The International Standards for Cytogenomic Arrays (ISCA) Consortium is a worldwide collaborative effort dedicated to optimizing patient care by improving the quality of chromosomal microarray testing. The primary effort of the ISCA Consortium has been the development of a database of copy number variants (CNVs) identified during the course of ...

Contemporary Japan is known both for its high tech culture and its rapidly aging population, with 22 % of people currently 65 years and older. Yet there has been little attention to the material culture of the elderly. This paper explores the way aging bodies, official ideology, and consumption of what are ...

Issues: By allowing for the efficient delivery of instructional content and the secure collection of self-report data regarding substance use and related problems, the Internet has tremendous potential to improve the effectiveness and accessibility of Substance Use Disorder (SUD) treatment and recovery-oriented services. Approach: This article discusses some of the ...

OBJECTIVES: to analyse the existing evidence on the cost-effectiveness of midwife-led care compared with consultant-led care in settings potentially generalisable to the United Kingdom, and to estimate the potential cost savings accruing from an expansion of midwife-led care in the United Kingdom. DESIGN: a systematic review of the literature was ...

BACKGROUND: Recently, rib fracture fixation for flail chest has been used increasingly at both academic and nonacademic trauma centers. Although a few small non-US studies have demonstrated a clinical benefit, it is unclear whether this benefit outweighs the added expense and potential perioperative complications related to the procedure. We therefore ...

Children and youth with complex medical issues, especially those with technology dependencies, experience frequent and often lengthy hospitalizations. Hospital discharges for these children can be a complicated process that requires a deliberate, multistep approach. In addition to successful discharges to home, it is essential that pediatric providers develop and implement ...

Because the Affordable Care Act will expand health insurance to cover an estimated thirty-two million additional people, new approaches are needed to expand the primary care workforce. One possible solution is Grand-Aides®, who are health care professionals operating under the direct supervision of nurses, and who are trained and equipped ...

ABSTRACT: Mortality is the most widely measured outcome parameter. Improvement of this outcome parameter in critical care is nowadays expected not to come from new technologies or treatment, but from delivering the right care at the right moment in a safe way. The measurement of mortality as an outcome parameter ...

Severe preeclampsia/eclampsia and postpartum hemorrhage (PPH) are serious obstetric problems worldwide. Quality improvement of care measured by evidence-based indicators is recommended as a recent important strategy; however, the indicators for quality of care of these two conditions have not been established. This study aimed to develop such indicators and assess ...

Adoption of health information technology (HIT) is a key effort in improving care delivery, reducing costs of health care, and improving the quality of health care. Evidence from electronic health record (EHR) use suggests that HIT will play a significant role in transforming primary care practices and chronic disease management. ...

Reliable epidemiological data on pituitary adenomas (PAs) are of major importance for estimating the burden on the Health Care System and for designing optimal resource distribution for clinical care and for research activities. Cross-sectional studies from Switzerland, Belgium and the UK have shown that PAs have a prevalence of 78 ...

In the concept of total quality management that was originally developed in industry, the use of quality indicators is essential. The implementation of quality indicators in the intensive care unit to improve the quality of care is a complex process. This process can be described in seven subsequent steps of ...

Stroke units have become established as the central component of modern stroke services. However, most stroke-unit trials and service developments have been done in high-income countries, which raises the question of whether such care is relevant and applicable to low-income and middle-income settings. To address this question, we first need ...

Objective: To evaluate the impact of the final Centers for Medicare & Medicaid Services' (CMS) "short-fill" rule regarding the appropriate dispensing of prescription drugs in long-term care facilities. Design: A prospective study to determine rates of unconsumed medication and the net-cost impact on Medicare Part D prescription drug plans based ...

BACKGROUND: There is dearth of information about the burden of osteoporosis in Canadian men. To fill this gap, we conducted a burden of illness study aimed at estimating the economic burden attributable to osteoporosis in Canadian men aged 50 years and older. METHODS: Five national data sources were used to ...

ABSTRACT: BACKGROUND: High-risk prescribing of non-steroidal anti-inflammatory drugs (NSAIDs) and antiplatelet agents accounts for a significant proportion of hospital admissions due to preventable adverse drug events. The recently completed PINCER trial has demonstrated that a one-off pharmacist-led information technology (IT)-based intervention can significantly reduce high-risk prescribing in primary care, but ...

Despite the growing number of older adults experiencing TBI, little information exists regarding their utilization and cost of healthcare services. Identifying patterns in the type of care received and determining their costs is an important first step to understanding the return on investment and potential areas for improvement. A health ...

INTRODUCTION: Quality of care is associated with patient volume. Regionalization of care is therefore one of the approaches that is suited to improve quality of care. A disadvantage of regionalization is that the accessibility of the facilities can decrease. By investigating the tradeoff between quality and accessibility it is possible ...

This paper investigates the technology cost structure in US physical therapy care. We exploit formal economic theories and a rich national data of providers to tease out implications for operational cost efficiencies. The 2008-2009 dataset comprising over 19 000 bi-weekly, site-specific physical therapy center observations across 28 US states and Occupational ...

OBJECTIVE: To determine if nonoperative fracture Current Procedural Technology codes generate a significant portion of annual revenues in an academic practice. DESIGN: Retrospective review of an orthopaedic trauma practice billings during fiscal year 2008. SETTING: An urban level-1 trauma center. PATIENTS: Outpatient clinic, and all consults, to the orthopaedic trauma ...

ABSTRACT: Study Design. Multi-centred randomized controlled trial with quality of life and resource use data collected.Objective. The objective of this study is to evaluate the cost-effectiveness of yoga intervention plus usual care compared with usual care alone for chronic or recurrent low back pain.Summary of Background Data. Yoga has been ...

ABSTRACT: Study Design. Serial, cross-sectional, nationally representative surveys of non-institutionalized adults.Objective. To examine expenditures on common ambulatory health services for the management of back and neck conditions.Summary of Background Data. Although it is well recognized that national costs associated with back and neck conditions have grown considerably in recent years, ...

The need is urgent to bring US health care costs into a sustainable range for both public and private payers. Commonly, programs to contain costs use cuts, such as reductions in payment levels, benefit structures, and eligibility. A less harmful strategy would reduce waste, not value-added care. The opportunity is ...

BACKGROUNDThis study aimed to calculate costs and health-related quality of life of women with endometriosis-associated symptoms treated in referral centres.METHODSA prospective, multi-centre, questionnaire-based survey measured costs and quality of life in ambulatory care and in 12 tertiary care centres in 10 countries. The study enrolled women with a diagnosis of ...

The United States has been singularly unsuccessful at controlling health care spending. During the past four decades, American policymakers and analysts have embraced an ever changing array of panaceas to control costs, including managed care, consumer-directed health care, and most recently, delivery system reform and value-based purchasing. Past panaceas have ...

BACKGROUND: As different definitions for PC have been used across the last three decades, a common terminology is lacking. To ensure quality of care, (a) a consensus on outcome criteria and indicators and (b) validated and applicable outcome assessment instruments are necessary. The aim of this study is to systematically ...

The diagnosis of ocular disease is increasingly important in optometric practice and there is a need for cost effective point of care assays to assist in that. Although tears are a potentially valuable source of diagnostic information difficulties associated with sample collection and limited sample size together with sample storage ...

ABSTRACT: Over the past decade technological advances in the realm of ultrasound have allowed what was once a cumbersome and large machine to become essentially hand-held. This coupled with a greater understanding of lung sonography has revolutionized our bedside assessment of patients. Using ultrasound not as a diagnostic test, but ...

To update the 1993 burden of illness of osteoporosis in Canada, administrative and community data were used to calculate the 2010 costs of osteoporosis at $2.3 billion in Canada or 1.3% of Canada's healthcare expenditures. Prevention of fractures in high-risk individuals is key to decrease the financial burden of osteoporosis. ...

Purpose of the Study: To examine the components of cost that drive increased total costs after a medical fall over time, stratified by injury severity.  DESIGN AND METHODS:  We used 2004-2007 cost and utilization data for persons enrolled in an integrated care delivery system. We used a longitudinal cohort study design, ...

: Little is known about the healthcare experiences of Medicare beneficiaries in Puerto Rico. : We compare the experiences of elderly Medicare beneficiaries in Puerto Rico with their English-preferring and Spanish-preferring Medicare counterparts in the U.S. mainland. : Linear regression models compared mean Consumer Assessment of Healthcare Providers and Systems ...

The management of acute and chronic wounds has drastically changed within the past 20 years. This update focuses on the most recent recommendations for acute wound care as well as new technologies that are available for chronic wounds.

Background In 2010, the federal government introduced the first comprehensive national policy statement for primary healthcare in Australia. This policy identifies key reform initiatives with the overall aim of improving the quality of healthcare. However, what constitutes quality and how to measure it is the subject of ongoing debate both ...

Common "quality" metrics may represent the quality of care for large populations; however, they do not adequately represent quality in individual primary care settings, especially as stand-alone indices. Using discreet threshold values to measure quality in primary care may result in physicians focusing on managing patients by the numbers at ...

Male skin care needs are heavily influenced by the need to remove facial hair on a regular basis. Facial skin issues associated with poor hair removal approaches are common and include razor burn and irritation. This paper evaluates current research on shaving technology and how careful ingredient selection can contribute ...

Clinical Question Does point-of-care testing (POCT) for lipids improve the risk stratification and management of cardiovascular disease compared to standard practice.

The health reform law boosted Medicare fees for primary care ambulatory visits by 10 percent for five years starting in 2011. Using a simulation model with real-world parameters, we evaluate the effects of a permanent 10 percent increase in these fees. Our analysis shows the fee increase would increase primary ...

The GE QuietCare® passive monitoring system uses advanced motion sensor technology that learns the daily living patterns of senior community residents and sends alerts when certain out-of-the-ordinary events occur. This study compared falls, hospitalizations, care level changes, and resident attrition between two similar assisted living facilities where one facility adopted ...

BACKGROUND AND PURPOSE: High blood pressure (BP) is the most important modifiable stroke risk factor. Worldwide high BP in many people is uncontrolled or people are unaware of their BP status. We aimed to assess whether a program of organized multidisciplinary care and medication would be cost-effective for improving BP ...

High-fidelity simulation facilitates the professional development and interprofessional collaboration of health care providers across multiple disciplines and specialties, thus reducing medical errors, improving patient safety, and changing the way that health care professionals feel about and manage the low-occurrence, high-risk scenarios that inevitably occur in the clinical setting. Less complex ...

Shared-housing arrangements (SHA) in Germany are a specific type of housing arrangement that belongs to the global concept of small-scale living arrangements. This caring approach comprises characteristics of both home and institutional care for persons with dementia. To evaluate the impact of SHA on the quality of life (QoL) of ...

A large part of the excitement behind microfluidics is in its potential for producing practical devices, but surprisingly few lab-on-a-chip based technologies have been successfully introduced into the market. Here, we review current work in commercializing microfluidic technologies, with a focus on point-of-care diagnostics applications. We will also identify challenges ...

Intensive care units (ICUs) are an essential and unique component of modern medicine. The number of critically ill individuals, complexity of illness, and cost of care continue to increase with time. In order to meet future demands, maintain quality, and minimize medical errors, intensivists will need to look beyond traditional ...

Accidental hypothermia is an environmental condition with basic principles of classification and resuscitation that apply to mountain, sea or urban scenarios. Along with coagulopathy and acidosis, hypothermia belongs to the lethal triad of trauma victims requiring critical care. A customized healthcare chain is involved in its management, extending from on ...

The basic parameters for medical workups have scarcely changed in the past 30 years. That is, what the internal medicine community has deemed acceptable for outpatient, inpatient, emergency department, and urgent care evaluation has remained pretty much stable or stagnant during all that time. We are failing to take advantage ...

ABSTRACT: BACKGROUND: The timely and appropriate adoption of new radiation therapy (RT) technologies is a challenge both in terms of providing of optimal patient care and managing health care resources. Relatively little is known regarding the rate at which new RT technologies are adopted in different jurisdictions, and the barriers ...

The concept of an artificial placenta has been pursued in experimental research since the early 1960s. The principle has yet to be successfully implemented in neonatal care despite the constant evolution in extracorporeal life support technology and advancements in neonatal intensive care in general. For more than three decades, the ...

A high-throughput, simple, fast, low-cost and sensitive paper-based electrochemical immunodevice has been demonstrated based on a functionalized 3D paper-based device for point-of-care diagnosis.

This study determined the impact of a computerized care documentation system on client outcomes, regulatory compliance, and staff workloads after 3 years of use. The survey was conducted at an 800-bed aged care facility, and staff using the computerized care system were invited to participate (n = 112). The survey was an adapted ...

Abstract Objective: To demonstrate that concepts of patient-centeredness and technology-centeredness must work together within the context of the transformation to the patient-centered medical home (PCMH), a primary care model that emphasizes coordinated, comprehensive, accessible, and cost-effective care. Materials and Methods: Information in this article was gathered from a workshop on ...