Maryland’s Global Budget Revenue Program: Impact on Neonatal Intensive Care Unit Admissions and Infant Mortality
Conclusions:
Maryland’s hospitals reacted to the GBR program by reducing NICU services for infants that did not have clear observed clinical need. Our results suggest that GBR constrained high-cost services, without adversely affecting infant mortality. (Source: Medical Care)
Source: Medical Care - July 15, 2021 Category: Health Management Tags: Original Articles Source Type: research
Medicare Advantage Chart Reviews Are Associated With Billions in Additional Payments for Some Plans: Erratum
No abstract available (Source: Medical Care)
Source: Medical Care - July 1, 2021 Category: Health Management Tags: Erratum Source Type: research
Effects of the Affordable Care Act Medicaid Expansion on the Distribution of New General Internists Across States
Conclusions:
The Medicaid expansion influenced the practice location choices of new general internists. States that opted not to expand Medicaid under the Affordable Care Act lost general internists to expansion states, potentially affecting access to care for all their residents irrespective of insurance coverage. (Source: Medical Care)
Source: Medical Care - July 1, 2021 Category: Health Management Tags: Original Articles Source Type: research
Provider Perceptions of Virtual Care During the Coronavirus Disease 2019 Pandemic: A Multispecialty Survey Study
The objective of this study was to assess provider perceptions of the quality, efficiency, and challenges of VC versus in-person care with masks.
Design:
This was a voluntary survey.
Participants:
Mental health (MH), primary care, medical specialty, and surgical specialty providers across the 8 VA New England Healthcare System medical centers.
Measures:
Provider ratings of: (1) quality and efficiency of VC (phone and video telehealth) compared with in-person care with masks; (2) challenges of VC; and (3) percentage of patients that providers are comfortable seeing via VC in the future.
Results:
...
Source: Medical Care - July 1, 2021 Category: Health Management Tags: Original Articles Source Type: research
Comparative Effectiveness of Risk-adjusted Cumulative Sum and Periodic Evaluation for Monitoring Hospital Perioperative Mortality
Conclusions:
CUSUM evaluation identifies hospitals with clusters of mortality in excess of expected more rapidly than periodic analysis. CUSUM represents an analytic tool national QI programs could utilize to provide participating hospitals with data that could facilitate more proactive implementation of local interventions to help reduce potentially avoidable perioperative mortality. (Source: Medical Care)
Source: Medical Care - July 1, 2021 Category: Health Management Tags: Original Articles Source Type: research
A Mixed-method Evaluation of the Behavioral Health Integration and Complex Care Initiative Using the Consolidated Framework for Implementation Research
Conclusions:
All clinical settings received support from the health plan, but differences between BHOs and FQHCs affected integration progress. Study results can help identify organizational practices that advance or undermine the delivery of integrated care across multiple clinical settings. (Source: Medical Care)
Source: Medical Care - July 1, 2021 Category: Health Management Tags: Original Articles Source Type: research
Electronic Health Record Usability: Associations With Nurse and Patient Outcomes in Hospitals
Conclusion:
Employing EHR systems with suboptimal usability was associated with higher odds of adverse nurse job outcomes and surgical patient mortality and readmission. EHR usability may be more important to nurse job and patient outcomes than comprehensive EHR adoption. (Source: Medical Care)
Source: Medical Care - July 1, 2021 Category: Health Management Tags: Original Articles Source Type: research
National Institutes of Health Advancing Multimorbidity Research
Conclusions:
Multimorbidity research can be advanced by addressing gaps in study design and target populations, and by increasing attention to universal outcome measurement. (Source: Medical Care)
Source: Medical Care - July 1, 2021 Category: Health Management Tags: Brief Reports Source Type: research
Impact of a Resiliency Training to Support the Mental Well-being of Front-line Workers: Brief Report of a Quasi-experimental Study of the Community Resiliency Model
Conclusions:
After a 3-hour CRM training, participants reported improved mental well-being and decreased secondary traumatic stress and somatic symptoms. This simple body awareness intervention may be a good resource during the COVID-19 pandemic. (Source: Medical Care)
Source: Medical Care - July 1, 2021 Category: Health Management Tags: Brief Reports Source Type: research
Association of Serious Hypoglycemic Events in Older Adults With Changes in Glycemic Performance Measures
Conclusion:
The cooccurrence of decreasing rates for HbA1c (Source: Medical Care)
Source: Medical Care - July 1, 2021 Category: Health Management Tags: Brief Reports Source Type: research
Association Between Attending Physicians’ Rates of Referral to Palliative Care and Location of Death in Hospitalized Adults With Serious Illness: A Population-based Cohort Study
Conclusions and Relevance:
An attending physicians’ rates of referral to palliative care is associated with a lower risk of dying in hospital. Therefore, patients who are cared for by physicians with higher rates of referral to palliative care are less likely to die in hospital and more likely to die at home. Standardizing referral to palliative care may help reduce physician-level variation as a barrier to access. (Source: Medical Care)
Source: Medical Care - July 1, 2021 Category: Health Management Tags: Original Articles Source Type: research
Advanced Practice Provider-inclusive Staffing Models and Patient Outcomes in Pediatric Critical Care
Background:
Pediatric intensive care units (PICUs) are increasingly staffed with advanced practice providers (APPs), supplementing traditional physician staffing models.
Objectives:
We evaluate the effect of APP-inclusive staffing models on clinical outcomes and resource utilization in US PICUs.
Research Design:
Retrospective cohort study of children admitted to PICUs in 9 states in 2016 using the Healthcare Cost and Utilization Project’s State Inpatient Databases. PICU staffing models were assessed using a contemporaneous staffing survey. We used multivariate regression to examine associations between ...
Source: Medical Care - July 1, 2021 Category: Health Management Tags: Original Articles Source Type: research
Markers of Quality Care for Newly Diagnosed People With Epilepsy on Medicaid
Conclusions:
There are notable differences in demographics among people with incident epilepsy who do or do not see a neurologist. Differences in NHEs persist, even after controlling for neurologist care and diagnostic evaluation. Continued attention to these disparities and comorbidities is needed in the evaluation of newly diagnosed PWE. (Source: Medical Care)
Source: Medical Care - July 1, 2021 Category: Health Management Tags: Original Articles Source Type: research
Associations of Common Depression Treatment Metrics With Patient-centered Outcomes
Conclusions:
Choice of depression response metric impacts observed response and remission rates, though PCOs tend to improve with depression improvement regardless of metric choice. Absolute incremental PHQ-9 score decreases are broadly associated with an increased likelihood of favorable PCO scores. Our findings support a novel PHQ-9 metric defined by an absolute score change of 8 points or greater. (Source: Medical Care)
Source: Medical Care - July 1, 2021 Category: Health Management Tags: Original Articles Source Type: research
Patterns of Mental Health Care Before Initiation of Telemental Health Services
Conclusions:
Our findings highlight 3 distinct patterns of care before telemental health initiation, providing insight into the role that telemedicine may play in mental health care for rural Medicare beneficiaries with SMI. Overall, telemental health was most often used to maintain care with existing providers. (Source: Medical Care)
Source: Medical Care - July 1, 2021 Category: Health Management Tags: Original Articles Source Type: research
