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Andrew J. Schoenfeld Mitchel B. Harris Haiyin Liu John D. Birkmeyer 《The spine journal》2014,14(12):2793-2798
Background contextAlthough the high cost of spine surgery is generally recognized, there is little information on the extent to which payments vary across hospitals.PurposeTo examine the variation in episode payments for spine surgery in the national Medicare population. We also sought to determine the root causes for observed variations in payment at high cost hospitals.Study designAll patients in the national fee for service Medicare population undergoing surgery for three conditions (spinal stenosis, spondylolisthesis, and lumbar disc herniation) between 2005 and 2007 were included.Patient sampleIncluded 185,954 episodes of spine surgery performed between 2005 and 2007.Outcome measuresPayments per episode of spine surgery.MethodsAll patients in the national fee for service Medicare population undergoing surgery for three conditions (spinal stenosis, spondylolisthesis, and lumbar disc herniation) between 2005 and 2007 were identified (n=185,954 episodes of spine surgery). Hospitals were ranked on least to most expensive and grouped into quintiles. Results were risk- and price-adjusted using the empirical Bayes method. We then assessed the contributions of index hospitalization, physician services, readmissions, and postacute care to the overall variations in payment.ResultsEpisode payments for hospitals in the highest quintile were more than twice as high as those made to hospitals in the lowest quintile ($34,171 vs. $15,997). After risk- and price-adjustment, total episode payments to hospitals in the highest quintile remained $9,210 (47%) higher. Procedure choice, including the use of fusion, was a major determinant of the total episode payment. After adjusting for procedure choice, however, hospitals in the highest quintile continued to be 28% more expensive than those in the lowest. Differences in the use of postacute care accounted for most of this residual variation in payments across hospitals. Hospital episode payments varied to a similar degree after subgroup analyses for disc herniation, spinal stenosis, and spondylolisthesis. Hospitals expensive for one condition were also found to be expensive for services provided for other spinal diagnoses.ConclusionsMedicare payments for episodes of spine surgery vary widely across hospitals. As they respond to the new financial incentives inherent in health care reform, high cost hospitals should focus on the use of spinal fusion and postacute care. 相似文献
994.
R. Fatima E. Qadeer D. A. Enarson S. G. Hinderaker R. Harris A. Yaqoob A. Bassili 《Public Health Action》2014,4(2):110-112
Pakistan''s National Tuberculosis Control Programme (NTP) is missing data on many tuberculosis (TB) cases who visit private providers. A survey on the incidence and under-reporting of TB in Pakistan provided a database for exploring the investigation and referral of presumptive TB cases by private health providers. The survey showed that private health providers requested both sputum smear and X-ray for diagnostic investigations. Of 2161 presumptive TB cases referred, 1189 (55%) were sent for investigations to a district NTP TB centre, of whom only 314 (26.4%) were registered. This indicates an urgent need to strengthen the link between private health providers and NTP to enhance TB notification. 相似文献
995.
Michelle DeGeeter Kira Harris Heather Kehr Carolyn Ford Daniel C. Lane Donald S. Nuzum Cynthia Compton Whitney Gibson 《American journal of pharmaceutical education》2014,78(2)
Objective. To determine if an educational intervention in a doctor of pharmacy (PharmD) degree program increases pharmacy students’ ability to identify plagiarism.Methods. First-year (P1), second-year (P2), and third-year (P3) pharmacy students attended an education session during which types of plagiarism and methods for avoiding plagiarism were reviewed. Students completed a preintervention assessment immediately prior to the session and a postintervention assessment the following semester to measure their ability.Results. Two hundred fifty-two students completed both preintervention and postintervention assessments. There was a 4% increase from preintervention to postintervention in assessment scores for the overall student sample (p<0.05). The mean change was greatest for P1 and P2 students (5% and 4.8%, respectively).Conclusion. An educational intervention about plagiarism can significantly improve students’ ability to identify plagiarism. 相似文献
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Chudi O. Ndubaku TerryD. Crawford Huifen Chen JasonW. Boggs Joy Drobnick Seth F. Harris Rajiv Jesudason Erin McNamara Jim Nonomiya Amy Sambrone Stephen Schmidt Tanya Smyczek Philip Vitorino Lan Wang Ping Wu Stacey Yeung Jinhua Chen Kevin Chen CharlesZ. Ding Tao Wang Zijin Xu Stephen E. Gould Lesley J. Murray Weilan Ye 《ACS medicinal chemistry letters》2015,6(8):913-918
998.
Ha-Soon Choi Paul V. Rucker Zhicheng Wang Yi Fan Pamela Albaugh Greg Chopiuk Francois Gessier Fangxian Sun Francisco Adrian Guoxun Liu Tami Hood Nanxin Li Yong Jia Jianwei Che Susan McCormack Allen Li Jie Li Auzon Steffy AnneMarie Culazzo Celine Tompkins Van Phung Andreas Kreusch Min Lu Bin Hu Apurva Chaudhary Mahavir Prashad Tove Tuntland Bo Liu Jennifer Harris H. Martin Seidel Jon Loren Valentina Molteni 《ACS medicinal chemistry letters》2015,6(5):562-567
999.
Neal A. Chatterjee Paul N. Jensen Andrew W. Harris Daniel D. Nguyen Henry D. Huang Richard K. Cheng Jainy J. Savla Timothy R. Larsen Joanne Michelle D. Gomez Jeanne M. DuFaydeLavallaz Rozenn N. Lemaitre Barbara McKnight Sina A. Gharib Nona Sotoodehnia 《Influenza and other respiratory viruses》2021,15(5):569
COVID‐19 has significant case fatality. Glucocorticoids are the only treatment shown to improve survival, but only among patients requiring supplemental oxygen. WHO advises patients to seek medical care for “trouble breathing,” but hypoxemic patients frequently have no respiratory symptoms. Our cohort study of hospitalized COVID‐19 patients shows that respiratory symptoms are uncommon and not associated with mortality. By contrast, objective signs of respiratory compromise—oxygen saturation and respiratory rate—are associated with markedly elevated mortality. Our findings support expanding guidelines to include at‐home assessment of oxygen saturation and respiratory rate in order to expedite life‐saving treatments patients to high‐risk COVID‐19 patients. 相似文献
1000.
Miriam Bender Patricia Baker James L. Harris Lisle Hites Robert J. LaPointe Elizabeth A. Murphy Linda Roussel LeeAnna Spiva Joan M. Stanley Patricia L. Thomas Marjory Williams 《Nursing outlook》2019,67(4):345-353
The nursing profession is tasked with identifying and evaluating models of care with potential to add value to health care delivery. In consideration of this goal, we describe the Clinical Nurse Leader (CNL) initiative and the activities of a national-level CNL research collaborative. The CNL initiative, launched by the American Association of Colleges of Nursing in collaboration with education and healthcare leaders, has delineated CNL education curriculum and practice competencies, and fostered the creation of academic-practice-policy partnerships to pilot CNL integration into frontline nursing care delivery. The partnership has evolved into an Agency for Healthcare Research and Quality affiliate practice-based research network, the CNL Research Collaborative, which links research, policy, education, and practice stakeholders to advance the CNL evidence base. We summarize foundational CNLRC research to explain CNL practice, quantify CNL effectiveness, and bring clarity to how CNLs can be implemented to consistently influence care, quality, and safety. 相似文献