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Academic literature on the topic 'Medical care – Utilization – Benin'

Author: Grafiati

Published: 4 June 2021

Last updated: 1 February 2022

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Journal articles on the topic "Medical care – Utilization – Benin"

Mendis, S., Igbal Al Bashir, Lanka Dissanayake, Cherian Varghese, Ibtihal Fadhil, Esha Marhe, Boureima Sambo, et al. "Gaps in Capacity in Primary Care in Low-Resource Settings for Implementation of Essential Noncommunicable Disease Interventions." International Journal of Hypertension 2012 (2012): 1–7. http://dx.doi.org/10.1155/2012/584041.

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Objective.The objective was to evaluate the capacity of primary care (PC) facilities to implement basic interventions for prevention and management of major noncommunicable diseases (NCDs), including cardiovascular diseases and diabetes.Methods.A cross-sectional survey was done in eight low- and middle-income countries (Benin, Bhutan, Eritrea, Sri Lanka, Sudan, Suriname, Syria, and Vietnam) in 90 PC facilities randomly selected. The survey included questions on the availability of human resources, equipment, infrastructure, medicines, utilization of services, financing, medical information, and referral systems.Results and Conclusions.Major deficits were identified in health financing, access to basic technologies and medicines, medical information systems, and the health workforce. The study has provided the foundation for strengthening PC to address noncommunicable diseases. There are important implications of the findings of this study for all low- and middle-income countries as capacity of PC is fundamental for equitable prevention and control of NCDs.

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Kane, John M. "Utilization of Long-Acting Antipsychotic Medication in Patient Care." CNS Spectrums 11, S14 (December 2006): 1–8. http://dx.doi.org/10.1017/s1092852900025852.

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AbstractSchizophrenia is a complex disorder characterized by a broad spectrum of psychopathology. Aggressive efforts to bring the patient into remission should begin immediately after the first episode. Consequences of non-remission include poor prognosis, psychiatric and general medical complications, treatment resistance, and death from medical comorbidities and suicide. Prevention of relapse following remission is critical to the well-being and optimal functioning of patients with schizophrenia.The key to optimizing patients' outcomes is to ensure a patient's long-term continuation on medication. As treatment discontinuation can greatly impact the progression of the illness and the patient's ultimate outcome, selecting a treatment with maximum treatment effectiveness is optimal. Nonadherence to treatment is extremely prevalent among patients with schizophrenia, due to such factors as impaired cognition, lack of insight, and side effects associated with antipsychotic treatment.Atypical antipsychotics have shown some advantages over conventional antipsychotics in terms of reducing positive and negative symptoms of schizophrenia, preventing relapse, and incidence of tardive dyskinesia. Injectables and long-acting formulations of antipsychotics offer additional benefits in terms of ensuring treatment adherence.

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Gleason, Patrick P., Brent W. Gunderson, and Kristin R. Gericke. "Are Incentive-Based Formularies Inversely Associated with Drug Utilization in Managed Care?" Annals of Pharmacotherapy 39, no. 2 (February 2005): 339–45. http://dx.doi.org/10.1345/aph.1e380.

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OBJECTIVE: To review recent studies comprehensively assessing the impact of incentive-based multitier formularies on pharmaceutical costs and utilization. DATA SOURCES: PubMed (2001–December 2003) was searched using the key terms formularies, cost-sharing, and drug costs. STUDY SELECTION AND DATA EXTRACTION: Studies addressing the impact of implementing multitiered incentive-based formularies as a central component of an outpatient drug benefit were selected. DATA SYNTHESIS: One study using pharmacy claims from 25 employers with data from 402 786 members modeled the range of anticipated plan/employer savings associated with single- to 3-tier shifts and found that, going from a single- to 3-tier benefit results in decreased plan/employer pharmaceutical costs from $650 to $494 (24% decrease) per member per year and decreased pharmaceutical utilization from 12.3 to 9.4 (23.6% decrease) prescriptions per member per year. Another study demonstrated that adding an additional tier decreased pharmaceutical utilization, with a dramatic increase in member contribution offsetting the plan's expected increase in expenditures. This shift in pharmaceutical expenditures appeared to have no effect on overall medical utilization over a 3-year follow-up. Finally, a study converting members from a single- to 3-tier incentive-based formulary, associated with two- to fourfold copayment increases, resulted in a 10% discontinuation rate for angiotensin-converting enzyme inhibitors, statins, and proton-pump inhibitors among members who were primarily hourly employees. For salaried workers, the addition of a tier to their benefit appeared to have minimal impact on pharmaceutical utilization. CONCLUSIONS: Emerging data suggest a potential inverse relationship between pharmaceutical utilization and incentive-based formularies that increase member contribution to drug costs. Future research should focus on identifying price points and percentage increases at which members are likely to begin discontinuing necessary medications.

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Galo, Jason, Bianca Madrid, and Warren Kupin. "Lanthanum-Induced Radiopaque Intestinal Precipitates: A Potential Cause of Intestinal Foreign Bodies." Case Reports in Nephrology 2019 (September 2, 2019): 1–3. http://dx.doi.org/10.1155/2019/1298674.

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Lanthanum carbonate is a commonly prescribed oral phosphate binder for use in patients with acute or chronic kidney disease. The elemental form of lanthanum is a soft metal, which will appear radiopaque on a standard X-ray radiograph. This case report illustrates the potential for Lanthanum to masquerade as multiple radiopaque intestinal foreign bodies, leading to the extensive mobilization of medical resources and consultations including serial X-ray monitoring, multiple consultants including acute care and colorectal surgery. Given the few published reports describing this finding in the literature, it is essential to consider Lanthanum precipitates in the differential diagnosis of radiopaque intestinal foreign bodies in patients with chronic kidney disease to avoid unnecessary utilization of medical resources for this predominantly benign condition.

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Paulukonis, Susan, Lynne Neumayr, Thomas D. Coates, Elliott Vichinsky, and Lisa Feuchtbaum. "Emergency Room Utilization by California Sickle Cell Patients During Pediatric to Adult Care Transition." Blood 116, no. 21 (November 19, 2010): 254. http://dx.doi.org/10.1182/blood.v116.21.254.254.

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Abstract Abstract 254 Clinical experience and research with sickle cell patients and those with other genetic diseases suggests that the period of “transition,” in which patients move from pediatric care to adult-centered clinical care, is a period of high health services utilization. Young adult patients may not have learned to effectively manage disease symptoms and may not be connected to a “medical home” or have established a relationship with a primary care physician or adult hematologist. Further, these patients may not have insurance coverage previously provided by parents or by public pediatric insurance programs. As part of a collaborative agreement through the Centers for Disease Control and Prevention (CDC) and the National Heart, Lung & Blood Institute (NHLBI), California and five other states are conducting epidemiologic surveillance to determine the prevalence of hemoglobinopathies as well as health services utilization. Such data are essential to inform allocation of resources to meet the medical and social service needs of patients. Within the state, this project is a collaborative effort among the CA Dept. of Public Health Genetic Disease Screening Program, Children's Hospital Los Angeles and Children's Hospital & Research Center Oakland. Using administrative data obtained as a part of this effort, we describe emergency room (ER) utilization patterns among young adults with sickle cell disease. The CA Office of Statewide Health Planning and Development has collected data on ER utilization for the years 2005 – 2008. Using ICD 9 codes beginning with 282.6 to identify sickle cell-related ER visits during those years, we report usage patterns by patient age, gender, and payer type. To calculate risk of repeat ER visits, we used a negative binomial regression model (with 1 visit as the baseline for analysis, rather than 0 visits, due to the limitations of the data set). The following means and counts are adjusted to account for this shift. Analyses were conducted using SAS 9.1. The mean number of ER visits among sickle cell patients in the data set was 3.36 per year and 54% of visits were made by women, but gender differences in average visits per year per patient (3.18 female, 3.60 male) were not statistically significant. Medi-Cal (Medicaid) was the primary payer for 47% of visits during this time frame, and patients with Medi-Cal averaged nearly one additional visit per year (3.82 visits) compared to patients with other forms of payment (3.04 visits). Among patients seen at any time during the four years and controlling for gender and payer type, we found a 78% increase (IRR 1.78, 95% CI 1.59, 2.00) in risk of visiting the ER a second or subsequent time in a given year among the 20 to 30 year old group compared to all other age groups, a four fold increase (IRR 4.22, 95% CI 3.61, 4.93) in risk of a second or subsequent visit in a year compared to the group aged 10 to 20 years, and a 30% increase (IRR 1.34, 95% CI 1.16, 1.55) compared to the group 30 to 40 years of age. Average number of visits in the transition age group was 4.53 per year, compared to 1.93 per year in the 10 to 20y group and 3.56 in the 30 to 40y age group. The number of individuals visiting the ER per year was higher in this age group compared to the two adjoining age groups (520 individuals on average per year for 20 – 30y, vs. 311 per year for 10 – 20y and 355 for 30 to 40y). The increase in visits per year of age can be seen (Figure 1) to begin at age 18 or 19 and continue to approximately age 30. The proportion of patients with no insurance coverage increased from 8% in the 10 to 20y age category to 19% of patients in the 20 to 30y age category, and remains high for the subsequent age categories (11 to 17%). The transition period from pediatric care to adult care in California sickle cell patients is marked by a dramatic increase in emergency room visits (both more patients visiting and more visits per patient) compared to other age groups. ERs are also visited significantly more often by uninsured sickle cell patients in this age group than other age groups. Patients in this age group would likely benefit from access to a medical home model of care.Figure 1.Mean Annual Number of Visits by Age of Patient among Those Seen in ER with SCD-related ICD 9 Codes, California, 2005–2008Figure 1. Mean Annual Number of Visits by Age of Patient among Those Seen in ER with SCD-related ICD 9 Codes, California, 2005–2008 Disclosures: Coates: Novartis: Research Funding, Speakers Bureau.

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Bersabe, Adrian R., Michael Osswald, and Nathan M. Shumway. "Peripheral Blood Smear Utilization within a Military Hematology/Oncology Fellowship Program." Blood 124, no. 21 (December 6, 2014): 5980. http://dx.doi.org/10.1182/blood.v124.21.5980.5980.

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Abstract Background: The practice of peripheral blood smear (PBS) interpretation is considered an important diagnostic skill in Hematology/Oncology (HO). The Accreditation Council of Graduate Medical Education (ACGME) requires trainees to become proficient in the preparation and interpretation of blood smears. We explored practice patterns of PBS utilization in a tertiary care, military medical center HO fellowship program. Methods: A retrospective chart review was conducted on 350 consecutive outpatient referrals for benign hematology diagnoses (ICD-9 codes 280-289) in a military medical center, from August 2011 to March 2012. Data obtained from the electronic medical records (EMR) included patient demographics, pertinent medical history, labs ordered, and provider status (resident, fellow, or staff). We also recorded HO ordering patterns for complete blood counts (CBC) and PBS and documentation of PBS findings. For those encounters in which the findings were documented, we reported any further diagnostic studies ordered. The practices of PBS review by HO clinicians and hematopathologists (HP) were also compared. Results: 334 of 350 records reviewed met inclusion criteria for the study. Of the 16 records excluded, one was due to age > 85, 11 due to malignant oncology diagnoses, and 4 were unavailable within the EMR. The median age was 52.5 with males representing 52% of the cohort. 43.8% were self-reported as Caucasian, 23.6% African-American, and 32.6% “Other.” The distribution of diagnoses were 52.7% (n = 176) erythrocyte (RBC) disorders, 23.0% (n = 77) leukocyte (WBC) disorders, 10.2% (n = 34) platelet (PLT) disorders, and 14.1% (n = 47) falling into the category of “other.” The five most common diagnoses were anemia, unspecified (n = 74, 19.3%), iron deficiency anemia (n = 53, 13.8%), leukocytosis, unspecified (n = 37, 9.6%), thrombocytopenia, unspecified (n = 31, 8.1%), and leukopenia, unspecified (n = 16, 4.2%) corresponding to ICD-9 codes 285.9, 280.9, 288.6, 287.5, and 288.5, respectively. A CBC was ordered in 82.9% encounters (n = 277/334, 95% confidence interval [CI], 78.9%-87%) A PBS was ordered in 52.3% of cases in which a CBC was ordered (n = 145/277, 95% CI, p < 0.001). There was no statistical significance between the rates at which residents, fellows, or staff ordered PBS with percentages of 40% (n = 18/45), 43.6% (n = 89/204), and 44.7% (n = 38/85), respectively. A HP reviewed 5.7% (n=19/334) of the CBC’s obtained. If a PBS was ordered, findings were documented in the EMR for 49% of cases (71/145). In the 71 encounters that had PBS documentation, only 7 had HP review (9.9%). Examination of PBS led to further evaluation in 40.8% (29/71) of cases, which represented 8.7% (29/334) of the entire cohort. Of these 29, there was one consult to Gastroenterology, one imaging study ordered (ultrasound for splenomegaly), 9 bone marrow biopsies (12.7%), and lab work in all 29. Of the labs ordered, 8 (27.6%) were studies for hemolysis (DAT, LDH, haptoglobin), 10 (34.5%) were studies for myeloproliferative disease (Jak2, BCR-ABL), and 5 (17.2%) were peripheral flow cytometry. A PBS was more likely to be ordered for WBC disorders (71.9%, CI 95%: 61.9%-81.9%; p ≤ 0.001), followed by PLT (61.3%, CI 95%: 44.2%-78.4%; p = 0.076) and RBC disorders (38.7%, CI 95%: 30.9%-46.5%; p ≤ 0.001), respectively. Of the 29 cases in which PBS findings were documented and further studies ordered, 8 (27.6%) were RBC disorders, 10 (34.5%) were WBC disorders, 6 (20.7%) were PLT disorders, and 5 (17.2%) fell into the category of “other.” In the “other” category, 2 were other specified disease of blood and blood-forming organs (289.89), and the remaining 3 were splenomegaly (789.2) polyclonal hypergammaglobulinemia (273), and monoclonal paraproteinemia (273.1). Discussion: The practice of interpreting the PBS is considered an important diagnostic skill for HO providers. In a military HO training program, PBS were ordered in about half of new benign hematologic outpatient referrals. When PBS were ordered, findings were documented in 49% of cases. While diagnoses could be made without getting PBS in a majority of cases, close to 10% of all benign hematology referrals had documented PBS fidings that led to further diagnostic evaluation. Disclosures No relevant conflicts of interest to declare.

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Pai, Ashok, Dinesh Kotak, Nancy Facher, Kyle Reader, Kevin Kong, Natalya Greyz, Jahan Tavakoli, et al. "Development of a Virtual Benign Hematology Consultation Service: Results of a Pilot Project Involving 5 Medical Centers." Blood 132, Supplement 1 (November 29, 2018): 824. http://dx.doi.org/10.1182/blood-2018-99-110009.

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Abstract Background: Benign hematology consultations constitute a sizable proportion of community hematology/oncology practices. There is a need for physicians with adequate training, experience, interest and expertise in evaluating and treating patients with these disorders1,2. Some hematologic issues are complex and require in-person histories and examinations, while others can be handled with advice electronically after a thorough chart review3. To improve the quality of the care provided to these patients, a virtual benign hematology consultative service was created. This program was developed in the setting of a multi-specialty group with a commonly accessible EMR, servicing 15 medical service area centers, each with their own hematology/oncology department. A pilot project was designed to evaluate the feasibility of performing benign hematology consults virtually with the goal of improving quality of care while simultaneously enhancing the expertise of the physicians performing the consultations. Methods: The setting for this program is a multi-specialty group with a capitated reimbursement model. A pilot project was begun in October 2017 between 2 participating medical centers and was expanded to include a total of 5 medical centers by April 2018. All non-urgent benign hematology consultation requests were submitted electronically through an 'e-consult' portal. Evidence based work ups for common hematologic conditions were developed with consensus amongst all 15 hematology departments and provided on the e-consultation landing pages. All urgent questions and in-patient consults were called in directly to an on-call physician. Results: Data from October 2017 through April 2018 are reported. During this time, there were 2013 consults submitted electronically for review. Of this, 1107 came under the non-specific 'Ask the Specialist' code, and 906 under a specific diagnosis code. Regarding the consults with a designated diagnosis code, anemia 239 (26.3%), abnormal SPEP 208 (22.9%), anticoagulation 142 (15.6%), thrombocytopenia 103 (11.3%), leukocytosis 73 (8.1%), thrombocytosis 56 (6.2%), erythrocytosis 45 (5.0%), leukopenia 40 (4.4%) were the most common inquires. The requests that came under the 'Ask the specialist' code included questions regarding iron deficiency, easy bruising, macrocytosis without anemia, elevated ferritin levels and an elevated PT/PTT to name a few . Of the 1107 'Ask the specialist' consults, 941 (85.0%) were handled with advice given electronically while 116 (15%) were triaged to an in-person appointment. When evaluating the specific diagnosis codes, 575 (63.4%) were handled with advice given electronically. The most commonly triaged diagnosis for in-person appointments were thrombocytosis (60.7%), leukopenia (50.0%) and thrombocytopenia (47.6%). 90.3% of the consultation requests were addressed within 24 hours. When evaluating the number of consults on each day of the week, there were an average of 32.7, 25.8, 19.6, 24.4 and 18.2 consults triaged Monday through Friday respectively. The time necessary to complete an electronic consult was calculated based on data from 7 hematologists with a sample size of 197 consults. It took an average of 14.47 minutes to complete each consultation when performed electronically (95% CI, 14.02 mins - 14.91 mins). This is similar to the time reported by Cecchini et al. in their experience with this program at the VA health system3. All referring physicians were surveyed regarding their perceptions of the program, scaling their responses from 1 to 5. When asked if the work-up algorithms were helpful, if the recommendations received were clear and whether it was easy to access the specialist, the weighted average responses were 4.60, 4.50 and 4.0 respectively. Conclusions: This was a pilot program to assess the feasibility of a virtual hematology consultative service. The initial success of the program shows that it is possible to provide high value consultations to referring providers in an expeditious manner that enhances quality of care by having experts focused in the area perform the evaluation. Patients are also spared a visit to the hematology/oncology clinic to discuss a benign condition, and therefore has the added benefit of reduced anxiety4. Future studies will involve measuring outcomes of patients who were managed virtually, and the effect of the recommendations on the utilization of laboratory tests. Disclosures No relevant conflicts of interest to declare.

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Benca, R., R. Ferziger, E. M. Wickwire, S. Bertisch, J. Biddle, M. Boustani, L. Culpepper, et al. "1185 Developing A Care Pathway For Insomnia In Older Adults And Adults With Dementia: Results Of A Consensus Meeting." Sleep 43, Supplement_1 (April 2020): A452—A453. http://dx.doi.org/10.1093/sleep/zsaa056.1179.

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Abstract Introduction Insomnia among older adults and dementia patients carries a high public health burden. Yet, treatment is inconsistent or absent. Standardized, programmatic carepaths can be implemented in clinics/systems/communities to address this after tailoring to local environments. To determine what elements should be included, a consensus meeting was convened, which included discussion, voting on components, and further consensus-building among diverse stakeholders. Methods Participants represented a wide range of stakeholders and specialties, including academic research, clinical care, industry, government, payors, sleep medicine, primary care, geriatrics, psychiatry, neurology, nursing, pharmacy, quality, and implementation science. 27 statements regarding key components of carepaths for insomnia in elderly and dementia populations were presented and discussed. These represented items addressing identification of patients, screening and assessment, deciding treatment modality and delivery, providing behavioral treatment, providing pharmacotherapy, addressing combined therapy, addressing comorbidities, and incorporating outcome evaluation. All N=20 participants voted individually whether they agreed or disagreed with each statement. Items were scored as 0=strongly agree, 1=agree, 2=disagree, and 3=strongly disagree. Mean scores were evaluated and responses were dichotomized to agree/disagree. Results Despite diversity among attendees, median rate of agreement was 95% (IQR=85-95%). Mean score was 0.69 (SD=0.31). 95%CIs were computed for each proportion and compared to the mean. The following elements were significantly different from the mean (p<0.05): medication decision trees (M=0.25), accounting for comorbidities (M=0.26), include outcome evaluation (M=0.30), utilization of EMR (M=0.40), incorporate caregiver (M=0.42), and differ across parts of the system (M=1.79). Conclusion Insomnia carepaths for older adults should address identification, screening and assessment, treatment decisions, treatment type and delivery, and evaluation. Organizations should consider these elements when designing carepaths for insomnia among older adults and dementia patients. Consensus-building should begin during the process of prioritizing care path components. Support Merck Research Labs provided support

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Broers, Michelle, Jodi Wojcik, and Lindsey k. Journey. "579 Benefits of Licensed Clinical Social Worker Utilization in an Adult Burn Clinic: More Than Just Checking the Box." Journal of Burn Care & Research 42, Supplement_1 (April 1, 2021): S141. http://dx.doi.org/10.1093/jbcr/irab032.229.

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Abstract Introduction Our burn institution cares for critically ill burn patients and provides post-acute care for a large referral base. The clinic is staffed by a wound certified physical therapist, an advanced practice registered nurse and a licensed clinical social worker (LCSW), with consult access to Trauma/Burn Surgeons. The incidence of acute stress symptoms after burn injury is noted in up to 35% to 40% of patients. Therefore, it is important to identify symptoms of anxiety and depression early and begin symptom management. Burn patients have access to a multi-disciplinary team, and a licensed therapist, that can identify symptoms of acute stress and make recommendations for appropriate treatment in concert with the medical staff. This project seeks to determine the prevalence of acute stress in post-acute burn patients seen in an adult burn clinic and the benefits of utilizing a Licensed Clinical Social Worker to perform screening. Methods For a one-year period all burn patients in the burn clinic were screened by the LCSW. The subjects underwent initial screenings for depression, anxiety, and suicide risk at their first clinic visit. The PHQ-2 and PHQ-9 were utilized to assess depression, the GAD-7 for anxiety and the Columbia Suicide scale to assess suicide risk. Patients were initiated into multi-modal therapies based on specific scoring. These intervention strategies were based on the Depression Screening Protocol which included education on depression, and/or anxiety, with or without participation in a Trauma/Burn Peer Support Group. Patients were prescribed medication per provider discretion, and/or connected to community resources such as, counseling, and psychiatric mental health services. Results During the one-year assessment period screening compliance was >90%. During this period, >50% of patient’s scores were clinically significant for acute stress. Over half of those that screened positive were connected to community resources of counseling services or psychiatric care. 100% of those that screened positive were given education and connection to peer support services. An incidental correlation was noted between increased total body surface area involvement and work-related accidents with increased symptomology. Conclusions The inclusion of an LCSW in the burn clinic has improved the overall care of the burn injured patient. The assessment of depression and anxiety related to the burn injury has led to an increase in peer support participation and an increase in referrals to counseling and/or psychiatric services.

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Mogle, Bryan T., Robert W. Seabury, Zachary Jones, Christopher D. Miller, and Jeffrey M. Steele. "The Culture of Carbapenem Overconsumption: Where Does It Begin? Results of a Single-Center Survey." Hospital Pharmacy 54, no. 3 (May 8, 2018): 175–79. http://dx.doi.org/10.1177/0018578718775328.

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Purpose: The United States has seen an increased consumption of carbapenem antibiotics in recent years. The increased utilization of these agents has potential negative consequences, including the increasing incidence of carbapenem-resistant Enterobacteriaceae. Reasons for the rise in carbapenem use among providers in acute care hospitals are not well elucidated in literature. The objectives of this study were to identify factors that influence empiric carbapenem use among providers in a single academic medical center, and to assess therapeutic knowledge pertaining to carbapenem use. Methods: A cross-sectional, single-center, 9-item electronic research survey was developed independently and validated by an infectious diseases pharmacist and infectious diseases physician. The survey was distributed to email accounts of providers at a single academic medical center. Demographic data, factors affecting carbapenem prescription, and baseline therapeutic knowledge were assessed. Results: Ninety-five of 416 providers responded to the survey (response rate of 22.8%). Respondents were well distributed across all levels of training with primary roles in internal medicine and surgery. The most important factors influencing empiric carbapenem use were suspected pathogens at the site of infection, drug allergies, history of multidrug resistant organisms, severity of illness, type of infection, and local resistance rates. A recommendation from a pharmacist was selected as the most likely factor for deterring carbapenem use. Misconceptions pertaining to penicillin drug allergy and beta-lactam cross reactivity, knowledge of local resistance rates according to the institutional antibiogram, and comparative efficacy data for carbapenems were apparent across all levels of training. Conclusions: Provider misconceptions regarding several factors appear to contribute to unnecessary use of carbapenems. An opportunity exists for hospital pharmacists to improve the prescribing patterns of carbapenems by correcting provider misconceptions through education.

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Dissertations / Theses on the topic "Medical care – Utilization – Benin"

Belanger, Marc Andrew. "Determinants of health care seeking behaviour in the Pahou PHC project in the People's Republic of Benin : an exploratory study." Thesis, McGill University, 1993. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=68072.

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The goal of this study is to identify factors which may be preventing use of an experimental health care program in the People's Republic of Benin. While previous surveys have focused more specifically on the impact of fees on use and demand, our aim to identify a wider range of factors.
There are two principle methods by which this can be done. One is to extract possible factors from a review of the relevant literature. The other is to carry out an exploratory, qualitative study in the field. We have used both these methods.
A qualitative study is a necessary prelude to a survey, since we initially have no specific idea about which factors to measure and investigate. The aim is to identify factors which may be relevant so that a subsequent survey, with a larger number of cases, could quantify and measure their influence and statistical significance.

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Shah, Ruby. "Naloxone Utilization in a Tertiary Care Medical Center." Thesis, The University of Arizona, 2013. http://hdl.handle.net/10150/281779.

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A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.
The purpose of this research project was to review the use of naloxone for oversedation events from 2008-2011 at the Mayo Clinic Hospital in Phoenix, Arizona. Opiates are generally an accepted form of acute and chronic pain management. Opiate analgesic use has increased in past decades due to several factors including cultural and healthcare ideas on the importance of pain management, as well as the availability, cost, and marketing of the drugs. Concomitant with the increased use of opiates has been a rise in addiction, diversion, and abuse. In addition, opiate overdose is a potentially lethal consequence. Balancing the use of opiates for effective pain control and the possible risks of opiates is a constant effort for healthcare professionals. Monitoring the use of naloxone has arisen as an effective metric to examine the safety and outcomes of opiate utilization in a hospital setting. Reviewing every dose of naloxone delivered over the years 2008-2011 has allowed us to recognize trends that have led to improvements in patient safety. 154 cases of naloxone use for sedation events were reviewed in a retrospective case controlled unmatched chart review. We were able to determine that patient risk for oversedation is greatest within our surgical practices, especially general and orthopedic, and that the overall risk is greatest within the first 24 hours in all surgical patients. In addition, we were able to determine statistically significant increase in risk with elevated creatinine level, American Society of Anesthesiology (ASA) Class, and patient controlled analgesia (PCA) use compared to our unmatched control group. The significance of these findings is that it identifies certain risk groups and factors that carry increased risk for sedation events, and therefore can lead to improvements in quality and education across the institution.

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Blanchard, Janice C. "Discrimination and health care utilization." Santa Monica, CA : RAND, 2006. http://www.rand.org/pubs/rgs_dissertations/RGSD198/.

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Basu, Rashmita. "Healthy lifestyle, disease prevention and health care utilization." Pullman, Wash. : Washington State University, 2009. http://www.dissertations.wsu.edu/Dissertations/Fall2009/r_basu_112309.pdf.

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Cheng, P. Y. Rachel. "Gender differences in health service utilization among Hong Kong adults." View the Table of Contents & Abstract, 2007. http://sunzi.lib.hku.hk/hkuto/record/B38479278.

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Li, Nan. "Study of patterns of medical care utilization using computer algorithms." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0016/MQ54931.pdf.

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Sonico, Eric A. "Implementation and utilization of electronic medical records| An analysis." Thesis, California State University, Long Beach, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=1522655.

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This master's thesis will present a literature review and analysis ofthe implementation and use of Electronic Medical Records (EMR). The literature review will discuss reasons that support implementation of EMRs, factors that are necessary for successful implementation and barriers that impede implementation. Also, real-world examples of implementation for medical billing in healthcare organizations will be discussed, as well as the disparity in implementation rates between larger and smaller healthcare organizations.

The analysis portion of this thesis will include data from the 2009 National Ambulatory Medical Survey (NAMCS) EMR Supplement and, through the application of the Chi-Square statistical test using SPSS, will assess whether size of the medical practice in terms of number of physicians is significantly associated with EMR implementation and functionality, the latter of which includes clinical reminders and prescription ordering. It will be shown that physician size is indeed significantly associated with implementation and functionality.

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Robisnon, Brenda Joyce. "Is there an Association between Non-VA Medical Care Coordination and Utilization of Care?" ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2376.

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The Non-Veteran Administration Care (NVC) is a program in which the Veterans Health Administration purchases health care when it cannot provide the health services needed for eligible Veterans. The rising cost of this program led to audits by the Office of the Inspector General and other entities. The scholarly problem for this DNP Project was the lack of oversight, accountability, and management, found throughout the audits of NVC, as well as a lack of evaluation of NVC. The purpose of this project was to ascertain if there was a relationship between the Non-VA Care Coordination program (NVCC) and utilization of care. The NVCC was implemented to eliminate the deficiencies cited by audits. Sleep study and chiropractic consults for FY 2013 (pre-NVCC) and FY 2014 (post-NVCC) were examined. Sleep apnea service was available at the local Veteran Administration Medical Center and chiropractic service was not. Utilization of care was determined by emergency room (ER) visits and admissions related to the consult. A logic model was used to conceptualize the project and the longer-term implementation and evaluation of NVCC, and descriptive statistics were used to analyze trends in the chiropractic data (sleep study consults were excluded from the analysis due to the minute number). There were a total of 859 chiropractic consults and 2,184 approved visits analyzed. The results revealed that Veterans who utilized the consults had no ER visits or admissions related to referrals for chiropractic consults. Completed chiropractic consults remained proportionality the same both years. NVCC had no association with the utilization of care. This scholarly project contributes to social change by empowering consumers and providing transparency in the government through audits that facilitate quality improvement and evaluation of the NVCC program.

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Boles, Brian Nelson. "An examination of relationships among indicators of socioeconomic status, health status, and selected health care utilization for fund allocation /." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq21255.pdf.

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Wong, Oi-ling Irene. "Medical ecology of inpatient service utilization in Hong Kong a population survey /." Click to view the E-thesis via HKUTO, 2003. http://sunzi.lib.hku.hk/hkuto/record/B31971337.

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Books on the topic "Medical care – Utilization – Benin"

Alberta. Utilization Committee. Utilization of medical services. [Edmonton]: Alberta Hospitals and Medical Care, 1985.

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Nelson, Cheryl. Medication therapy in ambulatory medical care: National Hospital Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, 1992. [Hyattsville, Md.] (6525 Belcrest Rd., Hyattsville 20782): [U.S. Dept. of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, 1997.

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Mitchell, Sharon. Standard utilization review criteria study. St. Paul, Minn: Minnesota Dept. of Health, Data Analysis Program, 1995.

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DeLozier, James E. National Ambulatory Medical Care Survey: 1989 summary. [Hyattsville, Md: U.S. Dept. of Health and Human Services, Public Health Service, Centers for Disease Control, National Center for Health Statistics, 1991.

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A physician's guide to utilization review. Philadelphia: F.A. Davis Co., 1987.

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Irish medical care resources: An economic analysis. Dublin: Economic and Social Research Institute, 1985.

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Glied, Sherry. Managed care. Cambridge, MA: National Bureau of Economic Research, 1999.

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), National Center for Health Statistics (U S. Publications from the National Medical Care Utilization and Expenditure Survey. [Hyattsville, MD: U.S. Public Health Service, National Center for Health Statistics, Division of Health Interview Statistics, 1987.

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Mazharul, Islam. Under-utilization of healthcare services in Bangladesh: An emerging issue. Dhaka: Centre for Policy Dialogue, 2000.

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Bernstein, A. B. Health care in America: Trends in utilization. Hyattsville, Md. (3311 Toledo Road, Hyattsville 20782): Center for Disease Control and Prevention, National Center for Health Statistics, 2003.

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Book chapters on the topic "Medical care – Utilization – Benin"

Giardino, Angelo P., and Michelle A. Lyn. "Utilization Management, Case Management, and Care Coordination." In Medical Quality Management, 139–75. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-48080-6_7.

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Bormann, Cornelia, and Enno Swart. "Utilization of Medical Services in Germany—Outline of Statutory Health Insurance System (SHI)." In Health Care Utilization in Germany, 29–41. New York, NY: Springer New York, 2013. http://dx.doi.org/10.1007/978-1-4614-9191-0_3.

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Swart, Enno, and Stephanie Griehl. "The Problem of Repeated Surveys. How Comparable are their Results Regarding the Utilization of Medical Services?" In Health Care Utilization in Germany, 45–62. New York, NY: Springer New York, 2013. http://dx.doi.org/10.1007/978-1-4614-9191-0_4.

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Katon, Wayne, Alfred Berg, Anthony Robins, and Steven Risse. "Depression: Pattern of Medical Utilization and Somatization in Primary Care." In Illness Behavior, 355–64. Boston, MA: Springer US, 1986. http://dx.doi.org/10.1007/978-1-4684-5257-0_27.

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Ticona, Luis. "Health-Care Reform and Its Impact in Medical Reimbursement." In Utilization Management in the Clinical Laboratory and Other Ancillary Services, 1–5. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-34199-6_1.

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Ellmann, R., and R. Laessle. "Social Class and Utilization of Primary Medical Care Services: Class-Specific Patterns of Utilization Behaviour in the Munich Follow-up Study." In Primary Health Care in the Making, 100–104. Berlin, Heidelberg: Springer Berlin Heidelberg, 1985. http://dx.doi.org/10.1007/978-3-642-69977-1_21.

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Alexandre, Pierre Kébreau, M. Christopher Roebuck, Michael T. French, Dale D. Chitwood, and Clyde B. McCoy. "Problem Drinking, Health Services Utilization, and the Cost of Medical Care." In Alcoholism, 285–98. Boston, MA: Springer US, 2002. http://dx.doi.org/10.1007/978-0-306-47193-3_16.

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Petrick, Anthony T., and Stacy A. Brethauer. "Utilization of the Electronic Medical Record to Enhance Value in Bariatric Care." In Quality in Obesity Treatment, 295–300. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-25173-4_30.

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Härtel, U., U. Keil, V. Cairns, A. Döring, and J. Stieber. "Medical Care Utilization and Self-Reported Health of Hypertensives: Results of the Munich Blood Pressure Study." In Primary Health Care in the Making, 456–63. Berlin, Heidelberg: Springer Berlin Heidelberg, 1985. http://dx.doi.org/10.1007/978-3-642-69977-1_89.

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Laessle, R., and R. Ellmann. "Effects of the Social Situation on Health and Utilization of Medical Care Services: Results from the Munich Follow-up Study." In Primary Health Care in the Making, 95–99. Berlin, Heidelberg: Springer Berlin Heidelberg, 1985. http://dx.doi.org/10.1007/978-3-642-69977-1_20.

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Conference papers on the topic "Medical care – Utilization – Benin"

Houngbo, P. T., G. J. v. Wilt, D. Medenou, L. Y. Dakpanon, J. Bunders, and J. Ruitenberg. "Policy and management of medical devices for the public health care sector in Benin." In 5th IET International Seminar on Appropriate Healthcare Technologies for Developing Countries (AHT 2008). IEE, 2008. http://dx.doi.org/10.1049/ic:20080570.

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Story, R., M. Conroy, E. Homsy, J. Johns, K. Patterson, A. Singha, K. Cape, et al. "Reducing Unnecessary Laboratory Utilization in the Medical Intensive Care Unit." In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a1400.

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Chu, Kuo-Chung, and Peng-Hua Jiang. "Visualization Analysis of Medical Resource Utilization for Long-Term Care Services." In 2017 IEEE International Conference on Information Reuse and Integration (IRI). IEEE, 2017. http://dx.doi.org/10.1109/iri.2017.78.

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Song, Myeong Kyeong, Eun Kwang Yoo, and Yeun Mi Kim. "Medical Aid Beneficiaries: Excessive Health Care Utilization Process Experience in Korea." In Healthcare and Nursing 2016. Science & Engineering Research Support soCiety, 2016. http://dx.doi.org/10.14257/astl.2016.128.50.

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Khan, Awaiz, Edmundo Rubio, and Bradley Icard. "Point-of-Care Viscosity Surrogate Measurement Through Utilization of Smartphone Sensors and Custom 3D Printed Design." In 2020 Design of Medical Devices Conference. American Society of Mechanical Engineers, 2020. http://dx.doi.org/10.1115/dmd2020-9004.

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Abstract This project sought to develop a method to provide a clinically meaningful, surrogate measure for viscosity that will help analyze complex biofluids. Goals for this project included precise measurements that differentiate a wide variety of standard viscosities, table-top level of size, and ease-of-use. The design utilized a custom 3D-printed analog of a cone and plate viscometer with an attachment for a smartphone to provide gyroscopic data. The device is currently in the stages of final validation and will ultimately be tested in a 40-patient clinical trial intended to assess efficacy of mucolytic therapy in mechanically ventilated patients.

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Kundel, Harold L., Sridhar B. Seshadri, Bruce Carey, Sheel Kishore, Eric R. Feingold, Peter E. Shile, and Ronald L. Arenson. "Display station utilization in a PACS serving the medical intensive care unit of the Hospital of the University of Pennsylvania." In Medical Imaging VI, edited by R. Gilbert Jost. SPIE, 1992. http://dx.doi.org/10.1117/12.60295.

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Khateeb, D., T. Bekker, N. Zahustecher, L. Tang, J. Stout, U. Vaid, and F. M. West. "Palliative Care Utilization in In-Hospital Cardiac Arrest at an Urban Academic Medical Center." In American Thoracic Society 2019 International Conference, May 17-22, 2019 - Dallas, TX. American Thoracic Society, 2019. http://dx.doi.org/10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a3400.

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Vranas, K. C., J. Y. Scott, M. P. Kerlin, M. S. Chesnutt, D. R. Sullivan, and C. G. Slatore. "Variability in Intensive Care Utilization Among Patients Admitted to VA Medical Centers with Acute Respiratory Failure." In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a2796.

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Vranas, K. C., J. Scott, D. R. Sullivan, M. P. Kerlin, and C. G. Slatore. "Variability in Intensive Care Utilization Among Patients Admitted to VA Medical Centers with Acute Gastrointestinal Bleeding." In American Thoracic Society 2021 International Conference, May 14-19, 2021 - San Diego, CA. American Thoracic Society, 2021. http://dx.doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1678.

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Hart, S., C. Kuntz, and M. Calder. "A Review of Hypothermia Protocol Utilization at Lankenau Medical Center: Would New Measures Improve Quality of Care?" In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a3618.

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Reports on the topic "Medical care – Utilization – Benin"

Currie, Janet, and Jonathan Gruber. Health Insurance Eligibility, Utilization of Medical care, and Child Health. Cambridge, MA: National Bureau of Economic Research, March 1995. http://dx.doi.org/10.3386/w5052.

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Fuchs, Victor, Mark McClellan, and Jonathan Skinner. Area Differences in Utilization of Medical Care and Mortality Among U.S. Elderly. Cambridge, MA: National Bureau of Economic Research, December 2001. http://dx.doi.org/10.3386/w8628.

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Cantor, Jonathan, Neeraj Sood, Dena Bravata, Megan Pera, and Christopher Whaley. The Impact of the COVID-19 Pandemic and Policy Response on Health Care Utilization: Evidence from County-level Medical Claims and Cellphone data. Cambridge, MA: National Bureau of Economic Research, November 2020. http://dx.doi.org/10.3386/w28131.

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Gindi, Renee. Health, United States, 2019. Centers for Disease Control and Prevention (U.S.), 2021. http://dx.doi.org/10.15620/cdc:100685.

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Health, United States, 2019 is the 43rd report on the health status of the nation and is submitted by the Secretary of the Department of Health and Human Services to the President and the Congress of the United States in compliance with Section 308 of the Public Health Service Act. This report was compiled by the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention (CDC). The Health, United States series presents an annual overview of national trends in key health indicators. The 2019 report presents trends and current information on selected measures of morbidity, mortality, health care utilization and access, health risk factors, prevention, health insurance, and personal health care expenditures in a 20-figure chartbook. The Health, United States, 2019 Chartbook is supplemented by several other products including Trend Tables, an At-a-Glance table, and Appendixes available for download on the Health, United States website at: https://www.cdc.gov/nchs/hus/ index.htm. The Health, United States, 2019 Chartbook contains 20 figures and 20 tables on health and health care in the United States. Examining trends in health informs the development, implementation, and evaluation of health policies and programs. The first section (Figures 1–13) focuses on health status and determinants: life expectancy, infant mortality, selected causes of death, overdose deaths, suicide, maternal mortality, teen births, preterm births, use of tobacco products, asthma, hypertension, heart disease and cancer, and functional limitations. The second section (Figures 14–15) presents trends in health care utilization: use of mammography and colorectal tests and unmet medical needs. The third section (Figures 16–17) focuses on health care resources: availability of physicians and dentists. The fourth section (Figures 18–20) describes trends in personal health care expenditures, health insurance coverage, and supplemental insurance coverage among Medicare beneficiaries. The Highlights section summarizes major findings from the Chartbook. Suggested citation: National Center for Health Statistics. Health, United States, 2019. Hyattsville, MD. 2021.

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