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At least 739 records · Page 41Linked to original sources
PubMed1996

Nutrition support billing practices: results of a nationwide survey and responses from the Health Care Financing Administration.

In response to numerous changes in reimbursement for physician services, a survey was conducted of physician directors of nutrition support services to obtain information about current physician billing practices and reimbursement for nutrition support. Demographic data were obtained concerning the type of practice and institution, percent of time and income derived from nutrition support, and the source of individual billing practices. Responses to six clinical scenarios provided information about billing practices. The responses were collated, analyzed, and then compared with those of a senior official at the Health Care Financing Administration (HCFA). This report summarizes the results of the survey and the responses from HCFA. It is hoped that this information will be useful to nutrition support practitioners and administrators in understanding various aspects of billing for physician services for nutrition support.

Centers for Medicare and Medicaid Services, U.S.↗
PubMedDate not supplied

Physician-administrator cooperation in the postprofessional era.

The basic question this article seeks to explore is how to reconcile HCO interests and physician interests in a time when interdependence is as high as or higher than ever before, yet once convergent interests appear to be diverging sharply? To do this, the major trends and forces affecting both HCOs and MDs will be outlined; then the issues facing each will be discussed, together with their responses; and finally the key interface problems will be laid out, together with possible strategic approaches.

Cooperative Behavior↗
PubMed2001

A focus on the institutionalized aged and special care patient for today's practice.

Dentists must understand the growing institutionalized-aged and special-needs population, the places wherein they reside, and the unique challenges of access that confront both the patient and dentist. This article discusses governmental regulation and legislation of long-term-care facilities and outlines professional duties and requirements of dentists who care for residents of such facilities. It will also cover the treatment needs of this population and the venues available to the hospital-trained dentist.

Aged↗
PubMed2003

Influence of the Angioplasty Revascularization Investigation National Heart, Lung, and Blood Institute Diabetic Clinical Alert on practice patterns: results from the National Cardiovascular Network Database.

BACKGROUND: In 1995, the Bypass Angioplasty Revascularization Investigation (BARI) found that patients with diabetes had a survival benefit when treated with surgical revascularization versus balloon angioplasty, prompting a National Heart Lung and Blood Institute (NHLBI) "Clinical Alert." The influence of the BARI findings and of the Clinical Alert on practice patterns is unknown. METHODS AND RESULTS: The practice patterns of coronary revascularization among patients with diabetes and multivessel coronary artery disease (CAD) were analyzed using data collected in 1994 to 1997 from 13 centers participating in the National Cardiovascular Network. The study population included patients with diabetes and multivessel CAD who underwent elective coronary revascularization (n=9619). Over the 4 years of the study, the Clinical Alert had no significant impact on the proportion of diabetic patients undergoing percutaneous revascularization (28.6% before versus 26.8% after the Clinical Alert; P=0.06). Among individual hospitals, the probability of diabetic patients receiving percutaneous revascularization varied by >13-fold (4.3% to 56.6%). Adjusting for clinical factors and the BARI Clinical Alert did not alter this variability. Among the investigators surveyed, although 91% were aware of the Clinical Alert and 76% felt the findings were valid, >50% felt the Clinical Alert had limited or no impact on their personal or institution's care patterns. CONCLUSIONS: Limited consensus exists regarding the most appropriate method of revascularization for diabetic patients with multivessel CAD. The results from a large, randomized, clinical trial and subsequent Clinical Alert had no measurable impact on this practice variability.

Adolescent↗
PubMed1995

Clinical path coordinator: pulling it all together.

Institutions across the country are using different approaches to restructuring health care delivery systems. At Lehigh Valley Hospital collaborative practice was instituted to ensure the achievement of patient outcomes within appropriate time frames and with efficient use of resources. The role of the clinical path coordinator emerged from the collaborative practice model developed to manage the care of the patient with an abdominal aortic aneurysm. The step-by-step process for selecting, orienting, and implementing the role of the coordinator is discussed. Since the implementation of the coordinator role, patient satisfaction has been positive, length of stay and cost have decreased, and quality of care has improved for these patients.

Aortic Aneurysm, Abdominal↗
PubMed2004

Writing trauma: emotion, ethnography, and the politics of suffering among Somali returnees in Ethiopia.

By comparing Somali narratives of emotion and suffering with literature about emotion in relation to trauma and "the refugee experience," this paper contributes to the understanding of emotion, suffering, and trauma in different cultural and sociopolitical contexts, and interrogates the roles and methods of ethnographies of trauma in situations of high political, social, and economic stakes. In the mid-1990s, emotional distress among Ethiopian Somali returnees was about social rupture and injustice and not simply about private suffering. Emotion is critical to creating, recognizing, reinforcing, and mobilizing the moral webs on which both individual and collective survival depend. In the aftermath of dispossession and war, and amidst ongoing hunger and destitution, certain expressions of emotion carry a particularly important valence: anger, passion, and rhetorics of demoralization revolving around a collective narrative of dispossession and demands for restitution. "Experience near" descriptions of Somali emotion expressions cannot be conflated with "psychological" analyses or "Posttraumatic Stress Disorder." Somali refugee narratives index and challenge the embodiment in lived experience of local, national, and global institutions' (in)action and inequality. To the extent that academic debates over emotion and trauma help to shape, reinforce, or challenge the assumptions and practices of institutions affecting millions of lives, we researchers must address in our analyses the practical and political implications of how we interpret and write about emotion, trauma, and politics.

Affect↗
PubMed1987

Family physicians' activities in nursing homes: the Minnesota experience.

The Minnesota Academy of Family Physicians surveyed its members to determine their nursing home activities. The response rate was 66 percent. Eighty-three percent of members who responded had made at least one nursing home visit in the previous month. Nearly one half (48.1 percent) of physicians not currently caring for nursing home patients would continue to treat their own patient if that person were admitted to a nursing home. As the number of years in medical practice increased, statistically significant increases occurred in (1) the percentage of a practice composed of geriatric patients, (2) the number of visits made to nursing home patients, and (3) the number of hours and days spent in nursing homes. Physicians caring for nursing home patients (1) live in smaller communities, (2) spend more days each week in the office, (3) are not residency trained, (4) are board certified, and (5) have a greater percentage of patients in the geriatric age group. Physician nonparticipation in nursing homes was due to (1) too few nursing home patients in the practice, (2) inconvenience, and (3) excessive paperwork.

Humans↗
PubMed1978

The supply of optometric manpower.

Approaches to determining health manpower requirements are reviewed. The paper identifies a source of error in determining the present supply of optometric manpower which will ultimately influence any policy or program intended to either correct or adjust future health manpower supplies. The study also demonstrates a need to refine the data on health manpower supplies with particular reference to the characteristics and practices of the optometrist.

Adult↗
PubMed1987

Effects of the National Institutes of Health Consensus Development Program on physician practice.

The effects of the National Institutes of Health Consensus Development Program on physician behavior were investigated. The medical records of 2770 patients treated in ten hospitals throughout the state of Washington were reviewed to determine if quality of care improved with respect to 12 recommendations put forth by four consensus panels concerning surgical management of primary breast cancer, the use of steroid receptors in breast cancer, cesarean childbirth, and coronary artery bypass surgery. Care was studied during 24 months before and 13 to 24 months after each consensus conference. Results showed that the conferences mostly failed to stimulate change in physician practice, despite moderate success in reaching the appropriate target audience. It was concluded that the consensus development conference is an important educational tool whose effects might be enhanced by focusing on areas of practice that need improvement and by encouraging follow-up programs at the state and local level.

Breast Neoplasms↗
PubMed2003

Audit of transfusion procedures in 660 hospitals. A College of American Pathologists Q-Probes study of patient identification and vital sign monitoring frequencies in 16494 transfusions.

CONTEXT: Hemolytic transfusion reactions are often the result of failure to follow established identification and monitoring procedures. OBJECTIVE: To measure the frequencies with which health care workers completed specific transfusion procedures required for laboratory and blood bank accreditation. DESIGN: In 2 separate studies, participants in the College of American Pathologists Q-Probes laboratory quality improvement program audited nonemergent red blood cell transfusions prospectively and completed questionnaires profiling their institutions' transfusion policies. SETTING AND PARTICIPANTS: A total of 660 institutions, predominantly in the United States, at which transfusion medicine services are provided. MAIN OUTCOMES MEASURES: The percentages of transfusions for which participants completed 4 specific components of patient and blood unit identifications, and for which participants monitored vital signs at 3 specific intervals during transfusions. RESULTS: In the first study, all components of patient identification procedures were performed in 62.3%, and all required patient vital sign monitoring was performed in 81.6% of 12 448 transfusions audited. The median frequencies with which institutions participating in the first study performed all patient identification and monitoring procedures were 69.0% and 90.2%, respectively. In the second study, all components of patient identification were performed in 25.4% and all patient vital sign monitoring was performed in 88.3% of 4046 transfusions audited. The median frequencies with which institutions participating in the second study performed all patient identification and monitoring procedures were 10.0% and 95.0%, respectively. Individual practices and/or institutional policies associated with greater frequencies of patient identification and/or vital sign monitoring included transporting units of blood directly to patient bedsides, having no more than 1 individual handle blood units in route, checking unit labels against physicians' orders, having patients wear identification tags (wristbands), reading identification information aloud when 2 or more transfusionists participated, using written checklists to guide the administration of blood, instructing health care personnel in transfusion practices, and routinely auditing the administration of transfusions. CONCLUSIONS: In many hospitals, the functions of identification and vital sign monitoring of patients receiving blood transfusions do not meet laboratory and blood bank accreditation standards. Differences in hospital transfusion policies influence how well health care workers comply with standard practices. We would expect that efforts designed to perfect transfusion policies might also improve performance in those hospitals in which practice compliance is substandard.

Accreditation↗