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Effect of IV Push Antibiotic Administration on Antibiotic Therapy Delays in Sepsis
Conclusions: Use of an IV push strategy may safely facilitate more rapid administration of β-lactam antibiotics and may allow for better compliance with sepsis management guidelines.
Source: Critical Care Medicine - July 30, 2020 Category: Emergency Medicine Tags: Brief Report Source Type: research

Comparison of Sepsis Definitions as Automated Criteria
CONCLUSIONS: The application of commonly used sepsis definitions on a single population produced sepsis cohorts with low agreement, significantly different baseline demographics, and clinical outcomes.
Source: Critical Care Medicine - March 25, 2021 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Advanced imaging use and payment trends in a large pediatric accountable care organization
ConclusionOver the study period, advanced imaging utilization at this large pediatric ACO serving the Medicaid population increased, especially with US use in the ED. Overall payments related to advanced imaging remained stable over this period.
Source: Pediatric Radiology - September 17, 2021 Category: Radiology Source Type: research

Celebrating the 12th Anniversary of the Affordable Care Act in a Pandemic: Where Would We Be Without It?
BY ROSEMARIE DAY When the Affordable Care Act (ACA) was signed into law twelve years ago today, Joe Biden called it “a big f-ing deal.”  Little did he, or anyone else at that time, realize how big of a deal it was. Just ten years later, America was engulfed in a global pandemic, the magnitude of which hadn’t been seen in a century. Two years after that, the numbers are chilling: over 79 million people were infected, at least 878,613 were hospitalized, and 971,968 have died. As bad as these numbers are, things would have been much worse if the ACA hadn’t come to pass. The ACA created an essential safety net t...
Source: The Health Care Blog - March 23, 2022 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Health Policy Obamacare Affordable Care Act covid19 Life In the Affordable Care Act Medicaid Pandemic rosemarie day Source Type: blogs

A Narrative Review of Pediatric Respite Care Initiatives in the United States
Families of children receiving palliative care depict lack of respite services as a top unmet need. Although the benefits of access to respite services are notable, little is known on a state-by-state basis about respite provision or funding. The study objective was to conduct a national evaluation of pediatric respite care programs to identify and describe how states provide and fund respite care for children. The study approach adhered to the Scale for the Assessment of Narrative Review Articles quality standards using multiple data sources including engagement with the existing literature, content analyses of public-fac...
Source: Journal of Hospice and Palliative Nursing - July 4, 2022 Category: Nursing Tags: Feature Articles Source Type: research

Seasonality of Pediatric Mental Health Emergency Department Visits, School, and COVID-19
Objectives The aim of this study was to explore how the academic calendar, and by extension school-year stressors, contributes to the seasonality of pediatric mental health emergency department (ED) visits. Methods The authors reviewed all pediatric mental health ED visits at a large urban medical center from 2014 to 2019. Patients who were younger than 18 years at time of presentation, were Durham residents, and had a primary payer of Medicaid were included in the sample population, and the dates of ED visits of the sample population were compared against dates of academic semesters and summer/winter breaks of ...
Source: Pediatric Emergency Care - December 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Starting from scratch: Creating an antibiotic stewardship program in a Pediatric skilled nursing facility
In October 2016, the Centers for Medicare and Medicaid Services (CMS) published the Reform of Requirements for Long-Term Care (LTC) Facilities final rule. This rule was a long overdue revision of the requirements that LTC facilities had to meet to participate in CMS programs and had not been comprehensively reviewed and updated since 1991. (Medicare and Medicaid Programs; Reform of Requirements for Long-Term Care Facilities, 2016). As part of this rule, LTC facilities were required to develop an Infection Prevention and Control Program (IPCP) that included an antibiotic stewardship program (ASP) and employ at least one inf...
Source: Journal of Pediatric Nursing - July 1, 2023 Category: Nursing Authors: Rochelle Beard Tags: Society of Pediatric Nurses Department Source Type: research

The RUC. "an Independent Group of Physicians?" - But It Includes Executives and Board Members of For-Profit Health Care Corporations and Large Hospital Systems
Introduction We just discussed how a major story in Politico has once again drawn attention to the opaque RUC (Resource Based Relative Value System Update Committee) and its important role in determining what physicians are paid for different kinds of services, and hence the incentives that have helped make the US health care system so procedurally oriented.  (See the end of our last post for a summary of the complex issues that swirl around the RUC.)The Politico article covered most of the bases, but notably omitted how the RUC may be tied to various large health care organizations, especially for-profit, and how the...
Source: Health Care Renewal - August 28, 2014 Category: Health Management Tags: AMA boards of directors conflicts of interest health care prices healthcare executive hospital systems perverse incentives regulatory capture RUC Source Type: blogs

Validation of a Pediatric Primary Care Network in a US Metropolitan Region as a Community-Based Infectious Disease Surveillance System.
Authors: Feemster KA, Li Y, Grundmeier R, Localio AR, Metlay JP Abstract This cross-sectional study used Geographic Information System methods to compare sociodemographic and clinical characteristics of children enrolled and not enrolled in a primary care network to determine the suitability of the network to estimate population-based disease rates. We validated the network surveillance system by comparing invasive pneumococcal disease rates between network and nonnetwork children using population-based surveillance data. Among the study population of 130300 children, network children were more likely to be female,...
Source: Interdisciplinary Perspectives on Infectious Diseases - November 18, 2014 Category: Infectious Diseases Tags: Interdiscip Perspect Infect Dis Source Type: research

Cost Analysis and Policy Implications of a Pediatric Palliative Care Program
In 2010, California launched Partners for Children (PFC), a pediatric palliative care pilot program offering hospice-like services for children eligible for full-scope Medicaid delivered concurrently with curative care, regardless of the child’s life expectancy.
Source: Journal of Pain and Symptom Management - May 23, 2016 Category: Palliative Care Authors: Daphna Gans, Max W. Hadler, Xiao Chen, Shang-Hua Wu, Robert Dimand, Jill M. Abramson, Betty Ferrell, Allison L. Diamant, Gerald F. Kominski Source Type: research

Better Patient Care Doesn’t Necessarily Equal Patient Savings
Discussion The study did suggest that Initiative practices are transforming care delivery; however, they have not yet generated savings in Medicare Part A and B expenditures that are sufficient to cover care-management fees. The 3% reduction in primary care visits suggests the non-billable calls, emails, and interactions related to care management may have reduced, or even supplanted, the need for office visits. The study also provided some possible reasons as to why the results were not more favorable. One such reason was that practices may need more time to fully implement changes in care delivery that translate to i...
Source: Policy and Medicine - June 12, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Cost Analysis and Policy Implications of a Pediatric Palliative Care Program
In 2010, California launched Partners for Children (PFC), a pediatric palliative care pilot program offering hospice-like services for children eligible for full-scope Medicaid delivered concurrently with curative care, regardless of the child's life expectancy.
Source: Journal of Pain and Symptom Management - May 23, 2016 Category: Palliative Care Authors: Daphna Gans, Max W. Hadler, Xiao Chen, Shang-Hua Wu, Robert Dimand, Jill M. Abramson, Betty Ferrell, Allison L. Diamant, Gerald F. Kominski Tags: Original Article Source Type: research

Geographic Variation in the Use of Low-Acuity Pediatric Emergency Medical Services
Conclusions: After adjusting for known covariates, residential zip code was associated with low-acuity EMS activation, stressing the importance of geographic variation in EMS use. Providing alternate means of transportation, or targeted education to certain residential areas, may decrease unnecessary EMS activation.
Source: Pediatric Emergency Care - February 1, 2017 Category: Emergency Medicine Tags: Original Articles Source Type: research

Evidence-Based Policy Making? - Dumb Things Politicians Say About Health Care Policy
There have been multiple legislative attempts at major health care reform in the US.  Typically, such attempts feature considerable public debate, including speechs, congressional committee hearings, sometimes progressing to debates by the House and Senate.  (For example, see thisFrontline chronology of the proceedings up to the passage of the Affordable Care Act, aka " Obamacare, " in 2009.)  Usually the discussion includes some real experts on health care policy, and some real health care professionals, and at least appears to reference some data about medicine, health care, and health economics. Whether p...
Source: Health Care Renewal - May 23, 2017 Category: Health Management Tags: health care reform postmodernism Source Type: blogs