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Latest:
Baffled by NAFLD: The Horse Might Be Out of the Barn but Should Not Take Us for a RideAs awareness of nonalcoholic fatty liver disease (NAFLD) rises, it is essential to develop and implement a rigorously determined approach to identify patients who will, or will not, benefit from diagnostic evaluation.
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Continuity of Opioid Prescribing Among Older Adults on Long-term OpioidsAmong older adults with chronic noncancer pain on long-term opioid therapy, greater continuity of opioid prescribing was significantly associated with fewer opioid-related adverse outcomes.
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Barriers That Prevent Access to Optimal Treatment in Primary Urethral CancerEligibility issues, a need for better multidisciplinary collaboration, and a lack of incorporation in community practices are all barriers to the use of neoadjuvant chemotherapy followed by surgery for patients with primary urethral cancer, said Rohan Garje, MD.
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Intensive Care Management of a Complex Medicaid Population: A Randomized EvaluationThe authors present findings of a randomized evaluation of Medicaid patients at an academic medical center, which found that intensive care management was associated with reduced total medical expense.
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Variability of COPD Inhaler Coverage in Medicare Part DAlthough most Medicare Part D plans cover guideline-recommended outpatient chronic obstructive pulmonary disease (COPD) inhalers, the utilization controls applied to these therapies vary by plan type.
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Examining Developments in Multicancer Early Detection: Highlights of New Clinical Data from Recent ConferencesCancer remains the second leading cause of death in the United States despite decades of treatment advances. While death rates have fallen for breast, cervical, and colorectal cancers, death rates remain high for the majority of malignancies, primarily given the late stage at which they are diagnosed. The US Preventive Services Task Force currently recommends routine screening for just 4 cancers: breast, cervical, colorectal, and lung (for high-risk individuals); for prostate cancer, recommendations support individual decision making. However, cancers without recommended screening tests account for 71% of cancer deaths in the United States. In addition, screening rates remain below national goals, with numerous barriers to population-based screening. Recently, initial results of studies on blood-based multicancer early detection tests, which rely on measurement of a range of analytes, demonstrate the potential to identify multiple cancers in a single blood test and detect many cancers for which no screening tests are currently recommended. Blood-based tests have the potential to be more accessible and easier to disseminate than organ-specific tests. However, it remains unclear if their use can reduce deaths from these cancers. Other issues include cost-effectiveness, the impact of false-positive and false-negative results on patients and costs, and uptake among individuals and clinicians. Research and development of blood-based multicancer early detection tests continue.
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Older Adults’ Perspectives on Emergency Department Costs During COVID-19Most older US adults have concerns about emergency department visit affordability. Lower income, being uninsured, poor or fair physical/mental health, and younger age were associated with increased concerns.
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Real-World Data Support First-Line Avelumab Plus Axitinib in Advanced RCCReal-world data confirmed the findings of JAVELIN Renal 101, supporting the combination of avelumab and axitinib in advanced renal cell carcinoma (RCC), said Axel Merseburger, MD, University Hospital Schleswig Holstein, Campus Lübeck, in Germany.
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Are Work Relative Value Units Correlated With Operative Duration of Common Surgical Procedures?Work relative value units (wRVUs) correlate with operative duration of common surgical procedures. Reimbursement for physicians depending on wRVUs is fair for commonly performed surgeries.
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Spending Patterns Among Commercially Insured Individuals During the COVID-19 PandemicIn this analysis of more than 97 million commercially insured individuals, investigators found that the COVID-19 pandemic induced a spending shock in 2020 and that health care spending did not recover to baseline until mid-2021.
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Patients’ Needs Following Emergency Care for Ambulatory Care–Sensitive ConditionsTo inform intervention development, we assessed for medication changes and patient care needs following treat-and-release Veterans Affairs emergency department visits for chronic ambulatory care–sensitive conditions.
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Office Procedures for Older Adults by Physician Associates and Nurse PractitionersThe authors probed Medicare Part B data to explore outpatient clinical procedures performed by physician associates and nurse practitioners and report the trends from 2014 through 2021.
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Economics of a Health System’s Direct-to-Consumer Telemedicine for Its EmployeesA direct-to-consumer telemedicine service resulted in lower per-episode unit costs for care within 7 days and only marginally increased the use of services overall.
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Racial and Ethnic Disparities in Telemental Health Use Among Publicly Insured ChildrenAmong publicly insured children with mental health–related encounters, racial and ethnic disparities in telemental health use widened following the onset of the COVID-19 pandemic.
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Predicting Hospital Readmission in Medicaid Patients With Diabetes Using Administrative and Claims DataA statistical model based entirely on claims data can accurately predict 30-day hospital readmission in Medicaid patients with diabetes.
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Impact of COVID-19 Pandemic on Accessibility of Taiwanese Medical CareThe COVID-19 pandemic disrupted access to routine medical care in community populations in Taiwan. The unmet needs should be emphasized as normal life resumes.
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Contingency Management in a Perinatal Substance Exposure ClinicProject CARA, a perinatal substance exposure clinic, has implemented a contingency management program that targets appointment attendance for patients with any use disorder, regardless of substance or urine drug screen results.
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Clinician Characteristics Associated With Fluoride Varnish Applications During Well-Child VisitsClinicians treating a higher percentage of patients insured by Medicaid and patients younger than 5 years were more likely to apply fluoride varnish.
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Primary Care Case Conferences to Mitigate Social Determinants of Health: A Case Study From One FQHC SystemThis article describes perceived benefits, facilitators, and challenges of conducting interprofessional team case conferences in primary care settings to address patients’ complex social needs.
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An Accelerated Hospital Observation Pathway to Reduce Length of Stay for Patients With COVID-19For select patients hospitalized due to COVID-19, an academic urban hospital implemented an observation pathway that incorporated mobile health technology, reducing hospital length of stay by more than 2 days.
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Adherence Patterns 1 Year After Initiation of SGLT2 Inhibitors: Results of a National Cohort StudyThis article describes the trajectory of adherence patterns among users of sodium-glucose cotransporter 2 (SGLT2) inhibitors. The authors found that baseline factors were unable to predict the adherence trajectory groups.
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An Accelerated Hospital Observation Pathway to Reduce Length of Stay for Patients With COVID-19For select patients hospitalized due to COVID-19, an academic urban hospital implemented an observation pathway that incorporated mobile health technology, reducing hospital length of stay by more than 2 days.
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Investigating Real-world Consequences of Biases in Commonly Used Clinical CalculatorsClinical calculators that do not include demographic variables may be biased, and their equity should be understood in the context of clinical guidelines.
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Standardized Total Knee Arthroplasty Pathway Improves Outcomes in Minority PatientsIn a minority-predominant patient population, a standardized pathway for total knee arthroplasty was associated with improved outcomes with no change in postoperative complication rates.
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IMS 2024 Speakers Look Back on Exciting Myeloma UpdatesSpeakers at the 2024 International Myeloma Society (IMS) conference share the updates from the myeloma space that they were most excited about this year.
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Patient Perspectives on Technology-Based Approaches to Social Needs ScreeningPatients are essential stakeholders in designing systems to capture social needs. The authors present key findings from patient interviews regarding social needs screening through technology-based modalities.
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Outcomes in Patients With IBD Stratified by Risk of Disease ProgressionThis study validates criteria to identify patients with inflammatory bowel disease (IBD) at risk of worsening disease who may benefit from early treatment with advanced therapies.
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Assessing the Impact of Transplant Case Management on Clinical OutcomesThis article examines the effect of a transplant case management program on clinical outcomes following transplant surgery.
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Contributor: Modern Medicine Meets House Calls—Caring for the Patient With Diabetes in 2020Physicians agree that telehealth leads to better and more consistent patient care for patients and their families and provides many more touchpoints for patients with diabetes—all of which should continue after the pandemic in order to provide these patients with the best care going forward.
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What Value Do Teaching Hospitals Provide Commercial Beneficiaries When in an ACO?Accountable care organizations (ACOs) with a major teaching hospital were associated with lower mortality, lower inpatient spending, lower emergency department utilization, and higher overall outpatient spending.
