Medical care
-
There is growing attention given to the spiritual needs of dying patients and long-term care (LTC) facilities are common settings in which patients receive care as they approach death. ⋯ Spiritual support and care are associated with better overall care at the end of life for LTC residents, and interventions to improve this type of care may best target interactions between residents and facility staff.
-
Medicaid preferred drug lists (PDLs) might reduce costs for Medicaid programs while creating costs to physicians. ⋯ Medicaid PDLs generate considerable costs to physicians, as would adoption of PDLs in Medicare Part D. Policymakers should weigh these and other costs against the benefits of PDLs.
-
Review Meta Analysis
The association of registered nurse staffing levels and patient outcomes: systematic review and meta-analysis.
To examine the association between registered nurse (RN) staffing and patient outcomes in acute care hospitals. ⋯ Studies with different design show associations between increased RN staffing and lower odds of hospital related mortality and adverse patient events. Patient and hospital characteristics, including hospitals' commitment to quality of medical care, likely contribute to the actual causal pathway.
-
Comparative Study
Cross-national comparative performance of three versions of the ICD-10 Charlson index.
The Charlson comorbidity index has been widely used for risk adjustment in outcome studies using administrative health data. Recently, 3 International Statistical Classification of Diseases, Tenth Revision (ICD-10) translations have been published for the Charlson comorbidities. This study was conducted to compare the predictive performance of these versions (the Halfon, Sundararajan, and Quan versions) of the ICD-10 coding algorithms using data from 4 countries. ⋯ Our analyses show that all of the ICD-10 versions of the Charlson algorithm performed satisfactorily (c-statistics 0.70-0.86), with the Quan version showing a trend toward outperforming the other versions in all data sets.
-
Latinos experience substantial barriers to primary care. Limited English language proficiency may be a mechanism for these deficiencies, even for Latinos with health coverage. ⋯ Among insured Latinos, low English language proficiency is associated with worse reports of the quality of primary care. These results suggest that interventions to address limited English proficiency may be important to improving the quality of primary care for this rapidly growing population.