scholarly journals Patient Experience with In-Person and Telehealth Visits Before and During the COVID-19 Pandemic at a Large Integrated Health System in the United States

2022 ◽  
Author(s):  
Ron D. Hays ◽  
Samuel A. Skootsky
Keyword(s):  
United States ◽  
Health System ◽  
Patient Experience ◽  
The United States ◽  
Integrated Health

The Rate and Costs Attributable to Intravenous Patient-Controlled Analgesia Errors

2009 ◽  
Vol 44 (4) ◽  
pp. 312-324 ◽  
Author(s):  
Brian Meissner ◽  
Winnie Nelson ◽  
Rodney (Rod) Hicks ◽  
Vanja Sikirica ◽  
Josh Gagne ◽  
...  
Keyword(s):  
United States ◽  
Health System ◽  
The United States ◽  
Error Rates ◽  
Error Reporting ◽  
Patient Controlled Analgesia ◽  
System Perspective ◽  
Medication Error Reporting ◽  
The Us ◽  
Integrated Health

Purpose To estimate the rates and costs of intravenous patient-controlled analgesia (IV PCA) errors from the hospital or integrated health system perspective. Methods This study used a cost-accounting methodology to estimate the costs attributable to IV PCA errors in the United States. Data for the study were obtained from the MEDMARX and Manufacturer and User Facility Device Experience (MAUDE) datasets, published literature, and expert opinions. MEDMARX is a voluntary, anonymous, medication-error-reporting database owned and operated by the United States Pharmacopeia. MAUDE is a mandatory, device-error-reporting database maintained by the US Food and Drug Administration. Levels of care rendered as a result of the IV PCA errors were estimated by applying clinical assumptions (validated by an expert advisory panel) to each of the 7 error consequences considered in this analysis. Variable and opportunity costs (2006 values) were considered, including medication, laboratory, lost revenue, and labor. The corresponding costs were applied to the error consequences to derive the estimated mean cost for each error cause. The numbers of errors documented in each dataset and the published literature were used to extrapolate the rate of IV PCA errors annually. Results The average cost per error event was $733 in the MEDMARX dataset and $552 in the MAUDE dataset. Harmful IV PCA errors were 120 to 250 times more costly than nonharmful errors. The annual error rates were estimated as 407 IV PCA-related errors and 17 device-related errors per 10,000 people within the United States. Conclusion: Analysis of 2 datasets, MEDMARX and MAUDE, revealed that IV PCA medication- and device-related errors are costly to hospitals and integrated health systems and represent a significant burden on the US health system. This study provided a novel approach to estimating the associated costs of undesired IV PCA-related events. Additional research is needed to validate the methodology (as applied to this area) and results.

Clinical and economic consequences of statin intolerance in the United States: Results from an integrated health system

2017 ◽  
Vol 11 (1) ◽  
pp. 70-79.e1 ◽  
Author(s):  
Jove H. Graham ◽  
Robert J. Sanchez ◽  
Joseph J. Saseen ◽  
Usha G. Mallya ◽  
Mary P. Panaccio ◽  
...  
Keyword(s):  
United States ◽  
Health System ◽  
The United States ◽  
Economic Consequences ◽  
Statin Intolerance ◽  
Integrated Health

Characteristics of patients discharged and readmitted after COVID-19 hospitalisation within a large integrated health system in the United States

2021 ◽  
pp. 1-5
Author(s):  
Cheng-Wei Huang ◽  
Prashant P. Desai ◽  
Kenneth K. Wei ◽  
In-Lu Amy Liu ◽  
Janet S. Lee ◽  
...  
Keyword(s):  
United States ◽  
Health System ◽  
The United States ◽  
Integrated Health

Valuing Diversity and Inclusion in Healthcare: Pathways to Equip Workforces in the Post-COVID-19 New Normal (Preprint)

2021 ◽  
Author(s):  
Jiban Khuntia ◽  
Xue Ning ◽  
Wayne Cascio ◽  
Rulon Stacey
Keyword(s):  
United States ◽  
Health System ◽  
Health Systems ◽  
The United States ◽  
Mediating Effect ◽  
New Normal ◽  
Diversity And Inclusion ◽  
Healthcare Workforce ◽  
The Us ◽  
Service Oriented

BACKGROUND The COVID-19 pandemic, with all its virus variants, remains a serious situation. Health systems across the United States are trying their best to respond. The healthcare workforce remains relatively homogenous, even though they are caring for a highly diverse array of patients (6-12). It is a perennial problem in the US healthcare workforce that has only been accentuated during the COVID-19 pandemic. Medical workers should reflect the variety of patients they care for and strive to understand their mindsets within the larger contexts of culture, gender, sexual orientation, religious beliefs, and socioeconomic realities. Along with talent and skills, diversity and inclusion (D&I) are essential for maintaining a workforce that can treat the myriad needs and populations that health systems serve. Developing hiring strategies in a post-COVID-19 “new normal” that will help achieve greater workforce diversity remains a challenge for health system leaders. OBJECTIVE Our primary objectives are (1) to explore the characteristics and perceived benefits of US health systems that value D&I; (2) to examine the influence of a workforce strategy designed to balance talent and D&I; and (3) to explore three pathways to better equip workforces and their relative influences on business- and service-oriented benefits: (a) improving D&I among existing employees (IMPROVE), (b) using multiple channels to find and recruit a workforce (RECRUIT), and (c) collaborating with universities to find new talent and establish plans to train students (COLLABORATE). METHODS During February–March 2021, we surveyed 625 health system chief executive officers, in the United States, 135 (22%) of whom responded. We assessed workforce talent and diversity-relevant factors. We collected secondary data from the Agency for Healthcare Research and Quality’s (AHRQ) Compendium of the US. Health Systems, leading to a matched data set of 124 health systems for analysis. We first explored differences in talent and diversity benefits across the health systems. Then, we examined the relationship between IMPROVE, RECRUIT, and COLLABORATE pathways to equip the workforce. RESULTS Health system characteristics, such as size, location, ownership, teaching, and revenue, have varying influences on D&I and business and service outcomes. RECRUIT has the most substantial mediating effect on diversity-enabled business- and service-oriented outcomes of the three pathways. This is also true of talent-based workforce acquisitions. CONCLUSIONS Diversity and talent plans can be aligned to realize multiple desired benefits for health systems. However, a one-size-fits-all approach is not a viable strategy for improving D&I. Health systems need to follow a multipronged approach based on their characteristics. To get D&I right, proactive plans and genuine efforts are essential.

Cuba and the Covid-19 pandemic

2021 ◽  
Vol 122 (1) ◽  
pp. 118-131
Author(s):  
Bob Oram
Keyword(s):  
Public Health ◽  
United States ◽  
Health System ◽  
Health Professionals ◽  
The United States ◽  
The Past ◽  
The Uk ◽  
Universal Health

For the UK struggling to deal with the Covid-19 pandemic, the experience of Cuba’s Ministry of Public Health over the past six decades provides the clearest case for a single, universal health system constituting an underlying national grid dedicated to prevention and care; an abundance of health professionals, accessible everywhere; a world-renowned science and biotech capability; and an educated public schooled in public health. All this was achieved despite being under a vicious blockade by the United States for all of that time.

scholarly journals Nursing care in the anesthetic procedure: an integrative review

2016 ◽  
Vol 50 (1) ◽  
pp. 154-162 ◽  
Author(s):  
Cassiane de Santana Lemos ◽  
Aparecida de Cassia Giani Peniche
Keyword(s):  
United States ◽  
Health System ◽  
Patient Care ◽  
Nursing Care ◽  
Scientific Evidence ◽  
The United States ◽  
Nurse Anesthetists ◽  
Integrative Review ◽  
Nursing Professional

Abstract OBJECTIVE To search for the scientific evidence available on nursing professional actions during the anesthetic procedure. METHOD An integrative review of articles in Portuguese, English and Spanish, indexed in MEDLINE/PubMed, CINAHL, LILACS, National Cochrane, SciELO databases and the VHL portal. RESULTS Seven studies were analyzed, showing nurse anesthetists' work in countries such as the United States and parts of Europe, with the formulation of a plan for anesthesia and patient care regarding the verification of materials and intraoperative controls. The barriers to their performance involved working in conjunction with or supervised by anesthesiologists, the lack of government guidelines and policies for the legal exercise of the profession, and the conflict between nursing and the health system for maintenance of the performance in places with legislation and defined protocols for the specialty. Conclusion Despite the methodological weaknesses found, the studies indicated a wide diversity of nursing work. Furthermore, in countries absent of the specialty, like Brazil, the need to develop guidelines for care during the anesthetic procedure was observed.

scholarly journals Waiting for care: Chronic illness and health system uncertainties in the United States

2020 ◽  
Vol 264 ◽  
pp. 113296
Author(s):  
Amanda A. Lee ◽  
Aimee S. James ◽  
Jean M. Hunleth
Keyword(s):  
United States ◽  
Chronic Illness ◽  
Health System ◽  
The United States ◽  
System Uncertainties

Health Care

2010 ◽  
Author(s):  
Peter Baldwin
Keyword(s):  
United States ◽  
Health Care ◽  
Health Insurance ◽  
Social Policy ◽  
Health System ◽  
The United States ◽  
Working People ◽  
Free Health Care ◽  
European Standards ◽  
Political Philosopher

The U.S. Economy does Differ from Europe’s: a less regulated labor market, but also an economy that is more hemmed in than might be expected. By European standards, America has hardish-working people, a state that collects fewer tax dollars, and workers who are paid well even if their holidays are short. In social policy, the contrasts are more moderate. Europeans commonly believe that the United States simply has no social policy—no social security, no unemployment benefits, no state pensions, and no assistance for the poor. As Jean-François Revel, the political philosopher and académicien, summed up French criticism, the United States shows “not the slightest bit of social solidarity.” Will Hutton similarly assures us that “The structures that support ordinary peoples’ lives—free health care, quality education, guarantees of reasonable living standards in old age, sickness or unemployment, housing for the disadvantaged— that Europeans take for granted are conspicuous by their absence.” And, in fact, the United States is the only developed nation, unless one counts South Africa, without some form of national health insurance, which is to say a system of requiring all its citizens to be insured in one way or another. This lack of universal health insurance is the one fact that every would-be comparativist working across the Atlantic knows, and the first one to be hoisted as the battle is engaged. One of the first attempts to quantify and rank health care performance, by the World Health Organization in 2000, gave the American system its due. Overall, it came in below any of our comparison countries, three notches under Denmark. In various specific aspects of health policy, it did better. For disability adjusted life expectancy, it came in above Ireland, Denmark, and Portugal; on the responsiveness of the health system, it ranked first; on a composite measure of various indicators summed up as “overall health system attainment,” it ranked above seven Western European countries. Even on the measure of “fairness of financial contribution to health systems,” where we might have expected an abysmal rating, the United States squeaked in above Portugal. That is, of course, damning with faint praise, especially given that in this particular aspect of the ranking—a well-meaning but other-worldly attempt by international bureaucrats to rake the entire globe over the teeth of one comb—Colombia came in first, outpacing its close rivals, Luxembourg and Belgium, while Libya beat out Sweden.

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