Research on how health care reaches patients. Covers online screening programs, care delays, regional cardiology, and surgical treatment access.
Palliative care consultant Claud Regnard argues that the Liverpool Care Pathway was unfairly maligned and that its demise will not improve end-of-life care. He rejects recommendations to replace it with an 'end of life care plan', citing lack of evidence for its effectiveness.
A new study from Duke University finds that the Chiranjeevi Yojana program in Gujarat, India, has failed to deliver on its promise of reducing infant and maternal deaths. The program, which aimed to provide free childbirth care at private hospitals, saw no statistically significant change in birth outcomes or healthcare utilization.
A new study shows that telemedicine consultations can effectively manage Parkinson's symptoms and improve quality of life. Virtual house calls enable individuals with the condition to live independently while receiving specialized care.
A new study published in Health Affairs suggests that providers and organizations can reduce acute care costs through public health measures and educational initiatives. The authors propose a fee-for-service payment system with incentives based on resource and quality measures to encourage high-value care.
A study of over 30,000 women in Ireland found that private patients were more likely to have a C-section or surgical delivery, with rates twice as high for planned C-sections. The disparities remained after adjusting for social and medical factors.
A Kaiser Permanente study of 17,217 adult members with diabetes found that those using mail order pharmacies had significantly fewer emergency room visits for any cause. The study suggests that mail order pharmacy may improve patient safety and utilization without compromising patient outcomes.
A new Cochrane review shows that non-specialist health workers, such as doctors and nurses, can alleviate depression and anxiety in people with mental health problems. Non-specialists may also help treat maternal depression, post-traumatic stress disorder, and alcohol abuse, although the benefits may be smaller.
Penn Medicine researcher Ezekiel J. Emanuel recommends limiting US health care cost growth to match US economy's GDP growth for improved quality of care and transformed healthcare system. The proposal involves team-based care coordination, reduced hospitalizations, and more outpatient monitoring.
A proposed funding mechanism coupled with a competitive peer-review process may transform the physician workforce, according to an analysis in Health Affairs. The current system is inflexible, ignoring growing needs for competencies beyond acute patient care.
Researchers at Penn Medicine are studying health care disparities among people with disabilities through the Mrs. A and Mr. B Project, a collaborative effort with Virtual Ability, Inc. The project aims to provide patients with information to make informed decisions about their medical care.
A RAND Corporation study suggests that expanding patient-centered medical homes and nurse-managed health centers can help eliminate up to 50% of the expected primary care physician shortage by 2025. These new models rely on a mix of medical providers, including nurse practitioners and physician assistants.
A national panel of experts recommends that osteopathic medical schools develop programs in partnership with teaching hospitals and training sites to provide more hands-on learning. The goal is to train primary care-focused physicians who can deliver team-based care and are proficient in prevention, health systems planning, leadership,...
A Vanderbilt study found that providing patients with a simple biosketch card about their doctor can improve patient satisfaction scores by 22%. The study showed that patient comfort with care is crucial for recovery, and this intervention is an easy and cost-effective way to enhance the patient experience.
The American Thoracic Society expert panel recommends that patients work with their providers to develop individualized action plans to prevent 'dyspnea crisis' episodes. These plans can include alternative relaxation and breathing techniques, medications, and oxygen therapy to ease symptoms.
Kaiser Permanente's Complete Care model has shown steady improvement in quality scores, with an average increase of 13% compared to the national average. The program uses Proactive Office Encounters to address patient needs, promoting preventive care and improving chronic condition management.
BMC has been approved to receive two research awards from PCORI, focusing on socio-legal barriers in cancer care and effective treatments for chronic pain. The hospital's commitment to innovative health care delivery is highlighted through these studies.
The Latin American Urology Association names its highest accolade after UCLA's Dr. Shlomo Raz in recognition of his efforts to educate and train urologists in the region. The inaugural Shlomo Raz Medal will be awarded annually to a deserving urologist who furthered Raz's mission.
The Change AGEnts Initiative aims to create change in healthcare practice that improves the health of older adults. The project, funded by a $5 million grant from the John A. Hartford Foundation, brings together researchers, clinicians, and health system leaders to develop and implement evidence-based models.
A new study found that when ICUs are busy, doctors discharge patients more efficiently without negatively impacting patient outcomes. This suggests that strained resource settings prompt providers to critically re-evaluate patient needs and transfer patients who can be managed outside the ICU.
A new process called 'Smart Rounds' optimizes the safety and efficacy of radiation therapy by formalizing multidisciplinary reviews at the beginning of treatment planning. This leads to safer, more individualized radiation treatment plans and better utilization of medical resources.
A new study presented at ASTRO's Annual Meeting has identified the Common-Terminology-Criteria-for-Adverse Events (CTCAE) scale as a reliable method for assessing patient reactions to radiation therapy. The study found that using this standardized scale improved consistency among caregivers, enabling more uniform and effective care.
Residents enrolled in managed care had more nursing home-based primary care visits and nurse practitioner visits, reducing hospital transfers. Survival rates did not differ between groups, but intensive primary care services may improve end-of-life care affordability.
The ESMO Designated Centres programme has seen a significant increase in new applications, with 37 successful new entrants in 2013. The programme aims to promote integrated oncology and palliative care services for cancer patients and has been highly successful, with over 160 centres recognized globally.
A recent study published in JAMA Network found that chronic care management did not result in increased abstinence from alcohol among individuals with alcohol and other drug dependence. The study compared participants receiving chronic care management with those receiving usual primary care, but no significant difference was found.
The American College of Physicians outlines a team-based model of healthcare with 13 principles to encourage effective teamwork and collaboration. Highly-functioning teams assign responsibility based on patient needs, prioritize culture, communication, and mutual respect.
A survey of young breast cancer patients found that nearly all chose prophylactic mastectomy to reduce risk of contralateral breast cancer, despite knowing it doesn't improve survival rates. The study highlights the need for better risk communication strategies to help patients make informed decisions.
A new book by Harry P. Selker, M.D., M.S.P.H., offers a fresh perspective on the Affordable Care Act, highlighting its potential as an experiment in translational research. The book explores the history, impact, and future of healthcare reform.
A study published in the Journal of the American Medical Association found that electronic health records were associated with a decrease in emergency room visits and hospitalizations for patients with diabetes. The use of EHRs improved the quality of care, resulting in fewer negative events.
A study found that using electronic health records (EHRs) for patients with diabetes resulted in a modest reduction in emergency department visits and hospitalizations. However, EHR implementation did not affect office visit rates.
A new study reveals that nearly one in five older adults experience emergency department visits within a month of common surgeries, with significant variation between hospitals. Hospitals can use this measure to assess their quality of care and focus on preventing post-surgery emergencies.
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.
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 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.
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.