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Recent Trends in Prescribing Antibiotics for Acute Tonsillitis in Pediatric Ambulatory Care in Taiwan, 2000-2009: A Nationwide Population-based Study
Conclusion From 2000 to 2009, there was a remarkable decline in the antibiotic prescription rates for tonsillitis. Further studies to evaluate diagnostic tools such as rapid antigen detection tests or throat cultures to decrease antibiotic prescriptions are warranted.
Source: Journal of Microbiology, Immunology and Infection - September 9, 2015 Category: Microbiology Source Type: research

A Clinician’s Guide to Privacy and Communication in the ICU
Conclusions: The Health Insurance Portability and Accountability Act and related laws should not be viewed as barriers to clinicians sharing information with ICU patients and their loved ones. Generally, under Health Insurance Portability and Accountability Act, personal representatives have the same authority to receive information that patients would otherwise have. Persons involved in the patient’s care also may be given information relevant to the episode of care unless the patient objects. ICUs should develop policies for handling the issues we identify about such information sharing, including policies for respondi...
Source: Critical Care Medicine - February 18, 2017 Category: Emergency Medicine Tags: Concise Definitive Review Source Type: research

A patient’s perspective on our health care system
My interest in health care reform springs from my experiences as a consumer of medical services and a disillusioned consumer at that. Thankfully, at mid-life I find myself healthy. I take no prescription medications and I’ve never (knock wood) suffered from a serious illness. That being said, I’d like to keep things that way and I’m keenly interested in aging gracefully and staying healthy and active for many years to come. For this reason I worship at the altar of prevention and “alternative” medicine. I have experienced first-hand how changes to my diet and lifestyle result in improvements in my health and vit...
Source: Disruptive Women in Health Care - January 9, 2013 Category: Health Medicine and Bioethics Commentators Authors: dw at disruptivewomen.net Tags: Alternative Medicine Prevention Source Type: blogs

Recent trends in antibiotic prescriptions for acute respiratory tract infections in pediatric ambulatory care in Taiwan, 2000–2009: A nationwide population-based study
Conclusion The 10-year antibiotics prescription rate in ambulatory children with ARTIs was 7.0% and it decreased gradually from 2000 to 2009 in Taiwan. Through understanding the annual trends in antibiotic prescriptions, it may be possible to design interventions to improve the judicious use of antibiotics in children.
Source: Journal of Microbiology, Immunology and Infection - November 3, 2014 Category: Microbiology Source Type: research

Long-Term Outcomes in Critically Ill Septic Patients Who Survived Cardiopulmonary Resuscitation*
Conclusion: The long-term outcome was worse in ICU survivors of sepsis who received in-hospital cardiopulmonary resuscitation than in those who did not, but this increased risk of mortality diminished at 2 years after discharge.
Source: Critical Care Medicine - May 17, 2016 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Postarrest Steroid Use May Improve Outcomes of Cardiac Arrest Survivors
Objectives: To evaluate the ramifications of steroid use during postarrest care. Design: Retrospective observational population-based study enrolled patients during years 2004–2011 with 1-year follow-up. Setting: Taiwan National Health Insurance Research Database. Patients: Adult nontraumatic cardiac arrest patients in the emergency department, who survived to admission. Interventions: These patients were classified into the steroid and nonsteroid groups based on whether steroid was used or not during hospitalization. A propensity score was used to match patient underlying characteristics, steroid use prior...
Source: Critical Care Medicine - January 17, 2019 Category: Emergency Medicine Tags: Feature Articles Source Type: research

Impact of the Affordable Care Act on trauma and emergency general surgery: An Eastern Association for the Surgery of Trauma systematic review and meta-analysis
CONCLUSION Given the evidence quality, we conditionally recommend ME/MHR to improve insurance coverage and access to postacute care for trauma and EGS patients. We have no specific recommendation with respect to the impact of ME/MHR on trauma systems. Additional research into these questions is needed. LEVEL OF EVIDENCE Review, Economic/Decision, level III
Source: The Journal of Trauma: Injury, Infection, and Critical Care - July 30, 2019 Category: Orthopaedics Tags: SYSTEMATIC REVIEW 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

Trends in Early and Late Mortality in Patients With Severe Acute Pancreatitis Admitted to ICUs: A Nationwide Cohort Study
CONCLUSIONS: Over the 12-year period examined, mortality in patients with SAP admitted to Dutch ICUs did not change, although after 2010 late mortality decreased. Novel therapies should focus on preventing early mortality in SAP.
Source: Critical Care Medicine - September 23, 2022 Category: Emergency Medicine Tags: Clinical Investigations 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

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

Availability of critical care services in Taiwan under National Health Insurance
Editor —Since the implementation of Taiwan’s National Health Insurance (NHI) programme in 1995, use of health-care services has significantly increased.1 This is also true for the use of mechanical ventilation and extracorporeal membrane oxygenation.23 In contrast, information is limited about use of intensive care unit (ICU) beds.4 We conducted this study to investigate the availability of the critical care service in Taiwan under the NHI programme.
Source: British Journal of Anaesthesia - July 27, 2017 Category: Anesthesiology Source Type: research

Achieving a Zero Central Line-Associated Bloodstream Infection Rate in 4 Critical Care Units in Lebanon
Every health care facility aims to achieve and maintain a zero central line-associated bloodstream infection (CLABSI) rate. Infections can be costly for institutions of any size and are often not covered by health insurance. The interventions put in place in this quality improvement project were implemented in 4 phases: (1) develop a new standard of care for central lines and give nurses full responsibility for the care and handling of these lines (including blood sampling); (2) revise policy and provide educational sessions to support nurses; (3) document compliance with the new policy; and (4) document CLABSI rates. The ...
Source: Journal of Infusion Nursing - August 30, 2019 Category: Nursing Tags: Features Source Type: research

Critical call for hospital-based domestic violence intervention: The Davis Challenge
CONCLUSION Critical call for hospital-based IPV intervention programs as a priority for trauma centers to adopt cannot be underestimated but can be answered in a comprehensive integrated model. LEVEL OF EVIDENCE Therapeutic, level I.
Source: The Journal of Trauma: Injury, Infection, and Critical Care - November 1, 2019 Category: Orthopaedics Tags: 2019 WTA PODIUM PAPERS Source Type: research

Why Did the "Dean of Health Care Economics" Urge Reforms that "Appeal to Some Special Interests?"
We have often discussed, some would say belabored, the importance of the "anechoic effect" in health care.  Particular issues which would make those who benefit the most from our current dysfunctional health care system uncomfortable are often considered not to appropriate for polite conversation.  A prominent recent article in JAMA provided a great example of  how there are certain topics that health care, services, and policy experts avoid discussing.Summary of the Article The article was by Victor R Fuchs, who has been called the" dean of health care economics."  His topic was why US health care is s...
Source: Health Care Renewal - January 7, 2013 Category: Health Medicine and Bioethics Commentators Tags: health care reform health services research anechoic effect Source Type: blogs