scholarly journals Surgical Technology, Anaesthesia and Pain Medicine, Ambulatory Anaesthesia for Outpatient Surgery

2020 ◽  
Vol 5 (1) ◽  
Keyword(s):  
Outpatient Surgery ◽  
Healthcare Providers ◽  
Cost Effective ◽  
The United States ◽  
Postoperative Management ◽  
Insurance Companies ◽  
Pain Medicine ◽  
Ambulatory Anaesthesia ◽  
Surgical Technology ◽  
Surgical Methods

Owing to burgeoning improvements in surgical technology, anaesthesia and pain medicine, ambulatory anaesthesia for outpatient surgery has become commonplace, with a proportion of 66% in the United States of America, 50% in the United Kingdom, 11%-23% in India and an ambitious 75% in the next decade. Its advent was driven by financial and economic issues which it adequately abates by 25%-75% lesser than an inpatient procedure. Among other benefits to patients, healthcare providers, insurance companies and hospitals, outpatient anaesthesia decreases costs, minimises respiratory failure, enhances early hospital discharge, contributes to the economic growth of the nation, and decreases exposure to nosocomial infections. The growing complexity of surgical methods and number of comorbidities these days have increased the indications for ambulatory anaesthesia. In order for it to be safe and successful, the appropriate selection of patients, surgical and anaesthetic methods as well as postoperative management should be considered simultaneously. Nevertheless, ambulatory anaesthesia is still hindered by limited resources, inadequate expertise, and poor coordination between medical and organisational aspects of care in some countries. This problem can be minimized by providing resources and the training of healthcare providers on better organisation and the use and manipulation of these equipment through seminars and conferences. Furthermore, the global burden of disease study projects an increase in future anaesthesia demands due to the ever rising disease burden worldwide. This can be resolved by adequately managing the challenges of ambulatory anaesthesia and creating more centers either within or without hospitals. By and large, safe and convenient cost-effective methods to ensure patient’s quick return to function and recovery are necessary in ambulatory anaesthesia. Still and all, many challenges are being confronted daily, and numerous barriers have to be broken before ambulatory anaesthesia and surgery can make its concrete place and establishment in the clinical society.

The Demise of Interdisciplinary Chronic Pain Management and Its Relationship to the Scourge of Prescription Opioid Diversion and Abuse

2018 ◽  
Author(s):  
Michael E. Schatman
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Healthcare Providers ◽  
Well Being ◽  
Insurance Companies ◽  
Prescription Opioid ◽  
Pain Medicine ◽  
Opioid Crisis ◽  
Opioid Medications ◽  
Opioid Diversion

Even though the efficacy of interdisciplinary pain management programs is supported, their numbers have decreased and the vast majority of Americans with chronic pain do not have access to them. Insurance companies do not want to pay for these services, hospitals believe they are financial losers, and the opioid crisis has placed a pall over the practice of pain medicine. The demise of these programs has left pain medicine in a fragmented state. Few healthcare providers who treat chronic pain patients have the time to coordinate care by multiple professionals The opioid crisis seen in certain areas, such as Appalachia, may be related to the lack of these interdisciplinary programs. There should be concerted efforts to increase access to and funding of these programs. Although they are not a panacea for all types of chronic pain, they can improve patients’ well-being and function and reduce their need for opioid medications.

The Value of Preoperative Speech-Language Pathology Counseling for Candidates for Cochlear Implants

2020 ◽  
Vol 5 (4) ◽  
pp. 946-950
Author(s):  
Lindsay Zombek
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implants ◽  
The United States ◽  
Postoperative Management ◽  
Insurance Companies ◽  
Aural Rehabilitation ◽  
Speech Language Pathologist ◽  
Language Pathology ◽  
Operative Assessment ◽  
Rehabilitation Assessment

Purpose This article identifies benefits of pre-operative counseling as part of an aural rehabilitation assessment with a speech-language pathologist as part of adult candidacy for cochlear implants. Aural rehabilitation assessment is not mandated by the Food and Drug Administration in the United States, by some insurance companies, nor consistently by cochlear implant centers as part of cochlear implant candidacy. Although these entities do not require an aural rehabilitation assessment pre-operatively, this assessment and counseling opportunity may offer benefits beyond its contributions to the actual candidacy determination. The perceived benefits of the aural rehabilitation counseling will be discussed. Method A retrospective review was conducted of adults who did and did not receive counseling by a speech-language pathologist as part of their candidacy determination for a cochlear implant. Results Benefits of pre-operative counseling were found to include realistic expectations and motivation for postoperative management, established rapport with the postoperative therapist, determination of candidates’ personal goals ahead of initiation of aural rehabilitation, and increased rates of enrollment in postoperative aural rehabilitation. Conclusion Pre-operative assessment and counseling by aural rehabilitation practitioners may provide benefits and warrant inclusion in pre-operative cochlear implant candidacy determination.

Education and Support: Tilting the Scale Toward Exclusive Breastfeeding

2021 ◽  
Vol 12 (2) ◽  
pp. 83-90
Author(s):  
Naomi Pitcock ◽  
Kimberly Pineda ◽  
Natasha Ossinova ◽  
Laura Yoder
Keyword(s):  
Peer Support ◽  
Low Income ◽  
Exclusive Breastfeeding ◽  
Healthcare Providers ◽  
Cost Effective ◽  
The United States ◽  
Peer Counseling ◽  
Culturally Competent ◽  
Breastfeeding Intention ◽  
Quasi Experimental

The Hispanic population in the United States is growing, and healthcare providers are challenged to design targeted, culturally appropriate programs to improve health outcomes related to breastfeeding.ObjectivesThis study was designed to detect the exclusive breastfeeding (EBF) rate among Hispanic women who chose education plus peer support versus peer support only. In addition, this study further evaluates ¡Tengo Leche!, an educational program previously evaluated in the literature.MethodsThe sample (n = 103) consisted of Hispanic pregnant, low-income, and uninsured women. A two-group quasi-experimental design was used to test the educational intervention combined with peer support (n = 35) versus stand-alone peer support (n = 68). The education-plus group (n = 35) voluntarily participated in the education portion. All participants received the inpatient peer counseling. The participants' breastfeeding intention was gathered through chart review.ResultsEBF at discharge was significantly higher (c2 = 4.51, p = .02) among mothers in the education plus peer support group, who were more likely to be exclusively breastfeeding at discharge (46.7%) versus the peer-support-only group (24.6%).ConclusionsThe outcomes of this study may provide guidance for designing culturally competent interventions with a focus on cost-effective and outcome-driven interventions to increase EBF.

When disaster strikes: Bridging the hospital preparedness gap

2009 ◽  
Vol 7 (4) ◽  
pp. 46
Author(s):  
Matthew S. Yoder, PhD ◽  
Connie L. Best, PhD ◽  
Ralph M. Shealy, MD ◽  
David R. Garr, MD ◽  
Michael G. Schmidt, PhD
Keyword(s):  
Public Health ◽  
Disaster Preparedness ◽  
Healthcare Providers ◽  
Cost Effective ◽  
The United States ◽  
Health Concern ◽  
Primary Role ◽  
Significant Public Health ◽  
Hospital Preparedness ◽  
Basic Evaluation

Bioterrorism has emerged as a serious public health threat in the United States and continues to warrant significant public health concern. In the event of a bioterrorist attack, hospitals and healthcare providers will play a primary role in the community’s response. However, recent research has suggested that hospitals are unprepared to respond to a bioterrorism event lacking personnel, equipment, knowledge, and experience. The current article highlights the gaps between need and implementation of disaster preparedness programs in healthcare settings; presents a program designed to address these limitations in a cost-effective, portable, accessible training package; and analyzes data from a basic evaluation of the program. The program is a 4.5-day training developed by the a state Area Health Education Consortium (AHEC) to help prepare hospitals for a bioterrorist attack by training personnel in the creation of a decontamination team responsible for decontaminating patients before they enter the hospital. A basic evaluation of the program found that participants who complete the training reported high ratings of competency related to decontamination procedures, their confidence in future performance, and the training overall. Results suggest that the training program holds promise in beginning to address hospital preparedness gaps.

Uncovering inefficiencies in the workers’ compensation industry using Lean methodology

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Omar Taha ◽  
Thomas A. Mazzuchi ◽  
Shahram Sarkani ◽  
Jiju Antony ◽  
Sandra Furterer
Keyword(s):  
Physical Therapy ◽  
Case Studies ◽  
Healthcare Provider ◽  
Healthcare Providers ◽  
Value Added ◽  
The United States ◽  
Injured Workers ◽  
Insurance Companies ◽  
Workers Compensation ◽  
Content Type

PurposeThe purpose of this paper is to apply Lean in the workers’ compensation industry. It focuses on identifying patterns of repetitive non-value-added transnational activities for physical-therapy patients and healthcare providers. It addresses the research gap in this field.Design/methodology/approachIn this study, we designed and deployed multiple case studies to better understand the journey of an injured worker within the worker compensation system in the United States of America. We partnered with Concentra Inc., a leading national healthcare provider in the field of workers’ compensation having 520 medical centers in 44 states. Both case studies included conducting direct observations, Gemba walk, in five clinics in two states: Florida and Pennsylvania. We analyzed the data of 263 injured workers with 8 or more physical therapy visits who got admitted to Concentra clinics in both states over the period of 31 days.FindingsThe results revealed that the time intervals at which activities associated with physical therapy treatment pre-authorization accounted for 91.59% of the total non-value-added activities and are thus the key administrative factor leading to process inefficiency in the state of Florida. The Process Cycle Efficiency of Pennsylvania was 75.36% compared to 53.16% of Florida. The injured workers in Florida needed 39.58 days on average to complete eight physical therapy visits compared to 27.92 days in Pennsylvania (a median of 34.09 vs 22.15 days).Research limitations/implicationsThis study is limited as it only focuses on processes on the healthcare provider side. An expanded value stream map that includes the treatment pre-authorization process on the insurance side would be beneficial for generating more potential solutions to streamline the process.Practical implicationsThis study shows that Lean could play a critical role in identifying and quantifying continuous improvement opportunities that could accelerate patient’s treatment, reduce administrative burden on healthcare providers and improve the overall claim cost of insurance companies. It provides data-driven argument for insurance companies to consider eliminating physical therapy pre-authorization.Originality/valueThis is the first study to apply Lean methodology in the workers’ compensation field.

scholarly journals Prospects of Developing Medical Tourism in India

2007 ◽  
Vol 2 (1) ◽  
pp. 61-73
Author(s):  
Binoy T A
Keyword(s):  
Health Care ◽  
Medical Treatment ◽  
Medical Tourism ◽  
Low Cost ◽  
Healthcare Providers ◽  
Cost Effective ◽  
Vital Role ◽  
Tourism Industry ◽  
Insurance Companies ◽  
Medical Systems

Medical tourism is one of the recently developed and rapid growing tourism activities of the World, especially in India. "Medical Tourism can be generally defined as the movement of people for the purpose of getting cost effective personal health care in association with the tourism industry for patients needing surgical health care and other forms of dedicated treatment." Recent days several Indian state governments have realized the potential of medical tourism and have been actively promoting it Visitors, especially from the West and the Middle East find Indian hospitals a very affordable and viable option to grdppling with insurance and National medical systems in their native lands and combine their treatments with a visit to the 'exotic east' with their families.Quality medical treatment at low cost, coupled with great traveling experience is possibly the perfect way to recover from any medical ailment. An inexpensive vacation package combined with a low cost medical treatment has led to the evolution of a new but rapidly growing industry called medical tourism. This process is being facilitated by M1 the corporate sector concerned in heath care as well as the tourism industry including tour operators, hospital administrators, travel agents, airlines, hotels and government tourism organizations. Medical or health treatment package tourism has become a persistent form of engaging the vacation in a different way by inculcating leisure with treatment and covers a broad range of health, medical and dental services. Medical tourism is organized in such a manner that leisure time inculcate with enjoyment and recreation together with wellness and health care packages in a country other than the place of residence. Health and Medical Tourism is perceived as one of the fastest growing segments in marketing 'Destination India' today. The Ministry of Tourism, airlines, tour operators, insurance companies, tourism sector and healthcare providers can make India as a dream destination for medical Tourism through an orchestrated effort. Government and private organizations that are playing a vital role in the development of tourism in India should orchestrate their developmental efforts to take advantage of the enormous potential of Medical and Dental tourism through ensuring international standard treatment to the patients and envisage a coordinated marketing and promotional strategies enough to overcome the Asian competitors.

scholarly journals Screening for Chagas Disease during Pregnancy in the United States—A Literature Review

2021 ◽  
Vol 6 (4) ◽  
pp. 202
Author(s):  
Elizabeth G. Livingston ◽  
Ryan Duggal ◽  
Sarah Dotters-Katz
Keyword(s):  
United States ◽  
Chagas Disease ◽  
Healthcare Providers ◽  
Obstetric Care ◽  
Cost Effective ◽  
The United States ◽  
Diagnosis And Treatment ◽  
Care Providers ◽  
Future Health ◽  
In Pregnancy

Obstetrician-gynecologists in the United States have little clinical experience with the epidemiology, pathophysiology, diagnosis, and treatment of Chagas disease. The number of US parturients born in Central and South America has continued to increase over the last 20 years, making US obstetricians more and more likely to care for Chagas-infected mothers who may never be identified until dealing with long-term consequences of the disease. A literature search demonstrates that few US obstetric care providers recognize the risk of vertical transmission for the neonate and the missed opportunity of infant treatment to decrease disease prevalence. Most women will be asymptomatic during pregnancy, as will their neonates, making routine laboratory screening a necessity for the identification of at-risk neonates. While the benefits of treating asymptomatic women identified in pregnancy are not as clear as the benefits for the infants, future health screenings for evidence of the progression of Chagas disease may be beneficial to these families. The literature suggests that screening for Chagas in pregnancy in the US can be done in a cost-effective way. When viewed through an equity lens, this condition disproportionately affects families of lower socioeconomic means. Improved education of healthcare providers and appropriate resources for diagnosis and treatment can improve this disparity in health outcomes.

E-Insurance :A Platform For Insurance Penetration In India

2019 ◽  
Vol 118 (6) ◽  
pp. 90-93
Author(s):  
L. Terina Grazy ◽  
Dr.G. Parimalarani
Keyword(s):  
Insurance Industry ◽  
Cost Effective ◽  
Online Marketing ◽  
Insurance Companies ◽  
The Internet ◽  
Insurance Sector ◽  
The People ◽  
Cost Effective Approach ◽  
Time And Energy ◽  
Work Done

E-commerce is a part of Internet Marketing. The arrival of Internet made the world very simple and dynamic in all the areas. Internet is the growing business as a result most of the people are using it in their day to day life. E-commerce is attractive and efficient way for both buyers and sellesr as it reduce cost, time and energy for the buyer. No surprise the insurance sector has become quite active within the internet sphere. Most insurance companies are offering policies to be brought online and also the portals for paying premiums. It actually saves from hassles involved in going to an insurance office and spend hours to get the insurance work done. Insurance has become an important and crucial aspect of life. Online insurance is the best and most cost effective approach of taking the insurance deal. This paper focused on influence of online marketing on the insurance industry in India, usage of internet in India , the internet penetration in India and the online sale of insurance product by the insurance sector.

Detection of enteroviruses in marine waters by direct RT-PCR and cell culture

1995 ◽  
Vol 31 (5-6) ◽  
pp. 323-328 ◽  
Author(s):  
K. A. Reynolds ◽  
C. P. Gerba ◽  
I. L. Pepper
Keyword(s):  
Cell Culture ◽  
Polymerase Chain Reaction Amplification ◽  
Cost Effective ◽  
The United States ◽  
Water Runoff ◽  
Rt Pcr ◽  
Marine Waters ◽  
Storm Water Runoff ◽  
Routine Monitoring ◽  
Reaction Amplification

Sewage outfalls and storm water runoff introduces pathogenic human enteric viruses into marine coastal waters, which may pose a potential public health risk. Although members of the enterovirus group have been suggested as possible indicators of sewage pollution in marine waters, the lack of rapid, sensitive and cost effective methods have prevented routine monitoring in the United States. This study compared traditional cell culture and direct RT-PCR (reverse transcriptase-polymerase chain reaction) amplification for detection of an enterovirus. Poliovirus could be recovered from 100 L of artificial seawater with an average efficiency of 77%, using adsorption and elution from electronegative filters. Viruses were eluted from the filters with 1.5% beef extract for viruses (BEV) adjusted to pH 9.5 and reconcentrated by organic flocculation to a volume of 30 mL. Substances which interfered with detection by RT-PCR were removed by treatment of the concentrates with sephadex and chelex resins. Direct RT-PCR could detect 2.5 and 0.025 PFU (plaque forming units) for single (25 cycles) and double PCR (2 × 25 cycles) in 10 μL of pure culture poliovirus samples, respectively. These methods are currently being applied to assess the occurrence of enteroviruses at marine bathing beaches influenced by sewage discharges.

Capturing the surge of public interest towards Hydroxychloroquine, Azithromycin and BCG vaccine during COVID-19 Pandemic (Preprint)

2020 ◽  
Author(s):  
Shabbir Syed-Abdul ◽  
Shwetambara Malwade ◽  
Sim-Mei Choo
Keyword(s):  
Social Media ◽  
Preventive Measures ◽  
Healthcare Providers ◽  
Specific Treatment ◽  
Drug Effects ◽  
The United States ◽  
Bcg Vaccine ◽  
Public Interests ◽  
Treatment Regimes ◽  
Appropriate Treatment

UNSTRUCTURED The outbreak of COVID-19 that started in December 2019, was declared a pandemic in March 2020. Currently, there is no specific treatment recommended and healthcare providers are struggling to find appropriate treatment regimes. Medication misinformation spread through social media has caused panic situations and self-prescription leading to harmful drug effects. The situation worsened following false propaganda via social media, leading to shortage of some medications. Our study shows the frequency of search for the medications Hydroxychloroquine (HCQ), Azithromycin and Bacillus Calmette-Guérin (BCG) vaccine in Google Trends, across 6 countries. Public interests from the United States, Italy and Spain leaned towards HCQ, whereas those from Taiwan, Japan and South Korea were keen towards learning about the BCG vaccine. Our article aimed to inform the general public of the adverse drug reactions to avoid self-prescription or yield to the assumptions of leaders and unanimous social media posts. Proactive participation and preventive measures such as social distancing, use of face masks and hand sanitizers are recommended to help curb COVID-19 and other infections.

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