Medical care
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We sought to compare the ability of the EQ-5D, Health Utilities Index Mark 2 (HUI2), and HUI Mark 3 (HUI3) index scores to discriminate between respondents based on the presence or absence of chronic medical conditions in a population health survey. ⋯ Although the EQ-5D seems to be marginally less informative, the EQ-5D, HUI2, and HUI3 index scores were generally comparable in determining health burden of chronic medical conditions in this population health survey data.
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Similar patient populations and favorable regulations have led many home health agencies to become Medicare and/or Medicaid certified as hospice agencies (mixed), but home health and hospice programs differ in focus and scope. Little research has been performed examining the differences between mixed hospices and those agencies only certified as hospices (nonmixed). ⋯ Mixed agencies provide a narrower range of services to hospice patients than nonmixed agencies, including fewer services considered cornerstones of hospice treatment.
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With the increasing use of colonoscopy there is growing concern about the quality of these procedures. ⋯ Only 29.4% of individuals with an incomplete colonoscopy underwent complete colonic evaluation within 1 year after the procedure. Women > or =80 years and those who had their colonoscopy in a private office or clinic were less likely to undergo complete colonic evaluation. The quality of care provided to older women and colonoscopy practice in office settings may be suboptimal.
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Electronic health records (EHRs) have been promoted as an important tool to improve quality of care. We examined the association between EHR components, a complete EHR, and the quality of care. ⋯ We found no consistent association between blood pressure control, management of chronic conditions, and specific EHR components. Future research focusing on how an EHR is implemented and used and how care is integrated through an EHR will improve our understanding of the impact of EHRs on the quality of care.
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To estimate the actual cost savings that could be achieved through reductions in intensive care unit (ICU) length of stay and duration of mechanical ventilation by determining the short-run marginal variable cost of an ICU and ventilator day. ⋯ Marginal variable ICU costs are relatively small compared with average total costs and are only slightly greater than the cost of a ward day.