The verification of systemic factors of oncology care organization in the Saratov oblast

2021 ◽  
Vol 29 (2) ◽  
Author(s):  
M. V. Erugina ◽  
◽  
I. L. Krom ◽  
A. B. Shmerkevich ◽  
M. G. Eremina ◽  
...  
Keyword(s):  
Care Organization ◽  
Saratov Oblast ◽  
Systemic Factors ◽  
Oncology Care

scholarly journals Hospitalization Rates Related to Coordinated Home Health Care Services With a Community Oncology Practice

2020 ◽  
Vol 16 (9) ◽  
pp. e1045-e1049
Author(s):  
John F. Sandbach ◽  
John Bachelor ◽  
Kimberly Larson ◽  
Denize Jordan ◽  
Janet Mullins ◽  
...  
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Health Care Services ◽  
Home Health ◽  
Cost Of Care ◽  
Care Organization ◽  
Fee For Service ◽  
Hospitalization Rates ◽  
Community Oncology ◽  
Oncology Care

PURPOSE: Oncology care reimbursement has been shifting from a traditional fee-for-service model to either 1- or 2-sided risk models during the past 5 years. A major expense associated with the total cost of care is hospitalization cost. The study set out to investigate whether the creation of an Advanced Community Care Model (ACCM) of home health care would affect 60-day hospitalization and 30-rehospitalization rates in a community oncology setting. METHODS: In conjunction with a single home health care organization, an ACCM was modified for oncology care to include intervention protocols to address antiemetic issues, pain control, dehydration, shortness of breath, diarrhea, and fever. Weekly and monthly joint management meetings began. Quality metrics were defined. RESULTS: Overall, 457 unique home health care admissions were evaluated. Hospitalization associated with intervention protocols was evaluated. Sixty-day hospitalization rates decreased from 14% to 8%. Thirty-day rehospitalization rates decreased from 25% to 10%. CONCLUSION: An oncology ACCM, as created in this study, appears to have reduced both 60-day hospitalization and 30-day rehospitalization rates.

scholarly journals Benefits of High-Volume Medical Oncology Care for Noncurable Pancreatic Adenocarcinoma: A Population-Based Analysis

2020 ◽  
Vol 18 (3) ◽  
pp. 297-303 ◽  
Author(s):  
Julie Hallet ◽  
Laura Davis ◽  
Alyson Mahar ◽  
Michail Mavros ◽  
Kaitlyn Beyfuss ◽  
...  
Keyword(s):  
Pancreatic Adenocarcinoma ◽  
Medical Oncology ◽  
High Volume ◽  
Population Based ◽  
Care Organization ◽  
Comorbidity Burden ◽  
Provider Volume ◽  
Care Systems ◽  
Oncology Care ◽  
Oncology Providers

Background: Although pancreatic adenocarcinoma (PA) surgery performed by high-volume (HV) providers yields better outcomes, volume–outcome relationships are unknown for medical oncologists. This study examined variation in practice and outcomes in noncurative management of PA based on medical oncology provider volume. Methods: This population-based cohort study linked administrative healthcare datasets and included nonresected PA from 2005 through 2016. The volume of PA consultations per medical oncology provider per year was divided into quintiles, with HV providers (≥16 patients/year) constituting the fifth quintile and low-volume (LV) providers the first to fourth quintiles. Outcomes were receipt of chemotherapy and overall survival (OS). The Brown-Forsythe-Levene (BFL) test for equality of variances was performed to assess outcome variability between provider-volume quintiles. Multivariate regression models were used to examine the association between management by HV provider and outcomes. Results: A total of 7,062 patients with noncurable PA consulted with medical oncology providers. Variability was seen in receipt of chemotherapy and median survival based on provider volume (BFL, P<.001 for both), with superior 1-year OS for HV providers (30.1%; 95% CI, 27.7%–32.4%) compared with LV providers (19.7%; 95% CI, 18.5%–20.6%) (P<.001). After adjustment for age at diagnosis, sex, comorbidity burden, rural residence, income, and diagnosis period, HV provider care was independently associated with higher odds of receiving chemotherapy (odds ratio, 1.19; 95% CI, 1.05–1.34) and with superior OS (hazard ratio, 0.79; 95% CI, 0.74–0.84). Conclusions: Significant variation was seen in noncurative management and outcomes of PA based on provider volume, with management by an HV provider being independently associated with superior OS and higher odds of receiving chemotherapy. This information is important to inform disease care pathways and care organization. Cancer care systems could consider increasing the number of HV providers to reduce variation and improve outcomes.

Intelligent Processing of Loosely Structured Documents as a Strategy for Organizing Electronic Health Care Records

1993 ◽  
Vol 32 (04) ◽  
pp. 265-268 ◽  
Author(s):  
D. J. Essin
Keyword(s):  
Health Care ◽  
Health Care Organization ◽  
Database Systems ◽  
Relevant Information ◽  
Full Potential ◽  
Care Organization ◽  
Intelligent Processing ◽  
Data Interchange ◽  
Structured Documents ◽  
Health Care Records

AbstractLoosely structured documents can capture more relevant information about medical events than is possible using today’s popular databases. In order to realize the full potential of this increased information content, techniques will be required that go beyond the static mapping of stored data into a single, rigid data model. Through intelligent processing, loosely structured documents can become a rich source of detailed data about actual events that can support the wide variety of applications needed to run a health-care organization, document medical care or conduct research. Abstraction and indirection are the means by which dynamic data models and intelligent processing are introduced into database systems. A system designed around loosely structured documents can evolve gracefully while preserving the integrity of the stored data. The ability to identify and locate the information contained within documents offers new opportunities to exchange data that can replace more rigid standards of data interchange.

Effective and cost-efficient health care organization in cataract patient

2018 ◽  
Vol 5 (2) ◽  
pp. 119-127
Author(s):  
Monika Raulinajtys-Grzybek ◽  
Renata Wachowicz ◽  
Arnold Maciejewski
Keyword(s):  
Health Care ◽  
Health Care Organization ◽  
Care Organization ◽  
Cataract Patient ◽  
Cost Efficient

The role of personality in shaping pandemic response: Systemic sociopolitical factors drive country differences

2020 ◽  
Author(s):  
Meghan Siritzky ◽  
David M Condon ◽  
Sara J Weston
Keyword(s):  
Individual Differences ◽  
Big Five ◽  
Public Health Research ◽  
Cross Cultural ◽  
Economic Factors ◽  
State Fragility ◽  
Systemic Factors ◽  
Pandemic Response ◽  
The Relationship

The current study utilizes the current COVID-19 pandemic to highlight the importance of accounting for the influence of external political and economic factors in personality public-health research. We investigated the extent to which systemic factors modify the relationship between personality and pandemic response. Results shed doubt on the cross-cultural generalizability of common big-five factor models. Individual differences only predicted government compliance in autocratic countries and in countries with income inequality. Personality was only predictive of mental health outcomes under conditions of state fragility and autocracy. Finally, there was little evidence that the big five traits were associated with preventive behaviors. Our ability to use individual differences to understand policy-relevant outcomes changes based on environmental factors and must be assessed on a trait-by-trait basis, thus supporting the inclusion of systemic political and economic factors in individual differences models.

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