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[PMID]:29194142
[Ti] Título:Connected Health 2015: The Year of Virtual Patient Visits.
[So] Source:Nurs Educ Perspect;36(2):131-133, 2015 Mar/Apr.
[Is] ISSN:1536-5026
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Internet
Visita a Consultório Médico/tendências
Telemedicina/métodos
Telemedicina/tendências
Interface Usuário-Computador
Realidade Virtual
[Mh] Termos MeSH secundário: Previsões
Seres Humanos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE


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[PMID]:29296141
[Au] Autor:Olorunsaiye CZ; Langhamer MS; Wallace AS; Watkins ML
[Ad] Endereço:Global Immunization Division, Centers for Disease Control and Prevention, Atlanta 30329, GA, USA.
[Ti] Título:Missed opportunities and barriers for vaccination: a descriptive analysis of private and public health facilities in four African countries.
[So] Source:Pan Afr Med J;27(Suppl 3):6, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:eng
[Ab] Resumo:Introduction: Missed opportunities and barriers to vaccination limit progress toward achieving high immunization coverage and other global immunization goals. Little is known about vaccination practices contributing to missed opportunities and barriers among private healthcare providers in Africa. Methods: Service Provision Assessments (SPA) of representative samples of health facilities in four African countries (Kenya, Tanzania, Senegal, Malawi) in 2010-2015 were used to describe missed opportunities and barriers for vaccination in public, private for-profit, private not-for-profit and faith-based facilities. Data included vaccination practices, observations during sick child and antenatal visits, and exit interviews following sick child visits. Results: Data from 3,219 health facilities, 11,613 sick child visits and 8,698 antenatal visits were included. A smaller proportion of for-profit facilities offered child vaccination services (country range, 25-37%) than did public facilities (range, 90-96%). The proportion of facilities offering pentavalent vaccine (diphtheria, pertussis, tetanus, hepatitis B and type b antigens) daily ranged 0-77% across countries and facility types. Less than 33% of for-profit facilities in any country offered measles vaccination daily. A minority of public or private providers assessed the child's vaccination status during a sick child visit (range by country and facility type, 14-44%), or offered tetanus toxoid during antenatal visits (range, 19-51%). Very few providers discussed the importance of newborn vaccination. Conclusion: Substantial missed opportunities for, and barriers to, vaccination were identified across this representative sample of health facilities in four African countries. Strategies are needed to ensure that private and public providers implement practices to minimize barriers and missed opportunities for vaccination.
[Mh] Termos MeSH primário: Assistência à Saúde/estatística & dados numéricos
Instalações de Saúde/estatística & dados numéricos
Vacinação/estatística & dados numéricos
Vacinas/administração & dosagem
[Mh] Termos MeSH secundário: África
Criança
Seres Humanos
Visita a Consultório Médico/estatística & dados numéricos
Cobertura Vacinal
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Vaccines)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.supp.2017.27.3.12083


  3 / 6273 MEDLINE  
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[PMID]:28463879
[Au] Autor:Long LC; Maskew M; Brennan AT; Mongwenyana C; Nyoni C; Malete G; Sanne I; Fox MP; Rosen S
[Ad] Endereço:aDepartment of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand bHealth Economics and Epidemiology Research Office, Wits Health Consortium, Johannesburg, South Africa cDepartment of Global Health dDepartment of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA.
[Ti] Título:Initiating antiretroviral therapy for HIV at a patient's first clinic visit: a cost-effectiveness analysis of the rapid initiation of treatment randomized controlled trial.
[So] Source:AIDS;31(11):1611-1619, 2017 Jul 17.
[Is] ISSN:1473-5571
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Determine the cost and cost-effectiveness of single-visit (same-day) antiretroviral treatment (ART) initiation compared to standard of care initiation. DESIGN: Cost-effectiveness analysis of individually randomized (1 : 1) pragmatic trial of single-visit initiation, which increased viral suppression at 10 months by 26% [relative risk (95% confidence interval) 1.26 (1.05-1.50)]. SETTING: Primary health clinic in Johannesburg, South Africa. STUDY PARTICIPANTS: HIV positive, adult, nonpregnant patients not yet on ART or known to be eligible who presented at the clinic 8 May 2013 to 29 August 2014. INTERVENTION: Same-day ART initiation using point-of-care laboratory instruments and accelerated clinic procedures to allow treatment-eligible patients to receive antiretroviral medications at the same visit as testing HIV positive or having an eligible CD4 cell count. Comparison was to standard of care ART initiation, which typically required three to five additional clinic visits. MAIN OUTCOME MEASURE(S): Average cost per patient enrolled and per patient achieving the primary outcome of initiated 90 days or less and suppressed 10 months or less, and production cost per patient achieving primary outcome (all costs per primary outcome patients). RESULTS: The average cost per patient enrolled, per patient achieving the primary outcome, and production cost were $319, $487, and $738 in the standard arm and $451, $505, and $707 in the rapid arm. CONCLUSION: Same-day treatment initiation was more effective than standard initiation, more expensive per patient enrolled, and less expensive to produce a patient achieving the primary outcome. Omitting point-of-care laboratory tests at initiation and focusing on high-volume clinics have the potential to reduce costs substantially and should be evaluated in routine settings.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/administração & dosagem
Fármacos Anti-HIV/economia
Infecções por HIV/tratamento farmacológico
Infecções por HIV/economia
Visita a Consultório Médico/economia
Testes Imediatos
Atenção Primária à Saúde
[Mh] Termos MeSH secundário: Assistência Ambulatorial/economia
Assistência Ambulatorial/métodos
Contagem de Linfócito CD4
Análise Custo-Benefício
Infecções por HIV/imunologia
Seres Humanos
Testes Imediatos/economia
Atenção Primária à Saúde/economia
África do Sul
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRAGMATIC CLINICAL TRIAL; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anti-HIV Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180202
[Lr] Data última revisão:
180202
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1097/QAD.0000000000001528


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[PMID]:25816377
[Au] Autor:Ajiboye F; Dong F; Moore J; Kallail KJ; Baughman A
[Ad] Endereço:Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita, KS, USA.
[Ti] Título:Effects of revised consultation room design on patient-physician communication.
[So] Source:HERD;8(2):8-17, 2015.
[Is] ISSN:1937-5867
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the impact of a revised consultation room design on patient-physician interaction in an outpatient setting. BACKGROUND: The growth of ambulatory medical care makes outpatient facilities the primary point of health care contact for many Americans. However, the outpatient consultation room design remains largely unchanged, despite its increased use and the adoption of technology-mediated information sharing in clinical encounter. METHODS: A randomized controlled trial used a postvisit questionnaire to assess six domains of interest (satisfaction with the visit and the consultation room, mutual respect, patient trust in the physician, communication quality, people-room interaction, and interpersonal-room interaction) in two different room designs (a traditional room and an experimental room in which a pedestal table had replaced the examination table). RESULTS: Interpersonal-room interaction was enhanced in the experimental consultation room when compared to the traditional consultation room (p = .0038). Participants in the experimental consultation room had better access to the computer screen, increased provider information sharing, and more time engaging providers in conversation about information on the monitor. CONCLUSIONS: Changing the layout of a consultation room has the potential to improve interpersonal communication through better information sharing. Clinicians who are interested in maximizing the benefits of their clinical encounter should consider changing the layout of their consultation room, especially the positioning of the computer screen.
[Mh] Termos MeSH primário: Instituições de Assistência Ambulatorial
Decoração de Interiores e Mobiliário
Visita a Consultório Médico
Satisfação do Paciente/estatística & dados numéricos
Assistência Centrada no Paciente/organização & administração
Relações Médico-Paciente
[Mh] Termos MeSH secundário: Idoso
Comunicação
Projeto Arquitetônico Baseado em Evidências
Feminino
Seres Humanos
Kansas
Masculino
Meia-Idade
Assistência Centrada no Paciente/métodos
Inquéritos e Questionários
Confiança
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180126
[Lr] Data última revisão:
180126
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150328
[St] Status:MEDLINE
[do] DOI:10.1177/1937586714565604


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[PMID]:29320653
[Au] Autor:Duffy S; Lee TH
[Ad] Endereço:From Omada Health, San Francisco (S.D.); and Press Ganey, Wakefield, and Harvard Medical School, Boston - both in Massachusetts (T.H.L.).
[Ti] Título:In-Person Health Care as Option B.
[So] Source:N Engl J Med;378(2):104-106, 2018 Jan 11.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Relações Médico-Paciente
Telemedicina
[Mh] Termos MeSH secundário: Seres Humanos
Visita a Consultório Médico
Inovação Organizacional
Telemedicina/métodos
Telemedicina/organização & administração
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180118
[Lr] Data última revisão:
180118
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMp1710735


  6 / 6273 MEDLINE  
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[PMID]:29244811
[Au] Autor:Rajaram S; Wiecek W; Lawson R; Blak BT; Zhao Y; Hackett J; Brody R; Patel V; Amzal B
[Ad] Endereço:Formerly of AstraZeneca, Luton, United Kingdom.
[Ti] Título:Impact of increased influenza vaccination in 2-3-year-old children on disease burden within the general population: A Bayesian model-based approach.
[So] Source:PLoS One;12(12):e0186739, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: During the 2013-2014 influenza season, Public Health England extended routine influenza vaccination to all 2- and 3-year-old children in England. To estimate the impact of this change in policy on influenza-related morbidity and mortality, we developed a disease transmission and surveillance model informed by real-world data. METHODS: We combined real-world and literature data sources to construct a model of influenza transmission and surveillance in England. Data were obtained for four influenza seasons, starting with the 2010-2011 season. Bayesian inference was used to estimate model parameters on a season-by-season basis to assess the impact of targeting 2- and 3-year-old children for influenza vaccination. This provided the basis for the construction of counterfactual scenarios comparing vaccination rates of ~2% and ~35% in the 2- and 3- year-old population to estimate reductions in general practitioner (GP) influenza-like-illness (ILI) consultations, respiratory hospitalizations and deaths in the overall population. RESULTS: Our model was able to replicate the main patterns of influenza across the four seasons as observed through laboratory surveillance data. Targeting 2- and 3-year-old children for influenza vaccination resulted in reductions in the general population of between 6.2-9.9% in influenza-attributable GP ILI consultations, 6.1-10.7% in influenza-attributable respiratory hospitalizations, and 5.7-9.4% in influenza-attributable deaths. The decrease in influenza-attributable ILI consultations represents a reduction of between 4.5% and 7.3% across all ILI consultations. The reduction in influenza-attributable respiratory hospitalizations represents a reduction of between 1.2% and 2.3% across all respiratory hospitalizations. Reductions in influenza-attributable respiratory deaths represent a reduction of between 0.9% and 2.4% in overall respiratory deaths. CONCLUSION: This study has provided evidence that extending routine influenza vaccination to all healthy children aged 2 and 3 years old leads to benefits in terms of reduced utilization of healthcare resources and fewer respiratory health outcomes and deaths.
[Mh] Termos MeSH primário: Vírus da Influenza A Subtipo H1N1/imunologia
Vírus da Influenza A Subtipo H3N2/imunologia
Vacinas contra Influenza/administração & dosagem
Influenza Humana/economia
Influenza Humana/prevenção & controle
Vacinação em Massa/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Teorema de Bayes
Criança
Pré-Escolar
Inglaterra/epidemiologia
Monitoramento Epidemiológico
Feminino
Hospitalização/economia
Hospitalização/estatística & dados numéricos
Seres Humanos
Lactente
Recém-Nascido
Influenza Humana/imunologia
Influenza Humana/mortalidade
Masculino
Meia-Idade
Visita a Consultório Médico/economia
Visita a Consultório Médico/estatística & dados numéricos
Estações do Ano
Análise de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Influenza Vaccines)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171216
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0186739


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[PMID]:29194229
[Au] Autor:Slota C; Davis SA; Blalock SJ; Carpenter DM; Muir KW; Robin AL; Sleath B
[Ti] Título:Patient-Physician Communication on Medication Cost during Glaucoma Visits.
[So] Source:Optom Vis Sci;94(12):1095-1101, 2017 Dec.
[Is] ISSN:1538-9235
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:SIGNIFICANCE: This article is the first to investigate the nature of medication cost discussions between ophthalmologists and glaucoma patients. Only 87 of the 275 office visits analyzed had a discussion of medication cost. Providers should consider discussing medication cost with patients to identify potential cost-related barriers to medication use. PURPOSE: Glaucoma is an incurable chronic eye disease affecting a growing portion of the aging population. Some of the most commonly utilized treatments require lifelong use, requiring high patient adherence to ensure effectiveness. There are numerous barriers to glaucoma treatment adherence in the literature, including cost. The aim of this secondary analysis was to describe the frequency and nature of patient-physician communication regarding medication cost during glaucoma office visits. METHODS: This was a mixed-methods secondary analysis of video-recorded participant office visits (n = 275) from a larger observational study of glaucoma communication. We analyzed medical information, demographic characteristics, and interviewer-administrated questionnaires, as well as verbatim transcripts of interviews. RESULTS: Only 87 participants discussed medication cost during their glaucoma office visit. The majority of the subjects who discussed cost had mild disease severity (51%), took one glaucoma medication (63%), and had Medicare (49%) as well as a form of prescription insurance (78%). The majority of glaucoma office visits did not discuss medication cost, and providers often did not ask about cost problems. Of the few conversations related to cost, most focused on providers offering potential solutions (n = 50), medical and prescription service coverage (n = 41), and brand or generic medication choices (n = 41). CONCLUSIONS: Our findings are similar to previous studies showing few patients have conversations with providers about the cost of glaucoma medications. Providers should consider bringing up medication cost during glaucoma office visits to prompt a discussion of potential cost-related barriers to medication use.
[Mh] Termos MeSH primário: Anti-Hipertensivos/economia
Comunicação
Custos de Medicamentos
Glaucoma/economia
Oftalmologistas/estatística & dados numéricos
Participação do Paciente/estatística & dados numéricos
Relações Médico-Paciente
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Glaucoma/tratamento farmacológico
Seres Humanos
Masculino
Meia-Idade
Visita a Consultório Médico
Cooperação do Paciente
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antihypertensive Agents)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171220
[Lr] Data última revisão:
171220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE
[do] DOI:10.1097/OPX.0000000000001139


  8 / 6273 MEDLINE  
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[PMID]:28741448
[Au] Autor:Gilani S; Shin JJ
[Ad] Endereço:1 Division of Otolaryngology, Department of Surgery, University of California, San Diego, California, USA.
[Ti] Título:The Burden and Visit Prevalence of Pediatric Chronic Rhinosinusitis.
[So] Source:Otolaryngol Head Neck Surg;157(6):1048-1052, 2017 Dec.
[Is] ISSN:1097-6817
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives Pediatric chronic rhinosinusitis has a substantial impact, but its epidemiology has yet to be elucidated. Our objectives were (1) to determine the associated national visit burden and (2) to assess its frequency relative to other frequent childhood otolaryngological illnesses. Study Design Analysis of national survey databases. Setting Ambulatory care settings in the United States, 2005 to 2012. Subjects and Methods Cases with a diagnosis of chronic rhinosinusitis were assessed in total and as a proportion of all visits reported in National Ambulatory Medical Care Surveys. To place these data into context, results for acute rhinosinusitis, allergic rhinitis, upper respiratory tract infection, and otitis media were also extracted and compared. Data specific to individual age group and calendar year were assessed. Results Chronic rhinosinusitis accounted for 5.6 million visits per annum (range, 3.7-7.5 million) among patients 0 to 20 years of age. Children in the >5- to 10-year-old and >10- to 15-year-old age groups were more likely to be affected ( P < .001). Among all visits, chronic rhinosinusitis was diagnosed in 2.1% (95% confidence interval [CI], 1.9%-2.4%), acute rhinosinusitis in 0.6% (95% CI, 0.5%-0.7%), allergic rhinitis in 2.6% (95% CI, 2.3%-2.8%), upper respiratory tract infection in 8.0% (95% CI, 7.5%-8.4%), and otitis media in 6.7% (95% CI, 6.5%-7.1%). Chronic rhinosinusitis visits were significantly more prevalent than for acute rhinosinusitis (relative risk, 3.40; 95% CI, 2.70-4.10; P < .0001). Among those >15 to 20 years of age, chronic rhinosinusitis was 2.18-fold (95% CI, 1.65-2.70) more frequently diagnosed than otitis media. Conclusions The visit burden from pediatric chronic rhinosinusitis exceeds that of acute rhinosinusitis and equals the burden from allergic rhinitis.
[Mh] Termos MeSH primário: Visita a Consultório Médico/estatística & dados numéricos
Rinite/epidemiologia
Sinusite/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Distribuição por Idade
Criança
Pré-Escolar
Doença Crônica
Estudos Transversais
Feminino
Seres Humanos
Lactente
Recém-Nascido
Masculino
Prevalência
Estudos Retrospectivos
Distribuição por Sexo
Estados Unidos/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171211
[Lr] Data última revisão:
171211
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1177/0194599817721177


  9 / 6273 MEDLINE  
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[PMID]:28460385
[Au] Autor:Bishop S; Kushinka J; Tu SP
[Ad] Endereço:From Virginia Commonwealth University School of Medicine, Chester, Virginia.
[Ti] Título:Allocation of Physician Time in Ambulatory Practice.
[So] Source:Ann Intern Med;166(9):682-683, 2017 05 02.
[Is] ISSN:1539-3704
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Visita a Consultório Médico
Médicos
[Mh] Termos MeSH secundário: Assistência Ambulatorial
Seres Humanos
Padrões de Prática Médica
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171208
[Lr] Data última revisão:
171208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.7326/L17-0076


  10 / 6273 MEDLINE  
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[PMID]:28460384
[Au] Autor:Serota DP
[Ad] Endereço:From Emory University, Atlanta, Georgia.
[Ti] Título:Allocation of Physician Time in Ambulatory Practice.
[So] Source:Ann Intern Med;166(9):683, 2017 05 02.
[Is] ISSN:1539-3704
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Visita a Consultório Médico
Médicos
[Mh] Termos MeSH secundário: Assistência Ambulatorial
Seres Humanos
Padrões de Prática Médica
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171208
[Lr] Data última revisão:
171208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.7326/L17-0075



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