Articles tagged with Health Care Delivery
A study published in the Journal of the National Cancer Institute found that increases in managed care market share were not associated with improved quality of care for cancer patients, except for a specific blood test. The authors conclude that expansion of managed care may not improve quality of care for all patients.
A study by Harvard Medical School researchers found that older doctors are less likely to follow current medical standards, with declining performance over time. The findings suggest that quality improvement interventions targeting all physicians, including those who have trained recently, may be necessary to update knowledge and tools.
A new assessment tool provides comprehensive data on home care quality, identifying areas for improvement. The 22 measures cover processes and outcomes, revealing that no single provider excels in all aspects.
VA patients outperformed non-VA patients in delivering recommended care for acute, chronic, and preventive conditions, with significant differences found in areas with established performance measures and electronic medical records.
A randomized trial found that computerized standing orders for influenza and pneumococcal vaccines significantly increased vaccine administration rates compared to physician reminders. Patients with standing orders received vaccinations 12-24% more often, highlighting the effectiveness of this approach in improving preventive care.
Operations research and manufacturing techniques will improve healthcare delivery by reducing costs and enhancing quality. Techniques such as supply chain management and scheduling systems are being adopted in hospitals and blood banks to reduce delays and improve patient care.
A meta-analysis found that cardiac resynchronization therapy improved the quality of life of people with heart failure, while a cost-effectiveness study showed it costs $90,000 per quality-adjusted life-year saved. Guidelines for follow-up colonoscopies were also criticized for being too often performed.
A study found that adults with regular doctors were more likely to receive influenza vaccinations and mammography, as well as advice on smoking cessation. This suggests that trust in a single provider contributes to better adherence to health recommendations.
Research by P.J. Devereaux et al found higher mortality rates and higher costs associated with private for-profit hospitals compared to not-for-profit hospitals. This supports a policy shift towards not-for-profit healthcare delivery, as suggested by S. Woolhandler and D.U. Himmelstein.
A Johns Hopkins-led study found that most physicians reported positive attitudes towards caring for patients with chronic conditions, but felt they had received less training than needed. Chronic problems like diabetes and heart disease account for over 75% of healthcare spending in the US.
A University of Pittsburgh study found that over half a million Americans die annually in ICUs after admission, with average lengths of stay ranging from 8.9 days and cost $8,548 for non-ICU hospitalization. The researchers recommend improving prediction models to reduce ICU admissions at end-of-life
The UPMC Community Medicine initiative improved HbA1c levels by 0.83 percent and reduced blood pressure and cholesterol below target ranges in a large proportion of patients. Physician compliance with evidence-based guidelines was significantly increased through data tracking and education.
A randomized controlled trial found that a home-based program, PEARLS, significantly improved depressive symptoms and health-related quality of life in medically ill, low-income, mostly homebound older adults. The study showed promising results for non-pharmacological treatments in this vulnerable population.
A prospective observational study found that physician residents worked an average of 69 hours a week, receiving 41 pages of seeking services. Ketonuria was observed in 21% of shifts, highlighting the need for stricter work hour limitations to ensure patient and physician safety.
A new study published in the Canadian Medical Association Journal found that infants born over the weekend had a slightly elevated risk of stillbirth and neonatal death compared to those born on weekdays. The researchers suggested that selective timing of low-risk elective deliveries may explain this difference.
Researchers found that women with preeclampsia are more likely to have a successful vaginal delivery at tertiary care hospitals compared to primary and secondary care facilities. Tertiary hospitals offer comprehensive maternity and neonatal care services, including transport, education, and research.
A study found that teenagers face challenges in accessing relevant health information online, with common barriers including poorly designed websites, lack of targeted content, and ineffective search strategies. To improve access, researchers suggest teaching better search skills and designing websites more tailored to users' needs.
The CHEST Foundation and Eli Lilly and Company Foundation have expanded the Critical Care Family Assistance Program to five additional hospitals. The program provides critical support to families of critically ill patients, including computerized kiosks, staff services, and local accommodations.
The report compares six Democratic candidates' plans to address the problem of the uninsured, revealing a range of proposals from covering most or all of the uninsured to 1 in 10. Most Democratic candidates would repeal some or all of President Bush's tax cuts to help finance their health plans.
New guidelines improve pregnancy, labour, and delivery care for HIV-positive women. These updated recommendations allow for longer, healthier pregnancies and increased chances of healthy, HIV-free offspring.
The US healthcare system faces a high-performance goal with increasing efficiency and effectiveness. Key steps outlined include public reporting of data on providers, health plans, and demonstrations of new approaches to insurance coverage, technology, and quality standards.
Researchers analyzed variability in demand for hospital services and found that scheduled surgical ICU caseload is a potentially reducible source of stress on ICUs. Smoothing this type of variability can improve patient flow and preserve access to critical services.
Patients with acute depression who received phone-based disease management were six times more likely to reduce their symptoms to a low level compared to those receiving standard care. The program also led to primary care doctors using nationally approved guidelines in treating their patients.
A five-year initiative aims to change primary care practice in Canada by focusing on physical activity, rather than diet. The PROACTIVE study will examine the effectiveness of a behavioral-based program to increase physical activity and reduce obesity.
Competition among Medicare health plans may not be enough to reduce costs and address fiscal concerns. Beneficiaries may absorb savings, and market instability is a concern in structured market-based strategies.
The article highlights the critical state of primary care in the United States, citing organizational and financial pressures that threaten its viability. The UCSF-led report proposes seven principles for reconstructing primary care, focusing on patient-centered care, adequate reimbursement, and improved education.
The study found that physician groups use only 32% of recommended care management processes, leaving many patients without optimal care. External incentives from health plans and large purchasers can encourage the adoption of these processes.
The Harvard Medical School study found that hospital length of stay does not significantly impact newborn health, contradicting popular assumptions. The study also showed that introducing a state law guaranteeing minimum postpartum stays actually led to less frequent follow-up care for newborns.
University of Pittsburgh researchers have developed a urinary catheter that can directly measure blood flow and oxygen utilization in the body. This innovation allows for more timely monitoring of trauma patients and could lead to better outcomes by providing insights into mechanisms of organ failure.
A study of Puerto Rican women found that their level of satisfaction with obstetrical care is significantly influenced by institutional settings, medical staff characteristics, and the continuity of care. Latino physicians are culturally sensitive, but their ethnicity does not affect patient satisfaction.
A new journal series aims to educate physicians about individual and systems factors contributing to medical errors. The series analyzes real-life cases, including a study of 17 errors that allowed one patient to receive an invasive procedure intended for another.
A study published in JAMA found that restorative home care significantly improves the likelihood of remaining at home, reduces emergency visits, and enhances self-care and mobility among older patients. The model is based on principles adapted from geriatric medicine, nursing, rehabilitation, and goal attainment.
A study published by Massachusetts General Hospital found that moderate alcohol consumption may lower the risk of developing hypertension in young women. The research, based on data from over 70,000 women aged 25 to 42, shows a J-shaped curve where light drinkers have a decreased risk compared to nondrinkers and heavier drinkers are at...
A study found that women are more likely to get regular cancer screenings if they have a well-organized primary care system. Women in private HMOs were also more likely to receive regular screenings compared to uninsured or underinsured women.
A national survey of 787 physicians found that 40% encourage sicker patients to avoid capitated managed care plans and 23% encourage healthier patients to join them. This practice, known as risk selection, raises legal, ethical, and policy issues.
A comprehensive UK study highlights the risk factor of high staff workload on infant mortality in intensive care units. After adjusting for initial clinical risk and illness severity, patient volume and staffing provision did not influence mortality or cerebral-damage outcomes.
Researchers found a significant decline in meningitis deaths among children, attributed to improvements in intensive care and treatment. The study revealed a 59% reduction in fatality rates over five years, with most cases resulting from septicaemia.
A new bacteria test has shown promise in detecting contaminated platelets before they are used for transfusion, reducing the risk of severe illness and death. The Pall BDS system measures oxygen levels in a sample obtained from a platelet unit, indicating bacterial contamination and allowing for safe disposal.
Parents of children with chronic conditions are less likely to enroll in gatekeeping HMO plans, which are designed to improve care coordination. The study found that after switching to an HMO, kids with chronic illness had fewer visits to specialists and primary care physicians.
A new study by Penn State researchers reveals that managed care plans' use of performance measures can lead to improved quality of care, but significant variations in effectiveness remain. The study found that tightly integrated relationships between healthcare providers and the plan are key factors in delivering high-quality care.
The UCSF program will support senior-level nurses in executive roles with $45,000 over three years to develop key leadership competencies. The focus is on addressing complex issues in healthcare through a comprehensive leadership project and mentorship.
A study by Ashish K. Jha and colleagues found that black patients in VA hospitals had lower mortality rates than white patients for six common medical diagnoses, including pneumonia, angina, and diabetes. The survival advantage was consistent across disease, age, financial status, and hospital-level subgroups.
A new healthcare team model, called Virtual Integrated Practice (VIP), aims to improve the management of chronic diseases in geriatric patients. The study uses team principles from the business world and will link patients and doctors with a team of health professionals using technology such as cellular phones and the Internet.
The NYC Council has awarded $750,000 to the Consortium of New York Geriatric Education Centers and The Hartford Institute for Geriatric Nursing to train healthcare professionals in caring for older adults. The three-year program will provide geriatric training to all five boroughs and focus on nurse-led care.
A recent study analyzing the data behind an Institute of Medicine report suggests that medical errors had no estimable effect on death rates. The authors argue that the patients studied were already quite ill before entering the hospital, making it difficult to isolate a critical determinant of death.
A new Harvard Medical School study found that only 14% of patients treated for three common mental illnesses received adequate care. African-Americans and those without insurance coverage are less likely to receive satisfactory mental health care.
The symposium will focus on practical information to implement change, improve health care delivery, and reduce errors. Key topics include cultural obstacles, innovations in technology, and strategies for moving beyond blame-based safety policies.
A University of Washington study reveals that women who have Caesarean or assisted vaginal deliveries are at a higher risk of rehospitalization compared to those who have unassisted vaginal deliveries. The study found significant risks for complications such as uterine infection, postpartum hemorrhage, and cardio-pulmonary conditions.
A new study by Yale researchers reveals a significant difference in patient satisfaction between those with chronic illnesses and healthier individuals under managed care. The study, which analyzed data from over 16,000 employees, found that chronically ill patients are twice as likely to report dissatisfaction with their care.
A recent study found that alcohol consumption during pregnancy can cause early delivery, with potential health consequences including low birth weight and increased risk of death or long-term illness. Researchers believe a critical period for drinking may exist, and prevention is key to reducing premature births.
A PricewaterhouseCoopers study suggests that consumerism, e-commerce, and genetic mapping will transform the US healthcare system. The report highlights potential disruptions, including increased competition for capital investments and a shift towards preventive care through genomics.
A UCSF report identifies three contributing factors to the problems facing allied and auxiliary workforce: market survival, flexible team members, and educators' skills preparation. The report recommends partnerships among health delivery organizations, workers, and educators to forge new approaches.
A study by Boston University researchers found that delivering bad news via email is more accurate and less painful for the messenger than personal or phone delivery. The research suggests that electronic communication can increase honesty and accuracy in delivering negative information, challenging current norms.
Four Harvard physicians recommend a moratorium on reducing the national cesarean section delivery rate due to concerns about maternal and infant safety. They argue that economic forces are driving the goal, rather than patient well-being.
A CDC pilot study developed an integer programming model to optimize vaccine selection and procurement, potentially saving millions of dollars in health care costs. The study examined the economic value of combining vaccines and identified opportunities for reducing medical staff time and storage costs.
The National Library of Medicine (NLM) announces 24 contract awards totaling $2.3 million to develop innovative medical projects leveraging the capabilities of the Next Generation Internet (NGI). These projects aim to improve data transfer, security, and usability in healthcare settings.
The Pan American Health Organization emphasizes the importance of addressing health inequities in its new report, citing evidence that poorest populations face the worst health outcomes. Strategies aimed at promoting health and preventing disease are necessary to improve regional health.
Two studies found a direct relationship between RN staff mix and lower rates of medication errors, patient falls, and other adverse occurrences. However, the optimal RN staffing level remains unclear, with medication errors increasing above 87.5% RN care hours.
Following guidelines improves patient safety and reduces liability costs by 96% compared to no guideline compliance. MMI's report highlights the financial impact of adhering to core risk modification programs, with average cost per claim reduced by $70,000.
The article recommends adopting nurse-midwifery as the standard of care for normal deliveries in the US, citing its cost-effectiveness and ability to mitigate low birth weight and infant mortality. Nurse-midwives' non-interventionist approach can provide high-quality care with equivalent outcomes to physicians.