Articles tagged with Health Care Delivery
A systematic review found that private healthcare is not superior to the public sector in terms of efficiency, accountability, or effectiveness. The public sector often lacks timeliness and hospitality, while both sectors have financial barriers to care.
RAND Corporation researchers suggest that existing administrative data may be unable to detect the effects of health IT. To accurately gauge impact, new measurement tools are needed. Health IT can lead to greater convenience, access and quality while lowering costs if it supports teamwork, care coordination and innovative approaches.
Researchers combined data from 11 integrated health systems to form the SUPREME-DM DataLink, a unique resource for population-based diabetes research and clinical trials. The database contains over 1.1 million people with diabetes, mirroring the general population, allowing for more effective prevention and treatment strategies.
A new study found that companion presence in physician visits hinders communication for older adults with poor mental health, leading to shorter visits and less patient-centered care. The research suggests a need for greater attention to primary care infrastructure to support delivery of mental health care.
A study by Brigham and Women's Hospital found that doctors who dictated their patient notes had significantly worse quality of care compared to those who used structured documentation. Doctors who used free-text notes had better quality of care in providing influenza vaccinations.
A new report shows that integrated heart failure services can reduce unwanted hospital deaths, allowing many patients to die at home. The study found that specialist nurses played a pivotal role in discussing end-of-life care with patients, enabling them to make plans and set their affairs in order.
The US Commission on a High Performance Health System proposes a community-based initiative to enhance health and reduce spending, focusing on chronically ill patients and quality improvement efforts. The plan aims to save $184 billion in health spending over the next decade by improving care for patients with multiple chronic conditions.
Community health plans have broken down silos of care to coordinate among providers and directly engage with patients, leading to successful transitions. The Avalere report highlights five practices that facilitate care transition programs, including using data to tailor programs to patients' needs.
The Merkin Family Foundation will fund promising Broad Institute scientists as Merkin Institute Fellows, supporting bold research in areas like stem cell biology and regenerative medicine. The program aims to create a pipeline of talented researchers advancing science and medicine at the Broad Institute.
A new study found that communication problems between patients and their care providers are more prevalent than traditional medical errors, leading to significant harms. Patients often take positive steps to address issues, but some become more hesitant to seek care.
A study published in Journal of Hospital Medicine reveals that 82% of PICU bed-time is used for value-added purposes, while 75% of full PICUs have at least one non-value-added bed. The research provides an understanding of opportunities for improvement to optimize patient flow and resource utilization.
A study by Michigan Oncology Quality Consortium found that most practices followed guidelines for breast, colorectal, and lung cancers, but had gaps in managing symptoms and end-of-life care. To improve quality, the consortium initiated a project to provide palliative care delivery.
A systematic review found that a difference of more than 10mmHg or 15mmHg in systolic blood pressure between arms is associated with increased risk of vascular disease and mortality. The study supports the need for two-arm blood pressure checks to become the norm.
A study led by Salomeh Keyhani found no evidence to support the notion that higher regional healthcare costs indicate inappropriate care. The researchers reviewed 114,830 peer-reviewed articles and concluded that there is a lack of scientific evidence to design policies that reduce unnecessary care.
A network approach improved outcomes for children with inflammatory bowel disease (IBD), increasing remission rates from 55% to 68%. The ImproveCareNow network implemented quality improvement efforts, leading to improvements in care processes and patient outcomes.
Researchers project that the cost of family health insurance premiums will surpass household income by 2033, with a current estimate suggesting this could happen as early as 2021. The study highlights the challenges and opportunities facing the US healthcare environment following the passage of the Patient Protection and Affordable Car...
A two-year behavioral program implemented by health educators in physician offices resulted in significant, yet modest, reductions in waist circumference among obese patients. The intervention showed greater reductions in men, while women experienced smaller and less sustained reductions.
The ACGME's new accreditation system will evaluate residents' core competencies in six areas: patient care, medical knowledge, and interpersonal skills. Teaching institutions must develop learning outcomes and submit reports every six months to document resident progress.
A new UCLA study found that a widely used assessment tool for community health centers may not accurately measure the quality of diabetes care. The study examined 30 Los Angeles County health centers and found no correlation between the tool's scores and the actual quality of care.
Clinicians have 10 proposed rights regarding their electronic health record use, including uninterrupted access and succinct summaries of patient health histories. These rights aim to ensure safe, efficient, and effective use of electronic health records.
The American Academy of Orthopaedic Surgeons has established a new credentialing process for doctors who plan to travel internationally to disaster sites. The Disaster Responders Certification Program provides training and certification for orthopaedic surgeons, with three levels of certification available. A study reports long-term po...
Two studies suggest that cleansing umbilical cord with chlorhexidine solution during and after birth can reduce sepsis and mortality in babies in rural parts of Sindh province, Pakistan. The interventions showed a significant reduction in infections and mortality risk, with no effect seen from handwashing alone.
A new study published by Kaiser Permanente found that older women who lose more than two inches in height face a higher risk of fractures and death. The research suggests that clinicians should consider bone density testing, counseling, and treatment to help prevent fractures. Women who lost more than two inches in height were 50% more...
A study published in Archives of Ophthalmology found that commercial insurance was the most frequent payer of emergency department outpatient services in Florida, followed by self-pay and Medicaid. The data suggest a shift towards Medicaid as patients move into eligible categories, which may impact eye care delivery models in the state.
Christian Davis Furman, a leading geriatrician at UofL, has been chosen for the CMS Innovation Advisors Program to enhance healthcare delivery and reduce costs. She will receive a stipend of up to $20,000 to support her activities during the one-year program.
A study of nurses and physicians in ICUs found that perceived inappropriateness of care was common, associated with inadequate decision sharing, communication, and job autonomy. The main reported reason for perceived inappropriateness of care was a mismatch between the level of care and the expected patient outcome.
Physician-defined patient complexity differs from common diagnosis-based measures, highlighting social and behavioral contexts that impact primary care. Primary care physicians designated about one-quarter of their patients as complex, with older, more experienced physicians reporting higher proportions.
A study at Beth Israel Deaconess Medical Center found that patients are overwhelmingly interested in accessing their doctors' notes, but doctors are cautious about the impact on their workflow. Patients reported benefits such as improved medication adherence and feeling more in control of their care.
A study published in Medical Care explores ways to empower patients and transform cancer care systems to improve quality. Researchers propose new approaches, including accountable care and personal health records, to address racial disparities and wasteful overuse.
Research on funding models in primary care practices found no association with superior preventive care delivery. Instead, female physicians, smaller patient loads, and electronic reminders were linked to better health outcomes.
The study found that the nation's largest for-profit chains operate with significantly lower staffing levels than non-profit and government-owned nursing homes, leading to poorer quality of care. The top 10 chains have a strategy of keeping labor costs low to increase profits, resulting in more deficiencies and serious deficiencies.
A community-based care coordination approach combining evidence-based science and asthma education has shown improvements in health outcomes, particularly among low-income and minority children. The program demonstrated reductions in emergency room visits and hospitalizations, as well as increased parent empowerment and environmental t...
A partnership between Xavier University, Daughters of Charity Services and Children's Health Fund is bringing reliable healthcare to children with asthma in New Orleans. The program uses a unique approach to deliver evidence-based care through community health centers and mobile clinics.
New Zealand's strategic approach to health care, from patient to provider and community, has enabled the development of integrated care services. The country's experience with electronic medical records and health IT systems has helped make it a leader in overall quality of care delivery.
A recent study reveals that nearly half of physician practices in the US do not meet national standards for 'medical homes', a model of care that aims to provide higher quality and cost-efficient care. The lack of access to these medical homes disproportionately affects vulnerable populations, including those living below the poverty l...
A survey of 87 mostly developing countries shows improvement in awareness of mental health issues among leaders, but poor political will and limited resources remain major barriers. Successful examples include mental health campaigns in Nigeria and Uganda's integration of services into primary care.
A QUT program trains nurses to provide end-of-treatment care plans for cancer patients, reducing the need for ongoing information and emotional support. The intervention also leads to lower proportions of patients requiring emotional support and improved GP feedback on care plans.
A new study found that patients who visited physical therapists directly had fewer visits and lower overall costs, while maintaining continuity of care. The study analyzed 62,707 episodes of physical therapy and suggested eliminating physician referral requirements for physical therapist services.
A study by UCLA researchers found that primary care physicians who treat Latino patients are less likely to believe they can provide high-quality care. The challenges include inadequate time with patients, lack of affordability, non-adherence to treatments, and difficulties in communication. Implementing the Affordable Care Act may add...
A new report highlights significant disparities in health care access and outcomes among vulnerable populations. The Commonwealth Fund Commission recommends a three-pronged policy framework to ensure adequate access, financial protection, and improved coordination of care. This will help reduce rates of preventable hospital admissions ...
A study found that almost 60% of people who have a stroke experience one or more falls afterwards, with most occurring in their own homes. To address this risk, experts recommend proactive measures such as assessments to create fall-proof homes and post-stroke rehabilitation to test balance and learn exercises to prevent falls.
The Austen BioInnovation Institute's Accountable Care Community (ACC) initiative aims to improve the health status and healthcare delivery in Akron, focusing on chronic diseases such as diabetes and obesity. The project will gather a group of health providers from nearly every community outpost to develop a blueprint guiding Akron's de...
A survey of US primary care physicians reveals that nearly half believe their patients receive too much medical care, while 52% think the amount is just right. The authors suggest that reimbursement systems should encourage longer visits to reduce pressures on physicians.
A recent study by Kaiser Permanente found that women aged 65-69 who break a hip are five times more likely to die within a year than those who don't. The study also discovered that for women aged 70-79, a hip fracture doubles the risk of dying, while for those aged 80 and older in excellent health, it nearly triples. These findings hig...
Tens of billions committed globally to improve the health of women and children, with over $11 billion from poorest countries. The Every Woman, Every Child effort aims to reduce death tolls and improve health outcomes through policy and service delivery commitments.
The Schwartz Center for Compassionate Healthcare proposes an agenda to improve compassionate care in the US healthcare system. The center's recommendations include measuring compassionate care through a national quality standard, funding comparative effectiveness research, and developing comprehensive training programs.
A review article by BUSM professor Judith A. Linden outlines comprehensive protocols for evaluating and treating adult victims of sexual assault in emergency departments and primary care settings. The article highlights the importance of evidence collection, emotional support, and medical follow-up appointments to provide optimal care.
Japan has seen a recent decline in mortality rates for adult men and women, falling behind countries like Sweden, Italy, and Australia. The main explanations for this trend include high tobacco consumption, rising body mass index, and increasing suicide rates.
A study in PLoS Medicine found significant improvements in Afghanistan's health care services between 2004 and 2008, particularly in capacity and delivery of care. However, the authors warn that security issues threaten progress and the likelihood of Afghanistan emerging from its fragile status.
A new patient-centered medical home (PCMH) model has shown significant improvement in diabetes management, increasing adherence to evidence-based care guidelines and clinical outcomes. The study found a notable increase in patients receiving essential services such as yearly exams and vaccinations, leading to better health outcomes.
Using a dataset of 873 children's heart rate, temperature, and oxygen saturation measurements, researchers developed data fusion models that predicted the severity of their illness with moderate accuracy. The best-performing model had a sensitivity of 79% and specificity of 75.8%, outperforming existing scoring systems.
A lack of understanding about HPV vaccination and its link to future cervical screening has been found among parents and girls in the UK. Despite being effective against two high-risk HPV types, vaccinated individuals still require regular cervical screenings to protect against other strains that can cause cancer.
Hospitals in US territories demonstrate worse performance on core processes for acute myocardial infarction, heart failure, and pneumonia compared to hospitals in the US. The territories have higher mortality rates and lower performance measures for patients discharged after these conditions.
Project ECHO demonstrates that primary care providers can be trained to manage complex chronic conditions via videoconferencing technology, expanding their ability to treat very sick patients. The model has been shown to improve treatment outcomes and reduce racial and ethnic disparities in minority communities.
A study of over 2,900 pediatric patients found that 12% returned to the ER within six months of their initial visit, despite having an outpatient mental health provider. The majority of ER visits stemmed from behavioral problems or minor psychiatric crises.
A recent study indicates that prolonged sleep deprivation among doctors can result in higher rates of surgical complications. The authors suggest establishing minimum uninterrupted sleep hours as a best practice standard to ensure patient safety.
A study found that areas with higher levels of primary care physicians had modestly lower death rates and fewer preventable hospitalizations among Medicare beneficiaries. Beneficiaries in high-primary-care-physician areas had 6% lower ACSC hospitalization rates compared to low-primary-care-physician areas.
A telemedicine intervention in ICUs was associated with lower hospital and ICU mortality, lower rates of preventable complications, and shorter hospital and ICU lengths of stay. The study found that the tele-ICU team improved best clinical practice adherence for critical care procedures, leading to better patient outcomes.
Researchers found that heart-related hospitalizations among Medicare beneficiaries decreased from 1998 to 2008, with coronary artery disease and heart attack seeing significant declines. However, cardiac arrhythmia hospitalizations increased, while chronic bronchitis hospitalizations rose.
Dr. Ed Wagner receives the prestigious William B. Graham Prize for his work in chronic illness management, cancer care, and patient-centered care. The prize recognizes his significant contributions to studying how best to provide healthcare.