Background: The Centers for Medicare and Medicaid Services (CMS) promulgated regulations commencing October 1, 2008, which deny payment selected conditions occurring during the hospital stay are not present on admission. Three of 10 hospital-acquired covered by new CMS policy involve healthcare-associated infections, a common, expensive, often preventable cause inpatient morbidity mortality. Objective: To outline research agenda impact CMS's healthcare system prevention infections. Methods:...

In 2008 Medicare stopped reimbursing hospitals for treating eight avoidable hospital-acquired conditions. Using 2006 California data, we modeled the financial impact of this policy on six such Hospital-acquired conditions were present in 0.11 percent acute inpatient discharges; only 3 these affected by policy. Payment reductions negligible (0.001 percent, or $0.1 million—equivalent to $1.1 million nationwide) and are unlikely encourage providers improve quality. Options strengthen incentives...

Lymphocytopenia is a common finding in hospital patients especially since the advent of automated differential leukocyte counters. The causes and significance lymphocytopenia are generally poorly understood. There has been no large-scale study its for 25 years. HIV epidemic, recently described idiopathic CD4+ T-lymphocytopenia have raised interest this finding.To describe spectrum an adult teaching investigate clinical significance.Using available computer facilities, with significant (< 0.6...

Objectives: To determine the utility of various autoantibodies in predicting progression to clinical diabetes first-degree relatives patients with type 1 mellitus. Participants: 3315 (1161 parents, 1206 siblings and 948 offspring) recruited through clinics, private endocrinologists, Diabetes Australia Juvenile Foundation. Main outcome measures: Prevalence islet cell antibodies (ICA) levels ≥20 JDFu, insulin (IAA) > 100nU/ml, glutamic acid decarboxylase (GADAb) tyrosine phosphatase IA2...

The European project Patient Safety through Intelligent Procedures in medication (PSIP) aims at preventing medical errors. objective are: (1) to facilitate the systematic production of epidemiological knowledge on Adverse Drug Events (ADE) and (2) improve entire cycle a hospital environment. first sub-objective is produce ADE: know, as exactly possible, per hospital, department, their number, type, consequences causes, including human factors. Data Mining structured data bases, semantic...

Abstract Background : Reactive arthritis (ReA) is an inflammatory triggered by certain gastrointestinal and genitourinary infections. Single source outbreaks of triggering infections provide opportunity to elucidate host susceptibility factors in this disease. Aim To determine the role Major Histocompatibility Complex (MHC) Class I alleles ReA after two large single Salmonella Typhimurium gastroenteritis. Methods A questionnaire screening for features a request HLA class typing were sent all...

To investigate a method to identify and understand patterns of adverse events by utilising secondary data analysis; the types complications associated with elective surgery; any specific "adverse event-prone" procedures; consider implications these for hospital patient safety programs.Public hospitals in Victoria.Secondary analysis on acute admissions surgery period 1 July 2000 30 June 2001, non-obstetric patients older than 15 years (n = 177 533).Estimated rates most commonly performed...

Background: Casemix-based inpatient prospective payment systems allocate payments for acute care based on what is done within an episode of without regard the outcome. To date, they have provided little incentive to improve quality. The Centers Medicare & Medicaid Services recently excluded 8 avoidable complications from their system. Objective: This study models system that comprehensively excludes not-present-on-admission and other complication diagnoses entire funding process, effectively...

Causes of variations in outcomes from cancer care developed countries are often unclear. Australia has health system pathways describing consensus standards optimal across the phases prevention through to follow-up or end-of-life. These Optimal Care Pathways (OCP) were introduced 2013 14. We investigated whether consistent with OCP improved for colon patients.Colon patients diagnosed 2008 2014 identified Australian State Victoria Cancer Registry (VCR) and cases linked Federal datasets....

Length of hospital stay (LOS) is considered a vital component for successful colorectal surgery treatment. Evidence an association between volume and LOS has been mixed. Data modelling techniques may give inconsistent results that adversely impact conclusions. This study applied to overcome possible drawbacks.An additive quantile regression model formulated isolate contextual effects was every cancer conducted in Victoria, Australia, 2005 2015, involving 28,343 admissions 90 Victorian...

The current Medicare policy of non-payment to hospitals for Hospital-Acquired Conditions (HAC) seeks avoid payment preventable complications identified within a single admission. financial impact ($1 million-$50 million/yr) underestimates the true HACs when readmissions are taken into account.Define and quantify acute inpatient arising directly from, or completing definition of, HACs.Observational study.All non-federal admissions California hospitals, July 2006 June 2007 with recorded Social...

On 1 July 1993 Victoria became the first Australian state to use casemix information set budgets for its public hospitals commencing with funding inpatient services. Victoria's approach now embracesinpatient, outpatient and rehabilitation

Introduction: As the system manager for Victoria's acute care system, Department of Health and Human Services recognises benefits integrated approaches patients with chronic complex conditions. However, current hospital funding model is not particularly well suited to supporting these patients.Health links: Chronic Care a funding-neutral reform that aims support Public in adopting better identify at risk becoming frequent users responds their needs earlier.Description policy context...

Serum islet antibodies signify increased risk for type 1 diabetes (T1D). Knowledge of the relationship between age and seroconversion would guide screening at-risk individuals. We aimed to determine effectiveness antibody in early childhood, particular proportion negative children who subsequently seroconverted.We identified 554 with a first-degree relative T1D had tested cell (ICA) insulin autoantibodies (IAA) when first screened at mean 7.2 yr. Of 423 were eligible, 350 consented...

OBJECTIVE To determine whether the reproducibility of first-phase insulin response (FPIR) measured during an intravenous glucose tolerance test is improved by use a lower dose or retrograde sampling from arterialized hand vein. RESEARCH DESIGN AND METHODS Previous studies have suggested that high within-subject variation FPIR measurement up to 110% could be reduced cannulated and vein opposite cubital fossa through which was injected glucose. Two low-dose (glucose, 5 g/m2 over 30 s) two...

Objective: To model the effect of excluding payment for eight hospital-acquired conditions (HACs) on hospital payments in Victoria, Australia. Design, setting and participants: Retrospective ecological study using Victorian Admitted Episodes Dataset. The analysis involved all acute inpatient admissions to public private hospitals between 1 July 2007 30 June 2008. Interventions: Each admission record includes up 40 diagnosis procedure codes from which are calculated. deleted HACs records,...

The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field integrated care on a continuous basis.IJIC has Impact Factor 5.120 (2020 JCR, received June 2021)