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Coordination of care

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93 papers 0 to 25 followers
By Jamie Jarmul Md / PhD student at UNC - Chapel Hill, PhD in Health Policy and Management
https://www.readbyqxmd.com/read/27512721/factors-associated-with-emergency-department-visits-a-multistate-analysis-of-adult-fee-for-service-medicaid-beneficiaries
#1
Parul Agarwal, Thomas K Bias, Suresh Madhavan, Nethra Sambamoorthi, Stephanie Frisbee, Usha Sambamoorthi
OBJECTIVE: The objective of this study was to examine the association of patient- and county-level factors with the emergency department (ED) visits among adult fee-for-service (FFS) Medicaid beneficiaries residing in Maryland, Ohio, and West Virginia. METHODS: A cross-sectional design using retrospective observational data was implemented. Patient-level data were obtained from 2010 Medicaid Analytic eXtract files. Information on county-level health-care resources was obtained from the Area Health Resource file and County Health Rankings file...
January 2016: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/27552616/association-of-integrated-team-based-care-with-health-care-quality-utilization-and-cost
#2
COMPARATIVE STUDY
Brenda Reiss-Brennan, Kimberly D Brunisholz, Carter Dredge, Pascal Briot, Kyle Grazier, Adam Wilcox, Lucy Savitz, Brent James
IMPORTANCE: The value of integrated team delivery models is not firmly established. OBJECTIVE: To evaluate the association of receiving primary care in integrated team-based care (TBC) practices vs traditional practice management (TPM) practices (usual care) with patient outcomes, health care utilization, and costs. DESIGN: A retrospective, longitudinal, cohort study to assess the association of integrating physical and mental health over time in TBC practices with patient outcomes and costs...
August 23, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27724889/roles-of-disease-severity-and-post-discharge-outpatient-visits-as-predictors-of-hospital-readmissions
#3
Hao Wang, Carol Johnson, Richard D Robinson, Vicki A Nejtek, Chet D Schrader, JoAnna Leuck, Johnbosco Umejiego, Allison Trop, Kathleen A Delaney, Nestor R Zenarosa
BACKGROUND: Risks prediction models of 30-day all-cause hospital readmissions are multi-factorial. Severity of illness (SOI) and risk of mortality (ROM) categorized by All Patient Refined Diagnosis Related Groups (APR-DRG) seem to predict hospital readmission but lack large sample validation. Effects of risk reduction interventions including providing post-discharge outpatient visits remain uncertain. We aim to determine the accuracy of using SOI and ROM to predict readmission and further investigate the role of outpatient visits in association with hospital readmission...
October 10, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27858564/preparing-for-value-based-payment-a-stepwise-approach-for-cancer-centers
#4
Kerin B Adelson, Salimah Velji, Kavita Patel, Basit Chaudhry, Catherine Lyons, Rogerio Lilenbaum
Most cancer centers are ill-equipped to pursue value-based payment (VBP) because of limited information on their population's cost of care. Herein, we outline the stepwise approach used by Smilow Cancer Hospital at Yale-New Haven in our pursuit of better value care. First, we addressed institutional barriers. A move toward value required demonstration to Yale-New Haven Health System leadership that OCM would improve patient care, fund new infrastructure, and provide the opportunity to gain experience with VBP without a major threat to the financial stability of the health system...
October 2016: Journal of Oncology Practice
https://www.readbyqxmd.com/read/27856087/hemodialysis-hospitalizations-and-readmissions-the-effects-of-payment-reform
#5
Kevin F Erickson, Wolfgang C Winkelmayer, Glenn M Chertow, Jay Bhattacharya
BACKGROUND: In 2004, the Centers for Medicare & Medicaid Services changed reimbursement for physicians and advanced practitioners caring for patients receiving hemodialysis from a capitated to a tiered fee-for-service system, encouraging increased face-to-face visits. This early version of a pay-for-performance initiative targeted a care process: more frequent provider visits in hemodialysis. Although more frequent provider visits in hemodialysis are associated with fewer hospitalizations and rehospitalizations, it is unknown whether encouraging more frequent visits through reimbursement policy also yielded these benefits...
November 14, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/23804841/enhancing-quality-of-primary-care-using-an-ambulatory-icu-to-achieve-a-patient-centered-medical-home
#6
Joy Lewis, Alex Hoyt, Rose M Kakoza
RESEARCH OBJECTIVE: The Patient-Centered Medical Home (PCMH) has been advocated as a model to address the lack of coordination and continuity in the health system. However, implementation in practice has been slow and incompletely described. STUDY DESIGN: Patients referred into the program received intensive nurse follow-up focused on medication adherence, care coordination, and education. Patients graduate from the program when treatment goals are met. POPULATION STUDIED: The first 100 patients enrolled into the PCMH focused program of a primary care clinic in an urban, academic medical center...
October 1, 2011: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/24195142/new-care-model-targets-high-utilizing-complex-patients-frees-up-emergency-providers-to-focus-on-acute-care-concerns
#7
(no author information available yet)
Hennepin County Medical Center in Minneapolis, MN, has developed a new model of care, designed to meet the needs of high-utilizing hospital and ED patients with complex medical, social, and behavioral needs.The Coordinated Care Center (CCC) provides easy access to patients with a history of high utilization, and delivers multidisciplinary care in a one-stop-shop format. In one year, the approach has slashed ED visits by 37%, freeing up emergency providers to focus on patients with acute needs. In-patient care stays are down by 25%...
November 2013: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/27864481/meaningful-use-in-chronic-care-improved-diabetes-outcomes-using-a-primary-care-extension-center-model
#8
Samuel Cykert, Ann Lefebvre, Thomas Bacon, Warren Newton
BACKGROUND: The effect of practice facilitation that provides onsite quality improvement (QI) and electronic health record (EHR) coaching on chronic care outcomes is unclear. This study evaluates the effectiveness of such a program-similar to an agricultural extension center model-that provides these services. METHODS: Through the Health Information Technology for Economic and Clinical Health (HITECH) portion of the American Recovery and Reinvestment Act, the North Carolina Area Health Education Centers program became the Regional Extension Center for Health Information Technology (REC) for North Carolina...
November 2016: North Carolina Medical Journal
https://www.readbyqxmd.com/read/27702961/rethinking-thirty-day-hospital-readmissions-shorter-intervals-might-be-better-indicators-of-quality-of-care
#9
David L Chin, Heejung Bang, Raj N Manickam, Patrick S Romano
Public reporting and payment programs in the United States have embraced thirty-day readmissions as an indicator of between-hospital variation in the quality of care, despite limited evidence supporting this interval. We examined risk-standardized thirty-day risk of unplanned inpatient readmission at the hospital level for Medicare patients ages sixty-five and older in four states and for three conditions: acute myocardial infarction, heart failure, and pneumonia. The hospital-level quality signal captured in readmission risk was highest on the first day after discharge and declined rapidly until it reached a nadir at seven days, as indicated by a decreasing intracluster correlation coefficient...
October 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27398874/effectiveness-of-a-multicomponent-quality-improvement-strategy-to-improve-achievement-of-diabetes-care-goals-a-randomized-controlled-trial
#10
Mohammed K Ali, Kavita Singh, Dimple Kondal, Raji Devarajan, Shivani A Patel, Roopa Shivashankar, Vamadevan S Ajay, A G Unnikrishnan, V Usha Menon, Premlata K Varthakavi, Vijay Viswanathan, Mala Dharmalingam, Ganapati Bantwal, Rakesh Kumar Sahay, Muhammad Qamar Masood, Rajesh Khadgawat, Ankush Desai, Bipin Sethi, Dorairaj Prabhakaran, K M Venkat Narayan, Nikhil Tandon
BACKGROUND: Achievement of diabetes care goals is suboptimal globally. Diabetes-focused quality improvement (QI) is effective but remains untested in South Asia. OBJECTIVE: To compare the effect of a multicomponent QI strategy versus usual care on cardiometabolic profiles in patients with poorly controlled diabetes. DESIGN: Parallel, open-label, pragmatic randomized, controlled trial. (ClinicalTrials.gov: NCT01212328). SETTING: Diabetes clinics in India and Pakistan...
September 20, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27373527/creating-a-lesion-specific-roadmap-for-ambulatory-care-following-surgery-for-complex-congenital-cardiac-disease
#11
Gil Wernovsky, Stacey L Lihn, Melissa M Olen
Over the past 20 years, the successes of neonatal and infant surgery have resulted in dramatically changed demographics in ambulatory cardiology. These school-aged children and young adults have complex and, in some cases, previously unexpected cardiac and non-cardiac consequences of their surgical and/or transcatheter procedures. There is a growing need for additional cardiac and non-cardiac subspecialists, and coordination of care may be quite challenging. In contrast to hospital-based care, where inpatient care protocols are common, and perioperative expectations are more or less predictable for most children, ambulatory cardiologists have evolved strategies of care more or less independently, based on their education, training, experience, and individual styles, resulting in highly variable follow-up strategies...
July 4, 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/27039304/the-use-and-impact-of-quality-of-life-assessment-tools-in-clinical-care-settings-for-cancer-patients-with-a-particular-emphasis-on-brain-cancer-insights-from-a-systematic-review-and-stakeholder-consultations
#12
Sarah King, Josephine Exley, Sarah Parks, Sarah Ball, Teresa Bienkowska-Gibbs, Calum MacLure, Emma Harte, Katherine Stewart, Jody Larkin, Andrew Bottomley, Sonja Marjanovic
PURPOSE: Patient-reported data are playing an increasing role in health care. In oncology, data from quality of life (QoL) assessment tools may be particularly important for those with limited survival prospects, where treatments aim to prolong survival while maintaining or improving QoL. This paper examines the use and impact of using QoL measuresĀ on health care of cancer patients within a clinical setting, particularly those with brain cancer. It also examines facilitators and challenges, and provides implications for policy and practice...
September 2016: Quality of Life Research
https://www.readbyqxmd.com/read/27184992/encouraging-patient-centered-care-by-including-quality-of-life-questions-on-pre-encounter-forms
#13
Becky A Purkaple, James W Mold, Sixia Chen
PURPOSE: Patient participation in clinical decision making improves outcomes, including quality of life (QOL), but the typical problem-oriented approach may impede consideration of functional goals. We wondered if patients could encourage primary care physicians to pay attention to their QOL goals by writing them on pre-encounter forms. METHODS: We conducted a randomized controlled trial comparing the impact of 2 different pre-visit questionnaires on the content of patient-physician encounters in a family medicine practice at an academic medical center...
May 2016: Annals of Family Medicine
https://www.readbyqxmd.com/read/27185320/pediatrician-preferences-local-resources-and-economic-factors-influence-referral-to-a-subspecialty-access-clinic
#14
Matthew D Di Guglielmo, Jay S Greenspan, Diane J Abatemarco
BACKGROUND: Pediatric patients seek timely access to subspecialty care within a complex delivery system while facing barriers: distance, economics, and clinician shortages. Aim We examined stakeholder perceptions about solutions to the access challenge. We engaged over 300 referring primary care pediatricians in the evaluation of Access Clinics at an academic children's hospital. METHODS: Using an anonymous online survey, we asked pediatricians about their and their patients' experiences and analyzed factors that may influence referrals...
November 2016: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/27220370/feasibility-of-a-team-approach-to-complex-congenital-heart-defect-neurodevelopmental-follow-up-early-experience-of-a-combined-cardiology-neonatal-intensive-care-unit-follow-up-program
#15
Olena Chorna, H Scott Baldwin, Jamie Neumaier, Shirley Gogliotti, Deborah Powers, Amanda Mouvery, David Bichell, Nathalie L Maitre
Infants with complex congenital heart disease are at high risk for poor neurodevelopmental outcomes. However, implementation of dedicated congenital heart disease follow-up programs presents important infrastructure, personnel, and resource challenges. We present the development, implementation, and retrospective review of 1- and 2-year outcomes of a Complex Congenital Heart Defect Neurodevelopmental Follow-Up program. This program was a synergistic approach between the Pediatric Cardiology, Cardiothoracic Surgery, Pediatric Intensive Care, and Neonatal Intensive Care Unit Follow-Up teams to provide a feasible and responsible utilization of existing infrastructure and personnel, to develop and implement a program dedicated to children with congenital heart disease...
July 2016: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/27266868/a-cluster-randomized-trial-of-a-transition-intervention-for-adolescents-with-congenital-heart-disease-rationale-and-design-of-the-chapter-2-study
#16
Andrew S Mackie, Gwen R Rempel, Adrienne H Kovacs, Miriam Kaufman, Kathryn N Rankin, Ahlexxi Jelen, Cedric Manlhiot, Samantha J Anthony, Joyce Magill-Evans, David Nicholas, Renee Sananes, Erwin Oechslin, Dimi Dragieva, Sonila Mustafa, Elina Williams, Michelle Schuh, Brian W McCrindle
BACKGROUND: The population of adolescents and young adults with congenital heart disease (CHD) is growing exponentially. These survivors are at risk of late cardiac complications and require lifelong cardiology care. However, there is a paucity of data on how to prepare adolescents to assume responsibility for their health and function within the adult health care system. Evidence-based transition strategies are required. METHODS: The Congenital Heart Adolescents Participating in Transition Evaluation Research (CHAPTER 2) Study is a two-site cluster randomized clinical trial designed to evaluate the efficacy of a nurse-led transition intervention for 16-17 year olds with moderate or complex CHD...
June 6, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/26978568/post-discharge-follow-up-characteristics-associated-with-30-day-readmission-after-heart-failure-hospitalization
#17
Keane K Lee, Jingrong Yang, Adrian F Hernandez, Anthony E Steimle, Alan S Go
BACKGROUND: Readmission within 30 days after hospitalization for heart failure (HF) is a major public health problem. OBJECTIVE: To examine whether timing and type of post-discharge follow-up impacts risk of 30-day readmission in adults hospitalized for HF. DESIGN: Nested matched case-control study (January 1, 2006-June 30, 2013). SETTING: A large, integrated health care delivery system in Northern California. PARTICIPANTS: Hospitalized adults with a primary diagnosis of HF discharged to home without hospice care...
April 2016: Medical Care
https://www.readbyqxmd.com/read/25702745/adapting-chronic-disease-care-for-the-underserved-innovations-in-the-safety-net
#18
Bianca Perez, Janelle Schrag
Safety-net hospitals are resource-constrained and serve complex patients yet are innovators in chronic disease care. Their strategies include personalized care, multidisciplinary teams, and information systems yielding real-time data. Safety-net providers are prime examples from which the health care community can learn to improve the delivery of chronic disease care.
February 2015: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/25759487/use-of-a-transition-of-care-coordinator-to-improve-ambulatory-follow-up-after-hospital-discharge
#19
Ruben Rhoades, Caitlin Dietsche, Rebecca Jaffe, Cara Reynolds, Michael Latreille, Albert Crawford, Lawrence Ward
No abstract text is available yet for this article.
May 2015: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/25755035/effects-of-primary-care-team-social-networks-on-quality-of-care-and-costs-for-patients-with-cardiovascular-disease
#20
Marlon P Mundt, Valerie J Gilchrist, Michael F Fleming, Larissa I Zakletskaia, Wen-Jan Tuan, John W Beasley
PURPOSE: Cardiovascular disease is the leading cause of mortality and morbidity in the United States. Primary care teams can be best suited to improve quality of care and lower costs for patients with cardiovascular disease. This study evaluates the associations between primary care team communication, interaction, and coordination (ie, social networks); quality of care; and costs for patients with cardiovascular disease. METHODS: Using a sociometric survey, 155 health professionals from 31 teams at 6 primary care clinics identified with whom they interact daily about patient care...
March 2015: Annals of Family Medicine
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