Effectiveness of the IQM peer review procedure to improve in-patient care —a pragmatic cluster randomized controlled trial (IMPRESS): study design and baseline results

ConclusionThe IMPRESS study provides a unique opportunity to assess the impact of the IQM peer review on the mortality in patients ventilated> 24  h. The secondary, exploratory, and qualitative analyses are expected to provide insights on determinants of in-hospital mortality, structure and process quality, and the robustness of different approaches to risk adjustment of quality indicators.
Source: Journal of Public Health - Category: Health Management Source Type: research

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Introduction: Patients with chronic obstructive pulmonary disease (COPD) have higher risk of hospitalization for cardiovascular events (CVE). An association between influenza infection and myocardial infarction (MI) is established. Our objective is to evaluate the COPD as an additional risk factor for CVE and respiratory events (RE) in patients with respiratory viral infection.Methods: We performed a retrospective cross-sectional analysis of 139 patients, with positive PCR for respiratory viruses in January of 2018. Cardiovascular risk factors (CVRF) (hypertension, diabetes, dyslipidemia and smoking) and medical history we...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Monitoring airway disease Source Type: research
By KIP SULLIVAN, JD The notion that hospitals can reduce readmissions, and that punishing them for “excess” readmissions will get them to do that, became conventional wisdom during the 2000s on the basis of very little evidence. The Medicare Payment Advisory Commission (MedPAC) urged Congress to enact the Hospital Readmissions Reduction Program (HRRP) beginning in 2007, and in 2010 Congress did so. State Medicaid programs and private insurers quickly adopted similar programs. The rapid adoption of readmission-penalty programs without evidence confirming they can work has created widespread concern that th...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Health Policy CMS hospital readmissions Hospital Readmissions Reduction Program HRRP Kip Sullivan MedPAC Source Type: blogs
We examined the association between average annual fine particulate matter (PM2.5) and ozone and first hospital admissions of Medicare participants for stroke, chronic obstructive pulmonary disease (COPD), pneumonia, myocardial infarction (MI), lung cancer, and heart failure (HF). Annual average PM2.5 and ozone levels were estimated using high-resolution spatio-temporal models. We fit a marginal structural Cox proportional hazards model, using stabilized inverse probability weights (IPWs) to account for the competing risk of death and confounding. Analyses were then repeated after restricting to exposure levels below the c...
Source: Environment International - Category: Environmental Health Authors: Tags: Environ Int Source Type: research
Publication date: May 2019Source: The Lancet Global Health, Volume 7, Issue 5Author(s): MyLinh Duong, Shofiqul Islam, Sumathy Rangarajan, Darryl Leong, Om Kurmi, Koon Teo, Kieran Killian, Gilles Dagenais, Scott Lear, Andreas Wielgosz, Sanjeev Nair, Viswanathan Mohan, Prem Mony, Rajeev Gupta, Rajesh Kumar, Omar Rahman, Khalid Yusoff, Johannes Lodewykus du Plessis, Ehimario U Igumbor, Jephat ChifambaSummaryBackgroundThe associations between the extent of forced expiratory volume in 1 s (FEV1) impairment and mortality, incident cardiovascular disease, and respiratory hospitalisations are unclear, and how these associations mi...
Source: The Lancet Global Health - Category: International Medicine & Public Health Source Type: research
Conclusions reached by Gupta et al. and MedPAC In November of 2017 Ankur Gupta and 10 other experts in cardiovascular medicine published an article in JAMA Cardiology entitled, “Association of the Hospital Readmissions Reduction Program implementation with readmission and mortality outcomes in heart failure.” The authors were affiliated with well-known universities, and three of them were also editors of JAMA Cardiology [4]. Their research was financed by grants from the NIH and Get With the Guidelines-Heart Failure (GWTG-HF), a “voluntary quality improvement program” sponsored by the Amer...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medicare Politics CMS Congress hospital readmissions HRRP Kip Sullivan MedPAC P4P Pay for Performance Source Type: blogs
Conclusions reached by Gupta et al. and MedPAC In November of 2017 Ankur Gupta and 10 other experts in cardiovascular medicine published an article in JAMA Cardiology entitled, “Association of the Hospital Readmissions Reduction Program implementation with readmission and mortality outcomes in heart failure.” The authors were affiliated with well-known universities, and three of them were also editors of JAMA Cardiology [4]. Their research was financed by grants from the NIH and Get With the Guidelines-Heart Failure (GWTG-HF), a “voluntary quality improvement program” sponsored by the Amer...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medicare Politics CMS Congress hospital readmissions HRRP Kip Sullivan MedPAC P4P Pay for Performance Source Type: blogs
Conclusion EMS is in a position to be the initiator of specialty center destination. In large cities with multiple hospitals, EMS should transport patients to the closest, most appropriate facility based on patient condition, even if this requires passing a closer facility. Where there are hospitals with multiple specialty services, EMS may be asked to activate a specific team, such as the stroke or cardiac team. In rural communities, EMS can communicate with the local hospital and by letting the hospital know of patient condition, help start the interfacility transport process from the field....
Source: JEMS Special Topics - Category: Emergency Medicine Authors: Tags: Exclusive Articles Columns Operations Source Type: news
Authors: Linnen DT, Kornak J, Stephens C Abstract CONTEXT: Evidence suggests an association between rurality and decreased life expectancy. OBJECTIVE: To determine whether rural hospitals have higher hospital mortality, given that very sick patients may be transferred to regional hospitals. DESIGN: In this ecologic study, we combined Medicare hospital mortality ratings (N = 1267) with US census data, critical access hospital classification, and National Center for Health Statistics urban-rural county classifications. Ratings included mortality for coronary artery bypass grafting, stroke, chronic obstructive...
Source: The Permanente journal - Category: General Medicine Tags: Perm J Source Type: research
We examined associations between mortality and accelerometer-measured PA using age-relevant intensity cutpoints in older women of various ethnicities. The results support the hypothesis that higher levels of accelerometer-measured PA, even when below the moderate-intensity threshold recommended in current guidelines, are associated with lower all-cause and CVD mortality in women aged 63 to 99. Our findings expand on previous studies showing that higher self-reported PA reduces mortality in adults aged 60 and older, specifically in older women, and at less than recommended amounts. Moreover, our findings challenge th...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Conclusions: Lag 0–2 OPDTT was associated with ED visits for multiple cardiorespiratory outcomes, providing support for the utility of OPDTT as a measure of fine particle toxicity. https://doi.org/10.1289/EHP1545 Received: 23 December 2016 Revised: 4 August 2017 Accepted: 12 August 2017 Published: 26 October 2017 Please address correspondence to J.Y. Abrams, Centers for Disease Control and Prevention, NCEZID/DHCPP, 1600 Clifton Rd. NE, CDC Mailstop A30, Atlanta, GA 30333 USA. Telephone: (404) 639-5121. Email: jabrams@cdc.gov Supplemental Material is available online (https://doi.org/10.1289/EHP1545). The authors ...
Source: EHP Research - Category: Environmental Health Authors: Tags: Research Source Type: research
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