Articles tagged with Health Care Delivery
A new study by George Washington University researchers finds no evidence that primary care physicians deliver less care to low-income and vulnerable patients. Despite critics' claims of substandard care, the study analyzed data from over 31,000 visits and found comparable care for all patients regardless of insurance status.
A Kaiser Permanente study found that women with low adiponectin levels prior to pregnancy are nearly seven times more likely to develop gestational diabetes. Low adiponectin levels were also linked to an increased risk of type 2 diabetes later in life.
Researchers found that commercial Alternative Quality Contract programs reduce spending and improve quality for Medicare beneficiaries served by participating providers. Providers in these plans implement systemic changes that result in higher-value care for all patients, not just those covered by the plan.
A study found that Massachusetts' commercial ACO contract was linked to reduced spending for Medicare beneficiaries served by participating providers. The initiative resulted in significant savings, particularly in outpatient care and testing, without compromising quality of care.
A large-scale hypertension program implemented in Northern California saw a near-doubling of blood pressure control rates between 2001 and 2009. The program's success was attributed to evidence-based guidelines and performance metrics, resulting in a higher rate of controlled blood pressure compared to national averages.
A growing population of older male prisoners requires better health and social care in prisons. The study found that many prisons lack policies for caring for older prisoners and fail to integrate health and social services.
The article highlights the need for a systematic framework of case identification, triage, and mental health interventions in post-disaster settings. Researchers found that standard treatments like pharmacotherapy and psychotherapy are effective, but psychosocial interventions have not been sufficiently evaluated.
A Kaiser Permanente study found that 16% higher vaccination rate in boys whose mothers received a flu shot, and 13% higher rate among those with a Pap screening. Boys from low-income neighborhoods, Hispanic, and enrolled in Medicaid programs also showed increased vaccine uptake.
Research by Northwestern Medicine cardiologist Jeffrey Goldberger combines evidence-based guidelines with tailored treatment for patients, reducing over-treatment and under-treatment. By analyzing clinical data and individual characteristics, physicians can make more precise decisions, leading to better patient care.
A systematic review of studies on long-term-stay patients' care found that interdisciplinary teams involving the patient's own physician and a pharmacist had better odds of improving nursing home care quality. The review, published in the Journal of the American Medical Directors Association, highlights the importance of team-based car...
The development of mobile-presence medical devices can help fill the void of limited healthcare infrastructure and access to medical professionals in remote locations. Pilot tests have successfully connected obstetricians with pregnant women in Bolivia, enabling real-time monitoring and diagnostic imaging.
A study by UCLA Center for Health Policy Research found that Californians with chronic conditions who have a regular doctor coordinating their care are more likely to get flu shots and receive preventive treatment. This 'medical home' model can help prevent chronic health conditions and reduce healthcare spending.
A regional system of organized stroke care delivery has improved outcomes for patients with stroke in Ontario, Canada. The study found a decrease in hospital admissions to long-term care facilities and death rates after stroke.
New research suggests healthcare professionals are not utilizing patient self-management support effectively, despite its potential to improve sustainability and reduce costs. The study found that while some patients benefited from the approach, it did not lead to significant improvements in patient outcomes or service usage.
A survey of nearly 1,000 primary care clinicians reveals significant disagreements between physicians and nurse practitioners on the scope of nurse practitioner responsibilities, including leadership roles, reimbursement levels, and service provision. The study highlights the need for further analysis of the economic implications and c...
New guidelines from the Canadian Task Force on Preventive Health Care recommend against routine screening for depression in adults without apparent symptoms. The recommendations are based on a lack of high-quality evidence on the benefits and harms of screening. Clinicians should be alert to the possibility of depression in patients wi...
The Hastings Center has released a new set of guidelines for good care near the end of life, aiming to improve communication, pain management, and treatment decisions. The guidelines clarify what is ethically permissible in the US regarding life-sustaining technologies and provide practical guidance for healthcare professionals.
A Kaiser Permanente study found that black women have a 47% higher risk of developing multiple sclerosis than white women, while Hispanic and Asian patients have lower risks. The study also showed that black women had a higher incidence of MS than white women of both genders.
A virtual patient advocate named Gabby delivers preconception care to African-American women through interactive conversations online. The pilot study found that 83% of identified risks were addressed or resolved by the users, resulting in improved pregnancy outcomes.
The new series aims to help achieve a Grand Challenge in Global Mental Health by redesigning health systems to integrate mental, neurological, and substance use disorders with other chronic-disease care. Integration is essential for achieving desired outcomes for priority health programs.
A team-based approach to primary care delivers improved patient outcomes, enhanced practice workflows, and increased physician satisfaction. By sharing responsibility and consulting with each other regularly, healthcare teams can provide more sensitive and responsive patient-centered care.
A matched cohort study found that MACE service patients had lower adverse event rates and shorter hospital stays compared to usual care. Functional status did not differ between groups, but MACE service showed better Care Transition Measure scores.
Kristina Fasteson Simacek, an Indiana University doctoral candidate, has won the Regenstrief Institute's People's Choice for Healthcare Delivery contest with her proposed computer application that translates doctor visits into actionable items. The app aims to improve patient care and reduce healthcare costs by providing a customized s...
A public-private partnership (PPP) successfully addressed the mental health needs of people in post-conflict northern Uganda, establishing five psycho-trauma centers and increasing clinic attendance from 300 to over 3,000. The most common diagnoses were depression, PTSD, epilepsy, and substance use disorders.
A study of over 4 million Veterans Health Administration records found that patients with severe psychosocial dysfunction and medical needs frequently visit the ER. Improved health outcomes may be achieved through increased spending on social services, such as housing subsidies and income supplements.
Current quality measures for outpatient settings neglect critical areas of high-quality care, including safety and effectiveness. Dr. Tara Bishop suggests revisiting quality measurement to include these neglected areas, which could improve patient care and safety.
Physician experts suggest adopting a 'user-led' innovation strategy, which prioritizes clinician and patient input, to rapidly address healthcare issues. This approach involves clinicians identifying problems, developing solutions, and testing them on a small scale before scaling up with feedback from patients.
The report finds that most health centers provide some form of family planning services, but only a quarter offer comprehensive access to contraceptive methods. Recommendations include investing in clinical quality improvement and partnerships with Title X programs to reach underserved populations.
A Penn Medicine physician highlights the need for a unified approach to value in health care reform, as divergent priorities between patients and physicians create obstacles. Patients and physicians have different notions of value, with patients seeking enhanced experiences and physicians focusing on efficiency and evidence-based care.
Involving generalists and specialists in primary palliative care skills can alleviate patient suffering through high-quality pain and symptom management. This approach could increase access to specialty palliative care consultation while providing fundamental aspects of palliative care.
State Medicaid programs offering coverage for birth doulas may capture cost savings associated with reduced cesarean rates, benefiting diverse, low-income women. Doula support improves birth outcomes and enhances the mother's birth experience.
A Kaiser Permanente analysis found significant variation in vitamin D potency among supplements, with some products containing up to 146% more or less than listed values. The study suggests that consumers may not be getting the expected amount of vitamin D from their supplements.
Researchers found racial and ethnic disparities in adverse obstetric outcomes, including postpartum hemorrhage, peripartum infection, and severe perineal laceration. The study also revealed differences in types of intrapartum care, with certain groups receiving more intensive or less invasive treatments.
Researchers found a reduction in elective deliveries prior to 39 weeks, from 29.9% to 25.4%, and a decrease in early-term cesareans. However, there was no significant change in neonatal or maternal morbidity, but a non-statistically significant increase in stillbirths after 37 weeks was observed.
The study found that using the laborist model resulted in significant reductions in labor inductions (15% fewer), maternal length of stay (0.09 days less), and preterm delivery (17%). This improvement in pregnancy outcomes is attributed to continuous coverage without competing duties.
The European Science Foundation proposes a new model of integrated care support for citizens' health through linked social and health care. Key priorities include personalized care delivery, effective use of ICT applications based on user acceptability, and ensuring respect for formal and informal carers.
A University of Oregon study finds that patients with higher levels of motivation, knowledge, and confidence in managing their health have substantially lower healthcare costs. The researchers recommend assessing patient activation scores to support more engaged patients and improve outcomes.
The majority of primary care physicians prefer delivering radiology test results to patients themselves, feeling medico-legally obligated by recommendations within reports. This preference is influenced by the wording and location of recommendations, highlighting the need for improvements in radiology reporting practices.
A new study by UAlberta researcher Trish Reay suggests that Primary Care Networks can thrive with strong leadership, redefined workspaces, and creative discord. The PCN model allows physicians to practice medicine in a team-based approach, improving patient care and doctor satisfaction.
The adoption of electronic health records by family physicians has doubled since 2005, reaching 68% nationally in 2011. Researchers found that family physicians are adopting EHRs at a higher rate than other office-based physicians and are likely to exceed 80% penetration by 2013 if the current trend continues. Meanwhile, patients' expe...
The hospital will conduct a study on transitional care models, enrolling 1,800 patients, to evaluate the effectiveness of hospital-PCMH collaborations within an Accountable Care Organization structure. The goal is to create seamless and patient-centered care.
An analysis of nationally representative survey data found significant improvement in the delivery of underused care, including better use of antithrombotic therapy and aspirin for atrial fibrillation. However, the study also found limited changes in reducing inappropriate care, such as overuse of antibiotics for asthma exacerbations.
A Kaiser Permanente study found a significant link between prenatal oxygen deprivation and an increased risk of developing Attention Deficit Hyperactivity Disorder (ADHD) in childhood. The study examined electronic health records of nearly 82,000 children ages 5 and found that exposure to birth asphyxia, neonatal respiratory distress s...
Two diabetes lifestyle interventions led to significant weight loss and improvements in waist circumference and fasting plasma glucose levels for overweight or obese adults. The adapted Diabetes Prevention Program (DPP) lifestyle interventions resulted in a 2.2-2.9 BMI reduction over usual care at month 15.
Researchers from Harvard Medical School found that integrated care provided by managed care plans reduces resource use, potentially leading to overall savings. Risk-adjustment reforms have mitigated favorable selection, reducing the tendency of health plans to attract healthier patients.
The largest community-based study of long-term diabetes outcomes after bariatric surgery found that most people don't experience long-lasting remission of their diabetes. However, those with less severe and earlier stage type 2 diabetes at the time of surgery tend to have better outcomes.
A study found that patients with online access to their medical records and secure email communication with clinicians had significantly increased use of clinical services, including office visits and telephone encounters. This contradicts the assumption that online access would substitute for traditional health care services.
A Kaiser Permanente study found that patients with online access to their medical records had a significant increase in office visits and telephone calls compared to those without online access. This association was seen across different age groups, including those with asthma or diabetes.
Only three percent of patients receive stress management counselling, highlighting the need for restructuring primary care delivery to include this crucial service as prevention. Stress management counseling is associated with longer office visits, underscoring the importance of providing this support earlier in the disease process.
A new set of policy considerations was released by the Alliance to Reduce Disparities in Diabetes to address systemic barriers and structural barriers that hinder effective diabetes care. The document proposes concepts to realign financial incentives, enhance patient self-management, and optimize healthcare systems.
A study found that mothers and newborns admitted to ICU together have a higher risk of death compared to those not needing ICU admission. This can lead to maternal-infant separation, negatively impacting bonding., The study suggests coordination of care plans and transfer to the same hospital may help lessen this burden.
Kaiser Permanente Research Affiliates has received a national designation as an Evidence-based Practice Center. The new collaboration will conduct comprehensive evidence reviews for the U.S. Preventive Services Task Force, focusing on cancer, obesity, diabetes, and other health conditions.
A new study by Weill Cornell researchers found that EHRs enhance the quality of patient care, particularly for physicians using commercially available systems. The study used data from five different health plans and found significant improvements in four measures, including hemoglobin A1c testing in diabetes.
Widespread telestroke adoption could provide optimal care to more Canadians, but current usage is limited. Research shows improved outcomes and cost savings in provinces like Alberta, where telestroke ensured rural patients received tPA at the same rate as those treated in larger centres.
A Kaiser Permanente study found that using electronic health records improved drug-treatment intensification, monitoring, and risk-factor control among patients with diabetes. The study also noted greater improvements among patients with poorer diabetes control.
The Calgary Stroke Program and Toronto Rehabilitation Institute have achieved Distinction status for their exceptional stroke care, demonstrating a commitment to best practices, leadership, and innovation. The awards recognize the organizations' rigorous accreditation process and dedication to improving patient outcomes.
A large study of nearly 200,000 females who received the HPV4 vaccine found that immunization was associated with same-day syncope and skin infections after vaccination. The findings support the general safety of routine vaccination with HPV4 in preventing cervical and other genital cancers.
A 15-year analysis shows that state-of-the-art HIV care improves health outcomes across all patient groups, including those most affected by the disease. Comprehensive care models with multiple levels of support lead to better clinical outcomes.
A new report by the University of Leeds and the University of Leicester found that death rates in children's intensive care units are decreasing overall. However, there is a persistent higher risk of mortality for children of south Asian origin, highlighting disparities in staffing levels and quality of care.
A collaborative maternity care program in Vancouver reduced cesarean deliveries by 25% and shortened hospital stays by 22 hours for mothers and babies. The program also increased breastfeeding rates, with midwives delivering 42% of births compared to obstetricians.