Impact of orthogeriatric care management by orthopedic surgeons and physicians on in‐hospital clinical outcomes: A difference‐in‐difference analysis

2022 ◽  
Author(s):  
Takahisa Ogawa ◽  
Haggai Schermann ◽  
Aayush Khadka ◽  
Janelle Moross ◽  
Mutsuko Moriwaki ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Care Management ◽  
Difference In Difference ◽  
Difference Analysis ◽  
Orthopedic Surgeons

scholarly journals Introduction of standardised packaging and availability of illicit cigarettes: a difference-in-difference analysis of European Union survey data 2015–2018

Thorax ◽  
2020 ◽  
Vol 76 (1) ◽  
pp. 89-91 ◽  
Author(s):  
Anthony A Laverty ◽  
Christopher Millett ◽  
Nicholas S Hopkinson ◽  
Filippos T Filippidis
Keyword(s):  
European Union ◽  
Survey Data ◽  
Tobacco Industry ◽  
Difference In Difference ◽  
Tobacco Products ◽  
Difference Analysis ◽  
Illicit Trade ◽  
European Union Countries ◽  
Before And After ◽  
The Uk

Standardised packaging of tobacco products is intended to reduce the appeal of smoking, but the tobacco industry claims this increases illicit trade. We examined the percentage of people reporting being offered illicit cigarettes before and after full implementation of standardised packaging in the UK, Ireland and France and compared this to other European Union countries. Reported ever illicit cigarette exposure fell from 19.8% to 18.1% between 2015 and 2018 in the three countries fully implementing the policy, and from 19.6% to 17.0% in control countries (p for difference=0.320). Standardised packaging does not appear to increase the availability of illicit cigarettes.

Interprofessional Teamwork Innovation Model (ITIM) to promote communication and patient-centred, coordinated care

2018 ◽  
Vol 27 (9) ◽  
pp. 700-709 ◽  
Author(s):  
Jing Li ◽  
Preetham Talari ◽  
Andrew Kelly ◽  
Barbara Latham ◽  
Sherri Dotson ◽  
...  
Keyword(s):  
Hospital Readmissions ◽  
Intervention Group ◽  
Hospital Setting ◽  
Control Group ◽  
Difference In Difference ◽  
Academic Medical Centre ◽  
Difference Analysis ◽  
Interprofessional Teamwork ◽  
Innovation Model ◽  
Ed Visits

BackgroundDespite recommendations and the need to accelerate redesign of delivery models to be team-based and patient-centred, professional silos and cultural and structural barriers that inhibit working together and communicating effectively still predominate in the hospital setting. Aiming to improve team-based rounding, we developed, implemented and evaluated the Interprofessional Teamwork Innovation Model (ITIM).MethodsThis quality improvement (QI) study was conducted at an academic medical centre. We followed the system’s QI framework, FOCUS-PDSA, with Lean as guiding principles. Primary outcomes included 30-day all-cause same-hospital readmissions and 30-day emergency department (ED) visits. The intervention group consisted of patients receiving care on two hospitalist ITIM teams, and patients receiving care from other hospitalist teams were matched with a control group. Outcomes were assessed using difference-in-difference analysis.ResultsTeam members reported enhanced communication and overall time savings. In multivariate modelling, patients discharged from hospitalist teams using the ITIM approach were associated with reduced 30-day same-hospital readmissions with an estimated point OR of 0.56 (95% CI 0.34 to 0.92), but there was no impact on 30-day same-hospital ED visits. Difference-in-difference analysis showed that ITIM was not associated with changes in average total direct costs nor average cost per patient day, after adjusting for all other covariates in the models, despite the addition of staff resources in the ITIM model.ConclusionThe ITIM approach facilitates a collaborative environment in which patients and their family caregivers, physicians, nurses, pharmacists, case managers and others work and share in the process of care.

scholarly journals Impact of Medicaid expansion on women with gynecologic cancer: a difference-in-difference analysis

2020 ◽  
Author(s):  
Benjamin B. Albright ◽  
Dimitrios Nasioudis ◽  
Stuart Craig ◽  
Haley A. Moss ◽  
Nawar A. Latif ◽  
...  
Keyword(s):  
Gynecologic Cancer ◽  
Medicaid Expansion ◽  
Difference In Difference ◽  
Difference Analysis

Improved Population-Based Clinical Outcomes of Patients with Atrial Fibrillation by Compliance with the Simple ABC (Atrial Fibrillation Better Care) Pathway for Integrated Care Management: A Nationwide Cohort Study

2019 ◽  
Vol 119 (10) ◽  
pp. 1695-1703 ◽  
Author(s):  
Minjae Yoon ◽  
Pil-Sung Yang ◽  
Eunsun Jang ◽  
Hee Tae Yu ◽  
Tae-Hoon Kim ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Integrated Care ◽  
Clinical Outcomes ◽  
Care Management ◽  
Care Pathway ◽  
Holistic Approach ◽  
Population Based ◽  
Composite Outcome ◽  
Care Approach ◽  
Multivariable Regression

Background An integrated care approach might be of benefit for clinical outcomes of patients with atrial fibrillation (AF). This study evaluated whether compliance with the Atrial fibrillation Better Care (ABC) pathway for integrated care management (“A” Avoid stroke; “B” Better symptom management; “C” Cardiovascular risk and Comorbidity optimization) would improve population-based clinical outcomes in a nationwide AF cohort. Methods and Results From the Korea National Health Insurance Service database, a total of 204,842 nonvalvular AF patients were enrolled between January 1, 2005 and December 31, 2015. Patients that fulfilled all criteria of the ABC pathway were defined as the “ABC” group, and those who did not were the “Non-ABC” group.Over a mean follow-up of 6.2 ± 3.5 years, the ABC pathway compliant group had lower rates of all-cause death (0.80 vs. 2.72 per 100 person-years, p < 0.001) and the composite outcome of “death, ischemic stroke, major bleeding, and myocardial infarction” (2.34 vs. 5.92 per 100 person-years, p < 0.001) compared with the Non-ABC compliant group. Adjusted Cox multivariable regression showed that the ABC group had a significantly lower risk of all-cause death (adjusted hazard ratio [HR] 0.82; 95% confidence interval [CI], 0.78–0.86) and the composite outcome (adjusted HR 0.86; 95% CI, 0.83–0.89). With the increasing numbers of ABC pathway criteria fulfilled, the risk of all-cause death and composite outcome were progressively lowered. Conclusion In the first study of a nationwide population cohort, we show that compliance with the simple ABC pathway is associated with improved clinically relevant outcomes of patients with AF. Given the high health care burden associated with AF, such a streamlined holistic approach to AF management should be implemented, to improve the care of such patients.

scholarly journals Effects of a Dementia Screening Program on Healthcare Utilization in South Korea: A Difference-In-Difference Analysis

2019 ◽  
Vol 16 (20) ◽  
pp. 3837 ◽  
Author(s):  
Su Jung Lee ◽  
Hyun-Ju Seo ◽  
Dong Young Lee ◽  
So-Hyun Moon
Keyword(s):  
Screening Program ◽  
Drug Prescription ◽  
Healthcare Services ◽  
Control Group ◽  
Difference In Difference ◽  
Difference Analysis ◽  
Screening Programs ◽  
Dementia Screening ◽  
People With Dementia ◽  
Prescription Rates

To determine whether Seoul’s dementia screening program increased the rate of diagnosis and the appropriate use of healthcare services for people with dementia, a retrospective data analysis was conducted based on administrative data from the Health Insurance Review and Assessment Service. Two cohorts were constructed to represent the year before Seoul’s dementia screening program began (2007) (control group) and the year after the implementation of the program (2009) (treatment group). A difference-in-difference analysis was used to compare the diagnosis rates, number of clinic visits, and dementia-related drug prescription rates for 4 districts that implemented dementia screening programs between 2007 and 2009 and 14 areas that did not. After the introduction of the program, there was a 55.4% increase in physician-diagnosed dementia. The “average drug cost per patient” increased by 52.2% (Exp(β) = 1.522, p = 0.0264), the “average outpatient visits per patient” tended to increase by 13.5% (Exp(β) = 1.135, p = 0.1852), and the “average outpatient treatment fees per visit per patient” tended to increase by 24.4% (Exp(β) = 1.244, p = 0.0821). The implementation of dementia screening programs led to an increase in healthcare service utilization. Therefore, this program was found to be an effective strategy for reducing undiagnosed dementia cases and encouraging patients to use adequate healthcare services.

scholarly journals Collaborative Care Management Associated With Improved Depression Outcomes in Patients With Personality Disorders, Compared to Usual Primary Care

2018 ◽  
Vol 9 ◽  
pp. 215013271877326 ◽  
Author(s):  
Jeremy J. Solberg ◽  
Mark E. Deyo-Svendsen ◽  
Kelsey R. Nylander ◽  
Elliot J. Bruhl ◽  
Dagoberto Heredia ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Clinical Outcomes ◽  
Collaborative Care ◽  
Care Management ◽  
Term Treatment ◽  
Study Cohort ◽  
Long Term Treatment ◽  
Patient Health ◽  
Short And Long Term

Background: The use of a collaborative care management (CCM) model can dramatically improve short- and long-term treatment outcomes for patients with major depressive disorder (MDD). Patients with comorbid personality disorder (PD) may experience poorer treatment outcomes for MDD. Our study seeks to examine the differences in MDD treatment outcomes for patients with comorbid PD when using a CCM approach rather than usual care (UC). Methods: In our retrospective cohort study, we reviewed the records of 9614 adult patients enrolled in our depression registry with the clinical diagnosis MDD and the diagnosis of PD (Yes/No). Clinical outcomes for depression were measured with Patient Health Questionnaire–9 (PHQ-9) scores at 6 months. Results: In our study cohort, 59.4% of patients (7.1% of which had comorbid PD) were treated with CCM, as compared with 40.6% (6.8% with PD) treated with UC. We found that the presence of a PD adversely affected clinical outcomes of remission within both groups, however, at 6 months patients with PD had significantly lower MDD remission rates when treated with UC as compared with those treated with CCM (11.5% vs 25.2%, P = .002). Patients with PD in the UC group were also noted to have an increased rate of persistent depressive symptoms (PHQ-9 score ≥10) at 6 months as compared with those in the CCM group (67.7% vs 51.7%, P = .004). Conclusions: In patients with comorbid MDD and PD, clinical outcomes at 6 months were significantly improved when treated with CCM compared with UC. This finding is encouraging and supports the idea that CCM is an effective model for caring for patients with behavioral concerns, and it may be of even greater benefit for those patients being treated for comorbid behavioral health conditions.

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