A Medical Director ’s Perspective: Influencing Rehospitalization Rates

Efforts to reduce hospitalizations often focus on identifying specific clinical conditions that contribute to hospitalizations, particularly those that are considered potentially preventable. Potentially preventable hospitalizations result from exacerbation of clinical conditions such as congestive heart failure, chronic obstructive pulmonary disease, or diabetes in which the exacerbation and hospitalization could have been prevented had optimal care been provided. The theory is that by incentivizing providers to focus on specific clinical categories that are likely to contribute to admissions for preventable reasons, we can reduce the overall rate of hospitalization.
Source: Caring for the Ages - Category: Health Management Authors: Tags: AHCA PERSPECTIVE Source Type: news

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CONCLUSIONS: Patients suffering from OSAS have very high prevalence of comorbidities indicating a great burden on the healthcare system. Despite this fact, over 50% of the patients studied did not receive any treatment. Charities were the main portal fortreatment. PMID: 30685854 [PubMed - as supplied by publisher]
Source: Sleep and Breathing - Category: Sleep Medicine Authors: Tags: Sleep Breath Source Type: research
In a blog post last week, I shared an excerpt from the new book that Paul Cerrato and I just completed,The Transformative Power of Mobile Medicine. Here is a second excerpt from Chapter 3,  “Exploring the Strengths and Weaknesses of Mobile Health Apps.”Even patients who are fully engaged in their own care still need access to medical apps they can trust. The IQVIA Institute for Human Data Science has performed a detailed analysis of the clinical evidence supporting mobile health apps, rating their maturity and relative quality. Its rating scale places a single observational study near the bottom of th...
Source: Life as a Healthcare CIO - Category: Information Technology Source Type: blogs
This study aimed to determine the predictors of discharge to a facility and develop and validate a predictive scoring model, utilizing the Oklahoma Trauma Registry (OTR).MethodsA multivariate analysis of the OTR 2005-2013 determined independent predictors of discharge to a facility. A scoring model was developed, and positive and negative predictive values (PPV and NPV) were evaluated for 2014 patients.Results101,656 patients were analyzed. The scoring model included age≥50 years, lower extremity fracture, ICU stay≥5 days, pelvic fracture, intracranial hemorrhage, congestive heart failure, cardiac dysrhythmia, histor...
Source: The American Journal of Surgery - Category: Surgery Source Type: research
Authors: Zewari S, Hadi L, van den Elshout F, Dekhuijzen R, Heijdra Y, Vos P Abstract COPD and obesity often coexist and there is a complex interaction between them. Our aim was to evaluate the prevalence of obesity in a secondary care COPD population. Furthermore, the presence of comorbidities in obese (COPDOB) and non-obese COPD (COPDNO) individuals was studied. In 1654 COPD patients (aged ≥18 years) who visited a pulmonologist between January 2015 and December 2015, patient characteristics, pulmonary function tests and comorbidities were obtained from the medical records. Subjects were categorized according t...
Source: COPD: Journal of Chronic Obstructive Pulmonary Disease - Category: Respiratory Medicine Tags: COPD Source Type: research
This report card is grossly inaccurate even though it relies on medical records data as well as claims data.) By the late 1990s, conventional wisdom among health policy “thought leaders” had elevated readmission rates to the same status as mortality rates – it was a legitimate quality measure that could be safely administered to thousands of hospitals and millions of patients. However, the conventional wisdom remained unproven by the early 2000s, and remains unproven to this day. “[T]he link between early readmission and quality of care is still uncertain,” is how five experts put it in a 2004...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medicare Politics ACA Affordable Care Act CHIP CMS Congress hospital readmissions Kip Sullivan MACRA MedPAC P4P Pay for Performance Source Type: blogs
AbstractThe recognition that chronic care delivery is suboptimal has led many health authorities around the world to redesign it. In Norway, the Department of Health and Care Services implemented the Coordination Reform in January 2012. One policy instrument was to build emergency bed capacity (EBC) as an integrated part of primary care service provided by municipalities. The explicit aim was to reduce the rate of avoidable admissions to state-owned hospitals. Using five different sources of register data and a quasi-experimental framework —the “difference-in-differences” regression approach—we esti...
Source: The European Journal of Health Economics - Category: Health Management Source Type: research
Background: Obstructive sleep apnea syndrome (OSAS) is a syndrome characterized by respiratory patterns such as recurrent apnea or hypopnea during sleep and usually with desaturation. We aimed to present comorbid conditions of patients admitted to our clinic with OSAS diagnosis.Method: The records of 1969 patients who admitted to Sleep Disorders Laboratory of the Faculty of Medicine, Dicle University between 2008 and 2015 were retrospectively reviewed. The demographic characteristics, severity of OSAS, comorbidities of these patients were evaluated.Results: The apnea hypopnea index (AHI) of 529 patients was normal, 357 pat...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sleep and control of breathing Source Type: research
While specifically targeting diabetes, chronic obstructive pulmonary disease (COPD), and congestive heart failure, this program takes a comprehensive approach to patients’ physical, mental, and social health needs. WSICP supports a move from a general practitioner (GP) to a patient-centered, “team-based” medical home model. It features a care facilitator role to oversee smoother transitions between hospital and primary care settings. Care facilitators, registered nurses employed by the Western Sydney Local Health District (WSLHD), engage with patients as soon as they are enrolled by a GP, a care facilitat...
Source: The Commonwealth Fund: Publications - Category: International Medicine & Public Health Source Type: research
Conclusions Clinicians should consider patient age and history of stroke, peripheral vascular disease, or anxiety/panic disorders when optimizing a lower limb prosthesis users' mobility because these variables may be predictive of modest but clinically meaningful decreased prosthetic mobility. By contrast, common comorbid health conditions such as arthritis, chronic obstructive pulmonary disease, congestive heart failure, and diabetes do not seem predictive of decreased mobility among lower limb prosthesis users.
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Original Research Articles Source Type: research
The objective of this study is to determine if certain comorbidities affect length of stay. A sample of 3,399 patients with COPD were assessed from the Premier© healthcare database. The cohort had a mean (standard deviation (SD)) age of 68.41 (10.85) years. The average number of comorbidities was 24.83 (10.46) with a mean length of stay (SD) of 11.64 (9.40) days. A negative binomial regression model was used to evaluate the impact that comorbidities have on the length of hospital stay. The authors found that the number of comorbidities was associated with an increased length of stay (r = .4596, p 
Source: COPD: Journal of Chronic Obstructive Pulmonary Disease - Category: Respiratory Medicine Tags: COPD Source Type: research
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