Evidence-based review, not change in usage patterns, should drive Medicare Benefit Schedule (MBS) disinvestment decisions

2017 ◽  
Vol 41 (6) ◽  
pp. 713
Author(s):  
John W. Orchard ◽  
Jessica J. Orchard ◽  
David J. Samra
Keyword(s):  
Evidence Based ◽  
Medicare Benefit Schedule ◽  
Usage Patterns ◽  
Medicare Benefit

scholarly journals Are socio-economically disadvantaged Australians making more or less use of the Enhanced Primary Care Medicare Benefit Schedule item numbers?

2003 ◽  
Vol 26 (3) ◽  
pp. 43 ◽  
Author(s):  
David Wilkinson ◽  
Heather McElroy ◽  
Justin Beilby ◽  
Kathy Mott ◽  
Kay Price ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Median Number ◽  
Disadvantaged Communities ◽  
Care Plans ◽  
Medicare Benefit Schedule ◽  
Medicare Benefit ◽  
Australian Bureau Of Statistics ◽  
National Trends ◽  
The Relationship

We aimed to examine the relationship between levels of socio-economic disadvantage (measured by the Socio EconomicIndexes for Areas [SEIFA] used by the Australian Bureau of Statistics) and uptake of the Enhanced Primary Care(EPC) item numbers on the Medicare Benefits Schedule. Health services are often less likely to reach those that mostneed them and so it is important to monitor whether disadvantaged communities are accessing EPC. The rates ofhealth assessments, care plans and case conferences are similar in each SEIFA quartile (from advantaged todisadvantaged populations), favouring the more disadvantaged quartiles in some cases. These national trends are notobserved in each state and territory. For all EPC services combined, the lowest number of doctors that provide EPCservices are found in the 2 most disadvantaged quartiles, yet more EPC services are provided in these quartiles, due tothe higher mean and median number of services provided by general practitioners in these quartiles. Overall,populations living in the most disadvantaged quartiles have similar or higher levels of EPC uptake, apparently due,at least in part, to greater than average use of EPC services by general practitioners in these areas.

scholarly journals Liability and collaborative arrangements for nurse practitioner practice in Australia

2020 ◽  
Vol 44 (2) ◽  
pp. 172
Author(s):  
Mary Chiarella ◽  
Jane Currie ◽  
Tim Wand
Keyword(s):  
Nurse Practitioners ◽  
Medical Practitioners ◽  
Australian Health ◽  
Medicare Benefit Schedule ◽  
Medicare Benefit ◽  
History Of ◽  
The Relationship ◽  
Models Of Service Delivery ◽  
Successful Collaboration ◽  
Improve Patient

The purpose of this paper is to clarify the relationship between medical practitioners (MPs) and nurse practitioners (NPs) in general, and privately practising NPs (PPNPs) in particular, in relation to collaboration, control and supervision in Australia, as well as to explore the difficulties reported by PPNPs in establishing mandated collaborative arrangements with MPs in Australia. In order for the PPNPs to have access to the Medicare Benefit Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) in Australia, they are required, by law, to establish a collaborative arrangement with an MP or an entity that employs MPs. This paper begins by describing the history of and requirements for collaborative arrangements, then outlines the nature of successful collaboration and the reported difficulties. It goes on to address some of the commonly held misconceptions in order to allay medical concerns and enable less restrictive access to the MBS and PBS for PPNPs. This, in turn, would improve patient access to highly specialised and expert PPNP care. What is known about the topic? NPs have been part of the Australian health workforce since 1998, but until 2009 their patients did not receive any reimbursement for care delivered by PPNPs. In 2009, the Federal government introduced limited access for PPNPs to the MBS and PBS, but only if they entered into a collaborative arrangement with either an MP or an entity that employs MPs. What does this paper add? The introduction of collaborative arrangements between PPNPs and MPs seems, in some instances, to have created confusion and misunderstanding about the way in which these collaborative arrangements are to operate. This paper provides clarification of the relationship between MPs and NPs in general, and PPNPs in particular, in relation to collaboration, control and supervision. What are the implications for practitioners? A clearer understanding of these issues will hopefully enable greater collegial generosity and improve access to patient care through innovative models of service delivery using NPs and PPNPs.

scholarly journals Development and implementation of a mobile device-based pediatric electronic decision support tool as part of a national practice standardization project

2018 ◽  
Vol 25 (9) ◽  
pp. 1175-1182 ◽  
Author(s):  
Russell J McCulloh ◽  
Sarah D Fouquet ◽  
Joshua Herigon ◽  
Eric A Biondi ◽  
Brandan Kennedy ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Decision Support ◽  
Diagnostic Testing ◽  
Clinical Decision ◽  
The United States ◽  
Medical Decision ◽  
Evidence Based ◽  
Support Tool ◽  
Usage Patterns ◽  
National Practice

Abstract Objective Implementing evidence-based practices requires a multi-faceted approach. Electronic clinical decision support (ECDS) tools may encourage evidence-based practice adoption. However, data regarding the role of mobile ECDS tools in pediatrics is scant. Our objective is to describe the development, distribution, and usage patterns of a smartphone-based ECDS tool within a national practice standardization project. Materials and Methods We developed a smartphone-based ECDS tool for use in the American Academy of Pediatrics, Value in Inpatient Pediatrics Network project entitled “Reducing Excessive Variation in the Infant Sepsis Evaluation (REVISE).” The mobile application (app), PedsGuide, was developed using evidence-based recommendations created by an interdisciplinary panel. App workflow and content were aligned with clinical benchmarks; app interface was adjusted after usability heuristic review. Usage patterns were measured using Google Analytics. Results Overall, 3805 users across the United States downloaded PedsGuide from December 1, 2016, to July 31, 2017, leading to 14 256 use sessions (average 3.75 sessions per user). Users engaged in 60 442 screen views, including 37 424 (61.8%) screen views that displayed content related to the REVISE clinical practice benchmarks, including hospital admission appropriateness (26.8%), length of hospitalization (14.6%), and diagnostic testing recommendations (17.0%). Median user touch depth was 5 [IQR 5]. Discussion We observed rapid dissemination and in-depth engagement with PedsGuide, demonstrating feasibility for using smartphone-based ECDS tools within national practice improvement projects. Conclusions ECDS tools may prove valuable in future national practice standardization initiatives. Work should next focus on developing robust analytics to determine ECDS tools’ impact on medical decision making, clinical practice, and health outcomes.

Abstraction: An alternative neurocognitive account of recognition, prediction, and decision making

2020 ◽  
Vol 43 ◽  
Author(s):  
Valerie F. Reyna ◽  
David A. Broniatowski
Keyword(s):  
Decision Making ◽  
Software Engineering ◽  
Systems Engineering ◽  
Evidence Based ◽  
Extensive Literature ◽  
Trace Theory ◽  
Fuzzy Trace Theory ◽  
Abstract Representations ◽  
Technical Systems

Abstract Gilead et al. offer a thoughtful and much-needed treatment of abstraction. However, it fails to build on an extensive literature on abstraction, representational diversity, neurocognition, and psychopathology that provides important constraints and alternative evidence-based conceptions. We draw on conceptions in software engineering, socio-technical systems engineering, and a neurocognitive theory with abstract representations of gist at its core, fuzzy-trace theory.

Vocal Communications of a Developmentally Delayed Child

1987 ◽  
Vol 18 (2) ◽  
pp. 112-130
Author(s):  
Mary Ann Romski ◽  
Sharon Ellis Joyner ◽  
Rose A. Sevcik
Keyword(s):  
Language Learning ◽  
Developmental Delays ◽  
Developmentally Delayed ◽  
Language Impaired ◽  
Diary Data ◽  
Word Acquisition ◽  
Diary Studies ◽  
Usage Patterns ◽  
Vocal Communications ◽  
Impaired Children

Studies of first-word acquisition in typical language-learning children frequently take the form of diary studies. Comparable diary data from language-impaired children with developmental delays, however, are not currently available. This report describes the spontaneous vocalizations of a child with a developmental delay for 14 months, from the time he was age 6:5 to age 7:7. From a corpus of 285 utterances, 47 phonetic forms were identified and categorized. Analysis focused on semantic, communicative, and phonological usage patterns.

Misophonia: An Evidence-Based Case Report

2020 ◽  
Vol 29 (4) ◽  
pp. 685-690
Author(s):  
C. S. Vanaja ◽  
Miriam Soni Abigail
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Case History ◽  
Pure Tone ◽  
Physiological Responses ◽  
Evidence Based ◽  
Management Option ◽  
Pure Tone Audiogram

Purpose Misophonia is a sound tolerance disorder condition in certain sounds that trigger intense emotional or physiological responses. While some persons may experience misophonia, a few patients suffer from misophonia. However, there is a dearth of literature on audiological assessment and management of persons with misophonia. The purpose of this report is to discuss the assessment of misophonia and highlight the management option that helped a patient with misophonia. Method A case study of a 26-year-old woman with the complaint of decreased tolerance to specific sounds affecting quality of life is reported. Audiological assessment differentiated misophonia from hyperacusis. Management included retraining counseling as well as desensitization and habituation therapy based on the principles described by P. J. Jastreboff and Jastreboff (2014). A misophonia questionnaire was administered at regular intervals to monitor the effectiveness of therapy. Results A detailed case history and audiological evaluations including pure-tone audiogram and Johnson Hyperacusis Index revealed the presence of misophonia. The patient benefitted from intervention, and the scores of the misophonia questionnaire indicated a decrease in the severity of the problem. Conclusions It is important to differentially diagnose misophonia and hyperacusis in persons with sound tolerance disorders. Retraining counseling as well as desensitization and habituation therapy can help patients who suffer from misophonia.

Meeting the Best Practice for Hearing Aid Verification in Children: Challenges and Future Directions

2019 ◽  
Vol 28 (4) ◽  
pp. 877-894
Author(s):  
Nur Azyani Amri ◽  
Tian Kar Quar ◽  
Foong Yen Chong
Keyword(s):  
Clinical Practice ◽  
Hearing Aids ◽  
Best Practice ◽  
Hearing Aid ◽  
Evidence Based ◽  
Future Directions ◽  
Major Barrier ◽  
Klang Valley ◽  
Age Range ◽  
Fitting Hearing Aids

Purpose This study examined the current pediatric amplification practice with an emphasis on hearing aid verification using probe microphone measurement (PMM), among audiologists in Klang Valley, Malaysia. Frequency of practice, access to PMM system, practiced protocols, barriers, and perception toward the benefits of PMM were identified through a survey. Method A questionnaire was distributed to and filled in by the audiologists who provided pediatric amplification service in Klang Valley, Malaysia. One hundred eight ( N = 108) audiologists, composed of 90.3% women and 9.7% men (age range: 23–48 years), participated in the survey. Results PMM was not a clinical routine practiced by a majority of the audiologists, despite its recognition as the best clinical practice that should be incorporated into protocols for fitting hearing aids in children. Variations in practice existed warranting further steps to improve the current practice for children with hearing impairment. The lack of access to PMM equipment was 1 major barrier for the audiologists to practice real-ear verification. Practitioners' characteristics such as time constraints, low confidence, and knowledge levels were also identified as barriers that impede the uptake of the evidence-based practice. Conclusions The implementation of PMM in clinical practice remains a challenge to the audiology profession. A knowledge-transfer approach that takes into consideration the barriers and involves effective collaboration or engagement between the knowledge providers and potential stakeholders is required to promote the clinical application of evidence-based best practice.

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