Delivery System Reform Tracking: A Framework for Understanding Change

Proposes a framework for tracking progress on delivery system reforms such as patient-centered medical homes and accountable care organizations by assessing structures, capabilities, incentives, and outcomes. Outlines challenges for data collection

Effects of Health Information Technology Adoption on Nursing Home Quality Rating Scores in Minnesota Nursing Homes

Adoption of health information technology (HIT) may be instrumental in improving quality of care in Minnesota nursing homes. The purpose of this non-experimental, quantitative study was to examine the relationship between nursing homes’ quality of care, as measured by CMS Quality Rating Scores, and adoption of HIT systems in Minnesota nursing homes. Additionally, the purpose of the study was to examine the relationship between nursing homes’ quality of care, as measured by the Minnesota Department of Health (MDH) inspection rating score, and the adoption of HIT systems in Minnesota nursing homes. The research questions were aimed at understanding the effects of HIT adoption on CMS overall quality rating scores and MDH inspection rating scores. The study was conducted by examining the status of health information technology (HIT) in Minnesota nursing homes. Descriptive statistics of the 2011 Minnesota HIT e-health survey helped describe and summarize the data for further investigation. The relationships (correlation) of HIT adoption in nursing homes with CMS Quality Rating Scores were analyzed. Additionally, the relationships (correlation) of HIT adoption in nursing homes with Minnesota Department of Health (MDH) inspection results were analyzed. Pearson correlation coefficient equation and linear regression analysis were used to evaluate the hypotheses. The findings of this study revealed significant correlations with a small effect size for the HIT adoption of medication administration, medication reconciliation, computerized provider order entry (CPOE) laboratory test, computerized provider order entry (CPOE) medication, and CMS quality rating scores. Additionally, the findings of this study revealed a significant correlation with a small effect size for the HIT adoption of medication reconciliation and MDH inspection scores. The findings of this study did not show a relationship between the remaining HIT systems and CMS quality ratings or MDH inspection scores. These findings contribute to positive social change by assisting to inform stakeholders of nursing homes that HIT adoption may have some relationship to quality of care and services as indicated by the CMS rating system and MDH inspection ratings. Policy makers and legislators can use this information as a guide to decision making concerning HIT adoption in Minnesota nursing homes

Classifying the End-of-Term Archive

Abstrac

Evaluation of the Hamilton Youth Court Pilot 2003-2005 - Research Findings

A pilot Youth Court was introduced at Hamilton Sheriff Court in June 2003. It targeted alleged offenders aged 16 and 17 who were resident in areas of North or South Lanarkshire; had three separate incidents of offending resulting in a criminal charge in the previous six months or whose contextual background suggested a referral to the Youth Court would reduce the risk of re-offending and promote community safety; and were appearing summarily before Hamilton Sheriff Court. The main aim of the Youth Court was to reduce the frequency and seriousness of offending by 16 and 17 year olds through targeted and prompt disposals with judicial supervision and continuing social work involvement

Using orthopaedic health care resources efficiently: a cost analysis of day surgery for unicompartmental knee replacement

Background: Day surgery for unicompartmental knee replacement (UKR) could potentially reduce hospital costs. We aimed to measure the impact of introducing a day surgery UKR pathway on mean length of stay (LOS) and costs for the UK NHS, compared to an accelerated inpatient pathway. Secondly, the study aimed to compare the magnitude of costs using three costing approaches: top-down costing; simple micro-costing; and real-world costing. Methods: We conducted an observational, before-and-after study of 2,111 UKR patients at one NHS hospital: 1,094 patients followed the day surgery pathway between September 2017 and February 2020; and 1,017 patients followed the accelerated inpatient pathway between September 2013 and February 2016. Top-down costs were estimated using Average NHS Costs. Simple micro-costing used the cost per bed-day. Real-world costs for this centre were estimated by costing actual changes in staffing levels. Results: 532 (48.5%) patients in the day surgery pathway were discharged on the day of surgery compared with 36 (3.5%) patients in the accelerated inpatient pathway. The day surgery pathway reduced the mean LOS by 2.2 (95% CI: 1.81, 2.53) nights and was associated with an 18% decrease in Average NHS Costs (p < 0.001). Mean savings were £1,429 per patient with the Average NHS Costs approach, £905 per patient with the micro-costing approach, and £577 per patient with the “real-world” costing approach. Overall, moving NHS UKR surgeries to a day surgery pathway could save the NHS £8,659,740 per year. Conclusion: Day surgery for UKR could produce substantial cost savings for hospitals and the NHS

Puberty timing associated with diabetes, cardiovascular disease and also diverse health outcomes in men and women: the UK Biobank study.

Early puberty timing is associated with higher risks for type 2 diabetes (T2D) and cardiovascular disease in women and therefore represents a potential target for early preventive interventions. We characterised the range of diseases and other adverse health outcomes associated with early or late puberty timing in men and women in the very large UK Biobank study. Recalled puberty timing and past/current diseases were self-reported by questionnaire. We limited analyses to individuals of White ethnicity (250,037 women; 197,714 men) and to disease outcomes with at least 500 cases (~ 0.2% prevalence) and we applied stringent correction for multiple testing (corrected threshold P < 7.48 × 10(-5)). In models adjusted for socioeconomic position and adiposity/body composition variables, both in women and men separately, earlier puberty timing was associated with higher risks for angina, hypertension and T2D. Furthermore, compared to the median/average group, earlier or later puberty timing in women or men was associated with higher risks for 48 adverse outcomes, across a range of cancers, cardio-metabolic, gynaecological/obstetric, gastrointestinal, musculoskeletal, and neuro-cognitive categories. Notably, both early and late menarche were associated with higher risks for early natural menopause in women. Puberty timing in both men and women appears to have a profound impact on later health.This research has been conducted using the UK Biobank Resource. This work was supported by the Medical Research Council [Unit Programme number MC_UU_12015/2].This is the final version of the article. It first appeared from NPG via http://dx.doi.org/10.1038/srep1120

At Risk: Capturing and Preserving Web Resources

This presentation discusses the Web-at-Risk project and the issues related to capturing and preserving web resources. It introduces collection development issues, organization and metadata issues, and the findings that support the needs for a web archiving service

How structural and symbolic violence during resettlement impacts the social and mental wellbeing of forced migrant women: the lived experiences of Arabic speaking survivors of IPV resettled in Melbourne, Australia.

Forced migrant women experience high levels of violence across their journeys and violence can be characterised as having three overarching forms: structural, symbolic, and interpersonal. It is important to understand the intersecting nature of gendered forms of symbolic, structural and interpersonal violence, and their impact on the mental health of forced migrant women in order to develop holistic IPV and resettlement programs and interventions. This article adopts an ecological framework of violence and qualitative methods with mental health service providers and survivors of IPV to understand the intersections of different forms of violence and their impact on mental health as they relate to the lived experiences of Arabic-speaking forced migrant survivors currently residing in Melbourne, Australia. Our research has three key findings: (1) that forced migrant women living in Melbourne, Australia experience intersecting forms of violence during resettlement (2) Structural and symbolic violence against forced migrant women persists regardless of marital status (3) Autonomy and independence plays a vital role in the mental health and wellbeing of forced migrant women. Our findings reveal that structural and symbolic violence increase the risk of IPV for forced migrant women during resettlement and that even when forced migrant women leave IPV situations, structural and symbolic violence persist and exacerbate mental ill-health. This article also reveals the importance autonomy and independence in both the perpetration of violence and in healing and recovery

Anxiety disorders in children and adolescents

Anxiety disorders are among the most common psychiatric disorders in children and adolescents. They commonly interfere with peer relationships, schooling and family life, and persist into adulthood if left untreated. This paper gives an overview of the identification, assessment and treatment of anxiety disorders in children and young people. Identification of anxiety disorders is often poor and many young people with anxiety disorders go untreated. We present a brief review of the evidence base for pharmacological and psychological treatment approaches to the management of anxiety disorders in youth. Both have been found to be effective in the treatment of anxiety disorders, although psychological treatments such as Cognitive Behavioural Therapy (CBT) are considered the first-line treatment due to relative benefits in terms of patient safety and parental preference. Low intensity CBT approaches such as bibliotherapy and online therapies are effective and have the potential to improve access to evidence-based interventions. CBT approaches have also been found to be effective with particular patient groups, such as those with long-term physical health conditions and autism spectrum disorders, who are at an increased risk of anxiety disorders

Evaluation of the Airdrie and Hamilton Youth Court Pilots - Research findings

Pilot Youth Courts were introduced at Hamilton Sheriff Court in June 2003 and at Airdrie Sheriff Court in June 2004. They are targeted at alleged offenders aged 16 and 17 (and appropriate 15 year olds) who are resident in areas of North and South Lanarkshire and are appearing summarily before the Sheriff Courts. Their main aims are to reduce the frequency and seriousness of offending through targeted and prompt disposals with judicial supervision and continuing social work involvement