Psychosocial Determinants of Readmission After Surgery
Background:
Quality of life and psychosocial determinants of health, such as health literacy and social support, are associated with increased health care utilization and adverse outcomes in medical populations. However, the effect on surgical health care utilization is less understood.
Objective:
We sought to examine the effect of patient-reported quality of life and psychosocial determinants of health on unplanned hospital readmissions in a surgical population.
Research Design:
This is a prospective cohort study using patient interviews at the time of hospital discharge from a Veterans Affairs hospital....
Source: Medical Care - September 16, 2021 Category: Health Management Tags: Original Articles Source Type: research
Value of Nurse Practitioner Inpatient Hospital Staffing
The objective of this study was to determine whether the presence of more NPs produces better inpatient outcomes net of RN staffing.
Research Design:
This was a 2015–2016 cross-sectional data on 579 hospitals linked from: (1) RN4CAST-US nurse surveys; (2) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient surveys; (3) surgical patient discharge abstracts; (4) Medicare Spending per Beneficiary (MSPB) reports; (5) American Hospital Association (AHA) Annual Survey. Hospitals were grouped according to their NP/beds ratios [ (Source: Medical Care)
Source: Medical Care - September 16, 2021 Category: Health Management Tags: Original Articles Source Type: research
Demographic Characteristics Driving Disparities in Receipt of Long-term Services and Supports in the Community Setting: Erratum
No abstract available (Source: Medical Care)
Source: Medical Care - September 1, 2021 Category: Health Management Tags: Erratum Source Type: research
Will Improvements in Patient Experience With Care Impact Clinical and Quality of Care Outcomes?: A Systematic Review
Conclusions:
Ratings of patient experience with care may influence clinical and quality outcomes of care. However, key inconsistencies between studies affirm that more research is needed to solidify this conclusion and investigate how patient experiences differentially relate to outcomes for various patient groups. (Source: Medical Care)
Source: Medical Care - September 1, 2021 Category: Health Management Tags: Original Articles Source Type: research
Application of the Risk Stratification Index to Multilevel Models of All-condition 30-Day Mortality in Hospitalized Populations Over the Age of 65
Conclusion:
RSI has superior accuracy and results in a significant shift in rankings compared with HCC in multilevel models of 30-day hospital mortality across all conditions. (Source: Medical Care)
Source: Medical Care - September 1, 2021 Category: Health Management Tags: Original Articles Source Type: research
Nonprofit Hospital Community Benefits: Collaboration With Local Health Departments to Address the Drug Epidemic
Conclusions:
Collaboration between NFPs and LHDs to address drug use was associated with a deceleration in drug-induced mortality. Policymakers can leverage community benefit regulation to encourage NFP-LHD collaboration in local health planning. (Source: Medical Care)
Source: Medical Care - September 1, 2021 Category: Health Management Tags: From the States Source Type: research
Quality and Cost in Community Health Centers
Conclusion:
Efforts toward improvement of primary health care quality delivered in CHCs need not involve greater cost. (Source: Medical Care)
Source: Medical Care - September 1, 2021 Category: Health Management Tags: Original Articles Source Type: research
An Alternative Method of Public Reporting of Comparative Hospital Quality and Performance Data for Transparency Initiatives
Conclusion:
Individualized peers that incorporate external complexity generate more nuanced comparators to evaluate quality. (Source: Medical Care)
Source: Medical Care - September 1, 2021 Category: Health Management Tags: Original Articles Source Type: research
Implications of Electronic Consultations for Clinician Communication and Relationships: A Qualitative Study
Conclusions:
Clinicians have diverse concerns about the implications of e-consults for communication and relationships. Our findings may inform efforts to expand and improve the use of e-consults in diverse health care settings. (Source: Medical Care)
Source: Medical Care - September 1, 2021 Category: Health Management Tags: Original Articles Source Type: research
Changes in Opioid Prescribing Following the Implementation of State Policies Limiting Morphine Equivalent Daily Dose in a Commercially Insured Population
Conclusions:
MEDD policies were associated with decreased use of any opioids relative to control states, but no change in high-dose prescribing was observed. While the overall policy environment in treatment states may have discouraged opioid prescribing, there was no evidence of MEDD policy impact, specifically. Further research is needed to understand the mechanisms through which MEDD policies may influence prescribing behavior. (Source: Medical Care)
Source: Medical Care - September 1, 2021 Category: Health Management Tags: Original Articles Source Type: research
Hepatitis C Treatment by Nonspecialist Providers in the Direct-acting Antiviral Era
Conclusions:
HCV treatment providers remain primarily gastroenterologists, even in the current simplified treatment era. Patients receiving treatment from general medicine or nonphysician providers had a similar likelihood of treatment completion, suggesting that removing barriers to the scale-up of treatment by nonspecialists may help close treatment gaps for hepatitis C. (Source: Medical Care)
Source: Medical Care - September 1, 2021 Category: Health Management Tags: Brief Reports Source Type: research
Changes in Type 2 Diabetes Medication Utilization and Costs in the United States, 2014–2019
The objective of this study was to describe national changes in utilization and associated costs of antidiabetic medications in the United States from 2014 to 2019, across different drug classes and insurance plans.
Research Design and Methods:
This retrospective, cross-sectional study examined administrative claims from a large national pharmacy benefits manager from January 1, 2014, to December 31, 2019. Patients aged 18 years and above enrolled in commercial, Medicare, or Medicaid health plans who filled ≥1 prescription claim for an antidiabetic medication(s) during the 6-year period were included. Utilization ...
Source: Medical Care - September 1, 2021 Category: Health Management Tags: Brief Reports Source Type: research
Cost-sharing With Medicaid Expansion in Michigan: Obligations and Propensity to Pay
Conclusions:
Many payment obligations go uncollected, suggesting that in a system without the threat of disenrollment, the impacts of cost-sharing may be muted. Similarly, the ability of cost-sharing to defray the program’s budgetary impact may also be less than anticipated. (Source: Medical Care)
Source: Medical Care - September 1, 2021 Category: Health Management Tags: Brief Reports Source Type: research
Rates of Disenrollment From Medicare Advantage Plans Are Higher for Racial/Ethnic Minority Beneficiaries
The objective of this study was to investigate differences in rates of voluntary disenrollment from MA plans by race/ethnicity.
Subjects:
A total of 116,770,319 beneficiaries enrolled in 736 MA plans in 2015.
Methods:
Differences in rates of disenrollment across racial/ethnic groups [Asian or Pacific Islander (API), Black, Hispanic, and White] were summarized using 4 types of logistic regression models: adjusted and unadjusted models estimating overall differences and adjusted and unadjusted models estimating within-plan differences. Unadjusted overall models included only racial/ethnic group probabilities as...
Source: Medical Care - September 1, 2021 Category: Health Management Tags: Original Articles Source Type: research
The Relationship Between Unemployment and Health Insurance Coverage: Before and After the Affordable Care Act’s Coverage Expansions
Conclusions:
Expanded access to coverage under the ACA could mitigate the adverse effects on insurance status and access to care historically linked to job loss. However, should the ACA be repealed, many households stand to lose their ability to turn to Medicaid or subsidized nongroup coverage as safety-net resources to offset the burdens of job loss. (Source: Medical Care)
Source: Medical Care - September 1, 2021 Category: Health Management Tags: Original Articles Source Type: research
