scholarly journals Health Care System for Employment in ‘Taxi-Drivers’-Utility and Follow Up

1993 ◽  
Vol 20 (2) ◽  
pp. 269-269
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Taxi Drivers ◽  
Care System

scholarly journals Patterns of Repeat Colorectal Cancer Screening and Follow-Up of Abnormal Results in an Integrated Safety-Net Health Care System

2017 ◽  
Vol 4 (3) ◽  
pp. 151-152
Author(s):  
Caitlin Murphy ◽  
Amit Singal ◽  
Joanne Sanders ◽  
Sandi Pruitt ◽  
Simon Craddock Lee ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Health Care System ◽  
Safety Net ◽  
Care System ◽  
Abnormal Results

Relation Between Cardiology Follow-Up Visits, Evidence-Based Statin Prescribing, and Statin Adherence (from the Veterans Affairs Health Care System)

2019 ◽  
Vol 124 (8) ◽  
pp. 1165-1170 ◽  
Author(s):  
Hasan Rehman ◽  
Sarah T. Ahmed ◽  
Julia Akeroyd ◽  
Dhruv Mahtta ◽  
Xiaoming Jia ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Veterans Affairs ◽  
Evidence Based ◽  
Statin Adherence ◽  
Care System

scholarly journals Collection and use of EQ-5D for follow-up, decision-making, and quality improvement in health care - the case of the Swedish National Quality Registries

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Olivia Ernstsson ◽  
Mathieu F. Janssen ◽  
Emelie Heintz
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Quality Improvement ◽  
Health Care System ◽  
Swedish Health Care ◽  
National Quality ◽  
Patient Reported ◽  
Different Levels ◽  
Care System

Abstract Background The Swedish National Quality Registries (NQRs) contain individual-level health care data for specific patient populations, or patients receiving specific interventions. Approximately 90% of the 105 Swedish NQRs include any patient-reported outcome measure, with EQ-5D being the most common. As there has been no general overview of EQ-5D data within the NQRs, this study fills a knowledge gap by reporting how the data are collected, presented, and used at different levels of the Swedish health care system. Methods All 46 NQRs with a license for the use of EQ-5D were included. Information was retrieved from the registries’ annual reports or from websites, using a template that was subsequently sent to each registry for completion and confirmation. If considered necessary, the contact was followed-up with an interview, either in-person or over the telephone. The uses of EQ-5D were categorised as denoting usage for follow-up, decision-making, or quality improvement in Swedish health care. Results In total, 41 of the 46 licensed registries reported collection of EQ-5D data. EQ-5D is most commonly collected within registries related to the musculoskeletal system, but it has a wide application also in other disease areas. Thirty-six registries provide EQ-5D results to patients, clinicians, or other decision-makers. Twenty-two of the registries reported that EQ-5D data are being used for follow-up, decision-making or quality improvement. The registries most commonly reported use of data for assessing interventions, and in quality indicators to follow-up the quality of care at a national level. Conclusion Collection and use of EQ-5D data vary across the Swedish NQRs, which may partly be accounted for by the different purposes of the registries. The provided examples of use illustrate how EQ-5D data can inform decisions at different levels of the health care system. However, there is potential for improving the use of EQ-5D data.

scholarly journals Very Severe Hypertriglyceridemia in a Large US County Health Care System: Associated Conditions and Management

2019 ◽  
Vol 3 (8) ◽  
pp. 1595-1607 ◽  
Author(s):  
Maria Isabel Esparza ◽  
Xilong Li ◽  
Beverley Adams-Huet ◽  
Chandna Vasandani ◽  
Amy Vora ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Health Care System ◽  
Serum Triglyceride ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Severe Hypertriglyceridemia ◽  
Uncontrolled Diabetes ◽  
Care System

Abstract Context Patients with very severe hypertriglyceridemia (triglyceride levels ≥2000 mg/dL; 22.6 mmol/L) require aggressive treatment. However, little research exists on the underlying etiologies and management of very severe hypertriglyceridemia. Objective We hypothesized (i) very severe hypertriglyceridemia in adults is mostly associated with secondary causes and (ii) most patients with very severe hypertriglyceridemia lack appropriate follow-up and treatment. Design We queried electronic medical records at Parkland Health and Hospital Systems for lipid measurements in the year 2016 and identified patients with serum triglyceride levels ≥2000 mg/dL (22.6 mmol/L). We extracted data on demographics, underlying causes, lipid-lowering therapy, and follow-up. Results One hundred sixty-four serum triglyceride measurements were ≥2000 mg/dL (22.6 mmol/L) in 103 unique patients. Of these, 60 patients were admitted to the hospital (39 for acute pancreatitis). Most were Hispanic (79%). The major conditions associated with very severe hypertriglyceridemia included uncontrolled diabetes mellitus (74%), heavy alcohol use (10%), medication use (7%), and hypothyroidism (2%). Two patients were known to have monogenic causes of hypertriglyceridemia. After the index measurement of triglycerides ≥2000 mg/dL (22.6 mmol/L), the use of triglyceride-lowering drugs increased, most prominently the use of fish oil supplements, which increased by 80%. However, in follow-up visits, hypertriglyceridemia was addressed in only 50% of encounters, and serum triglycerides were remeasured in only 18%. Conclusion In summary, very severe hypertriglyceridemia was quite prevalent (∼0.1% of all lipid measurements) in our large county health care system, especially in Hispanic men. Most cases were related to uncontrolled diabetes mellitus, and follow-up monitoring was inadequate.

Characteristics of Men Undergoing Testosterone Replacement Therapy and Adherence to Follow-up Recommendations in Metropolitan Multicenter Health Care System

Urology ◽  
2015 ◽  
Vol 85 (6) ◽  
pp. 1382-1388 ◽  
Author(s):  
Rena D. Malik ◽  
Chihsiung E. Wang ◽  
Brittany Lapin ◽  
Justin C. Lakeman ◽  
Brian T. Helfand
Keyword(s):  
Health Care ◽  
Replacement Therapy ◽  
Health Care System ◽  
Testosterone Replacement ◽  
Testosterone Replacement Therapy ◽  
Care System

Breast Radiologists: Extenders of Primary Care

2019 ◽  
Vol 1 (1) ◽  
pp. 43-46 ◽  
Author(s):  
Daniel W Dahl ◽  
Phan T Huynh
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care System ◽  
Breast Imaging ◽  
Health Care Industry ◽  
Performance Model ◽  
New Era ◽  
Care Industry ◽  
Care System

Abstract The health care industry has seen many changes in recent years. Gradually, the traditional volume-based fee-for-service health care system is being replaced by the patient-centered, value-based, pay-for-performance model. In response to this, the American College of Radiology has developed an initiative coined Imaging 3.0: a blueprint to help guide our profession through this transition in health care delivery. Radiologists are an integral part of the health care system, and they greatly affect patient care; however, we have progressively become less visible as a specialty. It is time that we, as radiologists, broaden our role in patient care. As breast radiologists, we are uniquely qualified to usher in this new era of medicine. We have the skill set to provide comprehensive breast care. We are actively involved in early breast cancer detection, pre-imaging patient-care decisions, imaging work-ups, diagnosis, care coordination, treatment, and follow-up. We have set the gold standard for concise structured reporting and follow-up recommendations with the American College of Radiology Breast Imaging Reporting and Data System lexicon, which offers value to our clinician colleagues. Our broad knowledge and role in breast conditions, patient relationships, and other noninterpretive skills offers personalized care and expertise that allows for the best, safest, most cost-effective, and efficient service for the patient and health care industry. Our comprehensive care provides direct interaction and education, decreases radiation exposure, and saves patients time and money. It also benefits the health care industry by improving throughput, reducing waste, and eliminating inefficiencies in the system. As breast radiologists, we are uniquely qualified to usher in this new era of radiology.

Building Personalized Cancer Follow-up Care Pathways in the United States: Lessons Learned From Implementation in England, Northern Ireland, and Australia

2019 ◽  
pp. 625-639 ◽  
Author(s):  
Catherine M. Alfano ◽  
Michael Jefford ◽  
Jane Maher ◽  
Sarah A. Birken ◽  
Deborah K. Mayer
Keyword(s):  
United States ◽  
Health Care ◽  
Northern Ireland ◽  
Health Care System ◽  
The United States ◽  
Lessons Learned ◽  
Care Pathways ◽  
Follow Up Care ◽  
Care System

There is a global need to transform cancer follow-up care to address the needs of cancer survivors while efficiently using the health care system to limit the effects of provider shortages, gaps in provider knowledge, and already overburdened clinics; improve the mental health of clinicians; and limit costs to health care systems and patients. England, Northern Ireland, and Australia are implementing an approach that triages patients to personalized follow-up care pathways depending on the types and levels of resources needed for patients’ long-term care that has been shown to meet patients’ needs, more efficiently use the health care system, and reduce costs. This article discusses lessons learned from these implementation efforts, identifying the necessary components of these care models and barriers and facilitators to implementation of this care. Specifically, the United States and other countries looking to transform follow-up care should consider how to develop six key principles of this care: algorithms to triage patients to pathways; methods to assess patient issues to guide care; remote monitoring systems; methods to support patients in self-management; ways to coordinate care and information exchange between oncology, primary care, specialists, and patients; and methods to engage all stakeholders and secure their ongoing buy-in. Next steps to advance this work in the United States are discussed.

scholarly journals A Multicenter Intervention to Improve Ambulatory Care Handoffs at the End of Residency

2014 ◽  
Vol 6 (1) ◽  
pp. 112-116 ◽  
Author(s):  
Michael J. Donnelly ◽  
Janelle M. Clauser ◽  
Rochelle E. Tractenberg
Keyword(s):  
Internal Medicine ◽  
Health Care ◽  
Health Care System ◽  
Transition Period ◽  
Time Frame ◽  
Free Text ◽  
Significant Difference ◽  
Short Time ◽  
Care System

Abstract Background Graduating residents transition their continuity clinic patients to junior colleagues every year, creating a vulnerable transition period for about 1 million patients nationally. Objective We examined a standardized, electronic template for handing off high-risk ambulatory patients by outgoing residents from 7 residencies within a large health care system, and compared handoff quantity and provider satisfaction for handoffs with and without that template. Methods Residents graduating in 2011 from 5 internal medicine, 1 family medicine, and 1 internal medicine-pediatrics residency programs in 1 health care system were randomized to a new electronic handoff process with a standardized intervention template or a free-text handoff. Expert reviewers independently evaluated all handoff notes, and providers were surveyed after follow-up appointments regarding use, helpfulness, and overall satisfaction with the handoffs. Results Fifty-two of 79 residents (66%) participated, performing 278 handoffs. Eighty-four patients (30%, 17 of 57) failed to follow up within the study period. For patients who followed up, providers read 61% (101 of 165) of the handoffs at the time of the visit. No significant difference existed between groups in the satisfaction of the follow up provider or the quality measure of the handoffs in our process. Expert agreement on which features make the handoff “helpful” was fair (κ  =  0.34). Conclusions A standardized template did not improve handoff quantity or satisfaction compared with a free-text handoff. Practical handoff programs can be instituted into diverse residencies within a short time frame, with most residents taking part in creating the handoff formats.

Can We Design a Better Immunization Mousetrap?

PEDIATRICS ◽  
1979 ◽  
Vol 63 (3) ◽  
pp. 501-502
Author(s):  
Edgar K. Marcuse
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Provider ◽  
Care Provider ◽  
Washington State ◽  
Immunization Schedule ◽  
National Immunization ◽  
Lost To Follow Up ◽  
Care System

Our nation's failure to adequately immunize children remains a vexing and embarrassing problem. An article in this issue (p 416) verifies the virtual impossibility of fully immunizing 90% of children by age 2 years. Repeated national immunization surveys have shown that most children receive some immunization by age 2 years.1 The failure results principally from children who enter the health care system and are then lost to follow-up. A 1977 immunization survey in Washington state showed that a single additional visit to a health care provider could have increased the number of two-yean-olds fully immunized from 60% to 82%.2 Part of the solution may lie in simplifying the recommended immunization schedule.

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