Health Care Systems
04 Mar Hospital Mortality: Association With Nurses’ Work Load and Education
Posted at 00:25h
in Author Interviews, Health Care Systems, Lancet, Nursing, University of Pennsylvania
MedicalResearch.com Interview with:
Professor Linda H Aiken PhD, FAAN, FRCN, RN
Claire M. Fagin Leadership Professor in Nursing, Professor of Sociology
Director of the Center for Health Outcomes and Policy Research
Center for Health Outcomes and Policy Research
University of Pennsylvania School of Nursing
MedicalResearch.com: Austerity measures and health-system redesign to minimise hospital expenditures risk adversely affecting patient outcomes. Against that backdrop, can you start by letting us know the background of the study?
Prof. Aiken: European Surgical Outcomes Study in 28 countries showed higher than necessary deaths after surgery.
A comparable study in the US showed that despite the nation spending hundreds of millions of dollars on improving patient safety, there were no improvements in adverse outcomes after surgery in US hospitals between 2000 and 2009. Clearly it is time to consider new solutions to improving hospital care for surgical patients, who make up a large proportion of all hospital admissions. Our study was designed to determine whether there are risks for patients of reducing hospital nurse staffing, and what, if any, are the benefits to patients of moving to a more educated nurse workforce.
18 Feb Expanded Health Insurance: Hospital Services Use by Young Adults with Behavioral Diagnoses
Posted at 21:53h
in Cost of Health Care, Dartmouth, Health Care Systems, Mental Health Research, Yale
MedicalResearch.com Interview with:
Ellen R. Meara
Associate Professor of The Dartmouth Institute
Adjunct Associate Professor in Economics & Nelson A. Rockefeller Center for Public Policy, Dartmouth College
MedicalResearch.com: What are the main findings of this study?
Answer: When insurance coverage for young adults rose by over 15 percentage points following Massachusetts' 2006 health reform, use of inpatient care for mental illness and substance use disorders fell and emergency department visits for these conditions grew more slowly for 19 to 25 year olds in Massachusetts relative to other states. Also, their care was much more likely to be paid for by private or public insurance insurers.
26 Jan Underserved Patients: Minority Physicians’ Role
MedicalResearch.com Interview with:
Dr. Lyndonna Marrast MD
Fellow in General Internal Medicine
Cambridge Health Alliance
Cambridge, MA 02139
MedicalResearch.com: What are the main findings of the study?
Dr. Marrast: We found that disadvantaged patients (categorized as racial and ethnic minorities, non-English home language speakers, being low income, having Medicaid, or reporting fair or poor health) were more likely than other patients to be cared for by a minority physician.
A majority, 54%, of black, Hispanic and Asian patients received care from a minority doctor and the vast majority, 70%, of those who report not speaking English at home got care from a minority physician.
22 Jan Transfers of Hospitalized Patients and Insurance Status
Posted at 01:00h
in Annals Internal Medicine, Author Interviews, Cost of Health Care, Health Care Systems, University of Pittsburgh
MedicalResearch.com Interview with:
Janel Hanmer, MD, PhD
University of Pittsburgh Medical Center
Montefiore Hospital
Pittsburgh, PA 15213
MedicalResearch.com: What are the main findings of the study?
Dr. Hanmer: We used the National Inpatient Sample - a sample of about 20% of US community hospitals with all discharges from those hospitals - to examine if insurance status is associated with transfer from one hospital to another. We were looking at patients who were already admitted to the hospital, not the patients who presented to the Emergency Department. We selected the five most common general medicine admissions for adults aged 18 to 64. We found that uninsured patients were less likely to be transferred than privately insured patients in four of the five conditions (about 20-40% less likely). We also found that women were less likely than men to be transferred in five of the conditions (about 35 to 40% less likely).
17 Jan Safety Net Hospitals: Death Rates After Major Complications
Posted at 02:32h
in Author Interviews, Brigham & Women's - Harvard, Health Care Systems, JAMA, Medical Research Centers, Outcomes & Safety
MedicalResearch.com Interview with
Elliot Wakeam MD
Center for Surgery and Public Health
Brigham and Women's Hospital
Boston MA 02115
MedicalResearch.com: What are the main findings of the study?
Dr. Wakeam: Our study examined failure to rescue (FTR), or death after postoperative complications, in safety net hospitals. Prior work has shown that hospital clinical resources can improve rescue rates, however, despite having higher levels of technology and other clinical resources that should lead to better rates of patient rescue, safety net hospitals still had greater rates of death after major complications.
16 Nov Mental Illness: Elderly Patients and Healthcare Utilization
MedicalResearch.com Interview with:
Hugh C. Hendrie, MB ChB, DSc
Professor, Department of Psychiatry, Indiana University School of Medicine
Center Scientist, Indiana University Center for Aging Research
Research Scientist, Regenstrief Institute, Inc.
MedicalResearch.com: What are the main findings of the study?
Answer: Our findings of higher rates of emergency care, longer hospitalizations and increased frequency of falls, substance abuse and alcoholism suggest that seriously mentally ill older adults remain a vulnerable population.
12 Sep Value of a Hospitalists-Led, Post-Discharge Clinic
MedicalResearch.com Interview with:
Lauren Doctoroff, MD
Hospitalist, Hospital Medicine Program
Beth Israel Deaconess Medical Center
Medical Director, HCA Post Discharge Clinic and PACT Transitional Care Program
Instructor, Harvard Medical School
Boston, MA 02215
MedicalResearch.com What are the main findings of the study?
Dr. Doctoroff: A dedicated post discharge clinic, staffed by hospitalists, led to a shorter interval to a clinic visit for patients after discharge. Patients with resident primary care doctors and those who are African American were most likely to use the clinic. The care provided in the clinic, in terms of testing, was consistent with the remainder of the practice.
29 Aug Kaiser’s Hypertension Program Dramatically Improves Blood Pressure Control in Large Population
Posted at 11:27h
in Author Interviews, Blood Pressure - Hypertension, Health Care Systems, JAMA, UCSF
MedicalResearch.com Interview with:
Dr. Marc Jaffe, MD
Clinical Leader, Kaiser Northern California Cardiovascular Risk Reduction Program
Clinical Leader, Kaiser National Integrated Cardiovascular Health (ICVH) Guideline Development Group
Associate Clinical Professor of Medicine, UCSF
Endocrinology and Internal Medicine
Kaiser South San Francisco Medical Center
1200 El Camino Real
South San Francisco, California 94080
MedicalResearch.com: What are the main findings of the study?
Dr. Jaffe: In 2001, we set out to improve blood pressure control in among Kaiser Permanente (KP) members in Northern California, and we ended up creating one of the largest, community-based hypertension programs in the nation. The paper published in JAMA explores how we combined a number of innovations, including a patient registry, single-pill combination therapy drugs and more, to nearly double blood pressure control rates.
If you had told us at the onset that blood pressure control among members would be more than 80 percent, and it was actually almost 90 percent in 2011, we wouldn’t have believed you. These results are truly incredible. During the study period, hypertension control increased by more than 35 percent from 43.6 percent to 80.4 percent in Kaiser Permanente Northern California between 2001 and 2009. In contrast, the national mean control rate increased from 55.4 percent to 64.1 percent during that period.