Articles tagged with Health Care Delivery
A recent study found that patients in Medicaid managed care programs tend to receive lower-quality care compared to those in commercial managed care programs. The study analyzed data from 383 health plans and found that overall commercial population performance exceeded overall Medicaid population performance in most measures.
A recent study published in Archives of Internal Medicine found that nearly 21% of US adults receive a preventive physical exam annually, with estimated total costs reaching $5.2 billion per year. The study also revealed significant variations in clinical practice patterns and patient beliefs across the country.
The Lancet series concludes that generating political will is key to overcoming barriers to scaling up mental health services. Advocates must deliver clear messages about required care, while developing secondary care-level community mental health services should be prioritized.
A cohort study found a small but significant increase in cesarean deliveries when women are cared for by an on-call obstetrician rather than their regular-care obstetrician. The study highlights the importance of smooth hand-offs of patient care between physicians.
A four-year study of 1,869 women found that the Active Management of Risk in Pregnancy at Term approach resulted in lower cesarean delivery rates compared to traditional care. Preventive labor induction also appeared to lower adverse birth outcomes. The findings challenge current beliefs about labor induction and suggest a preventive a...
A four-year study found a significantly lower cesarean delivery rate of 5.3% for women using an alternative obstetric care method compared to traditional care. Preventive labor induction was used based on accurate pregnancy dating and risk-factor scoring.
A new study found that electronic health records made no difference in 14 measures of quality care, while improving only two areas. The researcher emphasizes that electronic systems can provide valuable tools for physicians, but it's not enough to improve quality on their own.
Research highlights the association between acanthosis nigricans and type 2 diabetes risk factors in children and adults. Additionally, a study suggests that electronic medical records do not necessarily ensure high-quality diabetes care, highlighting the need for workflow redesign to improve patient health.
Researchers found that hospitals with lower-volume, lower-level NICUs had a significantly higher newborn death rate for very low birth weight infants. The study suggests increased regionalization of NICU births to high-level facilities may reduce infant mortality.
A quality improvement program in federally qualified community health centers improved diabetes care, reducing patients' lifetime risk of blindness, kidney disease, and coronary artery disease. The program cost less than $500 per patient each year and is projected to save the healthcare system millions.
The US critical care delivery system is in critical condition due to a growing mismatch between demand and supply. A new report proposes regionalizing the system to centralize expertise, equipment, and facilities, making services readily available to those most in need.
The FAST TRACK protocol dramatically reduces the time that elapses before patients undergo a life-saving procedure, saving both heart muscle and patient lives. The new system includes key elements such as single-call instant alerts, electrocardiograms within five minutes of arrival, and rapid loading by air ambulance.
The authors propose a market-based approach to increase the value of care delivered, organizing care around medical conditions and integrating treatment with prevention. Measuring results-risk-adjusted outcomes and costs-per-medical-condition is crucial for improving value.
A national series of interventions aimed at improving chronic disease management quality resulted in enhanced processes of care for diabetes, asthma, and hypertension. However, these efforts did not lead to improvements in intermediate clinical outcomes, such as control of high blood pressure or glycated hemoglobin levels.
A review of medical literature reveals that direct communication between hospital physicians and primary care physicians at discharge is infrequent. Discharge summaries often lack important information, contributing to primary care physician dissatisfaction and impacting quality of care. Urgent improvements are needed in the processes ...
Researchers from Indiana University found that active patient involvement during treatment of chronic heart failure, coupled with collaboration between healthcare teams, significantly improves quality of care. Lifestyle changes such as exercise, reducing salt intake, and managing stress are also crucial for longer survival rates.
A survey of 127 specialist registrars reveals that nearly a third view working with patients directly in community settings as a bad development. The respondents felt poorly prepared to meet the challenge and wanted additional training, but only half believed this would improve their job prospects.
The Commonwealth Fund Health Care Opinion Leaders survey found that expanding coverage for the uninsured (88%) and moderating rising healthcare costs (81%) are top priorities. Experts also suggest increasing recommended care levels and reducing inappropriate services to achieve a high-performance healthcare system.
Researchers found that high-performing hospitals had little difference in mortality rates for common conditions like heart attack and pneumonia. The study suggests that current quality measures are insufficient to accurately reflect patient outcomes, highlighting the need for new measures linked to clinical outcomes.
A study found little difference in death rates for common conditions at high and low-performing hospitals, suggesting that current measures may not accurately predict patient outcomes. The authors call for more tightly linked measures to improve health care quality.
A recent supplement to Critical Care Medicine outlines progress made in end-of-life care in intensive care units (ICU), with a focus on palliative care, quality indicators, and family communication. The study suggests that improving end-of-life care in ICUs can lead to better patient outcomes and reduced suffering.
Stroke patients who receive constraint-induced movement therapy show significant improvement in arm and hand function, regaining 52% more time to complete tasks and performing 24% more tasks with the partially paralyzed arm. The study, led by Emory University researchers, found greater improvements than usual care over a year.
Prioritizing health facility births with trained midwives can substantially reduce maternal mortality worldwide. The Lancet series highlights the stark disparities between rich and poor countries, with women in developing countries being 1000 times more likely to die from pregnancy-related complications.
Panic disorder affects up to 5% of the population, causing recurrent anxiety attacks and agoraphobia. Anti-depressants and cognitive-behavioural therapy (CBT) are effective treatments, but less than half of those in need receive care due to barriers such as diagnosis difficulties and insurance coverage issues.
Researchers found that infant and neonatal mortality rates are higher among babies delivered by cesarean section than vaginal deliveries, even in low-risk women. The study analyzed over 5.7 million live births and nearly 12,000 infant deaths, revealing a significant increase in cesarean deliveries without medical indication.
The year-long project aims to examine the impact of changes to scheduling of elective surgeries on hospital patient census and nurse-to-patient staffing ratios. The study will shed light on how variations in patient census affect nurse workload, direct care time, and overall quality of care.
A randomized controlled trial found collaborative care management significantly reduced behavioral and psychological symptoms of dementia in patients with Alzheimer disease. Caregiver stress also improved after the intervention.
Researchers are conducting a year-long study on pastoral care for older Australians, gathering insights from elderly individuals, relatives, and caregivers. The project seeks to understand the value and practice of pastoral care in Australia's rapidly aging population, with a focus on its spiritual significance.
The American College of Physicians (ACP) will release recommendations for reforming primary care compensation, education, and training. The reforms aim to strengthen the importance of primary care in the healthcare system by recognizing its value and role in delivering better quality care at lower costs. ACP leaders will discuss a comp...
A study proposes strategies to share health information across systems, eliminating duplicate tests and providing real-time information. The goal is to bridge the gap between current standards of care and optimal care through effective use of technology.
Researchers found significantly lower quality of care in for-profit health plans compared to not-for-profit plans, even after adjusting for demographic factors. The study's findings reinforce concerns about the impact of financial incentives on quality of care for Medicare beneficiaries.
A new study suggests that investing in existing medical treatments could be more effective in saving lives than developing new ones. The research highlights the importance of addressing system barriers and improving access to care for underprivileged patients.
The article discusses the importance of finding a balance between investing in new technologies and improving existing systems of care. Studies show that physicians employed by large health organizations report lower job satisfaction, while independent practice is associated with better quality of work life.
A recent study by Yale University researchers found that US Medicare patients with heart failure have a lower risk of dying within 30 days compared to their Canadian counterparts. However, the difference in long-term survival rates is negligible. The study suggests that the American system may excel at acute care, while the Canadian sy...
The Medical College of Georgia School of Nursing has received a $995,000 grant to support its new doctorate of nursing practice program, the 10th of its kind in the nation. The partnership with Emory University will prepare critical mass of nurse clinicians through increased collaboration.
A study found that resident physicians feel insufficiently prepared to care for patients from different cultures, with significant gaps in cross-cultural education and mentoring. The survey results highlight the need for improved training programs to address racial and ethnic disparities in healthcare.
A study found that hospital report cards using linked administrative databases did not improve acute myocardial infarction (AMI) care quality. The lack of effectiveness may be due to skepticism about the data or the need for more intensive interventions.
A recent study from the University of Pittsburgh highlights the challenges faced by paramedics in performing endotracheal intubation, a critical procedure that requires significant skill and experience. The research found that many paramedics perform intubations less than three times per year, with some not performing any at all.
A recent study found that outpatient care in the US has made modest improvements in some areas, but still lags behind evidence-based recommendations. The research highlights significant disparities in care, particularly for racial and ethnic minority groups.
Research found that primary care physicians have only 3.5 hours per day to provide care for common chronic diseases, increasing to over 10 hours per day when accounting for poorly controlled conditions. The authors suggest collaborative guideline development and team approaches to patient education to address this issue.
A University of Toronto report assesses the overall performance of 11 psychiatric hospitals and 45 acute-care facilities in Ontario, highlighting strengths and weaknesses. The study identifies key areas for improvement, including patient participation, continuity of care, regional variation, and evidence-based care.
ID physicians and expert general medicine physicians outperform non-expert generalists in treating patients with HIV. Key findings include improved viral load control and increased flu vaccination rates among expert groups.
A Penn State study shows that including spending in other service sectors reduces the between-community cost difference from 81% to 18%. The system of care approach also improves youth's chances of finishing high school and making a successful transition to adulthood.
The US healthcare system exhibits both strengths and failings, with private market competition driving inequality, inefficiency, and high costs. Researchers explore the role of corporate interests in shaping health care markets, organizational forces, and clinical practice guidelines.
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.
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 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
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.