Latent Class Analysis to Represent Social Determinant of Health Risk Groups in the Medicaid Cohort of the District of Columbia
Objective:
To develop distinct social risk profiles based on social determinants of health (SDH) information and to determine whether these social risk groups varied in terms of health, health care utilization, and costs.
Methods:
We prospectively enrolled 8943 beneficiaries insured by the District of Columbia Medicaid program between September 2017 and December 2018. Participants completed a SDH survey and we obtained their Medicaid claims data for a 2-year period before study enrollment. We used latent class analysis (LCA) to identify distinct social risk profiles based on their SDH responses. We assessed the ...
Source: Medical Care - February 14, 2021 Category: Health Management Tags: Original Articles Source Type: research
Predicting 2-Day Mortality of Thrombocytopenic Patients Based on Clinical Laboratory Data Using Machine Learning
This study shows how machine learning (ML) models can provide auxiliary information for more accurate identification of critical thrombocytopenic patients when compared with the traditional notification system.
Research Design:
A total of 50,505 patients’ platelet count and other 26 additional laboratory datasets of each thrombocytopenic event were used to build prediction models. Conventional logistic regression and ML methods, including random forest (RF), artificial neural network, stochastic gradient descent (SGD), naive Bayes, support vector machine, and decision tree, were applied to build different models a...
Source: Medical Care - February 14, 2021 Category: Health Management Tags: Original Articles Source Type: research
Service Involvement Across Multiple Sectors Among People Who Use Opioids, Methamphetamine, or Both, United States—2015–2018
Conclusions:
Multisector service involvement is highest among those who use both opioids and methamphetamine, suggesting that partnerships between health care, housing, social service, and criminal justice agencies are needed to develop, test, and implement interventions to reduce methamphetamine-related morbidity. (Source: Medical Care)
Source: Medical Care - February 14, 2021 Category: Health Management Tags: Brief Report Source Type: research
A Systematic Review of Surveys for Measuring Patient-centered Care in the Hospital Setting
Conclusions:
Multiple surveys for measuring PCC in hospitals are available. Opportunities exist to improve survey comprehensiveness regarding dimensions of PCC, reporting of psychometric properties, and development of measures to capture PCC for dyadic patients. (Source: Medical Care)
Source: Medical Care - February 14, 2021 Category: Health Management Tags: Patient-centered Care Source Type: research
Surgical Re-entry Strategy Following COVID-19 Pandemic: A Tiered and Balanced Approach
Following the Presidential declaration of a national emergency, many health care organizations adhered to recommendations from the Centers for Medicare and Medicaid (CMS) as well as the American College of Surgeons (ACS) to postpone elective surgical cases. The transition to only emergent and essential urgent surgical cases raises the question, how and when will hospitals and surgery centers resume elective cases? As a large health care system providing multispecialty tertiary/quaternary care with across the Southeast United States, a collaborative approach to resuming elective surgery is critical. Numerous surgical societ...
Source: Medical Care - February 14, 2021 Category: Health Management Tags: Patient-centered Care Source Type: research
The Impact of Halting Elective Admissions in Anticipation of a Demand Surge Due to the Coronavirus Pandemic (COVID-19)
Conclusions:
Hospitals that restricted elective care took on a substantial financial risk, potentially threatening viability. A sustainable public policy should therefore consider support to hospitals that responsibly served their communities through the crisis. (Source: Medical Care)
Source: Medical Care - February 14, 2021 Category: Health Management Tags: Original Articles Source Type: research
Model Homes: Evaluating Approaches to Patient-centered Medical Home Implementation
Conclusion:
The PCMH model has significant impact on patterns of health care utilization, especially when heterogeneity in implementation is accounted for in program evaluation. (Source: Medical Care)
Source: Medical Care - February 14, 2021 Category: Health Management Tags: Original Articles Source Type: research
Adjustment of Patient Experience Surveys for How People Respond
Conclusions:
It is best practice to evaluate known source of bias when analyzing patient experience surveys. Failure to adjust for patient case-mix, extreme response tendency, and survey mode in patient experience surveys may lead to erroneous comparisons of providers. (Source: Medical Care)
Source: Medical Care - February 14, 2021 Category: Health Management Tags: Brief Reports Source Type: research
Patient Experiences of Integrated Care in Medicare Accountable Care Organizations and Medicare Advantage Versus Traditional Fee-for-Service
Conclusions:
Despite characteristics of ACOs and MA that theoretically promote integrated care, we find that PPIC is largely similar across coverage types in Medicare. (Source: Medical Care)
Source: Medical Care - February 14, 2021 Category: Health Management Tags: Brief Reports Source Type: research
Limitations to National Policy and Financial Incentives: The Role of Organizational Dynamics
No abstract available (Source: Medical Care)
Source: Medical Care - February 14, 2021 Category: Health Management Tags: Editorial Source Type: research
Identifying Relative Changes in Social Risk Factors: An Analytic Approach
Conclusions:
Housing and transportation exhibited fewer relative changes than other social risk factors and might be more resistant to change. Awareness of the relationships between social risk factors can help define priorities for intervention. (Source: Medical Care)
Source: Medical Care - January 30, 2021 Category: Health Management Tags: Online Article: Applied Methods Source Type: research
Association Between State Policies on Improving Opioid Prescribing in 2 States and Opioid Overdose Rates Among Reproductive-aged Women
Background:
The opioid overdose epidemic has been declared a public health emergency. Women are more likely than men to be prescribed opioid medications. Some states have adopted policies to improve opioid prescribing, including prescription drug monitoring programs (PDMPs) and pain clinic laws.
Objective:
Among reproductive-aged women, we examined the association of mandatory use laws for PDMPs in Kentucky (concurrent with a pain clinic law) and New York with overdose involving prescription opioids or heroin and opioid use disorder (OUD).
Study Design, Subjects, and Outcome Measures:
We conducted interru...
Source: Medical Care - January 30, 2021 Category: Health Management Tags: Original Articles Source Type: research
Drivers of Cost Differences Between Nurse Practitioner and Physician Attributed Medicare Beneficiaries
Conclusions:
There are differences in the costs of primary care of Medicare beneficiaries provided by nurse practitioners and MDs. Especially in low-risk populations, the lower cost of PCNP provided care is primarily driven by lower service volume. (Source: Medical Care)
Source: Medical Care - January 30, 2021 Category: Health Management Tags: Original Articles Source Type: research
Better Nurse Staffing Is Associated With Survival for Black Patients and Diminishes Racial Disparities in Survival After In-Hospital Cardiac Arrests
Conclusions:
Our findings suggest that disparities in IHCA survival between black and white patients may be linked to the level of medical-surgical nurse staffing in the hospitals in which they receive care and that the benefit of being admitted to hospitals with better staffing may be especially pronounced for black patients. (Source: Medical Care)
Source: Medical Care - January 30, 2021 Category: Health Management Tags: Original Articles Source Type: research
The Cost of Implementing and Sustaining the COMprehensive Post-Acute Stroke Services Model
Conclusions:
We found that the costs of implementing COMPASS varied across hospitals. On average, hospitals with higher stroke volume and higher enrollment reported lower costs per patient. Based on average costs of COMPASS and readmissions for stroke patients, COMPASS could lower net costs if the model is able to prevent about 6 readmissions per year. (Source: Medical Care)
Source: Medical Care - January 30, 2021 Category: Health Management Tags: Original Articles Source Type: research
