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https://www.readbyqxmd.com/read/28751491/pediatric-chronic-critical-illness-reducing-excess-hospitalizations
#1
Renee D Boss, Erin P Williams, Carrie M Henderson, Rebecca R Seltzer, Miriam C Shapiro, Emily Hahn, Nancy Hutton
OBJECTIVES: The past 2 decades have seen an expanding pediatric population that is chronically critically ill: children with repeated and prolonged hospitalizations and ongoing dependence on technologies to sustain vital functions. Although illness complexity prompts many hospitalizations, our goal with this study was to explore modifiable patient, family, and health system contributions to excess hospital days for children with chronic critical illness (CCI). METHODS: Semistructured interviews were conducted with 51 stakeholders known for their CCI expertise...
July 27, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28692718/physician-reimbursement-in-medicare-advantage-compared-with-traditional-medicare-and-commercial-health-insurance
#2
Erin Trish, Paul Ginsburg, Laura Gascue, Geoffrey Joyce
Importance: Nearly one-third of Medicare beneficiaries are enrolled in a Medicare Advantage (MA) plan, yet little is known about the prices that MA plans pay for physician services. Medicare Advantage insurers typically also sell commercial plans, and the extent to which MA physician reimbursement reflects traditional Medicare (TM) rates vs negotiated commercial prices is unclear. Objective: To compare prices paid for physician and other health care services in MA, traditional Medicare, and commercial plans...
July 10, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28601373/evaluating-the-association-between-adjuvant-chemotherapy-and-function-related-adverse-events-among-older-patients-with-early-stage-breast-cancer
#3
Caroline Mariano, Jennifer L Lund, Sharon Peacock Hinton, Phyo Htoo, Hyman Muss, Katherine E Reeder-Hayes
PURPOSE: The incidence of treatment-related toxicity for adjuvant chemotherapy in breast cancer is well documented in clinical trials. However, the effect of chemotherapy on functional outcomes in older patients is less well known. We identified a cohort of older women diagnosed with early stage breast cancer to examine the association between exposure to chemotherapy and a claims-based measure of function-related adverse events (FAE). METHODS: Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare dataset, we identified women aged ≥66 diagnosed with stage I or II breast cancer from 2004 to 2011...
July 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28562401/using-a-standardized-patient-to-improve-collaboration-and-problem-solving-skills-with-cpap-usage-in-the-home
#4
Margaret G Williams, Joan Ruhs
A review of literature revealed a lack of research pertaining to nurses' or student nurses' knowledge of continuous positive airway pressure (CPAP) and the ability to troubleshoot CPAP malfunction. This study sought to answer the following questions: What are associate degree nursing (ADN) students' knowledge, interdisciplinary communication, and problem-solving skills regarding patients' home use of CPAP? Is there a change after participation in a simulation with a patient on CPAP in home setting? Twenty-one ADN students enrolled in small Midwest college participated...
June 2017: Home Healthcare Now
https://www.readbyqxmd.com/read/28497162/cadaver-embalming-fluid-for-surgical-training-courses-modified-larssen-solution
#5
Okan Bilge, Servet Celik
PURPOSE: 10% Formalin (F10)-fixed cadavers have disadvantages such as disturbing smell, mucosal irritation, discoloration and rigidity. We aimed to determine a suitable, simple and cost-effective embalming method that preserves color, texture, pliability and flexibility of the tissues for a long time without a disturbing smell and mucosal irritation. The embalmed cadavers were expected to be durable against environmental effects, utilizable for multiple and repetitive surgical trainings and instrumentations...
May 11, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28483010/pharmacist-managed-diabetes-center-interventions-ensure-quality-and-safety-in-elderly-patients
#6
Geoffrey Twigg, John Motsko, Jennifer Thomas, Tosin David
OBJECTIVES: This quality-improvement study aimed to replicate historical Patient Safety Clinical Pharmacy Services Collaborative results in high-risk Medicare beneficiaries with diabetes to achieve reductions in A1C, adverse drug events (ADEs), and potential ADEs (pADEs). DESIGN: The model included an interdisciplinary team led by a pharmacist located inside a community pharmacy to provide disease state management and medication therapy management (MTM) to the study population...
May 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28342694/nursing-led-home-visits-post-hospitalization-for-children-with-medical-complexity
#7
Sarah Wells, Margaret O'Neill, Jayne Rogers, Kevin Blaine, Amy Hoffman, Sarah McBride, Meghan M Tschudy, Igor Shumskiy, Sangeeta Mauskar, Jay G Berry
PURPOSE: Hospital discharge for children with medical complexity (CMC) can be challenging for families. Home visits could potentially benefit CMC and their families after leaving the hospital. We assessed the utility of post-discharge home visits to identify and address health problems for recently hospitalized CMC. DESIGN AND METHODS: A prospective study of 36 CMC admitted to a children's hospital from 4/15/2015 to 4/14/2016 identified with a possible high risk of hospital readmission and offered a post-discharge home visit within 72h of discharge...
March 23, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28186390/pain-management-in-the-ehlers-danlos-syndromes
#8
REVIEW
Pradeep Chopra, Brad Tinkle, Claude Hamonet, Isabelle Brock, Anne Gompel, Antonio Bulbena, Clair Francomano
Chronic pain in the Ehlers-Danlos syndromes (EDS) is common and may be severe. According to one study, nearly 90% of patients report some form of chronic pain. Pain, which is often one of the first symptoms to occur, may be widespread or localized to one region such as an arm or a leg. Studies on treatment modalities are few and insufficient to guide management. The following is a discussion of the evidence regarding the underlying mechanisms of pain in EDS. The causes of pain in this condition are multifactorial and include joint subluxations and dislocations, previous surgery, muscle weakness, proprioceptive disorders, and vertebral instability...
March 2017: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://www.readbyqxmd.com/read/28140832/assistive-technology-needs-functional-difficulties-and-services-utilization-and-coordination-of-children-with-developmental-disabilities-in-the-united-states
#9
Sue C Lin, Robert S Gold
Assistive technology (AT) enhances the ability of individuals with disabilities to be fully engaged in activities at home, at school, and within their communities-especially for children with developmental disabilities (DD) with physical, sensory, learning, and/or communication impairments. The prevalence of children with DD in the United States has risen from 12.84% in 1997 to 15.04% in 2008. Thus, it is important to monitor the status of their AT needs, functional difficulties, services utilization, and coordination...
January 31, 2017: Assistive Technology: the Official Journal of RESNA
https://www.readbyqxmd.com/read/28005410/results-of-a-medicare-bundled-payments-for-care-improvement-initiative-for-chronic-obstructive-pulmonary-disease-readmissions
#10
Surya P Bhatt, J Michael Wells, Anand S Iyer, deNay P Kirkpatrick, Trisha M Parekh, Lauren T Leach, Erica M Anderson, J Greg Sanders, Jessica K Nichols, Cindy C Blackburn, Mark T Dransfield
RATIONALE: Approximately 20% of Medicare beneficiaries hospitalized for acute exacerbations of chronic obstructive pulmonary disease (COPD) are readmitted within 30 days of discharge. In addition to implementing penalties for excess readmissions, the U.S. Centers for Medicare and Medicaid Services has developed Bundled Payments for Care Improvement (BPCI) initiatives to improve outcomes and control costs. OBJECTIVES: To evaluate whether a comprehensive COPD multidisciplinary intervention focusing on inpatient, transitional, and outpatient care as part of our institution's BPCI participation would reduce 30-day all-cause readmission rates for COPD exacerbations and reduce overall costs...
May 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27905888/medicare-program-end-stage-renal-disease-prospective-payment-system-coverage-and-payment-for-renal-dialysis-services-furnished-to-individuals-with-acute-kidney-injury-end-stage-renal-disease-quality-incentive-program-durable-medical-equipment-prosthetics-orthotics
#11
(no author information available yet)
This rule updates and makes revisions to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar year 2017. It also finalizes policies for coverage and payment for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury. This rule also sets forth requirements for the ESRD Quality Incentive Program, including the inclusion of new quality measures beginning with payment year (PY) 2020 and provides updates to programmatic policies for the PY 2018 and PY 2019 ESRD QIP...
November 4, 2016: Federal Register
https://www.readbyqxmd.com/read/27870667/the-role-of-dedicated-musculoskeletal-urgent-care-centers-in-reducing-cost-and-improving-access-to-orthopaedic-care
#12
Travis J Anderson, Peter L Althausen
OBJECTIVES: Over the past few years, the United States has seen the rapid growth of dedicated musculoskeletal urgent care centers owned and operated by individual orthopaedic practices. In June of 2014, our practice opened the first dedicated orthopaedic urgent care in the region staffed by physician assistants and supervised by orthopaedic surgeons. Our hypothesis is that such centers can safely improve orthopaedic care for ambulatory orthopaedic injuries, decrease volume for overburdened emergency departments (EDs), reduce wait times and significantly decrease the cost of care while improving access to orthopaedic specialists...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27694354/the-abcds-of-managing-morbidly-obese-patients-in-intensive-care-units
#13
Luis A Berrios
More than one-third of the US adult population and 17% of the youth are now obese, and obesity is associated with more than $147 billion a year in health care costs. Critical care nurses should understand the physiological differences and practice guidelines for patients with a body mass index greater than 30. The ABCD approach encompasses key clinical concepts in the management of critically ill obese and morbidly obese patients, including management of airways and breathing, minimizing nurses' back and other injuries, increasing awareness of bias, circulation problems, risks of decubitus ulcers and other skin breakdown, differences in drug calculations and metabolism, limitations in diagnostic equipment and imaging, diet and nutritional recommendations, and concerns with durable medical equipment...
October 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27688109/geographic-variation-in-medicare-treatment-costs-and-outcomes-for-advanced-head-and-neck-cancer
#14
Vasu Divi, Li Tao, Alice Whittemore, Ingrid Oakley-Girvan
BACKGROUND: Advanced head and neck cancer (HNC) is a complex group of diseases that requires the input and coordination of multiple providers. While there are general guidelines for treatment, there is also considerable variation in how patients are treated, and how long they survive after treatment. It is unclear how the treatment variations relate to treatment costs and survival. METHODS: We identified 3678 Medicare patients with advanced HNC treated in 12 US regions between 2004 and 2009 using the linked database containing Medicare and Surveillance Epidemiology and End Results (SEER) data...
October 2016: Oral Oncology
https://www.readbyqxmd.com/read/27662393/measuring-the-cost-implications-of-the-collaborative-accountable-care-initiative-in-texas
#15
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
https://www.readbyqxmd.com/read/27479830/providing-orthopaedic-care-for-the-incarcerated-obstacles-and-challenges
#16
REVIEW
Shafic A Sraj
Scant information on healthcare delivery to inmates is available in the medical literature. Healthcare provision to inmates has different rules than that for the general population and presents particular challenges for orthopaedic surgeons because of the nature of this population and restrictions imposed by their confinement. This population is typically of a lower socioeconomic status and is less well educated, has accumulated injuries over a lifetime, and has a considerable prevalence of communicable and blood-borne diseases, along with a high prevalence of smoking and high-risk behavior, such as drug-seeking, abuse, and self-inflicted injury...
September 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27153374/polyvinyl-chloride-plastisol-breast-phantoms-for-ultrasound-imaging
#17
Isabela Miller de Carvalho, Lucas Lobianco De Matheo, José Francisco Silva Costa Júnior, Cecília de Melo Borba, Marco Antonio von Krüger, Antonio Fernando Catelli Infantosi, Wagner Coelho de Albuquerque Pereira
Ultrasonic phantoms are objects that mimic some features of biological tissues, allowing the study of their interactions with ultrasound (US). In the diagnostic-imaging field, breast phantoms are an important tool for testing performance and optimizing US systems, as well as for training medical professionals. This paper describes the design and manufacture of breast lesions by using polyvinyl chloride plastisol (PVCP) as the base material. Among the materials available for this study, PVCP was shown to be stable, durable, and easy to handle...
August 2016: Ultrasonics
https://www.readbyqxmd.com/read/26885569/the-evolution-of-prostacyclins-in-pulmonary-arterial-hypertension-from-classical-treatment-to-modern-management
#18
REVIEW
Charles D Burger, Lesley D'Albini, Susan Raspa, Janis A Pruett
Prostacyclins for the treatment of pulmonary arterial hypertension (PAH) have historically been covered under the insurance medical benefit because they require durable medical equipment and are administered by an intravenous, subcutaneous, or inhalation route. However, more treatment options that target the prostacyclin pathway have become available. As the number and type of options expand, an improved understanding of these drugs will aid managed care decision makers in evaluating new treatment options and making clinically sound and cost-effective treatment decisions...
January 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/26717582/medicare-program-prior-authorization-process-for-certain-durable-medical-equipment-prosthetics-orthotics-and-supplies-final-rule
#19
(no author information available yet)
This final rule establishes a prior authorization program for certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) items that are frequently subject to unnecessary utilization. This rule defines unnecessary utilization and creates a new requirement that claims for certain DMEPOS items must have an associated provisional affirmed prior authorization decision as a condition of payment. This rule also adds the review contractor's decision regarding prior authorization of coverage of DMEPOS items to the list of actions that are not initial determinations and therefore not appealable...
December 30, 2015: Federal Register
https://www.readbyqxmd.com/read/26673912/a-scoping-literature-review-the-state-of-knowledge-on-home-care-equipment-and-supplies
#20
Kimberly D Fraser, Jonathan Lai, Catherine Nissen, Queenie Choo, Jamie Davenport, Abram Gutscher
We explored the state of knowledge on home care supplies and equipment because not much is known about this topic. We used a scoping review for the literature review because it was the most appropriate approach considering the state of the literature. We searched for articles published in both the gray and peer-reviewed literature. We established five overarching themes based on the findings. These were supply management, durable medical equipment, wound care, best practices, and costs. This review demonstrates that although knowledge about home care supplies and equipment is growing, it is still an understudied area...
2015: Care Management Journals: Journal of Case Management ; the Journal of Long Term Home Health Care
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