The purpose of this study was to provide normative data on fall prevalence in U.S. hospitals by unit type and determine the 27-month secular trend falls before implementation Centers for Medicare Medicaid Service (CMS) rule, which does not reimburse care related injury resulting from hospital falls.

Background: Bed alarm systems intended to prevent hospital falls have not been formally evaluated. Objective: To investigate whether an intervention aimed at increasing bed use decreases and related events. Design: Pair-matched, cluster randomized trial over 18 months. Nursing units were allocated by computer-generated randomization on the basis of baseline fall rates. Patients outcome assessors blinded unit assignment; may become unblinded. (ClinicalTrials.gov registration number:...

In 2008, Medicare implemented the Hospital-Acquired Conditions (HACs) Initiative, a policy denying incremental payment for 8 complications of hospital care, also known as never events. The regulation's effect on these events has not been well studied.To measure association between Medicare's nonpayment and 4 outcomes addressed by HACs Initiative: central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract (CAUTIs), hospital-acquired pressure ulcers (HAPUs),...

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To assess the extent to which market pressures, compensation incentives, and physician medical group culture are associated with use of evidence-based medicine practices in organizations.Cross-sectional exploratory study 56 groups affiliated 15 integrated health systems from across United States, involving 1,797 respondents. Larger multispecialty were overrepresented compared States as a whole. Data two sources: (1) surveys physicians assessing they work, (2) directors other managerial key...

A subset of pyramidal neurons in layer 5 the mammalian neocortex can fire action potentials brief, high-frequency bursts while others spikes at regularly-spaced intervals. Here we show that individual acute slices from mouse primary motor cortex adopt both regular and burst spiking patterns. During constant current injection soma, displayed a firing pattern 36-37 °C, but switched to patterns upon cooling slice 24-26 °C. This change was reversible repeatable independent somatic resting...

The findings of the Women's Health Initiative (WHI) estrogen plus progestin (E+P) trial led to a substantial reduction in use combined hormone therapy (cHT) among postmenopausal women United States. economic effect this shift has not been evaluated relative trial's $260 million cost (2012 U.S. dollars).

The Hospital Readmissions Reduction Program (HRRP) initiated by the Affordable Care Act levies financial penalties against hospitals with excess thirty-day Medicare readmissions. We sought to understand penalty burden over program's first five years, focusing on characteristics of that received during all how changed time, and relationship between baseline subsequent performance. More than half participating were penalized Centers for Medicaid Services in years program. From fiscal 2013...

Patient-provider communication is a critical component of healthcare and associated with treatment quality outcomes for women breast cancer. This qualitative study examines similarities differences in patient perspectives needs between Black White cancer survivors. We conducted four focus groups (N = 28) involving early-stage on adjuvant endocrine therapy (AET), stratified by race length time AET (< 6 months >6 months). Each group was moderated race-concordant moderator analyzed emergent...

Older adults receive treatment for fall injuries in both inpatient and outpatient settings. The effect of persistent polypharmacy (i.e. using multiple medications over a long period) on is understudied, particularly injuries. We examined the association between treated injury risk from settings community-dwelling older adults.The Health, Aging Body Composition Study included 1764 (age 73.6 ± 2.9 years; 52% women; 38% black) with Medicare Fee-For-Service (FFS) claims at or within 6 months...

Objective While continuous glucose monitoring (CGM) utilisation has been increasing among patients with type 1 diabetes (T1D), few studies have examined patterns of use across age, race/ethnicity and insurance status together. In this study, we examine CGM T1D from a regional academic medical centre all types. Design setting This is retrospective cohort study including both paediatric adult who visited between January 2018 31 December 2021. Methods Patients were followed the date their first...

The rational addiction (RA) model applied to alcoho consumption is tested using 1983 US Health Interview Survey data. RA yields refutable hypotheses concerning effects of current, past, and future prices, past consumption, time preference marginal utility wealth on addictive good consumption. estimations provide relatively strong support for the model. Past present had positive relationship with current Coefficients present, money prices fines first oflence drunk driving (as a form price...

Purpose: Although it is widely recognized that caregivers of individuals with dementia experience elevated stress places them at increased risk for health problems, little known about how caregiving may be alleviated among underserved ethnic minority populations. The purpose this study was to compare a complementary and alternative medicine therapy, polarity therapy (PT), an enhanced respite control condition (ERC) reduce depression improve quality life American Indian (AI) Alaskan Native...

The recent recession had a profound effect on all sectors of the US economy, including health care. We examined how private hospitals fared through and considered changes in their financial may affect ability to respond future industry challenges. categorized 2,971 short-term general medical or surgical (both nonprofit for-profit) according pre-recession safety-net status, we operational status operating total margins during 2006–11. found that were financially weak before remained so after...

The Community Oncology Medical Home offers a patient-centered model of care to improve quality and continuity care.

Abstract Background Hospitalization-associated functional decline is a common problem for older adults, but it unclear how hospitalizations affect physical performance measures such as gait speed. We sought to determine hospitalization-associated change in speed and likelihood of new limitations mobility activities daily living (ADLs). Methods used longitudinal data over 5 years from the Health, Aging Body Composition Study, prospective cohort black white community-dwelling men women, aged...

Incentives for vertical integration in the health care industry have led many hospitals to consolidate into systems and profess a desire closer alignment with affiliated physicians. In this study of fourteen organized delivery their 11,000 physicians sixty-nine medical groups, we found that did not align well Even ostensibly committed emphasized structural relationships enhance physician-system paid inadequate attention issues importance This gap between goal reality appears be result...

High-deductible health plans (HDHPs) are of high interest to employers, policy makers, and insurers because potential benefits risks this fundamentally new coverage model.To investigate the impact HDHPs on care utilization costs in a heterogeneous group enrollees from variety individual employer-based plans.Claims member data major insurer zip code-level census data.Retrospective difference-in-differences analyses were used examine HDHP plans. This analytical approach compared changes...

To assess the reliability of risk-standardized readmission rates (RSRRs) for medical conditions and surgical procedures used in Hospital Readmission Reduction Program (HRRP).State Inpatient Databases six states from 2011 to 2013 were identify patient cohorts HRRP, which was augmented with hospital characteristic HRRP penalty data.Hierarchical logistic regression models estimated hospital-level RSRRs each condition, RSRR, extent socioeconomic factors further explain RSRR variation. We...