Subscribe: PubMed: Quality of care
http://eutils.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=0io9yhXFu3Gv1156ftxVhqljBi2neLBffB1Bnd5Mwlh
Added By: Feedage Forager Feedage Grade B rated
Language: English
Tags:
care  claims data  data  guidance  indexed medline  patient  patients  pmid pubmed  practice  quality care  quality  treatment 
Rate this Feed
Rate this feedRate this feedRate this feedRate this feedRate this feed
Rate this feed 1 starRate this feed 2 starRate this feed 3 starRate this feed 4 starRate this feed 5 star

Comments (0)

Feed Details and Statistics Feed Statistics
Preview: PubMed: Quality of care

pubmed: Quality of care



NCBI: db=pubmed; Term=(("quality assurance, health care"[MeSH Terms] OR "quality indicators, health care"[MeSH Terms] OR "quality of health care"[MeSH Terms] OR "total quality management"[MeSH Terms]) AND quality[TI]) AND English[Lang] AND "adult"[MeSH Te



 



Anxiety symptoms and quality of interaction among oncology nurses: a correlational, cross-sectional study.
(image) Related Articles

Anxiety symptoms and quality of interaction among oncology nurses: a correlational, cross-sectional study.

Rev Esc Enferm USP. 2016 Sep-Oct;50(5):800-807

Authors: Karanikola MN, Giannakopoulou M, Kalafati M, Kaite CP, Patiraki E, Mpouzika M, Papathanassoglou EE, Middleton N

Abstract
OBJECTIVE: To explore the severity of Anxiety Symptoms (AS) among Greek oncology nursing personnel, the degree of satisfaction from professional relationships, and potential association between them.
METHOD: A descriptive cross-sectional correlational study was performed in 2 Greek Oncology Hospitals, in 72 members of nursing personnel. Hamilton Anxiety Scale was used for the assessment of AS severity and the Index of Work Satisfaction subscale "Satisfaction from Interaction" for the degree of satisfaction from professional relationships among nursing personnel (NN) and between nursing personnel and physicians (NP).
RESULTS: 11% of the sample reported clinical AS [≥26, scale range (SR): 0-52]. Satisfaction from NN [5.10 (SD: 1.04), SR: 1-7], and NP [4.21 (SD: 0.77), SR: 1-7] professional interaction were both moderate. Statistically significantly associations were observed between clinical AS and satisfaction from NN (p=0.014) and NP (p=0.013) professional interaction.
CONCLUSIONS: Anxiety reduction interventions and improvement of professional relationships are essentials in order to reduce oncology nurses' psychological distress.

PMID: 27982399 [PubMed - indexed for MEDLINE]




Quality of care in patients with atrial fibrillation in primary care: a cross-sectional study comparing clinical and claims data.
(image) (image) Related Articles

Quality of care in patients with atrial fibrillation in primary care: a cross-sectional study comparing clinical and claims data.

Ger Med Sci. 2016;14:Doc13

Authors: Preuss R, Chenot JF, Angelow A

Abstract
Objectives: Atrial fibrillation (AF) is a common cardiac arrhythmia with increased risk of thromboembolic stroke. Oral anticoagulation (OAC) reduces stroke risk by up to 68%. The aim of our study was to evaluate quality of care in patients with AF in a primary health care setting with a focus on physician guideline adherence for OAC prescription and heart rate- and rhythm management. In a second step we aimed to compare OAC rates based on primary care data with rates based on claims data. Methods: We included all GP practices in the region Vorpommern-Greifswald, Germany, which were willing to participate (N=29/182, response rate 16%). Claims data was derived from the regional association of statutory health insurance physicians. Patients with a documented AF diagnosis (ICD-10-GM-Code ICD I48.-) from 07/2011-06/2012 were identified using electronic medical records (EMR) and claims data. Stroke and bleeding risk were calculated using the CHA2DS2-VASc and HAS-BLED scores. We calculated crude treatment rates for OAC, rate and rhythm control medications and adjusted OAC treatment rates based on practice and claims data. Adjusted rates were calculated including the CHA2DS2-VASc and HAS-BLED scores and individual factors affecting guideline based treatment. Results: We identified 927 patients based on EMR and 1,247 patients based on claims data. The crude total OAC treatment rate was 69% based on EMR and 61% based on claims data. The adjusted OAC treatment rates were 90% for patients based on EMR and 63% based on claims data. 82% of the AF patients received a treatment for rate control and 12% a treatment for rhythm control. The most common reasons for non-prescription of OAC were an increased risk of falling, dementia and increased bleeding risk. Conclusion: Our results suggest that a high rate of AF patients receive a drug therapy according to guidelines. There is a large difference between crude and adjusted OAC treatment rates. This is due to individual contraindications and comorbidities which cannot be documented using ICD coding. Therefore, quality indicators based on crude EMR data or claims data would lead to a systematic underestimation of the quality of care. A possible overtreatment of low-risk patients cannot be ruled out.

PMID: 27980520 [PubMed - indexed for MEDLINE]




Decline in semen quality in men in northern Taiwan between 2001 and 2010.
Related Articles

Decline in semen quality in men in northern Taiwan between 2001 and 2010.

Chin J Physiol. 2016 Dec 31;59(6):355-365

Authors: Li CJ, Tzeng CR, Chen RY, Han BC, Yeh CY, Chien LC

Abstract
Semen quality is a key indicator of the male reproductive ability. The decline in semen quality has been debated for several decades. However, data on decline in semen quality might be inconsistent given factors such as geographical area, ethnicity, environmental exposure and lifestyle changes. This study aimed to provide information on the semen quality of men in Northern Taiwanese. We recruited 7,187 male participants between 2001 and 2010 from a reproductive medical center. The age of the participants ranged from 26 to 57 years, with a mean age of 36.9 ± 4.77 years. Semen analysis was performed through standardized methods outlined in the World Health Organization laboratory manual. Increasing age (per year) was significantly and negatively associated with semen volume (1.006 ml), progressive sperm motility, rapid progressive sperm motility and sperm with normal morphology (reduction by 1.010%, 1.013% and 1.002% per year, respectively). In addition, sperm concentration, semen volume, number of sperms, progressive sperm motility, rapid progressive sperm motility, and sperm with normal morphology were significantly reduced annually by 1.013 × 10⁶/ml, 1.015 ml, 1.028 × 10⁶, 1.021 %, 1.017% and 1.016%, respectively). Age-period-cohort (APC) analyses revealed that age and cohort had effects on reduction of the progressive and rapid progressive sperm motility. Moreover, all the sperm parameter values were significantly reduced annually. Our findings provide useful information for clinical practice and public health investigations of male reproductive health.

PMID: 27817197 [PubMed - indexed for MEDLINE]




Role of Patient and Practice Characteristics in Variance of Treatment Quality in Type 2 Diabetes between General Practices.
(image) (image) Related Articles

Role of Patient and Practice Characteristics in Variance of Treatment Quality in Type 2 Diabetes between General Practices.

PLoS One. 2016;11(11):e0166012

Authors: Cho YY, Sidorenkov G, Denig P

Abstract
BACKGROUND: Accounting for justifiable variance is important for fair comparisons of treatment quality. The variance between general practices in treatment quality of type 2 diabetes (T2DM) patients may be attributed to the underlying patient population and practice characteristics. The objective of this study is to describe the between practice differences in treatment, and identify patient and practice level characteristics that may explain these differences.
METHODS: The data of 24,607 T2DM patients from 183 general practices in the Netherlands were used. Treatment variance was assessed in a cross-sectional manner for: glucose-lowering drugs/metformin, lipid-lowering drugs/statins, blood pressure-lowering drugs/ACE-inhibitor or ARB. Patient characteristics tested were age, gender, diabetes duration, comorbidity, comedication. Practice characteristics were number of T2DM patients, practice type, diabetes assistant available. Multilevel logistic regression was used to examine the between practice variance in treatment and the effect of characteristics on this variance.
RESULTS: Treatment rates varied considerably between practices (IQR 9.5-13.9). The variance at practice level was 7.5% for glucose-lowering drugs, 3.6% for metformin, 3.1% for lipid-lowering drugs, 10.3% for statins, 8.6% for blood pressure-lowering drugs, and 3.9% for ACE-inhibitor/ARB. Patient and practice characteristics explained 19.0%, 7.5%, 20%, 6%, 9.9%, and 13.4% of the variance respectively. Age, multiple chronic drugs, and ≥3 glucose-lowering drugs were the most relevant patient characteristics. Number of T2DM patients per practice was the most relevant practice characteristic.
DISCUSSION: Considerable differences exist between practices in treatment rates. Patients' age was identified as characteristic that may account for justifiable differences in especially lipid-lowering treatment. Other patient or practice characteristics either do not explain or do not justify the differences.

PMID: 27806107 [PubMed - indexed for MEDLINE]




Sonazoid-enhanced ultrasonography guidance improves the quality of pathological diagnosis in the biopsy of focal hepatic lesions.
(image) Related Articles

Sonazoid-enhanced ultrasonography guidance improves the quality of pathological diagnosis in the biopsy of focal hepatic lesions.

Eur J Gastroenterol Hepatol. 2016 Dec;28(12):1462-1467

Authors: Eso Y, Takai A, Takeda H, Matsumoto T, Lee M, Inuzuka T, Takahashi K, Ueda Y, Marusawa H, Seno H

Abstract
BACKGROUND/AIM: Contrast-enhanced ultrasonography (US) has improved the detection and characterization of focal hepatic lesions. Recently, the importance of obtaining high-quality samples in the biopsy of hepatic lesions has been increasing not only in the field of pathological diagnosis but also in molecular analysis for predicting the effectiveness of anticancer agents and molecular targeted drugs. We evaluated the utility of Sonazoid-enhanced ultrasonography (SEUS) in guiding percutaneous biopsy of focal hepatic lesions by comparing the results of histopathological diagnosis between B-mode US and SEUS guidance.
METHODS AND MATERIALS: This retrospective study examined 121 focal hepatic lesions in 108 patients (mean age: 63.8 years) referred for US-guided percutaneous biopsy. The technical success rate was defined as the percentage of the lesions diagnosed clearly at the initial biopsy.
RESULTS: Among 121 lesions, 56 lesions were subjected to biopsy with B-mode US guidance whereas 65 were subjected to SEUS guidance. The technical success rate was significantly higher under SEUS guidance than under B-mode US guidance (92.3 vs. 76.8%, respectively, P<0.05). When biopsies were performed to diagnose or rule out malignancy in indeterminate lesions, the technical success rate was also significantly higher under SEUS guidance than under B-mode US guidance (100 vs. 73.9%, respectively, P<0.05). SEUS guidance resulted in a significantly higher rate of successful single-puncture attempts compared with B-mode US guidance (55.4 vs. 35.7%, respectively, P<0.05).
CONCLUSION: SEUS guidance is recommended for more accurate localization of suitable hepatic lesion biopsy areas as it increases conspicuity and differentiates viable areas from denaturalization or necrosis.

PMID: 27623001 [PubMed - indexed for MEDLINE]




Patient Navigators and Parent Use of Quality Data: A Randomized Trial.
(image) Related Articles

Patient Navigators and Parent Use of Quality Data: A Randomized Trial.

Pediatrics. 2016 Oct;138(4):

Authors: Goff SL, Mazor KM, Pekow PS, White KO, Priya A, Lagu T, Guhn-Knight H, Murphy L, Youssef Budway Y, Lindenauer PK

Abstract
BACKGROUND: Consumers rarely use publicly reported health care quality data. Despite known barriers to use, few studies have explored the effectiveness of strategies to overcome barriers in vulnerable populations.
METHODS: This randomized controlled trial tested the impact of a patient navigator intervention to increase consumer use of publicly reported quality data. Patients attending an urban prenatal clinic serving a vulnerable population enrolled between May 2013 and January 2015. The intervention consisted of 2 in-person sessions in which women learned about quality performance and viewed scores for local practices on the Massachusetts Health Quality Partners Web site. Women in both the intervention and control arms received a pamphlet about health care quality. Primary study outcomes were mean clinical quality and patient experience scores of the practices women selected (range 1-4 stars).
RESULTS: Nearly all (726/746; 97.3%) women completed the study, 59.7% were Hispanic, and 65.1% had a high school education or less. In both unadjusted and adjusted models, women in the intervention group chose practices with modestly higher mean clinical quality (3.2 vs 3.0 stars; P = .001) and patient experience (3.0 vs 2.9 stars; P = .05) scores. When asked to rate what factors mattered the most in their decision, few cited quality scores.
CONCLUSIONS: An intervention to reduce barriers to using publicly reported health care quality data had a modest effect on patient choice. These findings suggest that factors other than performance on common publicly reported quality metrics have a stronger influence on which pediatric practices women choose.

PMID: 27600316 [PubMed - indexed for MEDLINE]




Perceived and observed quality of long-term care for residents - Does functional ability account?
(image) Related Articles

Perceived and observed quality of long-term care for residents - Does functional ability account?

Int J Older People Nurs. 2016 Sep;11(3):194-203

Authors: Kahanpää A, Noro A, Finne-Soveri H, Lehto J, Perälä ML

Abstract
BACKGROUND: Measuring quality in long-term residential care involves challenges concerning both the measurement method and the impaired functional ability of many older people. Ensuring quality in care is even more important for people with functional impairments, as this is a vulnerable group who may be unable to report poor quality of care for themselves.
AIMS AND OBJECTIVES: The aim of this study was to analyse how perceived and observed assessments of the quality of care varied according to the residents' functional ability.
DESIGN: The data (n = 278) used in the analyses included residents', family members' and staff assessments of perceived and observed quality of care combined with the Resident Assessment Instrument (RAI) scales measuring the same residents' functional abilities (physical, psychological, cognitive and social). Observations were included in the data if all four assessment types (by residents, family members, staff and the RAI) were available. The dimensions of quality of care emerging from the factor analysis were used.
METHODS: Linear regression was used to explore the association between resident's functional abilities and assessed quality of care.
RESULTS: Higher level of depression symptoms and higher level of dependency in activities of daily living (ADL) were significantly associated with lower level of perceived and observed quality of care. By contrast, the level of residents' cognitive functioning was not significantly associated with any quality dimensions. The social aspect was the only dimension of functional ability on which better functional ability indicated better quality of care, although differences between respondent groups were also observed.
CONCLUSIONS: These analyses emphasize the importance of taking residents' functional ability into account when collecting information on and interpreting the results of perceived and observed quality of care reported separately by residents, family members and staff.
IMPLICATIONS FOR PRACTICE: The information obtained can inform care professionals of how dimensions of residents' functional impairments are associated with perceived and observed quality of care and the quality of older people's care can thereby be improved.

PMID: 26786715 [PubMed - indexed for MEDLINE]




The first step in ensuring patient-centred quality of care: ask the patient.
(image) Related Articles

The first step in ensuring patient-centred quality of care: ask the patient.

Eur J Cancer Care (Engl). 2017 Jan;26(1):

Authors: Zucca A, Sanson-Fisher R, Waller A, Carey M, Boadle D

Abstract
Health providers may not be aware of their patients' needs or preferences, and patients reluctant to raise their concerns. Consequently, the first step in ensuring quality of care is to ask the patient about the care that they would like. A cross-sectional sample of 244 medical oncology outpatients were surveyed about provider-asking behaviours across six dimensions of patient-centred care defined by the Institute of Medicine. Specifically, were patients asked by clinic staff at the treatment centre about their physical and emotional symptoms, information needs to enable decision-making, preferences for involvement in decision-making, involvement of family and friends, and appointment scheduling. Patients were significantly (Cochran's χ(2) (9) = 122.541, P < 0.001) less likely to be asked about emotional symptoms (35% infrequently asked), preferences for the involvement of family and friends (25% infrequently asked), and preferences for involvement in medical decision-making (23% infrequently asked). Only a minority of patients were infrequently asked about their treatment-related information needs (8%), physical symptoms (13% pain, 14% fatigue) and preferences for appointment scheduling (13%). Younger age, not Australian born and greater educational qualifications were associated with being infrequently asked. Improvements to care delivery can be made if clinic staff were to more regularly elicit patient's emotional symptoms, and their preferences for the involvement of family/friends and participation in medical decision-making.

PMID: 26750936 [PubMed - indexed for MEDLINE]