72 results match your criteria Health Services Insights [Journal]


Technical Efficiency of Maternal and Reproductive Health Services in Public Hospitals of Oromia Regional State, Ethiopia.

Health Serv Insights 2019 10;12:1178632919837630. Epub 2019 Apr 10.

Department of Health Policy and Management, Faculty of Public Health, Jimma University, Jimma, Ethiopia.

As the Ethiopian health system faced critical resource constraints, wise use of the available health resources is a priority agenda. Therefore, our study aimed to assess technical efficiency of maternal and reproductive health services in public hospitals of Oromia regional state, Ethiopia. Two-stage data envelopment analysis was performed among 14 hospitals with input orientation and variable returns to scale assumptions. Read More

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http://dx.doi.org/10.1177/1178632919837630DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458666PMC

Components Affecting Pharmaceutical Strategic Purchasing: A Scoping Review.

Health Serv Insights 2019 10;12:1178632919837629. Epub 2019 Apr 10.

Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.

Pharmaceutical strategic purchasing is considered as a key to improve access to medicines especially for developing countries. The aim of this scoping review is to determine the most important components affecting pharmaceutical strategic purchasing. Here, we employed a comprehensive search strategy across PubMed, ProQuest, EBSCO, ISI Web of Science, Scopus, ScienceDirect, and Google Scholar for the terms related to medicines strategic purchasing. Read More

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http://dx.doi.org/10.1177/1178632919837629DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458671PMC

Building Better Clinical Relationships With Patients: An Argument for Digital Health Solutions With Black Men.

Health Serv Insights 2019 12;12:1178632919834315. Epub 2019 Mar 12.

Division of Health Policy & Management, School of Public Health, The University of Minnesota, Minneapolis, MN, USA.

There is a rapid evolution of care delivery taking place across the globe in response to an explosion of novel health technologies. Growing in parallel to this expansion is the anticipation of mHealth technologies to drive patient-centered care into the future. Despite this hope, continuing reports of health inequities and lived experiences of substandard care fill national, state, and community health reports. Read More

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http://dx.doi.org/10.1177/1178632919834315DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6415479PMC

Resource Intensity for Children and Youth: The Development of an Algorithm to Identify High Service Users in Children's Mental Health.

Health Serv Insights 2019 24;12:1178632919827930. Epub 2019 Feb 24.

University of Waterloo, Faculty of Applied Health Sciences, Waterloo, ON, Canada.

Children's mental health care plays a vital role in many social, health care, and education systems, but there is evidence that appropriate targeting strategies are needed to allocate limited mental health care resources effectively. The aim of this study was to develop and validate a methodology for identifying children who require access to more intense facility-based or community resources. Ontario data based on the interRAI Child and Youth Mental Health instruments were analysed to identify predictors of service complexity in children's mental health. Read More

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http://dx.doi.org/10.1177/1178632919827930DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390227PMC
February 2019
1 Read

An Overview of International Staff Time Measurement Validation Studies of the RUG-III Case-mix System.

Health Serv Insights 2019 24;12:1178632919827926. Epub 2019 Feb 24.

School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.

The RUG-III case-mix system is a method of grouping patients in long-term and post-acute care settings. RUG-III groups patients by relative resource consumption and may be used as the basis for prospective payment systems to ensure that facility reimbursement is commensurate with patient acuity. Since RUG-III's development in 1994, more than a dozen international staff time measurement studies have been published to evaluate the utility of the case-mix system in a variety of diverse health care environments around the world. Read More

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http://dx.doi.org/10.1177/1178632919827926DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390217PMC
February 2019

An International Mapping of Medical Care in Nursing Homes.

Health Serv Insights 2019 23;12:1178632918825083. Epub 2019 Jan 23.

Department of Social & Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.

Nursing home (NH) residents are increasingly in need of timely and frequent medical care, presupposing not only available but perhaps also continual medical care provision in NHs. The provision of this medical care is organized differently both within and across countries, which may in turn profoundly affect the overall quality of care provided to NH residents. Data were collected from official legislations and regulations, academic publications, and statistical databases. Read More

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http://journals.sagepub.com/doi/10.1177/1178632918825083
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http://dx.doi.org/10.1177/1178632918825083DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348508PMC
January 2019
3 Reads

Predictors of Societal Costs of Older Care-Dependent Adults Living in the Community in 11 European Countries.

Health Serv Insights 2019 23;12:1178632918820947. Epub 2019 Jan 23.

Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, The Netherlands.

Background: The objective was to identify predictors of societal costs covering formal and informal care utilization by older home care clients in 11 European countries.

Methods: Societal costs of 1907 older clients receiving home care for 12 months from the Aged in Home care (AdHoc) study were estimated using the InterRAI Minimum Data Set for Home Care's (MDS-HC) resource use items. Predictors (medical, functional, and psychosocial domains) of societal costs were identified by performing univariate and multivariate generalized linear model analyses. Read More

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http://dx.doi.org/10.1177/1178632918820947DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348544PMC
January 2019

Management of Pain in the United States-A Brief History and Implications for the Opioid Epidemic.

Health Serv Insights 2018 26;11:1178632918819440. Epub 2018 Dec 26.

Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Pain management in the United States reflects attitudes to those in pain. Increased numbers of disabled veterans in the 1940s to 1960s led to an increased focus on pain and its treatment. The view of the person in pain has moved back and forth between a physiological construct to an individual with pain where perception may be related to social, emotional, and cultural factors. Read More

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http://dx.doi.org/10.1177/1178632918819440DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311547PMC
December 2018
37 Reads

Development and Testing of the interRAI Acute Care: A Standardized Assessment Administered by Nurses for Patients Admitted to Acute Care.

Health Serv Insights 2018 17;11:1178632918818836. Epub 2018 Dec 17.

Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.

Background: Underpinning standards for developing comprehensive care in hospital is the need to identify, early in the admission process, functional and psychosocial issues which affect patient outcomes. Despite the value of comprehensive assessment of patients on admission, the process is often sub-optimal due to a lack of standardized assessment practices. This project aimed to develop a concise, integrated assessment for patients admitted to acute care and test its psychometric properties. Read More

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http://dx.doi.org/10.1177/1178632918818836DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6299328PMC
December 2018
1 Read

Physician Parents Attending Work Despite Own Sick Children: A Qualitative Study on Caregiver Presenteeism Among Norwegian Hospital Physicians.

Health Serv Insights 2018 16;11:1178632918817298. Epub 2018 Dec 16.

Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.

Background: Studies have shown that physicians manifest a clear duty to work, even in the face of personal risk, and despite their own symptoms of ill health; this is termed presenteeism. We lack knowledge on their willingness to attend work when their children are sick or in times of concern for their unborn; this is termed . To gain a comprehensive knowledge on the occurrence of presenteeism among physicians, it is important to include caregiver presenteeism. Read More

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http://dx.doi.org/10.1177/1178632918817298DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6295711PMC
December 2018
11 Reads

Opioid-Related Harms: Simplistic Solutions to the Crisis Ineffective and Cause Collateral Damage.

Health Serv Insights 2018 25;11:1178632918813321. Epub 2018 Nov 25.

St. Paul's Hospital, Hospice Palliative Care Program, Providence Health Care, Vancouver, BC, Canada.

The narrative of the opioid crisis is that ill-informed and careless prescribing by physicians has led to increases in opioid-related harms including overdose deaths. Focusing on reducing the access to prescribed opioids without treating substance use disorder has led to increases in use of heroin and illicitly produced fentanyl. Overall prescribing of opioids has declined causing collateral damage to those who use opioids appropriately to reduce pain and improve function. Read More

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http://dx.doi.org/10.1177/1178632918813321DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6256311PMC
November 2018
20 Reads

Reducing the Cost of Medicaid: A Multistate Simulation.

Health Serv Insights 2018 27;11:1178632918813311. Epub 2018 Nov 27.

Health Policy Institute, Texas Medical Center, Houston, TX, USA.

According to some estimates, the United States wastes as much as 30% of health care dollars. Some of that waste can be mitigated by reducing certain costs associated with Medicaid. We chose 5 areas of savings applicable to Medicaid: (1) modification of physician payment models to reduce unnecessary care, (2) development of a medication adherence program for patients dually eligible for Medicaid and Medicare support ("dual eligibles"), (3) improvement in unnecessary admissions and readmissions for dual eligibles, (4) reduction in emergency department visits among children in Medicaid and dual-eligible beneficiaries, and (5) improvement in adoption of end-of-life advance directives. Read More

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http://dx.doi.org/10.1177/1178632918813311DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6262496PMC
November 2018
15 Reads

Unconventional Practitioners' Causal Beliefs and Treatment Strategies for Chronic Low Back Pain in Rural Nigeria.

Health Serv Insights 2018 30;11:1178632918808783. Epub 2018 Oct 30.

Department of Physiotherapy, School of Population Health Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.

Chronic low back pain (CLBP) is prevalent and CLBP disability reinforces poverty and Nigerian rural-urban inequality. Most rural Nigerian dwellers with CLBP consult unconventional practitioners due to difficulty in accessing conventional health care. This interaction may influence back pain beliefs and behaviours, and health outcomes including disability. Read More

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http://dx.doi.org/10.1177/1178632918808783DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6207981PMC
October 2018
16 Reads

Priorities and Challenges Accessing Health Care Among Female Migrants.

Health Serv Insights 2018 30;11:1178632918804825. Epub 2018 Oct 30.

Department of International Development, London School of Economics and Political Science, London, UK.

Women's ability to access health care requires access to and control of resources as well as the ability to make personal health decisions. Female migrants may experience additional challenges in accessing health care due to marginalization and vulnerability resulting from both their gender and their migrant status. Rural-to-urban migrant women working in the informal sector, such as Ghana's head porters (), experience exclusion from the health system, risk of being uninsured, and poor health outcomes. Read More

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http://dx.doi.org/10.1177/1178632918804825DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6207976PMC
October 2018
14 Reads

A Model for Out-of-Hospital Multispecialty Emergency Medicine: Accomplishments and Challenges.

Health Serv Insights 2018 23;11:1178632918805996. Epub 2018 Oct 23.

Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece.

Home care has been traditionally considered as an important type of medical service. "SOS Doctors" is a Greek organization providing out-of-hospital multispecialty emergency medicine services the past 25 years. Its services mainly meet the demands of the elderly and the nonambulatory patients. Read More

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http://dx.doi.org/10.1177/1178632918805996DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201181PMC
October 2018
1 Read

Too Early to Cut Transportation Benefits From Medicaid Enrollees.

Health Serv Insights 2018 14;12:1178632918804817. Epub 2018 Oct 14.

Faegre Baker Daniels Consulting, Washington, DC, USA.

Some state governments are considering cuts to the non-emergency medical transportation (NEMT) benefit for Medicaid enrollees, and some Federal officials have proposed making this easier. Yet, there is clear demand. In 2015 alone, low-income patients used 59 million rides for medical appointments. Read More

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http://journals.sagepub.com/doi/10.1177/1178632918804817
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http://dx.doi.org/10.1177/1178632918804817DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6194915PMC
October 2018
13 Reads

Opioids and the Internet: Convergence of Technology and Policy to Address the Illicit Online Sales of Opioids.

Authors:
Tim K Mackey

Health Serv Insights 2018 14;11:1178632918800995. Epub 2018 Sep 14.

Global Health Policy Institute, San Diego, CA, USA.

The United States is in the midst of an opioid public health emergency, one that is also influenced by a convergence of Internet-based technology, health policy, and the need for stakeholder collaboration and action around the need to combat the illicit online sales of opioids by illegal online pharmacies and digital drug dealers. This risk is not new, however, with calls to actively reduce online opioid availability as online pharmacies use a growing array of digital channels, including search engines, social media platforms, and the dark Web. In response, the US Food and Drug Administration convened a special June 2018 summit bringing together technology companies, government agencies, researchers, and advocacy groups with the goal of collaboratively developing and implementing solutions to tackle the problem. Read More

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http://dx.doi.org/10.1177/1178632918800995DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6144490PMC
September 2018
2 Reads

Accounting for What Matters to Patients in the G-DRG System: A Stakeholder's Perspective on Integrating Functioning Information.

Health Serv Insights 2018 3;11:1178632918796776. Epub 2018 Sep 3.

Swiss Paraplegic Research, Guido A. Zäch Institute (GZI), Nottwil, Switzerland.

Functioning information constitutes a relevant component for determining patients' service needs and respective resource use. Diagnosis-Related Group (DRG) systems can be optimized by integrating functioning information. First steps toward accounting for functioning information in the German DRG (G-DRG) system have been made; yet, there is no systematic integration of functioning information. Read More

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http://dx.doi.org/10.1177/1178632918796776DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122243PMC
September 2018
1 Read

The Pediatric Personal Care Allocation Model for Home Care (PCAM): A Personal Care Case-Mix Model for Children Facing Special Health Care Challenges.

Health Serv Insights 2018 6;11:1178632918795444. Epub 2018 Sep 6.

Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, TX, USA.

Background: State Medicaid programs in the United States provide services to children with special health care challenges through the Early Prevention, Screening, Diagnostic, and Treatment program. One element of the services provided is Medicaid Personal Care Services (PCS), which are intended to correct or ameliorate any functional impairments faced by a child or youth (C/Y) in the community. Previous research indicates that considerable variation in the allocation of PCS depends on the assessor. Read More

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http://dx.doi.org/10.1177/1178632918795444DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6128076PMC
September 2018
1 Read

Measuring Team Effectiveness in the Health Care Setting: An Inventory of Survey Tools.

Health Serv Insights 2018 24;11:1178632918796230. Epub 2018 Aug 24.

Health Policy Research, American Society of Anesthesiologists, Schaumburg, IL, USA.

Background: Guidance for measuring team effectiveness in dynamic clinical settings is necessary; however, there are no consensus strategies to help health care organizations achieve optimal teamwork. This systematic review aims to identify validated survey instruments of team effectiveness by clinical settings.

Methods: PubMed, MEDLINE, and ISI Web of Knowledge were searched for team effectiveness surveys deployed from 1990 to 2016. Read More

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http://dx.doi.org/10.1177/1178632918796230DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6109848PMC
August 2018
8 Reads

Predictors of Emergent Emergency Department Visits and Costs in Community-Dwelling Older Adults.

Health Serv Insights 2018 22;11:1178632918790256. Epub 2018 Aug 22.

Virginia Commonwealth University School of Medicine, Richmond, VA, USA.

Background: The number of yearly emergency department (ED) visits by older adults in the United States has been increasing.

Purpose: The objectives were to (1) describe the demographics, health-related variables, and ED visit characteristics for community-dwelling older adults using an urban, safety-net ED; (2) examine the association between demographics, health-related variables, and ED visit characteristics with emergent vs nonemergent ED visits; and (3) examine the association between demographics, health-related variables, ED visit characteristics, and ED visit costs.

Methods: A cross-sectional, retrospective analysis of administrative electronic medical record and billing information from 2010 to 2013 ED visits (n = 7805) for community-dwelling older adults (⩾65 years old) from an academic medical center in central Virginia was conducted. Read More

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http://dx.doi.org/10.1177/1178632918790256DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6108010PMC
August 2018
16 Reads

Predictors of Undiagnosed and Uncontrolled Hypertension in the Local Community of Byblos, Lebanon.

Health Serv Insights 2018 13;11:1178632918791576. Epub 2018 Aug 13.

Cardiology Department, University Hospital Notre Dame des Secours, Byblos, Lebanon.

Objective: This study aimed to determine the prevalence and predictors of undiagnosed and uncontrolled hypertension (HTN) in a local community in Lebanon.

Design And Methods: In this cross-sectional study, we interviewed 911 adults in the local community of Byblos, Lebanon, and 691 were enrolled in the study. Blood pressure (BP), height, and weight were measured. Read More

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http://dx.doi.org/10.1177/1178632918791576DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6090497PMC
August 2018
3 Reads

Marketplace Coverage and Limited Access to Care Among Employed Beneficiaries? Evidence From Ohio.

Health Serv Insights 2018 25;11:1178632918790880. Epub 2018 Jul 25.

College of Public Health, The Ohio State University, Columbus, OH, USA.

This article examines the initial effect of Affordable Care Act (ACA) Health Insurance Marketplace (Exchange) insurance on access to care among employed beneficiaries in a highly populated US state. Does Exchange insurance lead to better/worse health care access for employed beneficiaries, compared with similar individuals covered through standard employer-sponsored insurance (ESI) coverage? This retrospective study uses data from the 2015 Ohio Medicaid Assessment Survey, a dual-frame and computer-assisted telephone survey administered by the Ohio Colleges of Medicine Graduate Resource Center, the Ohio Department of Medicaid, the Ohio Department of Health, and Ohio State University, in conjunction with RTI International. This study examines a sub-sample of employed adults (age 18-64) covered by either an Exchange plan or ESI, extracted from the full sample of  = 42 876. Read More

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http://dx.doi.org/10.1177/1178632918790880DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6073828PMC
July 2018
11 Reads

Investigating Risk Adjustment Methods for Health Care Provider Profiling When Observations are Scarce or Events Rare.

Health Serv Insights 2018 5;11:1178632918785133. Epub 2018 Jul 5.

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.

Background: When profiling health care providers, adjustment for case-mix is essential. However, conventional risk adjustment methods may perform poorly, especially when provider volumes are small or events rare. Propensity score (PS) methods, commonly used in observational studies of binary treatments, have been shown to perform well when the amount of observations and/or events are low and can be extended to a multiple provider setting. Read More

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http://dx.doi.org/10.1177/1178632918785133DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6069022PMC
July 2018
3 Reads

Effects on Clinical Outcomes of a 5-Year Surgical Safety Checklist Implementation Experience: A Large-scale Population-Based Difference-in-Differences Study.

Health Serv Insights 2018 23;11:1178632918785127. Epub 2018 Jul 23.

Azienda Ospedaliera - Universitaria Policlinico of Modena-Emilia-Romagna, Modena, Italy.

The adoption of a surgical checklist is strongly recommended worldwide as an effective practice to improve patient safety; however, several studies have reported mixed results and a number of issues are still unresolved. The main objective of this study was to explore the impact of the first 5-year period of a surgical checklist-based intervention in a large regional health care system in Italy (4 500 000 inhabitants). We conducted a retrospective longitudinal study on 1 166 424 patients who underwent surgery in 48 public hospitals between 2006 and 2014. Read More

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http://dx.doi.org/10.1177/1178632918785127DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6056784PMC
July 2018
3 Reads

Childhood Tuberculosis in Nigeria: Disease Presentation and Treatment Outcomes.

Health Serv Insights 2018 22;11:1178632918757490. Epub 2018 Feb 22.

KNCV Tuberculosis Foundation, Hague, The Netherlands.

Objectives: Understanding the factors that influence tuberculosis (TB) treatment outcomes in children is key to designing interventions to address them. This study aimed to determine the case category distribution of childhood TB in Nigeria and assess which clinical and demographic factors are associated with different treatment outcomes in childhood TB.

Materials And Methods: This was a retrospective cohort study involving a review of medical records of children (0-14 years) with TB in 3 states in Nigeria in 2015. Read More

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http://dx.doi.org/10.1177/1178632918757490DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5826094PMC
February 2018
9 Reads

Perioperative Medicine: A Burgeoning Field with Profound Importance to a Modern Clinician.

Health Serv Insights 2018 11;11:1178632917750880. Epub 2018 Jan 11.

Moffitt Cancer Center, University of South Florida, Tampa, FL, USA.

AIMS AND SCOPE This article serves in introducing the readers to the developing field of perioperative medicine. We have made an effort to come up with the latest management guidelines covering multiple subspecialties in form of a special supplement. This compendium in perioperative medicine serves as a comprehensive guide to a practicing clinician, in managing patients with various medical comorbidities undergoing surgical procedures and avoiding common pitfalls. Read More

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http://dx.doi.org/10.1177/1178632917750880DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5768259PMC
January 2018
2 Reads

Perioperative Management of Patients with Diabetes.

Health Serv Insights 2017 15;10:1178632917735075. Epub 2017 Nov 15.

Division of Geriatric Medicine, North Shore University Hospital/Long Island Jewish Medical Center, Manhasset, NY, USA.

Hyperglycemia has long been recognized to have detrimental effects on postoperative outcomes in patients undergoing surgery. The manifestations of uncontrolled diabetes are manifold and can include risk of hyperglycemic crises, postoperative infection, poor wound healing, and increased mortality. There is substantial literature supporting the role of diligent glucose control in the prevention of adverse surgical outcomes, but considerable debate remains as to the optimal glucose targets. Read More

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http://dx.doi.org/10.1177/1178632917735075DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5692120PMC
November 2017
12 Reads

Perioperative Management of Neurological Conditions.

Health Serv Insights 2017 12;10:1178632917711942. Epub 2017 Jun 12.

Department of Medicine, Bronx-Lebanon Hospital Center, Bronx, NY, USA.

Perioperative care of the patients with neurological diseases can be challenging. Most important consideration is the management and understanding of pathophysiology of these disorders and evaluation of new neurological changes that occur perioperatively. Perioperative generally refers to 3 phases of surgery: preoperative, intraoperative, and postoperative. Read More

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http://dx.doi.org/10.1177/1178632917711942DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5470849PMC
June 2017
5 Reads

Marketization in Long-Term Care: A Cross-Country Comparison of Large For-Profit Nursing Home Chains.

Health Serv Insights 2017 8;10:1178632917710533. Epub 2017 Jun 8.

Department of Social Work, Stockholm University, Stockholm, Sweden.

This article presents cross-country comparisons of trends in for-profit nursing home chains in Canada, Norway, Sweden, United Kingdom, and the United States. Using public and private industry reports, the study describes ownership, corporate strategies, costs, and quality of the 5 largest for-profit chains in each country. The findings show that large for-profit nursing home chains are increasingly owned by private equity investors, have had many ownership changes over time, and have complex organizational structures. Read More

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http://dx.doi.org/10.1177/1178632917710533DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5467918PMC
June 2017
12 Reads

Reply to Commentary on Our Paper "Palliative Care and Patient Autonomy."

Health Serv Insights 2017 6;10:1178632917710022. Epub 2017 Jun 6.

Department of Philosophy, Cleveland State University, Cleveland, OH, USA.

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http://dx.doi.org/10.1177/1178632917710022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5462553PMC
June 2017
4 Reads

Response to LiPuma and DeMarco's Article on "Hastening Death".

Authors:
Julia Zenz

Health Serv Insights 2017 6;10:1178632917710017. Epub 2017 Jun 6.

Ruhr University Bochum, Germany.

The paper "Palliative care and patient autonomy: moving beyond prohibitions against hastening death" by LiPuma and DeMarco deals with an aspect of end of life care which is the source of considerable disagreement. It is important to emphasize that autonomy is not the unique feature for end of life care. There is always a medical and ethical commitment to care, i. Read More

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http://dx.doi.org/10.1177/1178632917710017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5462549PMC
June 2017
6 Reads

Cardiac Evaluation and Monitoring of Patients Undergoing Noncardiac Surgery.

Health Serv Insights 2017 20;9:1178632916686074. Epub 2017 Feb 20.

Division of Cardiology, Department of Medicine, Bronx-Lebanon Hospital Center, Bronx, NY, USA.

Surgical management of disease has a tremendous impact on our health system. Millions of people worldwide undergo surgeries every year. Cardiovascular complications in the perioperative period are one of the most common events leading to increased morbidity and mortality. Read More

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http://dx.doi.org/10.1177/1178632916686074DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5398290PMC
February 2017
6 Reads

Engaging Community Leaders in the Development of a Cardiovascular Health Behavior Survey Using Focus Group-Based Cognitive Interviewing.

Health Serv Insights 2017 21;10:1178632917701123. Epub 2017 Apr 21.

Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, USA.

Establishing the validity of health behavior surveys used in community-based participatory research (CBPR) in diverse populations is often overlooked. A novel, group-based cognitive interviewing method was used to obtain qualitative data for tailoring a survey instrument designed to identify barriers to improved cardiovascular health in at-risk populations in Washington, DC. A focus group-based cognitive interview was conducted to assess item comprehension, recall, and interpretation and to establish the initial content validity of the survey. Read More

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http://journals.sagepub.com/doi/10.1177/1178632917701123
Publisher Site
http://dx.doi.org/10.1177/1178632917701123DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5404898PMC
April 2017
12 Reads

Outcomes of Surgeries Performed in Physician Offices Compared With Ambulatory Surgery Centers and Hospital Outpatient Departments in Florida.

Health Serv Insights 2017 20;10:1178632917701025. Epub 2017 Apr 20.

Avalon Health Economics LLC, Morristown, NJ, USA.

Background: The proportion of outpatient surgeries performed in physician offices has been increasing over time, raising concern about the impact on outcomes.

Objective: To use a private insurance claims database to compare 7-day and 30-day hospitalization rates following relatively complex outpatient surgical procedures across physician offices, freestanding ambulatory surgery centers (ASCs), and hospital outpatient departments (HOPDs).

Methods: A multivariable logistic regression model was used to compare the risk-adjusted probability of hospitalization among patients after any of the 88 study outpatient procedures at physician offices, ASCs, and HOPDs over 2008-2012 in Florida. Read More

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http://dx.doi.org/10.1177/1178632917701025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5404902PMC
April 2017
13 Reads

Mental Health Service Provision in Low- and Middle-Income Countries.

Health Serv Insights 2017 28;10:1178632917694350. Epub 2017 Mar 28.

Department of Psychiatry, Queen's University, Kingston, ON, Canada.

This article discusses the provision of mental health services in low- and middle-income countries (LMICs) with a view to understanding the cultural dynamics-how the challenges they pose can be addressed and the opportunities harnessed in specific cultural contexts. The article highlights the need for prioritisation of mental health services by incorporating local population and cultural needs. This can be achieved only through political will and strengthened legislation, improved resource allocation and strategic organisation, integrated packages of care underpinned by professional communication and training, and involvement of patients, informal carers, and the wider community in a therapeutic capacity. Read More

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http://dx.doi.org/10.1177/1178632917694350DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5398308PMC
March 2017
9 Reads

Perioperative Care of Patients With Liver Cirrhosis: A Review.

Health Serv Insights 2017 24;10:1178632917691270. Epub 2017 Feb 24.

Division of Gastroenterology, Bronx-Lebanon Hospital Center, Bronx, NY, USA.

The incidence of cirrhosis is rising, and identification of these patients prior to undergoing any surgical procedure is crucial. The preoperative risk stratification using validated scores, such as Child-Turcotte-Pugh (CTP) and Model for End-Stage Liver Disease, perioperative optimization of hemodynamics and metabolic derangements, and postoperative monitoring to minimize the risk of hepatic decompensation and complications are essential components of medical management. The advanced stage of cirrhosis, emergency surgery, open surgeries, old age, and coexistence of medical comorbidities are main factors influencing the clinical outcome of these patients. Read More

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http://dx.doi.org/10.1177/1178632917691270DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5398291PMC
February 2017
46 Reads

Perioperative Management of Thyroid Dysfunction.

Health Serv Insights 2017 20;10:1178632916689677. Epub 2017 Feb 20.

Division of Endocrinology, Bronx-Lebanon Hospital Center, Bronx, NY, USA.

Due to the manifold effects of thyroid hormone across virtually all organ systems, the complications associated with thyroid dysfunction are numerous and diverse. The stresses encountered during the perioperative period may exacerbate underlying thyroid disorders, potentially precipitating decompensation and even death. Thus, it is of the utmost importance for the clinician to comprehend the mechanisms by which thyroid disease may complicate surgery and postoperative recovery and to be cognizant of the most effective means of optimizing the status of thyrotoxic and hypothyroid patients perioperatively. Read More

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http://dx.doi.org/10.1177/1178632916689677DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5398303PMC
February 2017
32 Reads

Evaluation and Monitoring of Patients With Cardiovascular Implantable Electronic Devices Undergoing Noncardiac Surgery.

Health Serv Insights 2017 20;10:1178632916686073. Epub 2017 Mar 20.

Division of Cardiology, Department of Medicine, Bronx-Lebanon Hospital Center, Bronx, NY, USA.

In this article, the reader will get some insights into managing patient with implantable cardiac devices while undergoing noncardiac surgery. We will review basic concepts regarding normal function of pacemakers and implantable cardioverter defibrillators, understanding how their function will be influenced during noncardiac surgeries. You will be guided through management steps from preoperative, intraoperative, and postoperative aspects. Read More

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http://dx.doi.org/10.1177/1178632916686073DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5398302PMC
March 2017
6 Reads

Perioperative Management of Direct Oral Anticoagulants (DOACs): A Systemic Review.

Health Serv Insights 2016 13;9(Suppl 1):25-36. Epub 2016 Dec 13.

Division of Gastroenterology, The Brooklyn Hospital Center, Brooklyn, NY, USA.

Direct oral anticoagulants (DOACs) are in wide use among patients requiring both short- and long-term anticoagulation, mainly due to their ease of use and the lack of monitoring requirements. With growing use of DOACs, it is imperative that physicians be able to manage patients on these medications, especially in the perioperative period. We aim to provide guidance on the management of DOACs in the perioperative period. Read More

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http://dx.doi.org/10.4137/HSI.S40701DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5156547PMC
December 2016
10 Reads

Palliative Care and Patient Autonomy: Moving Beyond Prohibitions Against Hastening Death.

Health Serv Insights 2016 8;9:37-42. Epub 2016 Dec 8.

Department of Philosophy, Cleveland State University, Cleveland, OH, USA.

The National Hospice and Palliative Care Organization (NHPCO) upholds policies prohibiting practices that deliberately hasten death. We find these policies overly restrictive and unreasonable. We argue that under specified circumstances it is both reasonable and morally sound to allow for treatments that may deliberately hasten death; these treatments should be part of the NHPCO guidelines. Read More

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http://dx.doi.org/10.4137/HSI.S39013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5147517PMC
December 2016
12 Reads

Perioperative Evaluation of Patients with Pulmonary Conditions Undergoing Non-Cardiothoracic Surgery.

Health Serv Insights 2016 9;9(Suppl 1):9-23. Epub 2016 Nov 9.

Assistant Professor, Clinical Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.; Attending, Division of Pulmonary and Critical Care Medicine, Bronx Lebanon Hospital Center, Bronx, NY, USA.

This review describes the perioperative management of patients with suspected or established pulmonary conditions undergoing non-cardiothoracic surgery, with a focus on common pulmonary conditions such as obstructive airway disease, pulmonary hypertension, obstructive sleep apnea, and chronic hypoxic respiratory conditions. Considering that postoperative pulmonary complications are common and given the increasing number of surgical procedures and the size of the aging population, familiarity with current guidelines for preoperative risk assessment and intra- and postoperative patient management is recommended to decrease the morbidity and mortality. In particular, smoking cessation and pulmonary rehabilitation are perioperative strategies for improving patients' short- and long-term outcomes. Read More

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http://dx.doi.org/10.4137/HSI.S40541DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5104294PMC
November 2016
11 Reads

Development, Functioning, and Effectiveness of a Preoperative Risk Assessment Clinic.

Health Serv Insights 2016 30;9(Suppl 1):1-7. Epub 2016 Oct 30.

Department of Medicine, Bronx Lebanon Hospital Center, Bronx, New York, NY, USA.

Lee first described the concept of preoperative assessment testing (PAT) clinic in 1949. An efficiently run clinic is associated with increased cost-effectiveness by lowering preoperative admission time and thus reducing the length of stay and the associated costs. The setup of the PAT clinic should be based on the needs, culture, and resources of the institution. Read More

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http://dx.doi.org/10.4137/HSI.S40540DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5090289PMC
October 2016
40 Reads

Urban-Rural Differences in Health-Care-Seeking Pattern of Residents of Abia State, Nigeria, and the Implication in the Control of NCDs.

Health Serv Insights 2016 5;9:29-36. Epub 2016 Oct 5.

Federal Ministry of Health, Abuja, Nigeria.

Background: Understanding the differences in care-seeking pattern is key in designing interventions aimed at improving health-care service delivery, including prevention and control of noncommunicable diseases. The aim of this study was to identify the differences and determinants of care-seeking patterns of urban and rural residents in Abia State in southeast Nigeria.

Methods: This was a cross-sectional, community-based, study involving 2999 respondents aged 18 years and above. Read More

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http://dx.doi.org/10.4137/HSI.S31865DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5053202PMC
October 2016
21 Reads

Cost-effectiveness of SHINE: A Telephone Translation of the Diabetes Prevention Program.

Health Serv Insights 2016 6;9:21-8. Epub 2016 Jul 6.

Departments of Medicine, Psychiatry and Behavioral Sciences, and Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, NY, USA.

Background: The Support, Health Information, Nutrition, and Exercise (SHINE) trial recently showed that a telephone adaptation of the Diabetes Prevention Program (DPP) lifestyle intervention was effective in reducing weight among patients with metabolic syndrome. The aim of this study is to determine whether a conference call (CC) adaptation was cost effective relative to an individual call (IC) adaptation of the DPP lifestyle intervention in the primary care setting.

Methods: We performed a stochastic cost-effectiveness analysis alongside a clinical trial comparing two telephone adaptations of the DPP lifestyle intervention. Read More

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http://dx.doi.org/10.4137/HSI.S39084DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4936790PMC
July 2016
11 Reads

The Need for Higher Minimum Staffing Standards in U.S. Nursing Homes.

Health Serv Insights 2016 12;9:13-9. Epub 2016 Apr 12.

Division of General Internal Medicine and Public Health, Center for Quality Aging, Vanderbilt University, Nashville, TN, USA.; Department of Veterans Affairs, Geriatric Research Education and Clinical Center, Tennessee Valley Healthcare System, Nashville, TN, USA.; Associate Professor, Department of Medicine, Division of Geriatrics, Vanderbilt University, Nashville, TN, USA.

Many U.S. nursing homes have serious quality problems, in part, because of inadequate levels of nurse staffing. Read More

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http://dx.doi.org/10.4137/HSI.S38994DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4833431PMC
April 2016
9 Reads

Marital Status and Survival in Patients with Carcinoid Tumors.

Health Serv Insights 2016 7;9:3-11. Epub 2016 Apr 7.

Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, USA.; Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, PA, USA.

Background: Marital status is a known prognostic factor in overall and disease-specific survival in several types of cancer. The impact of marital status on survival in patients with carcinoid tumors remains unknown. We hypothesized that married patients have higher rates of survival than similar unmarried patients with carcinoid tumors. Read More

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http://dx.doi.org/10.4137/HSI.S32093DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4825773PMC
April 2016
10 Reads

Integrating Estimates of the Social and Individual Costs of Caregiving into Dementia Treatment Trials.

Health Serv Insights 2016 9;9:1-2. Epub 2016 Mar 9.

Editor in Chief, Health Services Insights, Texas A&M University Health Science Center, College Station, TX, USA.; Emeritus Regents Professor, School of Public Health, Texas A&M University Health Science Center, College Station, TX, USA.

A variety of new treatments for dementia are awaiting or undergoing randomized clinical trails. These trials focus on outcomes such as changes in cognitive function, physical function, or amyloid plaques. What is quite important and is too often missing from these trials are estimates of the impact of these treatments on the social and individual costs of providing care for those facing dementia. Read More

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http://dx.doi.org/10.4137/HSI.S39433DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4786098PMC
March 2016
18 Reads

The Pediatric Home Care/Expenditure Classification Model (P/ECM): A Home Care Case-Mix Model for Children Facing Special Health Care Challenges.

Health Serv Insights 2015 28;8:35-43. Epub 2015 Dec 28.

Department of Health Policy and Management, School of Public Health, Health Science Center, Texas A&M University, College Station, TX, USA.

Case-mix classification and payment systems help assure that persons with similar needs receive similar amounts of care resources, which is a major equity concern for consumers, providers, and programs. Although health service programs for adults regularly use case-mix payment systems, programs providing health services to children and youth rarely use such models. This research utilized Medicaid home care expenditures and assessment data on 2,578 children receiving home care in one large state in the USA. Read More

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http://dx.doi.org/10.4137/HSI.S35366DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4694607PMC
January 2016
9 Reads

Evaluation of Patient Satisfaction with Tuberculosis Services in Southern Nigeria.

Health Serv Insights 2015 13;8:25-33. Epub 2015 Oct 13.

Department of Community Medicine, Imo State University, Owerri, Imo State, Nigeria.

Objective: Knowing tuberculosis (TB) patients' satisfaction enables TB program managers to identify gaps in service delivery and institute measures to address them. This study is aimed at evaluating patients' satisfaction with TB services in southern Nigeria.

Materials And Methods: A total of 378 patients accessing TB care were studied using a validated Patient Satisfaction (PS-38) questionnaire on various aspects of TB services. Read More

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http://dx.doi.org/10.4137/HSI.S27177DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4605255PMC
October 2015
19 Reads
2 Citations