Asthma Disease Management Demonstration Project:
|
|
- Heather Johnston
- 6 years ago
- Views:
Transcription
1 Asthma Disease Management Demonstration Project: Using EMS Health Coaches May Decrease Emergency Department Revisits, Length of Hospital Admissions and Costs Michael T. Hilton, MD Jan 13, 2012 NAEMSP Annual Meeting Disclosures Employer: UPMC Graduate Medical Education Grants for this study: None Grants provided to CTSI: CTSI contribution was made possible by Grant Number 2UL1 RR from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. The contents of this presentation are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH. Acknowledgements Kelly Close, MD, MPH Christian Martin-Gill, MD, MPH Jonathan Lever, MPH, NREMT-P Dan Swayze, DrPH, MBA, MEMS Melissa Saul and Dennis WIckline of the Clinical and Translational Science Insitute (CTSI) of the University of Pittsburgh 1
2 Approximately million adults in the United States have asthma million people yearly having an acute exacerbation. 2 Annually, asthma accounts for 1.7 million emergency department visits, 456,000 hospitalizations, and 4,000 deaths. Introduction Asthma is primarily patient-controlled Introduction Asthma is primarily patient-controlled - Interpretation of physiological testing peak-flow meter 2
3 Introduction Asthma is primarily patient-controlled - Interpretation of physiological testing - Recognition of disease state early exacerbation Introduction Asthma is primarily patient-controlled - Interpretation of physiological testing - Recognition of disease state - Titration of short term rescue medications -- albuterol Introduction Asthma is primarily patient-controlled - Interpretation of physiological testing - Recognition of disease state - Titration of short term rescue medications Asthma is ideal for patient-focused education intervention 3
4 Asthma Education programs Computer-based self-education programs 4,5 Asthma Education programs Computer-based self-education programs 4,5 Self-education brochures 6 Asthma Education programs Computer-based self-education programs 4,5 Self-education brochures 6 Small groups 7,8 4
5 Asthma Education programs Computer-based self-education programs 4,5 Self-education brochures 6 Small groups 7,8 In-home asthma disease management programs 9-2 Asthma Education programs Computer-based self-education programs 4,5 Self-education brochures 6 Small groups 7,8 In-home asthma disease management programs 9-2 Variable effectiveness Asthma Education programs Computer-based self-education programs 4,5 Self-education brochures 6 Small groups 7,8 In-home asthma disease management programs 9-2 Some have been shown to be cost-effective, others are not cost-effective 5
6 Asthma Education programs Computer-based self-education programs 4,5 Self-education brochures 6 Small groups 7,8 In-home asthma disease management programs 9-2 None of them have been performed by emergency medical service (EMS) providers EMS Providers EMS providers are an under-utilized community-based healthcare workforce EMS providers are accustomed to house calls EMS providers are well-distributed EMS providers are cheap - salaries range from 1/2 to 1/3 those of nurses (median hourly wage $12.54 vs. $26.28) 30 Overhead expenses already covered EMS Providers EMS providers are an under-utilized community-based healthcare workforce EMS providers are increasingly being considered to provide health promotion and disease management programs 31 6
7 Non-traditional EMS roles Promote injury prevention through homebased infant and child safety evaluations, 32 Screen older community members who may be at risk for falls Screen adults in need of vaccinations 32,34 Administer vaccinations 35 Non-traditional EMS roles Promote injury prevention through homebased infant and child safety evaluations, 32 Screen older community members who may be at risk for falls Screen adults in need of vaccinations 32,34 Administer vaccinations 35 However, there is no literature on the use of EMS providers as health coaches for asthma disease management In summary Asthma is ideal for patient-focused education intervention 7
8 In summary No asthma education intervention has been performed by emergency medical service (EMS) providers In summary EMS providers are increasingly being considered to provide health promotion and disease management programs In summary There is no literature on the use of EMS providers as health coaches for asthma disease management 8
9 Purpose and Hypothesis To determine the feasibility and potential impact of using EMS providers as health coaches for patients with asthma We hypothesized that this EMS provider-led intervention would decrease ED visits, hospital admissions, hospital length of stay (LOS), and hospital-related costs Program Description Created by Emed Health in 2005 Based on best practice guidelines Voluntary recruitment of EMS providers who were trained in: - peak-flow meter use - environmental trigger assessment - asthma action plan coordination with the patient s primary care physician - asthma medication instruction - smoking cessation and prescription medication assistance. Program Description Based in Braddock - 35% live below the poverty level - 69% are under-represented minorities 40 Patients were voluntarily recruited after identification via an electronic medical record review after discharge years - Asthma was one of the first three discharge diagnoses - ED visit or admission from July 1, 2005 to April 1, Uninsured or on Medicaid 9
10 Program Description Visit 1 Visit 2 Asthma Management Initial Questionnaire Peak flow meter Asthma Attack Booklet Review peak flow readings Asthma Action Plan Asthma Home Environment Evaluation Trigger Survey Visit 3 Visit 4 Review environmental trigger mitigation strategies Asthma Action Plan Asthma Management Final Questionnaire Smoking cessation program referral Prescription for Prednisone if needed $50 gift certificate Methods Approved by the University of Pittsburgh IRB Retrospective, case-controlled study The study subjects were all patients who completed the intervention by taking part in all four home visits. Matched control cases were initially identified by: - having one ED visit or hospitalization for asthma between July 1, 2005 to April 1, uninsured or Medicaid insurance status - final hospital disposition of being discharged to home Methods Controls were then matched to the intervention participants based on the following criteria in order of priority: - age (within 5 years) - sex, race/ethnicity - marital status, - severity of illness (asthma) using a modified Charlson score. 41,42 10
11 Methods Intervention period - from the first home visit - to the date when all four home visits were completed. Outcome data - collected for any visit to a UPMC hospital for which asthma was one of the top three diagnoses Methods Data was collected - for the six months before the intervention period - for the six months after the the intervention period The data collected included - # of ED visits - # of inpatient admissions - hospital length of stay (LOS) - associated costs Data Analysis A cost analysis compared hospital visits during the time periods - excluded one participant outlier and his control due to the performance of major procedures unrelated to asthma (including pacemaker insertion) during one hospitalization. All data were analyzed by descriptive statistics 11
12 Results 44 people initially screened 24 enrolled in home visits 2 dropped-out and 1 died - one due to lack of interest - one due to having a premature baby - one participant died at seven months of unrelated causes. 21 participants (87.5%) completed the program Results - Demographic characteristics of participants and matched controls Intervention Group Control Group (N=21) (N=21) Age (years, mean) 44.4 ± ± 13.8 Gender (female) 17 (0.81) 17 (0.81) Race -black 12 (0.57) 9 (0.43) -white 9 (0.43) 10 (0.48) -other 0 2 (0.10) Marital Status - single 16 (0.76) 15 (0.71) - married 4 (0.19) 5 (0.24) - unknown 1 (0.05) 1 (0.05) Charleson Score 1.3 ± 0.78, ± 0.78, 1-4 (mean, range Results Before After Change % Change Emergency Department Visits (n) - Study group 16 7 (9) (56.5%) - Control group % Inpatient Hospitalization (n) - Study group % - Control group % Admission Length of Stay (days) - Study group (4) (25.0%) - Control group % Hospital Costs - Study group $28, 272 $13, 969 ($14, 303) (50.6%) - Control group $39,554 $63, 626 $24, % 12
13 Results Before After Change % Change Emergency Department Visits (n) - Study group 16 7 (9) (56.5%) - Control group % Inpatient Hospitalization (n) - Study group % - Control group % Admission Length of Stay (days) - Study group (4) (25.0%) - Control group % Hospital Costs - Study group $28, 272 $13, 969 ($14, 303) (50.6%) - Control group $39,554 $63, 626 $24, % Results Before After Change % Change Emergency Department Visits (n) - Study group 16 7 (9) (56.5%) - Control group % Inpatient Hospitalization (n) - Study group % - Control group % Admission Length of Stay (days) - Study group (4) (25.0%) - Control group % Hospital Costs - Study group $28, 272 $13, 969 ($14, 303) (50.6%) - Control group $39,554 $63, 626 $24, % Results Before After Change % Change Emergency Department Visits (n) - Study group 16 7 (9) (56.5%) - Control group % Inpatient Hospitalization (n) - Study group % - Control group % Admission Length of Stay (days) - Study group (4) (25.0%) - Control group % Hospital Costs - Study group $28, 272 $13, 969 ($14, 303) (50.6%) - Control group $39,554 $63, 626 $24, % 13
14 Results Before After Change % Change Emergency Department Visits (n) - Study group 16 7 (9) (56.5%) - Control group % Inpatient Hospitalization (n) - Study group % - Control group % Admission Length of Stay (days) - Study group (4) (25.0%) - Control group % Hospital Costs - Study group $28, 272 $13, 969 ($14, 303) (50.6%) - Control group $39,554 $63, 626 $24, % Results Before After Change % Change Emergency Department Visits (n) - Study group 16 7 (9) (56.5%) - Control group % Inpatient Hospitalization (n) - Study group % - Control group % Admission Length of Stay (days) - Study group (4) (25.0%) - Control group % Hospital Costs - Study group $28, 272 $13, 969 ($14, 303) (50.6%) - Control group $39,554 $63, 626 $24, % Results Before After Change % Change Emergency Department Visits (n) - Study group 16 7 (9) (56.5%) - Control group % Inpatient Hospitalization (n) - Study group % - Control group % Admission Length of Stay (days) - Study group (4) (25.0%) - Control group % Hospital Costs - Study group $28, 272 $13, 969 ($14, 303) (50.6%) - Control group $39,554 $63, 626 $24, % 14
15 Results The intervention group had Results The intervention group had - fewer ED visits 7 vs. 16 Results The intervention group had - fewer ED visits - a shorter cumulative inpatient LOS 12 days vs. 16 days 15
16 Results The intervention group had - fewer ED visits - a shorter cumulative inpatient LOS - no change in the number of inpatient admission 3 in both periods Results Conversely, the control group had Results Conversely, the control group had increased ED visits 15 vs. 8 16
17 Results Conversely, the control group had increased ED visits increased inpatient LOS 32 days vs. 27 days Discussion Although limited by sample size, this study demonstrates - trend toward decreased ED visits - trend toward decreased hospital admission LOS for visits related to asthma exacerbation - trend toward decreased hospital related costs after completing the EMS-led intervention Discussion The number of admissions was similar between the two groups Suggests that the intervention - may have the greatest influence in decreasing mild to moderate exacerbations - those that lead to outpatient emergency department visits The effect on more severe exacerbations that require admission may be less pronounced 17
18 Discussion Suggests that the intervention helps educate participants on how to more effectively prevent and manage their symptoms - limiting the number of exacerbations that require additional treatment in a healthcare setting Discussion Significant implications for health systems and insurers - EMS provider-led home interventions help to improve the health status of asthma patients postdischarge - EMS provider-led home interventions lower associated health care costs for patients who are often frequent users of health care facilities Discussion Enrolled patients in one hospital system One socioeconomic group Outcome data from one hospital system Low enrollment in the program leading to. - small sample size 18
19 Conclusion This study analyzed a novel intervention utilizing EMS providers as health coaches for a home-based asthma disease management program This study provides preliminary support of the use of EMS providers as health coaches for asthma disease management but additional research is needed Questions? 19
[Type text] Alabama. The Burden of Asthma. Alabama Department of Public Health 201 Monroe Street Montgomery, AL
The Burden of Asthma Alabama 2013 [Type text] Alabama Department of Public Health 201 Monroe Street Montgomery, AL 36104 www.adph.org The Burden of Asthma in Alabama 2013 Alabama Department of Public
More informationDetroit: The Current Status of the Asthma Burden
Detroit: The Current Status of the Asthma Burden Peter DeGuire, Binxin Cao, Lauren Wisnieski, Doug Strane, Robert Wahl, Sarah Lyon Callo, Erika Garcia, Michigan Department of Health and Human Services
More informationEnrollment under the Medicaid Expansion and Health Insurance Exchanges. A Focus on Those with Behavioral Health Conditions in Michigan
Enrollment under the Medicaid Expansion and Health Insurance Exchanges A Focus on Those with Behavioral Health Conditions in Michigan Methods for Estimating Uninsured with M/SU Conditions by FPL From NSDUH,
More informationPrevalence of Mental Illness
Section 1 Prevalence of Mental Illness The prevalence of mental health problems or mental illness appears to be quite stable over time. Full epidemiological surveys of prevalence, reported using complex
More information2016 Community Service Plan & Community Health Improvement Plan
2016 Community Service Plan & Community Health Improvement Plan A.O. Fox Memorial Hospital The Mary Imogene Bassett Hospital (dba: Bassett Medical Center) & Otsego County Health Department Service Area:
More informationTOBACCO TREATMENT INPATIENT QUALITY MEASURES. Kathy Wonderly RN, MSEd, CPHQ Consultant Developed: December 2015
TOBACCO TREATMENT INPATIENT QUALITY MEASURES Kathy Wonderly RN, MSEd, CPHQ Consultant Developed: December 2015 The Joint Commission has included a tobacco treatment measure set in their National Hospital
More informationTrends in Pneumonia and Influenza Morbidity and Mortality
Trends in Pneumonia and Influenza Morbidity and Mortality American Lung Association Epidemiology and Statistics Unit Research and Health Education Division November 2015 Page intentionally left blank Introduction
More informationExecutive Summary To access the report in its entirety, visit
Executive Summary To access the report in its entirety, visit http://www.hpcswf.com/health-planning/health-planningprojects/. Demographic and Socioeconomic Characteristics Population Demographics has a
More informationOptimal Asthma Control Data Specifications
Optimal Asthma Control Data Specifications Final Version December 2009: Updated for Population Identification April 2010 MNCM Measure Description Methodology Rationale Composite measure of the percentage
More informationEvaluation Report ICC Asthma Network Project Integrated Care Collaboration and Seton Family of Hospitals July 2008
Evaluation Report ICC Asthma Network Project Integrated Care Collaboration and Seton Family of Hospitals July 2008 By Anjum Khurshid, PhD Contributors: Steve Conti, Cindy Batcher, Sandy Coe Simmons, &
More information2016 Collier County Florida Health Assessment Executive Summary
2016 Florida Health Assessment Executive Summary Prepared by: The Health Planning Council of Southwest Florida, Inc. www.hpcswf.com Executive Summary To access the report in its entirety, visit http://www.hpcswf.com/health-planning/health-planningprojects/.
More informationOregon Asthma Surveillance Summary Report August 2006
Oregon Asthma Surveillance Summary Report August 26 Oregon Asthma Program Office of Disease Prevention and Epidemiology Public Health Services Oregon Department of Human Services Mel Kohn, MD, MPH, State
More informationState of Iowa Outcomes Monitoring System
State of Iowa Outcomes Monitoring System THE IOWA CONSORTIUM FOR SUBSTANCE ABUSE RESEARCH AND EVALUATION Year 16 Annual Outcome Evaluation Trend Report November 2014 With Funds Provided By: Iowa Department
More informationOutlook and Outcomes Fiscal Year 2011
Baltimore Substance Abuse Systems, Inc. Outlook and Outcomes Fiscal Year 2011 Baltimore City Greg Warren, President Compiled July 2012 BSAS Outlook and Outcomes is the first edition of a planned annual
More information2013 Chronic Respiratory. Program Description. Our mission is to improve the health and quality of life of our members
2013 Chronic Respiratory Program Description Our mission is to improve the health and quality of life of our members Chronic Respiratory Program Description I. Purpose Care Coordination promotes the Plan
More informationTHE IOWA CONSORTIUM FOR SUBSTANCE ABUSE RESEARCH AND EVALUATION. Special Report: Opioid Admissions in Iowa August 2016
Special Report: State of Iowa Opioid Treatment Admissions 21-215 THE IOWA CONSORTIUM FOR SUBSTANCE ABUSE RESEARCH AND EVALUATION Special Report: Opioid Admissions in Iowa 21-215 August 216 With Funds Provided
More informationVoluntary Mental Health Treatment Laws for Minors & Length of Inpatient Stay. Tori Lallemont MPH Thesis: Maternal & Child Health June 6, 2007
Voluntary Mental Health Treatment Laws for Minors & Length of Inpatient Stay Tori Lallemont MPH Thesis: Maternal & Child Health June 6, 2007 Introduction 1997: Nearly 300,000 children were admitted to
More information2012 Chronic Respiratory. Program Evaluation. Our mission is to improve the health and quality of life of our members
2012 Chronic Respiratory Program Evaluation Our mission is to improve the health and quality of life of our members 2012 Chronic Respiratory Program Evaluation Program Title: Chronic Respiratory Program
More informationOMICS International Conferences
About OMICS Group OMICS Group is an amalgamation of Open Access Publications and worldwide international science conferences and events. Established in the year 2007 with the sole aim of making the information
More informationCOMMUNITY ASSESSMENT OF THE OPIOID CRISIS IN LORAIN COUNTY, OHIO EXECUTIVE SUMMARY
COMMUNITY ASSESSMENT OF THE OPIOID CRISIS IN LORAIN COUNTY, OHIO Prepared for The Nord Family Foundation December 20, 2017 Background The impact of the opioid crisis in Lorain County, Ohio is far-reaching
More informationTobacco Treatment Measures KATHY WONDERLY RN, MSED, CPHQ CONSULTANT DEVELOPED: JANUARY 2018
Tobacco Treatment Measures KATHY WONDERLY RN, MSED, CPHQ CONSULTANT DEVELOPED: JANUARY 2018 Background This measure set is required for The Joint Commission participating hospitals only. Tobacco use is
More informationRHODE ISLAND CANCER PREVENTION AND CONTROL
RHODE ISLAND CANCER PREVENTION AND CONTROL 2013 2018 STRATEGIC PLAN TABLE OF CONTENTS Purpose 1 The Partnership to Reduce Cancer 3 Prevention 4 Tobacco 4 Healthy Weight 6 Nutrition 6 Physical Activity
More informationPre-Conception & Pregnancy in Ohio
Pre-Conception & Pregnancy in Ohio Elizabeth Conrey, PhD 1 January 217 1 State Maternal and Child Health Epidemiologist, Ohio Department of Health EXECUTIVE SUMMARY The primary objective of the analyses
More informationTruth or Consequences: Making Choices that Impact Patient Care C A L G A R Y A P R I L
Truth or Consequences: Making Choices that Impact Patient Care C A L G A R Y A P R I L 2 0 1 4 FINANCIAL INTEREST DISCLOSURE (OVER THE PAST 24 MONTHS) Dr. R. G. McFadden I have no conflict of interest.
More informationState of Iowa Outcomes Monitoring System
State of Iowa Outcomes Monitoring System THE IOWA CONSORTIUM FOR SUBSTANCE ABUSE RESEARCH AND EVALUATION Year 17 Annual Outcome Evaluation Trend Report November 2015 With Funds Provided By: Iowa Department
More informationREHABILITATION UNIT ANNUAL OUTCOMES REPORT Prepared by
REHABILITATION UNIT ANNUAL OUTCOMES Prepared by REPORT - 2014 Keir Ringquist, PT, PhD, GCS Rehabilitation Program Manager Director of Occupational and Physical Therapy DEMOGRAPHICS OF THE REHABILITATION
More informationWHAT FACTORS INFLUENCE AN ANALYSIS OF HOSPITALIZATIONS AMONG DYING CANCER PATIENTS? AGGRESSIVE END-OF-LIFE CANCER CARE. Deesha Patel May 11, 2011
WHAT FACTORS INFLUENCE HOSPITALIZATIONS AMONG DYING CANCER PATIENTS? AN ANALYSIS OF AGGRESSIVE END-OF-LIFE CANCER CARE. Deesha Patel May 11, 2011 WHAT IS AGGRESSIVE EOL CARE? Use of ineffective medical
More informationEmergency Department Visits for Behavioral Health Conditions in Harris County, Texas,
Emergency Department Visits for Behavioral Health Conditions in Harris County, Texas, 2007-2008 Prepared by School of Public Health UT Health Patrick Courtney, MA August 2010 1 Table of Contents Executive
More informationHIV/AIDS Bureau Update
HIV/AIDS Bureau Update Ryan White HIV/AIDS Program Clinical Conference New Orleans, LA December 15, 2015 Laura Cheever, MD, ScM Associate Administrator Department of Health and Human Services Health Resources
More informationChristopher Okunseri, BDS, MSc, MLS, DDPHRCSE, FFDRCSI, Elaye Okunseri, MBA, MSHR, Thorpe JM, PhD., Xiang Qun, MS.
Dental Health Services Research Team Christopher Okunseri, BDS, MSc, MLS, DDPHRCSE, FFDRCSI, Elaye Okunseri, MBA, MSHR, Thorpe JM, PhD., Xiang Qun, MS., Aniko Szabo, PhD Research Support: National Institute
More informationLack of documentation on overweight & obese status in patients admitted to the coronary care unit: Results from the CCU study
Lack of documentation on overweight & obese status in patients admitted to the coronary care unit: Results from the CCU study Meriam F. Caboral,, RN, MSN, NP-C Clinical Coordinator Heart Failure Components
More informationAchieving Quality and Value in Chronic Care Management
The Burden of Chronic Disease One of the greatest burdens on the US healthcare system is the rapidly growing rate of chronic disease. These statistics illustrate the scope of the problem: Nearly half of
More information2012 PENNSYLVANIA ASTHMA BURDEN REPORT
2012 PENNSYLVANIA ASTHMA BURDEN REPORT Table Of Contents Introduction ----------------------------------------------------------------------------------------------------1 Methodology---------------------------------------------------------------------------------------------------2
More informationWelcome and Texas DSHS Overview
Welcome and Texas DSHS Overview July 24, 2015 Heart Attack and Stroke Systems of Care Summit: A Focus on Quality Improvement through the Texas Heart Attack and Stroke Data Collection Initiative Disclosure
More informationIdentifying Adult Mental Disorders with Existing Data Sources
Identifying Adult Mental Disorders with Existing Data Sources Mark Olfson, M.D., M.P.H. New York State Psychiatric Institute Columbia University New York, New York Everything that can be counted does not
More informationDUPLICATION DISTRIBUTION PROHIBBITED AND. Utilizing Economic and Clinical Outcomes to Eliminate Health Disparities and Improve Health Equity
General Session IV Utilizing Economic and Clinical Outcomes to Eliminate Health Disparities and Improve Health Equity Accreditation UAN 0024-0000-12-012-L04-P Participation in this activity earns 2.0 contact
More informationSenior Leaders and the Strategic Alignment of Community Benefit Programs: The Example of Diabetes
Senior Leaders and the Strategic Alignment of Community Benefit Programs: The Example of Diabetes Posted: February 17, 2009 By Patsy Matheny, Community Benefit Consultant. Sugar Grove, Ohio Moving community
More informationPerformance Analysis:
Performance Analysis: Healthcare Utilization of CCNC- Population 2007-2010 Prepared by Treo Solutions JUNE 2012 Table of Contents SECTION ONE: EXECUTIVE SUMMARY 4-5 SECTION TWO: REPORT DETAILS 6 Inpatient
More informationKENT BISHOP M.D. ProMedica Chief Experience Officer President Women s Service Line
KENT BISHOP M.D. ProMedica Chief Experience Officer President Women s Service Line 1 WHEN A VISION TAKES SHAPE. 2 3 4 Modern Facilities Clinical Service Lines Quality/ Safety Mental Health Clinical Research
More informationNew Brunswick Influenza Activity Summary Report: season (Data from August 30,2015 to June 4,2016)
New Brunswick Influenza ctivity Summary Report: - season (Data from ugust 30, to June 4,) Highlights of the - Influenza season: This season, we experienced later influenza activity than expected. This
More informationChild & Adolescent Mental Health Services Databook, FY08-09
Clients Receiving County- Unique clients funded Mental Health Services 17,779 ANASAZI CLIENTS, Q2-4 ONLY 15,179 Age Unique clients % Living Arrangement* Unique clients % Age 0 to 5 1,907 10.7% House or
More informationHospital Discharge Data
Hospital Discharge Data West Virginia Health Care Authority Hospitalization data were obtained from the West Virginia Health Care Authority s (WVHCA) hospital discharge database. Data are submitted by
More informationEffectiveness of a Multidisciplinary Patient Assistance Program in Diabetes Care
University of Rhode Island DigitalCommons@URI Senior Honors Projects Honors Program at the University of Rhode Island 2009 Effectiveness of a Multidisciplinary Patient Assistance Program in Diabetes Care
More informationONLINE DATA SUPPLEMENT - ASTHMA INTERVENTION PROGRAM PREVENTS READMISSIONS IN HIGH HEALTHCARE UTILIZERS
R2 (REVISED MANUSCRIPT BLUE 200208-877OC) ONLINE DATA SUPPLEMENT - ASTHMA INTERVENTION PROGRAM PREVENTS READMISSIONS IN HIGH HEALTHCARE UTILIZERS Mario Castro, M.D., M.P.H. Nina A. Zimmermann R.N. Sue
More information2017 Chronic Respiratory. Program Evaluation. Our mission is to improve the health and quality of life of our members
2017 Chronic Respiratory Program Evaluation Our mission is to improve the health and quality of life of our members 2017 Chronic Respiratory Program Evaluation Program Title: Chronic Respiratory Program
More informationRisk Mitigation in Bundled Payment
Risk Mitigation in Bundled Payment When to Hold Them and When To Fold Them Lily Pazand, MPH NYU Langone Medical Center Jonathan Pearce, MBA, CPA, FHFMA Singletrack Analytics Jessica Walradt, MS Association
More informationMaternal Substance Abuse: Challenges & Opportunities for Perinatal Nurses Catherine H. Ivory, PhD, RNC-OB October, 2015
Maternal Substance Abuse: Challenges & Opportunities for Perinatal Nurses Catherine H. Ivory, PhD, RNC-OB October, 2015 Objectives Discuss the current scope of maternal substance use and abuse List examples
More informationOBSERVATION UNIT ASTHMA PATHWAY OUTLINE Westmoreland Hospital PAGE 1 OF 5
PAGE 1 OF 5 Exclusion Criteria: (Reason to admit to hospital) A. New EKG changes except sinus tachycardia B. Respiratory Rate > 40 C. Signs/symptoms of Heart Failure D. Impending respiratory failure or
More informationCompeting Risks: Implications for Readmission Policy
Competing Risks: Implications for Readmission Policy KAREN E. JOYNT, MD, MPH HARVARD SCHOOL OF PUBLIC HEALTH, BRIGHAM AND WOMEN S HOSPITAL, AND VA BOSTON HEALTHCARE SYSTEM NATIONAL HEALTH POLICY FORUM,
More informationHuangdao People's Hospital
Table of contents 1. Background... 3 2. Integrated care pathway implementation... 6 (1) Workload indicators... 6 A. In eligible for care pathway... 6 B. Care pathway implementation... 7 (2) Outcome indicators...
More informationA COMPREHENSIVE REPORT ISSUED BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS IN PARTNERSHIP WITH:
A COMPREHENSIVE REPORT ISSUED BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS IN PARTNERSHIP WITH: Amputee Coalition of America Mended Hearts National Federation of the Blind National Kidney Foundation
More informationPHACS County Profile Report for Searcy County. Presented by: Arkansas Center for Health Disparities and Arkansas Prevention Research Center
PHACS County Profile Report for Searcy County Presented by: Arkansas Center for Health Disparities and Arkansas Prevention Research Center Contents Introduction... Page 2 Demographics...Page 3 Social Environment
More informationIdentifying Geographic & Socioeconomic Disparities in Access to Care for Pediatric Cancer Patients in Texas
Identifying Geographic & Socioeconomic Disparities in Access to Care for Pediatric Cancer Patients in Texas Mary T. Austin, MD, MPH Assistant Professor, Pediatric Surgery University of Texas Health Science
More informationRESULTS OF A STUDY ON IMMUNIZATION PERFORMANCE
INFLUENZA VACCINATION: PEDIATRIC PRACTICE APPROACHES * Sharon Humiston, MD, MPH ABSTRACT A variety of interventions have been employed to improve influenza vaccination rates for children. Overall, the
More informationThe Burden of Asthma in Mississippi:
The Burden of Asthma in Mississippi: 2009 Asthma Surveillance Summary Report April 2009 The Burden of Asthma in Mississippi: 2009 Asthma Surveillance Summary Report Haley Barbour Governor F.E. Thompson,
More informationCenter for Respiratory and Sleep Medicine COPD Chronic Disease Management Program
Center for Respiratory and Sleep Medicine COPD Chronic Disease Management Program Cristina Ashworth, NP Khalil Diab,MD Center for Respiratory and Sleep Medicine Subgroup of Indiana Internal Medicine Consultants
More informationBACKGROUND WILSON COUNTY SOTCH REPORT DEMOGRAPHICS (Source: Commerce Economic Development)
WILSON COUNTY SOTCH REPORT 2012 BACKGROUND The 2012 State of The County Health Report is a review of community health priorities that were established during the last Community Health Assessment (CHA)
More informationComparative Analysis of Individuals With and Without Chiropractic Coverage Patient Characteristics, Utilization, and Costs
Comparative Analysis of Individuals With and Without Chiropractic Coverage Patient Characteristics, Utilization, and Costs 1 Archives of Internal Medicine. October 11, 2004;164:1985-1992 Antonio P. Legorreta,
More informationFrom Jail to Peer Counselor: HIV Educator Training Increases HIV Testing
From Jail to Peer Counselor: HIV Educator Training Increases HIV Testing Skye Ross, LMSW, MPH Alison O Jordan, LCSW Randi Sinnreich, LMSW Allison Dansby, LMSW Presenter Disclosures Skye Dina Ross (1) The
More informationPREGNANCY SMOKING AND CHILD OUTCOMES FROM BIRTH TO 15 MONTHS: FINDINGS FROM NORTHEAST TENNESSEE. Beth Bailey, PhD
PREGNANCY SMOKING AND CHILD OUTCOMES FROM BIRTH TO 15 MONTHS: FINDINGS FROM NORTHEAST TENNESSEE Beth Bailey, PhD Associate Professor of Family Medicine, East Tennessee State University Associate Director
More informationHEALTH DISPARITIES AMONG ADULTS IN OHIO
OHIO MEDICAID ASSESSMENT SURVEY 2012 Taking the pulse of health in Ohio HEALTH DISPARITIES AMONG ADULTS IN OHIO Amy K. Ferketich, PhD 1 Ling Wang, MPH 1 Timothy R. Sahr, MPH, MA 2 1The Ohio State University
More informationThe Camden Coalition of Healthcare Providers Approach to Risk Stratified Care Management
Camden Coalition of Healthcare Providers Camden Coalition of Healthcare Providers The Camden Coalition of Healthcare Providers Approach to Risk Stratified Care Management Presentation by: Kennen S. Gross,
More informationAsthma Burden. in the C HILDREN S H EALTH I NSURANCE PROGRAM Population. Asthma Control Program Pennsylvania Asthma Surveillance System
Asthma Burden in the C HILDREN S H EALTH I NSURANCE PROGRAM Population Asthma Control Program Pennsylvania Asthma Surveillance System TABLE OF CONTENTS Introduction...1 Methodology...2 Summary...3 Figure
More informationObjectives. Health Disparities: Objectives. Health Disparities. Health Disparities. Health Disparities 10/13/2014
: Why Zip Code Matters Christy Eskes, DHSc, MPA, PA-C October 12, 2014 Differences in health outcomes across segments of the population Substantial disparities in health, life expectancy, and quality of
More informationPatterns of Hospital Admissions and Readmissions Among HIV-Positive Patients in Southwestern Pennsylvania
Patterns of Hospital Admissions and Readmissions Among HIV-Positive Patients in Southwestern Pennsylvania Keith T. Kanel, MD, MHCM, FACP Colleen Vrbin Susan Elster, PhD Jason Kunzman, MBA Michelle Murawski,
More informationHEALTH CARE EXPENDITURES ASSOCIATED WITH PERSISTENT EMERGENCY DEPARTMENT USE: A MULTI-STATE ANALYSIS OF MEDICAID BENEFICIARIES
HEALTH CARE EXPENDITURES ASSOCIATED WITH PERSISTENT EMERGENCY DEPARTMENT USE: A MULTI-STATE ANALYSIS OF MEDICAID BENEFICIARIES Presented by Parul Agarwal, PhD MPH 1,2 Thomas K Bias, PhD 3 Usha Sambamoorthi,
More informationStatewide Statistics and Key Findings 1
% s, 30 Days PHC4 s for Same Condition Jan 03 through Aug 04 Data Statewide information about readmissions and the key findings of this report are presented in this section. The study examines hospitalizations
More informationTHE BURDEN OF ASTHMA IN WEST VIRGINIA
THE BURDEN OF ASTHMA IN WEST VIRGINIA Bob Wise Governor Paul L. Nusbaum, Secretary Department of Health and Human Resources Chris Curtis, M.P.H. Acting Commissioner, Bureau for Public Health Catherine
More informationEpidemics of Obesity in the United States
Epidemics of Obesity in the United States Obesity: A Modern Epidemic It has recently become obvious that the prevalence of obesity has been rapidly increasing in the United States Obesity is definitely
More informationReducing COPD Exacerbation Readmissions in a Community-Based Teaching Hospital
Reducing COPD Exacerbation Readmissions in a Community-Based Teaching Hospital Dawn Waddell, PharmD, BCPS Clinical Pharmacy Manager Lisa Kingdon, PharmD, BCPS Clinical Pharmacy Specialist Dawn Waddell
More informationExhibit I-1 Performance Measures. Numerator (general description only)
# Priority Type Performance Measure Core Measures (implement 9/1/09) 1 C OE Hospital readmissions within 7, 30 and 90 days postdischarge 2 C OE Percent of Members prescribed redundant or duplicated antipsychotic
More informationAge as a Predictor of Functional Outcome in Anoxic Brain Injury
Age as a Predictor of Functional Outcome in Anoxic Brain Injury Mrugeshkumar K. Shah, MD, MPH, MS Samir Al-Adawi, PhD David T. Burke, MD, MA Department of Physical Medicine and Rehabilitation, Spaulding
More informationProject 3dii: Expansion of the Home Environmental Asthma Management Program
1 Project 3dii: Expansion of the Home Environmental Asthma Management Program Asthma Primary Care Project Participation Opportunity Purpose 2 This Project Participation Opportunity is specifically targeted
More informationApproved Care Model for Project 3dii: Expansion of the Home Environmental Asthma Management Program
1 Approved Care Model for Project 3dii: Expansion of the Home Environmental Asthma Management Program OneCity Health Webinar January 6, 2016 Overview of presentation 2 Approach to care model development
More informationPublic Health. In 2006, 23% of births were to mothers between the ages of 15 and 19. This is a decline from 25% in 2001.
Public Health In 2006, 23% of births were to mothers between the ages of 15 and 19. This is a decline from 25% in 2001. Eleven percent of children born in 2006 had a low birth weight (< 2,500 grams or
More informationCounty Health Rankings Baldwin County 2016 Graphics of County Health Rankings Include All Counties In the North Central Health District
Health Rankings Baldwin 2016 Graphics of Health Rankings Include All Counties In the North Central Health District Public Health for Middle Georgia Serving Baldwin, Bibb, Crawford, Hancock, Houston, Jasper,
More informationTobacco Health Cost in Egypt
1.Introduction 1.1 Overview Interest in the health cost of smoking originates from the desire to identify the economic burden inflicted by smoking on a society. This burden consists of medical costs plus
More informationAntithrombotics: Percent of patients with an ischemic stroke or TIA prescribed antithrombotic therapy at discharge. Corresponding
Get With The Guidelines -Stroke is the American Heart Association s collaborative performance improvement program, demonstrated to improve adherence to evidence-based care of patients hospitalized with
More informationLearning and Earning with Gateway Professional Education CME/CEU Webinar Series. Pediatric Asthma: Assessment & Control August 2, :00pm 1:00pm
Learning and Earning with Gateway Professional Education CME/CEU Webinar Series Pediatric Asthma: Assessment & Control August 2, 2017 12:00pm 1:00pm Allyson S. Larkin, MD Assistant Professor of Pediatrics
More informationIntegrated Diabetes Oncology Care
Integrated Diabetes Oncology Care Janelle Sharma, DNP, CRNP Dr. Gregory Harper Cara Habeck, RN CDE Cathy Coyne, PHD Roya Hamadani, MPH Hope Kincaid, MS Ada Rivera, MBA Dr. Gretchen Perilli Dr. Nicole Sully
More informationThe links between physical health in mental health
The links between physical health in mental health A holistic approach to managing mental and physical health is needed. Physical and mental health are inextricably linked 1 What is the problem? It is
More informationImmunization Safety Office: Overview and Considerations on Safety of Alternative Immunization Schedules
Immunization Safety Office: Overview and Considerations on Safety of Alternative Immunization Schedules Frank DeStefano MD, MPH Immunization Safety Office Division of Healthcare Quality Promotion, National
More informationGeriatric Emergency Management PLUS Program Costing Analysis at the Ottawa Hospital
Geriatric Emergency Management PLUS Program Costing Analysis at the Ottawa Hospital Regional Geriatric Program of Eastern Ontario March 2015 Geriatric Emergency Management PLUS Program - Costing Analysis
More informationPalliative Care: A Business Analysis of the Pros and Cons of Establishing a Palliative Care Program
1 Palliative Care: A Business Analysis of the Pros and Cons of Establishing a Palliative Care Program Daniel Maison, MD Larry Oberst, CPA Spectrum Health 2 Faculty Information Daniel Maison, MD FAAHPM
More informationCounty Health Rankings Monroe County 2016
Health Rankings Monroe 2016 Graphics of Health Rankings Include All Counties In the North Central Health District Public Health for Middle Georgia Serving Baldwin, Bibb, Crawford, Hancock, Houston, Jasper,
More informationPredictors of Rehospitalization After Admission for Pneumonia in the Veterans Affairs Healthcare System
ORIGINAL RESEARCH Predictors of Rehospitalization After Admission for Pneumonia in the Veterans Affairs Healthcare System Victoria L. Tang, MD 1,2, Ethan A. Halm, MD, MPH 2, Michael J. Fine, MD, MSc 3,
More informationSKIN CANCER SCREENING AT UPMC. Laura K. Ferris, MD, PhD Associate Professor of Dermatology
SKIN CANCER SCREENING AT UPMC Laura K. Ferris, MD, PhD Associate Professor of Dermatology UPMC Largest health care system in Western PA 21+ hospitals with >5,100 licensed beds More than 500 outpatient
More informationExploring the Relationship Between Substance Abuse and Dependence Disorders and Discharge Status: Results and Implications
MWSUG 2017 - Paper DG02 Exploring the Relationship Between Substance Abuse and Dependence Disorders and Discharge Status: Results and Implications ABSTRACT Deanna Naomi Schreiber-Gregory, Henry M Jackson
More informationSUMMARY OF STUDIES: MEDICAID / HEALTH SERVICES UTILIZATION AND COSTS
SUMMARY OF STUDIES: MEDICAID / HEALTH SERVICES UTILIZATION AND COSTS Studies Pertaining to Homeless People in Hospital Settings: City / State Study / Program Description Health Utilization Impact of Housing
More informationClasses and Quitlines and Patches, Oh My! Tobacco Use Why it is Your Business. Deirdre Sullivan, Health Educator
Classes and Quitlines and Patches, Oh My! Tobacco Use Why it is Your Business Deirdre Sullivan, Health Educator Why Tobacco? Smoking is the leading cause of preventable death and disability in the United
More informationVirginia s Health 2017
Virginia s Health 2017 Marissa J. Levine, MD, MPH, FAAFP Virginia State Health Commissioner The Virginia Department of Health HAC Health & Human Resources Subcommittee Overview Virginian s Health Status
More informationLongitudinal Care Management. September 2016
Longitudinal Care Management September 2016 Risk Score Assignment of Longitudinal CM Other C M Referral sources Screening: Need CM? Clinical Assessment tools Program Services Integrated Care Management
More informationDisclosures. Preventing Heart Failure Re-admissions in Deaths Due to Cardiovascular Disease (United States: ) Heart Failure
29 th Annual Cardiology for Clinicians Spring Symposium Workshop #3 Alumni Hallway, Northeastern Conference Room, 1-9525 Thursday, May 5, 2016 Preventing Heart Failure Re-admissions in 2016 Leway Chen,
More informationIssue Brief. Eliminating Adult Dental Benefits in Medi-Cal: An Analysis of Impact. Introduction. Background
Eliminating Adult Dental Benefits in Medi-Cal: An Analysis of Impact Introduction In 2009, California eliminated non-emergency dental services for adults in its Medicaid program, Medi-Cal. The California
More informationHistory 10/6/2015. National Conference on Tackling Tobacco Use in Vulnerable Populations
National Conference on Tackling Tobacco Use in Vulnerable Populations National SelfMade Health Network (SMHN) Dwana Dee Calhoun, MS-Director October 5-6, 2015 Bethesda, Maryland History One of a consortium
More informationPREVENTATIVE COMMUNITY PHARMACY DIABETES MANAGEMENT PROGRAMS BROOKE HUDSPETH, PHARMD, CDE, MLDE KROGER DIABETES CARE
PREVENTATIVE COMMUNITY PHARMACY DIABETES MANAGEMENT PROGRAMS BROOKE HUDSPETH, PHARMD, CDE, MLDE KROGER DIABETES CARE DISCLOSURE STATEMENT Brooke Hudspeth is employed by The Kroger Co. No other conflicts
More informationBaltimore City Public Schools Health Plan Comparison Chart Benefits Effective January 1, 2017
HOSPITAL INPATIENT SERVICES Baltimore City Public Schools Health Plan Comparison Chart Benefits Effective January 1, 2017 About this chart: This chart is to be used as a guide only and does not contain
More informationRegional Health Connectors
Regional Health Connectors SIM LPHA Grantee Kick-Off Meeting September 19, 2016 Sarah Lampe Colorado Foundation for Public Health and the Environment Ashlie Brown Colorado Health Institute 1 The Project
More informationImproving Women s Health Through the Prevention and Control of Chronic Disease
Improving Women s Health Through the Prevention and Control of Chronic Disease Pamela Protzel Berman, MPH, Doctoral Candidate Deputy Director Division of Cancer Prevention and Control, CDC December 10,
More informationPeer Support Services Improve Clinical Outcomes by Fostering Recovery and Promoting Empowerment
Peer Support Services Improve Clinical Outcomes by Fostering Recovery and Promoting Empowerment Optum has recognized the role of peer support services as an integral part of state Medicaid plans and has
More information