Do Report Cards Predict Future Quality?The Case of Skilled Nursing Facilities

Publication date: Available online 24 May 2019Source: Journal of Health EconomicsAuthor(s): Momotazur RahmanAbstractReport cards on provider performance are intended to improve consumer decision-making and address information gaps in the market for quality. However, inadequate risk adjustment of report-card measures often biases comparisons across providers. We test whether going to a skilled nursing facility (SNF) with a higher star rating leads to better quality outcomes for a patient. We exploit variation over time in the distance from a patient’s residential ZIP code to SNFs with different ratings to estimate the causal effect of admission to a higher-rated SNF on health care outcomes, including mortality. We found that patients who go to higher-rated SNFs achieved better outcomes, supporting the validity of the SNF report card ratings.Although quality is an essential determinant of the demand for goods and services, consumers often have incomplete information about quality prior to purchase. As such, in many markets consumers rely on published firm ratings to help choose a particular provider of goods or services. The quality of health care services is especially difficult for consumers to evaluate. Therefore, it can be efficient for the government to overcome this market failure by collecting information about quality and reporting it publicly. In the case of health care, the government publishes report cards online for hospitals, dialysis facilities, nursing home...
Source: Journal of Health Economics - Category: Health Management Source Type: research

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Infected arteriovenous grafts necessitate intervention to obtain source control. However, excising the graft material can be challenging and can lead to complications. Leaving a cuff of graft at the sites of anastomosis allows for the avoidance of potential risks. However, it is unclear whether doing so places patients at risk of recurrent graft infection. The purpose of the present study was to investigate the effect of complete vs partial excision of infected arteriovenous prosthetic dialysis access grafts.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Source Type: research
Prognostic value of N-terminal fragment of the prohormone brain-type natriuretic peptide (NT-proBNP) was analyzed in patients with multiple myeloma complicated by dialysisdependent renal failure. The prospective study included 20 patients with newly diagnosed multiple myeloma. The concentrations of NT-proBNP were measured before antimyeloma chemotherapy. The median age of the patients was 67 (63-76) years. The median glomerular filtration rate was 4 (4, 5) ml/min/1.73 m2. For overall survival, the area under ROC curve was 0.75 and the cut-off point was 7000 pg/ml. At median follow-up of 17.3 months, the overall survival wa...
Source: Bulletin of Experimental Biology and Medicine - Category: Biology Source Type: research
Authors: Niyyar VD Abstract Sonography is increasingly being used by nephrologists and the field of dialysis access is no exception. Advances in technology have allowed the addition of this universally available, portable, non-invasive tool to the nephrologist's armamentarium, which provides information on both morphology and physiology without the need for contrast or radiation. Ultrasound may be used across the spectrum of dialysis access, including central venous catheter placements, vascular mapping, regional anesthesia, creation, maintenance and assessment of hemodialysis access as well as assessment of the ab...
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research
Publication date: November 2019Source: Carbon, Volume 152Author(s): Pranjali Yadav, S.T. Nishanthi, Bhagyesh Purohit, Asifkhan Shanavas, Kamalakannan KailasamAbstractGraphitic carbon nitride (g-CN, commonly called as g-C3N4) quantum dots exhibiting excellent photoluminescence behaviour is explored as metal-free visible light photocatalytic antibacterial agents. The g-CNQDs were synthesized by two-step thermal polymerization and selective dialysis approach yielding particle size in the range of 2–7 nm with a large specific surface area of 264 m2/g. The fluorescent g-CNQDs could efficiently generate superoxide and ...
Source: Carbon - Category: Materials Science Source Type: research
ien-Cheng Huang Physicians experience high stress and have much responsibility during a night shift, which contributes to increased sympathetic activity, the risk factor for renal disease. The risk for end-stage renal disease (ESRD) in physicians is still unclear. Therefore, we conducted a nationwide population-based cohort study to clarify this issue. Using Taiwan’s National Health Insurance Research Database, we identified 30,268 physicians and 60,536 individuals from the general population matched with a ratio of 1:2 by age and sex. All participants who had ESRD before 2006 and residents were excluded. ESR...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
AbstractPurpose of ReviewNon-dialysis-dependent chronic kidney disease (NDD-CKD) patients are at an increased risk of cardiovascular disease (CVD) –related deaths in comparison with the general population. This review summarizes recent guideline recommendations and studies on primary and secondary prevention of traditional cardiovascular (CV) risk factors in those with NDD-CKD.Recent FindingsThe use of antiplatelet agents for primary prevention in CKD is not supported by clinical trial evidence; however, they offer potential benefits when used for secondary prevention of CVD in the absence of an elevated bleeding ris...
Source: Current Atherosclerosis Reports - Category: Cardiology Source Type: research
Sodium zirconium cyclosilicate effectively treats hyperkalemia in patients receiving hemodialysis for end-stage kidney disease, and no new safety concerns were observed in the phase 3 DIALIZE study.Medscape Medical News
Source: Medscape Transplantation Headlines - Category: Transplant Surgery Tags: Nephrology News Source Type: news
Conditions:   Chronic Kidney Disease Requiring Chronic Dialysis;   Hemodialysis, Home;   Electric Impedance Intervention:   Other: Measurement of the hydration state by bio-impedance spectroscopy Sponsor:   University Hospital, Caen Recruiting
Source: - Category: Research Source Type: clinical trials
Condition:   End Stage Renal Disease Interventions:   Drug: 0.7% Xylitol, 0.5% Glucose, and 0.02% L-carnitine - or - 1.5% Xylitol, 0.5% Glucose, and 0.02% L-carnitine - or - 2.0% Xylitol, 1.5% Glucose, and 0.02% L-carnitine;   Drug: 1.36% or 2.27% or 3.86% Glucose Sponsor:   Iperboreal Pharma Srl Not yet recruiting
Source: - Category: Research Source Type: clinical trials
Conditions:   Chronic Kidney Disease Requiring Chronic Dialysis;   Hemodialysis, Home;   Electric Impedance Intervention:   Other: Measurement of the hydration state by bio-impedance spectroscopy Sponsor:   University Hospital, Caen Recruiting
Source: - Category: Research Source Type: clinical trials
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