Base de dados : MEDLINE
Pesquisa : E02.765 [Categoria DeCS]
Referências encontradas : 336 [refinar]
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[PMID]:29318267
[Au] Autor:Joynt Maddox KE; Orav EJ; Zheng J; Epstein AM
[Ad] Endereço:Washington University School of Medicine, St Louis, Missouri.
[Ti] Título:Participation and Dropout in the Bundled Payments for Care Improvement Initiative.
[So] Source:JAMA;319(2):191-193, 2018 01 09.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Hospitais/estatística & dados numéricos
Medicare/economia
Pacotes de Assistência ao Paciente/economia
Mecanismo de Reembolso/utilização
[Mh] Termos MeSH secundário: Centers for Medicare and Medicaid Services (U.S.)
Modelos Logísticos
Estatísticas não Paramétricas
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.14771


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[PMID]:28453823
[Au] Autor:Borgert M; Binnekade J; Paulus F; Goossens A; Dongelmans D
[Ad] Endereço:Department of Intensive Care Medicine, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
[Ti] Título:A flowchart for building evidence-based care bundles in intensive care: based on a systematic review.
[So] Source:Int J Qual Health Care;29(2):163-175, 2017 Apr 01.
[Is] ISSN:1464-3677
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Purpose: The Institute for Healthcare Improvement is the founder of the care bundled approach and described the methods used on how to develop care bundles. However, other useful methods are published as well. In this systematic review, we identified what different methods were used to design care bundles in intensive care units. The results were used to build a comprehensive flowchart to guide through the care bundle design process. Data sources: Electronic databases were searched for eligible studies in PubMed, EMBASE and CINAHL from January 2001 to August 2014. Study selection: There were no restrictions on the types of study design eligible for inclusion. Methodological quality was assessed by using the Downs & Black-checklist or Appraisal of Guidelines, REsearch and Evaluation II. Data extraction: Data extraction was independently performed by two reviewers. Results of data synthesis: A total of 4665 records were screened and 18 studies were finally included. The complete process of designing bundles was reported in 33% (6/18). In 50% (9/18), one of the process steps was described. A narrative report was written about care bundles in general in 17% (3/18). We built a comprehensive flowchart to visualize and structure the process of designing care bundles. Conclusion: We identified useful methods for designing evidence-based care bundles. We built a comprehensive flowchart to provide an overview of the methods used to design care bundles so that others could choose their own applicable method. It guides through all necessary steps in the process of designing care bundles.
[Mh] Termos MeSH primário: Unidades de Terapia Intensiva/organização & administração
Pacotes de Assistência ao Paciente/métodos
[Mh] Termos MeSH secundário: Prática Clínica Baseada em Evidências/métodos
Seres Humanos
Melhoria de Qualidade/organização & administração
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/intqhc/mzx009


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[PMID]:29391113
[Au] Autor:Losh JM; Gough A; Rutherford R; Romero J; Diaz G; Schweitzer J
[Ad] Endereço:Ventura County Medical Center, Ventura, California, USA.
[Ti] Título:Surgical Site Infection Reduction Bundle: Implementation and Challenges at Ventura County Medical Center.
[So] Source:Am Surg;83(10):1147-1151, 2017 Oct 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Surgical Site Infections (SSIs) are a significant cause of morbidity and increased cost in the postoperative patient occurring in 2-5 per cent of those undergoing inpatient surgery. Ventura County Medical Center (VCMC) initiated an SSI reduction bundle in 2013, to try to reduce the incidence of SSI. The bundle is a series of best practices including preoperative, perioperative, intraoperative, and postoperative components, as well as items focused on the staff and electronic medical record. VCMC started with a 6.1 per cent SSI rate in 2013. A consistent reduction in SSI rate followed each quarter after that for a rate of less than 2.0 per cent in early 2016. The most critical aspect of this process was the necessary collaboration between disparate departments and the ongoing investment of the staff to this challenging process; the people at the heart of the collaborative process were the key to its success.
[Mh] Termos MeSH primário: Pacotes de Assistência ao Paciente
Assistência Perioperatória/métodos
Infecção da Ferida Cirúrgica/prevenção & controle
[Mh] Termos MeSH secundário: California
Seguimentos
Hospitais de Condado
Seres Humanos
Assistência Perioperatória/normas
Guias de Prática Clínica como Assunto
Infecção da Ferida Cirúrgica/epidemiologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE


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[PMID]:29329118
[Au] Autor:Makic MBF; Bridges E
[Ad] Endereço:Mary Beth Flynn Makic is a professor in the College of Nursing at the University of Colorado, Anschutz Medical Campus, Aurora. Elizabeth Bridges is a clinical nurse researcher at the University of Washington Medical Center, Seattle, and a professor in the University of Washington School of Nursing. Contact author: Mary Beth Flynn Makic, marybeth.makic@ucdenver.edu. The authors and planners have disclosed no potential conflicts of interest, financial or otherwise.
[Ti] Título:CE: Managing Sepsis and Septic Shock: Current Guidelines and Definitions.
[So] Source:Am J Nurs;118(2):34-39, 2018 Feb.
[Is] ISSN:1538-7488
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:: Sepsis is a leading cause of critical illness and hospital mortality. Early recognition and intervention are essential for the survival of patients with this syndrome. In 2002, the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM) launched the Surviving Sepsis Campaign (SSC) to reduce overall patient morbidity and mortality from sepsis and septic shock by driving practice initiatives based on current best evidence. The SSC guidelines have been updated every four years, with the most recent update completed in 2016. The new guidelines have increased the focus on early identification of infection, risks for sepsis and septic shock, rapid antibiotic administration, and aggressive fluid resuscitation to restore tissue perfusion.In 2014, the SCCM and the ESICM convened a task force of specialists to reexamine the definitions of terms used to identify patients along the sepsis continuum. In 2016, this task force published the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). The new definitions and recommendations included tools, based on an updated understanding of the pathobiology of sepsis, that can be used to predict adverse outcomes in patients with infection.This article discusses the new SSC treatment guidelines, changes in the sepsis bundle interventions, and the Sepsis-3 definitions and tools, all of which enable nurses to improve patient outcomes through timely collaborative action.
[Mh] Termos MeSH primário: Guias de Prática Clínica como Assunto
Sepse/diagnóstico
Sepse/terapia
Choque Séptico/diagnóstico
Choque Séptico/terapia
[Mh] Termos MeSH secundário: Antibacterianos/uso terapêutico
Cuidados Críticos/normas
Diagnóstico Precoce
Hidratação
Seres Humanos
Pacotes de Assistência ao Paciente
Sociedades Médicas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:180113
[St] Status:MEDLINE
[do] DOI:10.1097/01.NAJ.0000530223.33211.f5


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[PMID]:29327034
[Au] Autor:Wadhera RK; Yeh RW; Joynt Maddox KE
[Ad] Endereço:Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, Massachusetts.
[Ti] Título:The Rise and Fall of Mandatory Cardiac Bundled Payments.
[So] Source:JAMA;319(4):335-336, 2018 01 23.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Ponte de Artéria Coronária/economia
Medicare/economia
Infarto do Miocárdio/economia
Mecanismo de Reembolso
[Mh] Termos MeSH secundário: Centers for Medicare and Medicaid Services (U.S.)
Gastos em Saúde
História do Século XX
História do Século XXI
Medicare/história
Pacotes de Assistência ao Paciente
Mecanismo de Reembolso/história
Estados Unidos
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180131
[Lr] Data última revisão:
180131
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180113
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.19205


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Registro de Ensaios Clínicos
Registro de Ensaios Clínicos
Texto completo
[PMID]:28464867
[Au] Autor:Billah SM; Ferdous TE; Karim MA; Dibley MJ; Raihana S; Moinuddin M; Choudhury N; Ahmed T; Hoque DME; Menon P; Arifeen SE
[Ad] Endereço:Maternal and Child Health Division, icddr,b, 68 Shahid Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh. billah@icddrb.org.
[Ti] Título:A community-based cluster randomised controlled trial to evaluate the effectiveness of different bundles of nutrition-specific interventions in improving mean length-for-age z score among children at 24 months of age in rural Bangladesh: study protocol.
[So] Source:BMC Public Health;17(1):375, 2017 05 02.
[Is] ISSN:1471-2458
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Prevalence of stunting among under-five children in Bangladesh is 36%, varying with geographic and socio-economic characteristics. Previously, research groups statistically modelled the effect of 10 individual nutrition-specific interventions targeting the critical first 1000 days of life from conception, on lives saved and costs incurred in countries with the highest burden of stunted children. However, primary research on the combined effects of these interventions is limited. Our study directly addresses this gap by examining the effect of combinations of 5 preventive interventions on length-for-age z-scores (LAZ) among 2-years old children. METHODS: This community-based cluster randomised trial (c-RCT) compares 4 intervention combinations against one comparison arm. Intervention combinations are: 1) Behaviour change communication (BCC) on maternal nutrition during pregnancy, exclusive breastfeeding, and complementary feeding, along with prenatal nutritional supplement (PNS) and complementary food supplement (CFS); 2) BCC with PNS; 3) BCC with CFS; and 4) BCC alone. The comparison arm receives only routine health and nutrition services. From a rural district, 125 clusters were selected and randomly assigned to any one of the five study arms by block randomisation. A bespoke automated tab-based system was developed linking data collection, intervention delivery and project supervision. Total sample size is 1500 pregnant women, with minimum 1050 resultant children expected to be retained, powered to detect a difference of at least 0.4 in the mean LAZ score of children at 24 months, the main outcome variable, between the comparison arm and each intervention arm. Length and other anthropometric measurements, nutritional intake and other relevant data on mother and children are being collected during enrolment, twice during pregnancy, postpartum monthly till 6 months, and every third month thereafter till 24 months. DISCUSSION: This c-RCT explores the effectiveness of bundles of preventive nutrition intervention approaches addressing the critical window of opportunity to mitigate childhood stunting. The results will provide robust evidence as to which bundle(s) can have significant effect on linear growth of children. Our study also will have policy-level implications for prioritising intervention(s) tackling stunting. TRIAL REGISTRATION: The study was retrospectively registered on May 2, 2016 and is available online at ClinicalTrials.gov (ID: NCT02768181 ).
[Mh] Termos MeSH primário: Suplementos Nutricionais
Transtornos do Crescimento/prevenção & controle
Comportamentos Relacionados com a Saúde
Mães
Pacotes de Assistência ao Paciente
[Mh] Termos MeSH secundário: Antropometria
Bangladesh
Aleitamento Materno
Desenvolvimento Infantil
Pré-Escolar
Feminino
Seres Humanos
Lactente
Fenômenos Fisiológicos da Nutrição do Lactente
Fenômenos Fisiológicos da Nutrição Materna
Estado Nutricional
Gravidez
Projetos de Pesquisa
População Rural
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180121
[Lr] Data última revisão:
180121
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1186/s12889-017-4281-0


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[PMID]:27776899
[Au] Autor:Williams J; Kester BS; Bosco JA; Slover JD; Iorio R; Schwarzkopf R
[Ad] Endereço:Division of Adult Reconstruction, Department of Orthopaedic Surgery, NYU Langone Medical Center, Hospital for Joint Disease, New York, New York.
[Ti] Título:The Association Between Hospital Length of Stay and 90-Day Readmission Risk Within a Total Joint Arthroplasty Bundled Payment Initiative.
[So] Source:J Arthroplasty;32(3):714-718, 2017 03.
[Is] ISSN:1532-8406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To curb the unsustainable rise in health care expenses, health care payers are developing programs to incentivize hospitals and physicians to improve the value of care delivered to patients. Payers are utilizing various metrics, such as length of stay (LOS) and unplanned readmissions, to track progression of quality metrics. Relevant to orthopedic surgeons, the Centers for Medicare and Medicaid Services announced in 2015 the Comprehensive Care for Joint Replacement Payment Model-a program aimed at improving the quality of health care delivered to patients by shifting more of the financial risk of patient care onto providers. METHODS: We analyzed the medical records of 1329 consecutive lower extremity total joint patients enrolled in Centers for Medicare and Medicaid Services' Bundled Program for Care Improvement treated over a 21-month period. The goal of this study was to ascertain if hospital LOS is associated with unplanned readmissions within 90 days of admission for a total hip or knee arthroplasty. RESULTS: After controlling for multiple demographic variables including sex, age, comorbidities and discharge location, we found that hospital LOS greater than 4 days is a significant risk factor for unplanned readmission within 90 days (odd ratio = 1.928, P = .010). Total knee arthroplasty (TKA) and discharge to a location other than home are also independent risk factors for 90-day readmission. CONCLUSION: Our results demonstrate that increased LOS is a significant risk factor for readmission within 90 days of admission for a hip or knee arthroplasty in the Medicare population.
[Mh] Termos MeSH primário: Artroplastia de Quadril/estatística & dados numéricos
Artroplastia do Joelho/estatística & dados numéricos
Tempo de Internação/estatística & dados numéricos
Readmissão do Paciente/estatística & dados numéricos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Gastos em Saúde
Hospitais
Seres Humanos
Masculino
Medicaid
Medicare/economia
Meia-Idade
Razão de Chances
Pacotes de Assistência ao Paciente
Alta do Paciente
Estudos Retrospectivos
Fatores de Risco
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171222
[Lr] Data última revisão:
171222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


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[PMID]:29219922
[Au] Autor:Bolshinsky V; Li MH; Ismail H; Burbury K; Riedel B; Heriot A
[Ad] Endereço:Epworth Healthcare, Melbourne, Australia.
[Ti] Título:Multimodal Prehabilitation Programs as a Bundle of Care in Gastrointestinal Cancer Surgery: A Systematic Review.
[So] Source:Dis Colon Rectum;61(1):124-138, 2018 Jan.
[Is] ISSN:1530-0358
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Prehabilitation reflects a proactive process of preoperative optimization undertaken between cancer diagnosis and definitive surgical treatment, with the intent of improving physiological capacity to withstand the major insult of surgery. Prehabilitation before GI cancer surgery is currently not widely adopted, and most research has focused on unimodal interventions such as exercise therapy, nutritional supplementation, and hematinic optimization. A review of the existing literature was undertaken to investigate the impact of multimodal prehabilitation programs as a "bundle of care." DATA SOURCE: A systematic literature search was performed utilizing Medline, PubMed, Embase, Cinahl, Cochrane, and Google Scholar databases. STUDY SELECTION: The quality of studies was assessed by using the Cochrane tool for assessing risk of bias (randomized trials) and the Newcastle-Ottawa Quality Assessment scale (cohort studies). INTERVENTION: Studies were chosen that involved pre-operative optimization of patients before GI cancer surgery. MAIN OUTCOMES: The primary outcome measured was the impact of prehabilitation programs on preoperative fitness and postoperative outcomes. RESULTS: Of the 544 studies identified, 20 were included in the qualitative analysis. Two trials investigated the impact of multimodal prehabilitation (exercise, nutritional supplementation, anxiety management). Trials exploring prehabilitation with unimodal interventions included impact of exercise therapy (7 trials), impact of preoperative iron replacement (5 trials), nutritional optimization (5 trials), and impact of preoperative smoking cessation (2 trials). Compliance within the identified studies was variable (range: 16%-100%). LIMITATIONS: There is a lack of adequately powered trials that utilize objective risk stratification and uniform end points. As such, a meta-analysis was not performed because of the heterogeneity in study design. CONCLUSION: Although small studies are supportive of multimodal interventions, there are insufficient data to make a conclusion about the integration of prehabilitation in GI cancer surgery as a bundle of care. Larger, prospective trials, utilizing uniform objective risk stratification and structured interventions, with predefined clinical and health economic end points, are required before definitive value can be assigned to prehabilitation programs.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos do Sistema Digestório/reabilitação
Neoplasias Gastrointestinais/diagnóstico
Neoplasias Gastrointestinais/cirurgia
Pacotes de Assistência ao Paciente/métodos
Cuidados Pré-Operatórios/métodos
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171215
[Lr] Data última revisão:
171215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE
[do] DOI:10.1097/DCR.0000000000000987


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[PMID]:29215475
[Au] Autor:Gorgun E; Rencuzogullari A; Ozben V; Stocchi L; Fraser T; Benlice C; Hull T
[Ad] Endereço:Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio.
[Ti] Título:An Effective Bundled Approach Reduces Surgical Site Infections in a High-Outlier Colorectal Unit.
[So] Source:Dis Colon Rectum;61(1):89-98, 2018 Jan.
[Is] ISSN:1530-0358
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Surgical site infections are the most common hospital-acquired infection after colorectal surgery, increasing morbidity, mortality, and hospital costs. OBJECTIVE: The purpose of this study was to investigate the impact of preventive measures on colorectal surgical site infection rates in a high-volume institution that performs inherent high-risk procedures. DESIGN: This was a prospective cohort study. SETTINGS: The study was conducted at a high-volume, specialized colorectal surgery department. PATIENTS: The Prospective Surgical Site Infection Prevention Bundle Project included 14 preoperative, intraoperative, and postoperative measures to reduce surgical site infection occurrence after colorectal surgery. Surgical site infections within 30 days of the index operation were examined for patients during the 1-year period after the surgical site infection prevention bundle was implemented. The data collection and outcomes for this period were compared with the year immediately before the implementation of bundle elements. All of the patients who underwent elective colorectal surgery by a total of 17 surgeons were included. The following procedures were excluded from the analysis to obtain a homogeneous patient population: ileostomy closure and anorectal and enterocutaneous fistula repair. MAIN OUTCOME MEASURES: Surgical site infection occurring within 30 days of the index operation was measured. Surgical site infection-related outcomes after implementation of the bundle (bundle February 2014 to February 2015) were compared with same period a year before the implementation of bundle elements (prebundle February 2013 to February 2014). RESULTS: Between 2013 and 2015, 2250 abdominal colorectal surgical procedures were performed, including 986 (43.8%) during the prebundle period and 1264 (56.2%) after the bundle project. Patient characteristics and comorbidities were similar in both periods. Compliance with preventive measures ranged between 75% and 99% during the bundle period. The overall surgical site infection rate decreased from 11.8% prebundle to 6.6% at the bundle period (P < 0.001). Although a decrease for all types of surgical site infections was observed after the bundle implementation, a significant reduction was achieved in the organ-space subgroup (5.5%-1.7%; P < 0.001). LIMITATION: We were unable to predict the specific contributions the constituent bundle interventions made to the surgical site infection reduction. CONCLUSIONS: The prospective Surgical Site Infection Prevention Bundle Project resulted in a substantial decline in surgical site infection rates in our department. Collaborative and enduring efforts among multiple providers are critical to achieve a sustained reduction See Video Abstract at http://links.lww.com/DCR/A438.
[Mh] Termos MeSH primário: Cirurgia Colorretal/efeitos adversos
Pacotes de Assistência ao Paciente/métodos
Infecção da Ferida Cirúrgica/prevenção & controle
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Unidades Hospitalares/estatística & dados numéricos
Seres Humanos
Masculino
Meia-Idade
Equipe de Assistência ao Paciente
Estudos Prospectivos
Infecção da Ferida Cirúrgica/economia
Infecção da Ferida Cirúrgica/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171215
[Lr] Data última revisão:
171215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.1097/DCR.0000000000000929


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[PMID]:28920658
[Au] Autor:Engelman DT
[Ti] Título:Value-based health care: How to succeed in a bundled care APM.
[So] Source:Bull Am Coll Surg;102(3):24-8, 2017 03.
[Is] ISSN:0002-8045
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Children´s Health Insurance Program/legislação & jurisprudência
Medicare/legislação & jurisprudência
Pacotes de Assistência ao Paciente
Patient Protection and Affordable Care Act
Aquisição Baseada em Valor
[Mh] Termos MeSH secundário: Centers for Medicare and Medicaid Services (U.S.)
Children's Health Insurance Program/economia
Tabela de Remuneração de Serviços/economia
Tabela de Remuneração de Serviços/legislação & jurisprudência
Seres Humanos
Reembolso de Seguro de Saúde/economia
Reembolso de Seguro de Saúde/legislação & jurisprudência
Medicare/economia
Política
Sistema de Pagamento Prospectivo/economia
Sistema de Pagamento Prospectivo/legislação & jurisprudência
Mecanismo de Reembolso/economia
Mecanismo de Reembolso/legislação & jurisprudência
Reembolso de Incentivo/economia
Reembolso de Incentivo/legislação & jurisprudência
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:170919
[St] Status:MEDLINE



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