone graft substitute to promote spinal fusion and fracture healing. We sought to identify rate, type, and applications of use of BMP in spinal fusion surgery during 2005 to 2015. The Medicare 5% national sample (SAF5) database and the Humana Orthopaedics database (HORTHO) were searched for patients who underwent spinal fusion with BMP. Rate of use over time and influence of geographic region and payer type on utilization of BMP during 2005 to 2015 were analyzed...
September 11, 2017: Clinical Spine Surgery
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