In October 2008, the Centers for Medicare and Medicaid Services (CMS) discontinued additional payments certain hospital-acquired conditions that were deemed preventable. The effect of this policy on rates health care–associated infections is unknown.

To determine whether the simultaneous, partial repeal of needle prescription and drug paraphernalia laws in Connecticut affected purchasing usage needles syringes (syringes) by injecting-drug users (IDUs) risk needlestick injuries to police officers, we conducted two serial cross-sectional surveys with IDUs recruited treatment centers, correctional facilities, health department settings. Reports among Hartford officers were reviewed before after new laws. Among who reported ever sharing a...

Background: New rapid HIV antibody tests have allowed provision of results and result-specific counseling on the day initial visit, potential to increase efficiency testing. Methods: To evaluate use testing with same-day in public clinics, Single Use Diagnostic System HIV-1 assay was used for a 3-month period at an anonymous clinic sexually transmitted disease (STD) Dallas, Texas. Non-reactive test were reported as HIV-negative. Reactive 'preliminary positive'. These procedures compared...

Background and Objectives: Screening tests for detection ofChlamydia trachomatisinclude those processed in laboratories designed to be at the point of care. The latter can yield results time initial patient visit, but most available lab-processed have greater sensitivity. In settings where a proportion patients do not return treatment after positive test results, less sensitive rapid could lead more cost-effective. Goal this Study: To determine situations, if any, which might cost-effective...

This article presents evidence that sexually transmitted disease (STD) rates are responsive to increases in alcohol taxes and the drinking age. The presumed relationship is a more restrictive policy reduces consumption, which turn decreases risky sexual activity. Reduced‐form regressions of STD on state for years 1981—95 (with controls year) indicate $1 increase per‐gallon liquor tax gonorrhea by 2.1 percent, beer $.20 per six‐pack 8.9 with similar though pronounced effects syphilis rates....

The use of herbs has been advocated as an alternative treatment strategy for human immunodeficiency virus-related illness. To describe the medicinal among acquired syndrome clinic patients and to investigate possible toxic effects, we interviewed 114 randomly selected attending a university-based performed structured review literature identify potential adverse effects herbal use. Twenty-five participants (22%) reported using one or more products in past 3 months. Of those taking herbs, six...

BACKGROUND: Health care–associated infections (HAIs) are harmful and costly can result in substantial morbidity for hospitalized children; however, little is known about national trends HAIs neonatal pediatric populations. Our objective was to determine the incidence of among a large sample hospitals United States caring critically ill children from 2007 2012. METHODS: In this cohort study, we included NICUs PICUs located reporting data Centers Disease Control Prevention’s National...

Though the Centers for Medicare and Medicaid Services focuses primarily on health care delivery its beneficiaries, it is working at practice, delivery-system, broader-population levels to encourage incremental progress toward population health.

Rapid, on-site HIV testing with same-day results may improve services and increase the number of clients who learn their serostatus in developing countries. To validate test performance under field conditions assess change proportion serostatus, we conducted a trial using Capillus HIV-1/HIV-2 assay (Cambridge Diagnostics) at AIDS Information Centre counselling sites Uganda. Compared to standard 2-EIA algorithm, sensitivity was 99.6% (95% CI; 98.5%, 99.9%), specificity 98.8% 98.1%, 99.3%),...

Azithromycin, an approved single-dose therapy for cervical chlamydia infections, costs four times as much doxycycline, the standard multidose theapy.This study examined whether azithromycin is cost effective treating infections.Two diagnostic strategies were compared: 1) laboratory confirmation of chlamydia, and 2) presumptive diagnosis from perspective healthcare system publicly funded clinic.From perspective, per case pelvic inflammatory disease prevented with ranges a savings $3,502 to...

To determine what factors distinguish medical students who choose primary care careers, 381 graduating at eight New England schools were surveyed by questionnaire prior to the 1988 National Resident Matching Program. Students asked indicate degrees of influence that various had on their specialty choices, using a Likert-type scale ranging from "totally unimportant" "decisive." Compared with peers chose high-technology specialties, those more likely be motivated opportunities provide direct...

Objectives. To characterize recent HIV seroconverters in a sexually transmitted disease (STD) clinic population, and examine changing transmission patterns. Methods. We conducted case-control study nested within retrospectively defined cohort of individuals attending Baltimore STD clinics between January 1988 July 1990. Seroconverters, who tested HIV-positive after having negative test, were compared to both HIV-negative controls, also twice, second, prevalent control group. Controls matched...

Rapid, on-site human immunodeficiency virus (HIV) testing has the potential to improve delivery of prevention services in publicly funded counseling and sites. The Single Use Diagnostic System (SUDS) HIV-1 is only rapid enzyme immunoassay (EIA) approved for diagnostic use United States. To evaluate feasibility using SUDS public clinics validate test's performance a health laboratory, we conducted blinded on plasma sent HIV testing. From 19 March through 30 June 1993, 1,923 consecutive...

Identify how novel datasets and digital health technology, including both analytics-based artificial intelligence (AI)-based tools, can be used to assess non-clinical, social determinants of (SDoH) for population improvement. A state-of-the-art literature review with systematic methods was performed on MEDLINE, Embase, the Cochrane Library databases grey identify recently published articles (2013-2018) evidence-based qualitative synthesis. Following single titles abstracts, two independent...

To determine the frequency and predictors of receipt HIV test results.Analysis responses from 19,127 adults in 1994 16,848 1995 surveyed for U.S. National Health Interview Survey, using logit models to factors independently associated with decreased likelihood receiving results.Overall, 12.5% (+/-1.0%) persons tested 13.3% (+/-0.9%) had not received their results. Those whose was self-initiated were significantly less likely (p<.05) receive The proportion who did results lowest among sought...

BACKGROUND Policymakers may wish to align healthcare payment and quality of care while minimizing unintended consequences, particularly for safety net hospitals. OBJECTIVE To determine whether the 2008 Centers Medicare Medicaid Services Hospital-Acquired Conditions policy had a differential impact on targeted healthcare-associated infection rates in compared with non–safety DESIGN Interrupted time-series design. SETTING AND PARTICIPANTS Nonfederal acute hospitals that reported central...

Readers are invited to submit letters for publication in this department. Submit online at http://joem.edmgr.com. Choose "Submit New Manuscript." A signed copyright assignment and financial disclosure form must be submitted with the letter. Form available www.joem.org under Author Reviewer information. To Editor: Disasters often stress economy and, as case of current pandemic, expose structural weaknesses that reveal significant gaps organization, infrastructure, capacity. From time its...

Because syphilis can raise the likelihood of HIV transmission and acquisition, prevention in USA has potential benefit reducing number new cases HIV. We developed a simplified model to estimate annual cost new, heterosexually-acquired attributable syphilis.We estimated heterosexual, serodiscordant partnerships which was present 1996. The included probability (with without presence syphilis) other parameters based on data from recent literature. Published direct costs (HIV treatment including...

Background and Objectives: Partner notification is an important strategy for prevention ofChlamydia trachomatisinfection pelvic inflammatory disease (PID). PID can be prevented by early diagnosis treatment of the female sex partners men infected withC. trachomatis(strategy 1) preventing reinfection in women through their male (strategy 2). Study Design: Using a decision model, cost-effectiveness strategies 1 2 was compared to no partner notification. Outcomes were measured cases net costs...

Background. The Centers for Medicare and Medicaid Services (CMS) implemented a policy in October 2008 to eliminate additional payment mediastinitis following coronary artery bypass graft (CABG) surgery. Objective. To evaluate the impact of this on rates, using claims National Healthcare Safety Network (NHSN) prospective surveillance data. Methods. We used an interrupted time series design compare rates before after policy, adjusted secular trends. Billing came from inpatient 638,761 CABG...