The impact of commercial rapid respiratory virus diagnostic tests on patient outcomes and health system utilization

2017 ◽  
Vol 17 (10) ◽  
pp. 917-931 ◽  
Author(s):  
Fiona Ko ◽  
Steven J. Drews
Keyword(s):  
Health System ◽  
Patient Outcomes ◽  
Diagnostic Tests ◽  
Respiratory Virus ◽  
System Utilization ◽  
The Impact

Development of health-system inpatient pharmacy clinical metrics

2019 ◽  
Vol 76 (23) ◽  
pp. 1958-1964
Author(s):  
Stacy Cassat ◽  
Lindsay Massey ◽  
Stephanie Buckingham ◽  
Tamara Kemplay ◽  
Jeff Little
Keyword(s):  
Clinical Outcome ◽  
Health System ◽  
Outcome Measures ◽  
Patient Outcomes ◽  
Assessment Tool ◽  
Time Frame ◽  
Pharmacy Services ◽  
Systematic Process ◽  
Institutional Review Board Review ◽  
The Impact

Abstract Purpose To describe a process to identify metrics that represent the impact of inpatient pharmacy services on patient outcomes across a health system. Summary The authors describe a systematic process of identifying inpatient clinical outcome measures that could represent pharmacists’ impact on patient outcomes and eventually be displayed in a dashboard within the electronic medical record (EMR). A list was generated through literature review, assessment of practices at other sites, evaluation of current pharmacy services, and collaboration with the quality department and System Pharmacy Clinical User Group. The project team narrowed the list through assessment against standardized criteria. An assessment tool was designed and distributed to stakeholders to prioritize clinical outcome measures for inclusion on the dashboard. The clinical outcome measures were transformed into metrics by determining measurement criteria, inclusion and exclusion parameters, and review time frame. After validation, the metrics are planned to be displayed on an inpatient pharmacy EMR dashboard. Exemption from institutional review board review was granted for this project. Conclusion A systematic process was developed and used to identify inpatient clinical outcome metrics.

scholarly journals Improving the design of studies evaluating the impact of diagnostic tests for tuberculosis on health outcomes: a qualitative study of perspectives of diverse stakeholders

2019 ◽  
Vol 4 ◽  
pp. 183
Author(s):  
Eleanor A. Ochodo ◽  
Selvan Naidoo ◽  
Samuel Schumacher ◽  
Karen Steingart ◽  
Jon Deeks ◽  
...  
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Health System ◽  
Diagnostic Tests ◽  
Statistical Significance ◽  
Structured Interviews ◽  
Impact Studies ◽  
Study Results ◽  
The Impact ◽  
Test Impact

Background: Studies evaluating the impact of Xpert MTB/RIF testing for tuberculosis (TB) have demonstrated varied effects on health outcomes with many studies showing inconclusive results. We explored perceptions among diverse stakeholders about studies evaluating the impact of TB diagnostic tests, and identified suggestions for improving these studies. Methods: We used purposive sampling with consideration for differing expertise and geographical balance and conducted in depth semi-structured interviews. We interviewed English-speaking participants, including TB patients, and others involved in research, care or decision-making about TB diagnostics. We used the thematic approach to code and analyse the interview transcripts. Results: We interviewed 31 participants. Our study showed that stakeholders had different expectations with regard to test impact and how it is measured. TB test impact studies were perceived to be important for supporting implementation of tests but there were concerns about the unrealistic expectations placed on tests to improve outcomes in health systems with many influencing factors. To improve TB test impact studies, respondents suggested conducting health system assessments prior to the study; developing clear guidance on the study methodology and interpretation; improving study design by describing questions and interventions that consider the influences of the health-care ecosystem on the diagnostic test; selecting the target population at the health-care level most likely to benefit from the test; setting realistic targets for effect sizes in the sample size calculations; and interpreting study results carefully and avoiding categorisation and interpretation of results based on statistical significance alone. Researchers should involve multiple stakeholders in the design of studies. Advocating for more funding to support robust studies is essential. Conclusion: TB test impact studies were perceived to be important to support implementation of tests but there were concerns about their complexity. Process evaluations of their health system context and guidance for their design and interpretation are recommended.

Evaluating the impact of survivorship models on health system resources and costs.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 1-1
Author(s):  
Nicole Mittmann ◽  
Hasmik Beglaryan ◽  
Ning Liu ◽  
Soo Jin Seung ◽  
Farah Rahman ◽  
...  
Keyword(s):  
Primary Care ◽  
Health System ◽  
Healthcare Resource Utilization ◽  
Primary Study ◽  
X Rays ◽  
Health Care Environment ◽  
System Utilization ◽  
System Resources ◽  
The Impact

1 Background: The provincial cancer agency in Ontario developed and implemented a model of care (MOC) for breast cancer (BC) survivors to transition from oncology-lead care to primary care in a publically funded health care environment (2010-2013). Transition options included direct to primary care and stepped transition. The objective of our study was to examine the health system resources used by the women in the MOC group and compare them to those used by women who did not transition. Methods: A propensity score matched, quasi-experimental approach was used to compare the healthcare resource utilization and costs between BC survivors in the MOC program (case) and those receiving usual care (control). All MOC cases were linked using unique identifiers and linked into the provincial health system databases. Cases and controls were matched 1:1 on year of diagnosis and location of care and were followed from an index date to the earliest of her death date, date of last contact in the database, one day before another cancer diagnosis or the end of study available databases. The primary study outcome was overall health system utilization and mean cost during the follow-up period. Results: There were 2324 women in the MOC program. Demographic information (age, region, stage) were well balanced between cases and controls. Transitioned cases had lower hospitalizations (20.1% vs. 24.4%, p<0.05), fewer cancer clinic visits (6.0% vs. 15.1%, p<0.05), fewer medical oncologist visits (0.39 vs. 1.29, p<0.05) and fewer diagnostics (CT, MRI, ultrasound, x-rays) over an average of 25 months of follow-up. There was a trend for fewer family practice (7.35 vs. 7.91, p=0.08) and internal medical and hematology visits (0.81 vs. 1.03, p=0.08). Annual emergency visits were similar between the two groups (0.76 vs. 0.82, p=0.2). There was a $4300 (2012 $CAN) difference in the mean annual cost between cases and controls. Conclusions: Survivors in the MOC transition program used fewer health system resources and had lower health system costs when compared to controls. These findings provide real world evidence to inform transition policies for cancer survivors.

scholarly journals Improving the Population's Health: The Affordable Care Act and the Importance of Integration

2011 ◽  
Vol 39 (3) ◽  
pp. 317-327 ◽  
Author(s):  
Lorian E. Hardcastle ◽  
Katherine L. Record ◽  
Peter D. Jacobson ◽  
Lawrence O. Gostin
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Patient Outcomes ◽  
Health Care Services ◽  
Political Support ◽  
Public Health Services ◽  
Care Services ◽  
Heath Care ◽  
The Impact

Heath care and public health are typically conceptualized as separate, albeit overlapping, systems. Health care’s goal is the improvement of individual patient outcomes through the provision of medical services. In contrast, public health is devoted to improving health outcomes in the population as a whole through health promotion and disease prevention. Health care services receive the bulk of funding and political support, while public health is chronically starved of resources. In order to reduce morbidity and mortality, policymakers must shift their attention to public health services and to the improved integration of health care and public health. In other words, health care and public health should be treated as two parts of a single integrated health system (which we refer to as the health system throughout this article). Furthermore, in order to maximize improvements in health status, policymakers must consider the impact of all governmental policies on health (a Health in All Policies Approach).

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