Articles tagged with Health Care Delivery
Changes to labor and delivery care systems, introducing expanded midwifery and streamlined obstetric staffing, led to significant decreases in primary and repeat cesarean delivery rates. This study suggests that modifying the traditional model of obstetric care can lower cesarean delivery rates while improving maternal safety.
A recent study published in Clinical Infectious Diseases found that the adjusted risk ratio for heart attacks among HIV-positive patients decreased from an 80% increased risk in 1996 to no increased risk in 2010-2011. The improved care and treatments led by Kaiser Permanente's early awareness of cardiovascular disease risks have result...
Researchers at the University of Missouri School of Medicine have developed a credible tool to assess medical students' ability to deliver patient-centered care. The Patient-centered Care - Objective Structured Clinical Exam (PCC-OSCE) evaluates behaviors such as effective communication, empathy, and active listening.
A five-year national trial will investigate interventions for patients with multiple chronic conditions, including chronic kidney disease, diabetes, and hypertension. The study aims to identify effective treatments for patients with coexistent diseases and implement integrated healthcare delivery models.
A landmark study found that training older adults in social media improves mental health and well-being by enhancing cognitive capacity, increasing self-competence, and combating isolation. The study showed that participants became more positive about computers, engaged in social activity, and had a stronger sense of personal identity.
A study of healthcare professionals reveals persistent barriers to effective transitional care, emphasizing the importance of patient education and provider accountability in reducing complications and rehospitalizations among older adults
A new survey of 11 countries found that Americans with Medicare have quicker access to specialist care than many other nations. However, the US population is also reported to be sicker compared to older adults in these countries.
Researchers studied 30,670 patients undergoing heart surgery across 27 hospitals and found that the lowest-cost hospitals had significantly lower mortality rates, shorter lengths of stay, and fewer post-operative complications. These findings suggest that initiatives improving quality of care may also reduce costs for this population.
A new study by RAND Corporation found that most community-based mental health providers lack the necessary training to address the specific needs of military veterans. The survey of 522 mental health providers revealed that only 13% met criteria for cultural competency and delivering evidence-based care.
The latest issue of Global Heart explores the challenges of delivering critical care in resource-limited settings, where cardiovascular disease is emerging rapidly. Key findings include the need for effective diagnostic resources and treatments for conditions like sepsis, ARDS, and pulmonary vascular disease.
Research suggests that hospital interventions can significantly reduce smoking rates, with around 14.5% of hospital admissions being smokers. Implementing routine smoking cessation support could prevent hundreds of thousands of premature deaths.
The Victorian Cardiac Outcomes Registry (VCOR) collects data on coronary angioplasty procedures to ensure high-quality care for cardiac patients. The registry aims to establish best practices in addressing cardiovascular disease in Victoria, with plans to expand its activities beyond coronary angioplasty.
Researchers found that patients who received more accessible primary care had better health-related quality of life and improvements comparable to eliminating early complications of diabetes. Women particularly benefited from doctors being more available, leading to stronger health improvements.
A study of 237 converting hospitals found that for-profit status improved financial margins, but no association was found with changes in care quality or patient outcomes. The findings suggest that regulators and policymakers should consider the potential benefits of for-profit conversions primarily on financial health.
A new study published in Journal of Palliative Medicine shows that inpatient palliative care can significantly lower hospitalization costs and the rate of readmissions. By providing expert care to seriously ill patients, hospitals can improve patient outcomes while reducing healthcare expenses.
A study analyzed data from over 100,000 deliveries and found that quality indicators were not correlated with hospital-level obstetric quality of care. Maternal and neonatal complications still varied significantly between hospitals, highlighting the need for improved care measures.
A new study from BIDMC found that while patients didn't message doctors more over time, the overall number of messages per doctor increased as more patients enrolled in secure patient web portals. Primary care doctors received 85% of email traffic, despite representing only 40% of the system.
Dr. Leana Wen calls for standardized medical training curriculum to address inadequate care for patients with disabilities. She emphasizes the importance of provider awareness and advocacy to counter prevalent stigma.
The September issue of Health Affairs explores accountable care systems worldwide, suggesting five international framework components. The article also examines the effectiveness of social networking in reducing body mass index and highlights the potential for hospital transition interventions to reduce readmissions.
A new patient management system at Kelowna General Hospital has reduced stroke bed days by over 25% and saved the hospital up to $800,000 per year. The program, called Proprietary Physician, involves coordinating care between doctors, nurses, and family members.
A University of Alberta researcher has found that frailty among critically ill adults is surprisingly common and associated with higher mortality rates and poorer quality of life. The study aims to provide clinicians with a bedside tool to assess frailty and improve patient care.
Researchers found that coordinated patient care can reduce hospital admissions among seniors and people with chronic conditions by 20% and emergency department use by 31%. Empowering patients through education and tools also improves care outcomes.
University of Leeds researchers found that a single missed care step can lead to a 46% increased chance of death within a month of discharge and a 74% increased chance of dying within one year. The nine identified pathways of care include pre-hospital electrocardiogram, aspirin prescription, and cardiac rehabilitation referral.
The Illinois Medicaid primary care case management program, implemented in 2006, was associated with substantial savings, reductions in inpatient and emergency care, and improvements in quality measures. The programs promoted preventive care, reduced redundancy of services, and improved chronic disease management.
A new study suggests that focusing on improving utilization rates and quality outcomes could help reduce US healthcare expenditures. Researchers analyzed Medicaid and commercial insurance claims in Vermont to evaluate the impact of patient-centered medical homes on inpatient services and cost of care.
China's rapid emergence as a global power has coincided with unprecedented challenges to its people's health, including rising chronic disease burdens and inefficient healthcare delivery. China must act now to tackle these time-bombs of illnesses or face the huge toll of largely preventable health loss suffered by high-income countries.
Researchers found that giving a prescription to stroke patients before discharge increases short- and long-term stroke prevention by 70% and 40% respectively. The study suggests simple interventions like handing over prescriptions can improve patient care.
The pilot program aims to increase colorectal cancer screening rates and follow-up care for patients served by community health centers. Nine national medical professional societies will join forces with the National Association of Community Health Centers and other organizations to support the effort.
A new commentary suggests China's high caesarean section rate is driven by factors such as provider incentives, cultural preferences, and the healthcare system's structure. The current rate of over 50% may be revised with the relaxation of the One Child Policy and an increase in repeat caesarean sections.
The study highlights the potential of increased adoption of complex care management to reduce healthcare costs and improve patient outcomes. However, several barriers, including fee-for-service payment systems and lack of resources in small practices, must be addressed.
A nationwide study published in Health Affairs reveals that for-profit home health agencies are significantly more expensive for Medicare than nonprofit agencies, with operating costs accounting for $752 of the difference. Despite their higher costs, for-profits delivered lower-quality care, with patients experiencing more repeat hospi...
A large UK study found that telephone triage systems do not reduce overall practice workload, despite increasing patient contacts. Patients who receive over-the-phone support are more likely to seek follow-up advice, with no cost savings or efficiency gains reported.
A Rutgers study found that household income is the primary factor influencing avoidable hospital visits in New Jersey, with higher incomes associated with lower rates of hospitalizations. The research also identified some low-income areas where hospital systems perform better than expected, suggesting that social determinants such as a...
A team of researchers will evaluate whether providing patients with COPD who experience rapid symptom deterioration with a care bundle improves hospital care and reduces readmission. The study aims to shape future health services to deliver better care for patients with chronic obstructive pulmonary disease (COPD) nationwide.
A recent study found that older registered nurses are working longer, accounting for a quarter of the surge in RNs in recent years. The trend extends nursing careers by 2.5 years after age 50, increasing the 2012 RN workforce by 136,000 people.
A new study published in BMJ Open found that premature newborns are 32% less likely to die if admitted to high volume neonatal units compared to low volume units. High volume units provide more experience and resources for clinicians, leading to better clinical outcomes for vulnerable infants.
A study published in BMJ Open found that preterm babies admitted to high volume neonatal units have a lower risk of dying compared to those admitted to low volume units. High volume units provide more care days, which may contribute to better clinical outcomes for vulnerable infants.
The Kaiser Permanente Southern California Outpatient Safety Net Program uses electronic health records to identify and address potential gaps in patient care, targeting issues such as medication interactions and follow-up tests. The program has shown promise in improving patient safety across various clinical conditions.
A 15-year study found that HIV-positive individuals with high CD4 cell counts had no excess risk of ischemic stroke compared to HIV-negative subjects. This suggests that maintaining immune function may protect against ischemic stroke.
The study found that hospitalizations for STEMI increased from 3.7 to 15.8 per 100,000 population over the decade, despite improvements in treatment intensity.
The Affordable Care Act (ACA) offers significant benefits for diabetes patients, including non-exclusion of pre-existing conditions and access to preventive services. The law also authorizes the creation of the National Diabetes Prevention Program, delivering evidence-based lifestyle change programs to prevent type 2 diabetes.
A NYU Langone expert suggests reforms to improve the VA health system's administration, staffing, and management. Key proposals include changing the culture, creating new scheduling systems, and hiring more primary care physicians to meet the growing demand.
The American Cancer Society has released guidelines to support primary care of estimated 2.8 million men with a history of prostate cancer in the US. The guidelines outline posttreatment clinical follow-up care for long-term and late effects, including health promotion, surveillance for recurrence, and management of physical and psycho...
The VA's decline in safe, effective patient-centered care can be fixed by refocusing on primary mission, ensuring quick screening of veterans on wait lists, and implementing a 'continuous healing relationship' strategy. Strong leadership and greater transparency are key to restoring trust in the system.
A study found that primary care physicians in team-based care models with electronic health records (EHRs) improved their quality of care more than those without EHRs. The patient-centered medical home (PCMH) model was associated with significant improvements in care, including better preventive screening and testing.
The study found that physician-led ACOs are more likely to have comprehensive care management programs and advanced IT capabilities. These organizations also tend to measure and report financial and quality performance at the clinician level.
The European Society of Anaesthesiology and Intensive Care invites speakers to challenge common assumptions about end-of-life care. Raanan Gillon presents a case for weighing individual patient circumstances over age when deciding on life-prolonging therapies.
The GME system faces transparency and accountability issues, with only 20.9% of residents practicing primary care. Recommendations propose fully funding the National Health Care Workforce Commission and requiring transparent spending of GME funds to support a more efficient physician workforce.
A study published in JAMA Surgery found that critical access hospitals have higher transfer rates after surgery compared to non-CAHs. However, the proportion of patients using post-acute care was similar between CAHs and non-CAHs, raising questions about the long-term implications for these facilities.
Practitioners can use shared decision making and motivational interviewing to adapt approaches for different clinical situations.
The Penn team advocates for adopting a four-stage design process to identify and solve healthcare issues, where in-house professionals combine passion and knowledge to drive change. This approach enables hospitals to create more effective solutions quickly and efficiently.
A new Center at Indiana University School of Medicine aims to equip the future health care workforce with tools of implementation science. This enables optimal care in a rapidly changing environment, focusing on patient-centered and cost-efficient care.
The Lancet Oncology publishes a major new Commission examining the challenges to effective cancer control in China, India, and Russia. The report highlights disparities in access to cancer care, poor quality of data collection, and barriers to improving cancer care related to social, economic, and environmental factors.
The innovative Healthy Aging Brain Center care model improves health outcomes and quality of care for older adults with cognitive impairment by reducing patients' behavioral and psychological symptoms. The model generates an annual net cost savings of up to $2,856 per patient, with potential nationwide cost savings of billions of dollars.
Two new dementia care models seek to decrease stress for caregivers, reduce health care costs and improve quality of care for older adults. Caregivers' close involvement with the medical team is a key feature of both models.
A study found a substantial decrease in the use of nuclear myocardial perfusion imaging from 2006 to 2011, with a 51% relative decline. The study suggests changing physician behavior and declines in incident coronary disease contributed to the reduction.
A national randomized clinical trial led by University of Pittsburgh experts found that a structured approach to diagnose and treat sepsis did not change survival rates. The study provides strong evidence that may change the way sepsis is diagnosed and treated, with prompt recognition and treatment being key to effective care.
Health outcomes for people with cystic fibrosis have improved dramatically following the implementation of quality improvement strategies, including patient education, nutritional support, and enhanced continuity of care. Key clinical outcomes, such as improved lung function and nutritional status, have also seen significant progress.
A RAND Corporation study found that better continuity of care for patients with diabetes, congestive heart failure, or emphysema leads to significant reductions in hospital emergency department visits and hospitalizations. This improvement can result in substantial cost savings for Medicare, up to $1.5 billion per year.
Depression is the leading cause of pediatric primary mental health admissions, accounting for $1.33 billion in annual hospital charges. The study also found that bipolar disorder and psychosis are common and expensive diagnoses, emphasizing the need for prevention and wellness measures.