Articles tagged with Health Care Delivery
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.
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.
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.
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 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.
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.
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...
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 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 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 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.
Researchers analyze the effectiveness of Medicare's bundled payment program, finding that it faces challenges in rewarding providers for efficient care delivery. Experts discuss lessons learned from previous payment reforms, emphasizing the need for comprehensive reforms that address multiple aspects of the health system.
A national survey of over 1,000 registered nurses reveals that resistance from nursing leaders and organizational cultures prevent implementation of evidence-based practices. Respondents report a lack of education, access to information, and support as major barriers to adopting these practices.
A multi-center study of intensive care units (ICUs) led by UCSF faculty aims to better understand the nature of team-based care and patient involvement in ICU settings. The study, funded by the Gordon and Betty Moore Foundation, is expected to decrease healthcare costs and improve patient safety.
A Kaiser Permanente study found that overweight and obese pregnant women are 65% and 163% more likely, respectively, to have large babies compared to their healthy weight counterparts. Excess weight gain during pregnancy also contributes to having a large for gestational age baby.
A learning health system combines practice and research to rapidly apply best evidence in real-time clinical care. Group Health Cooperative's experience demonstrates the importance of strong leadership support, partnership between research and clinical operations, and effective communication for successful implementation.
Healthcare organizations discuss the benefits of Accountable Care Organizations (ACOs) in reducing healthcare costs while improving quality. However, they also highlight concerns and design flaws in the current ACO models, such as lack of beneficiary engagement and administrative complexity.
The University of Missouri will use the grant to create a program called LIGHT2, which combines advanced technology with education for patients and providers. The high-tech component leverages MU's partnership with Cerner Corporation to improve health outcomes and reduce costs.
Dr. Elizabeth McGlynn, a renowned expert in health services research and quality evaluation, has been recognized with the 2012 AcademyHealth Distinguished Investigator Award. Her landmark studies have significantly improved our understanding of US healthcare quality.
The Aging Brain Care model, developed by Indiana University researchers, aims to deliver better health care to older adults through interdisciplinary care teams and personalized treatment plans. The expanded program is expected to reduce emergency department visits and hospitalizations among Medicare beneficiaries.
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.