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Pesquisa : Z01.107.567.875.580.200.450 [Categoria DeCS]
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[PMID]:29206974
[Au] Autor:Narain KD; Katz ML
[Ad] Endereço:Greater Los Angeles Veterans Health Administration, Health Services Research and Development Service Center of Innovation, Implementation & Policy.
[Ti] Título:Experiences with Health Insurance and Health Care in the Context of Welfare Reform.
[So] Source:Health Soc Work;41(4):244-252, 2016 Nov 20.
[Is] ISSN:0360-7283
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Studies have shown that in the wake of welfare reform there has been a drop in the health insurance coverage and health care utilization of low-income mothers. Using data from 20 telephone interviews, this study explored the health insurance and health care experiences of current and former welfare participants living in Los Angeles County. This study found that half of these women had been uninsured at some point. Many of these lapses in health insurance coverage were linked to employment transitions and lack of knowledge regarding eligibility for different safety net programs. This study also found that satisfaction with access to health care was high among the insured respondents; however, barriers to care remained for many individuals, including appointment scheduling issues, limited scope of health insurance coverage, narrow provider networks, lack of care continuity, and perceived low quality of care. Better linkages between social programs assisting with health insurance coverage and improved knowledge among program clients may reduce health insurance cycling in this group. New rules for Medicaid managed care, currently being considered by the Centers for Medicare and Medicaid Services, have the potential to improve access to health care and the quality of care for these individuals.
[Mh] Termos MeSH primário: Reforma dos Serviços de Saúde
Seguro Saúde/estatística & dados numéricos
Mães
Seguridade Social
[Mh] Termos MeSH secundário: Adulto
Feminino
Acesso aos Serviços de Saúde
Seres Humanos
Entrevistas como Assunto
Los Angeles
Pessoas sem Cobertura de Seguro de Saúde/estatística & dados numéricos
Pobreza
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1093/hsw/hlw038


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[PMID]:29364957
[Au] Autor:Wayne NL; Miller GA
[Ad] Endereço:Department of Physiology, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California, United States of America.
[Ti] Título:Impact of gender, organized athletics, and video gaming on driving skills in novice drivers.
[So] Source:PLoS One;13(1):e0190885, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Given that novice drivers tend to be young, and teenagers and young adult drivers are involved in the greatest number of accidents, it is important that we understand what factors impact the driving skills of this population of drivers. The primary aim of the present study was to understand the impact of gender, organized athletics, and video gaming on driving skills of novice drivers under real-world driving conditions. Novice driving students having less than five hours driving experience previous to a normal driving lesson were evaluated on their self-confidence (self-reported) prior to the lesson and driving skill evaluated by their instructor during the course of the lesson. Information was collected about gender, age, whether or not the students were involved in organized athletics, and the extent of their video game playing. There was no impact of gender or extent of video game playing on driving skills. Females were significantly less self-confident with driving than males, but this did not translate to gender differences in driving skills. Being involved in organized athletics-either currently or in the past-significantly enhanced driving skills in both females and males. Finally, novice drivers' age was negatively correlated with driving skills. That is, younger novice drivers (especially males) had better driving skills than older novice drivers. This is counter to popular belief that young drivers lack technical driving skills because they have less experience behind the wheel. Based on the results of the current study, we hypothesize that the relatively high accident rate of younger drivers (especially male drivers) is most likely due to inattention to safety considerations rather than lack of technical driving ability.
[Mh] Termos MeSH primário: Condução de Veículo
Esportes/fisiologia
Esportes/psicologia
Jogos de Vídeo/psicologia
[Mh] Termos MeSH secundário: Acidentes de Trânsito/prevenção & controle
Acidentes de Trânsito/psicologia
Adolescente
Adulto
Fatores Etários
Condução de Veículo/psicologia
Feminino
Seres Humanos
Los Angeles
Masculino
Destreza Motora
Desempenho Psicomotor
Assunção de Riscos
Autoavaliação
Fatores Sexuais
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190885


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[PMID]:28448905
[Au] Autor:Bluthenthal RN; Wenger L; Chu D; Bourgois P; Kral AH
[Ad] Endereço:Department of Preventive Medicine, Institute for Prevention Research, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90033, USA. Electronic address: rbluthen@usc.edu.
[Ti] Título:Drug use generations and patterns of injection drug use: Birth cohort differences among people who inject drugs in Los Angeles and San Francisco, California.
[So] Source:Drug Alcohol Depend;175:210-218, 2017 06 01.
[Is] ISSN:1879-0046
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: A robust literature documents generational trends in drug use. We examined the implications of changing national drug use patterns on drug injection histories of diverse people who inject drugs (PWID). METHODS: Drug use histories were collected from 776 active PWID in 2011-13. Using descriptive statistics, we examine drug use initiation by year and birth cohort (BC) differences in drug first injected. A multivariate linear regression model of time to injection initiation ([TTII] (year of first injection minus year of first illicit drug use) was developed to explore BC differences. RESULTS: The first drug injected by BC changed in tandem with national drug use trends with heroin declining from 77% for the pre-1960's BC to 58% for the 1960's BC before increasing to 71% for the 1990's BC. Multivariate linear regression modeling found that shorter TTII was associated with the 1980's/1990's BC (-3.50 years; 95% Confidence Interval [CI]=-0.79, -6.21) as compared to the 1970's BC. Longer TTII was associated with being female (1.65 years; 95% CI=0.40, 2.90), African American (1.69 years; 95% CI=0.43, 2.95), any substance use treatment prior to injection (4.22 years; 95% CI=2.65, 5.79), and prior non-injection use of drug that was first injected (3.29 years; 95% CI=2.19, 4.40). CONCLUSION: National drug trends appear to influence injection drug use patterns. The prescription opiate drug era is associated with shorter TTII. Culturally competent, demographically and generationally-targeted prevention strategies to combat transitions to drug injection are needed to prevent or shorten upstream increases in risky drug use practices on a national level.
[Mh] Termos MeSH primário: Fatores Etários
Abuso de Substâncias por Via Intravenosa/epidemiologia
Transtornos Relacionados ao Uso de Substâncias/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Estudos de Coortes
Feminino
Heroína
Seres Humanos
Modelos Lineares
Los Angeles/epidemiologia
Masculino
Meia-Idade
Análise Multivariada
São Francisco/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
70D95007SX (Heroin)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE


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[PMID]:27771536
[Au] Autor:Khoddam R; Jackson NJ; Leventhal AM
[Ad] Endereço:Department of Psychology, University of Southern California, United States.
[Ti] Título:Internalizing symptoms and conduct problems: Redundant, incremental, or interactive risk factors for adolescent substance use during the first year of high school?
[So] Source:Drug Alcohol Depend;169:48-55, 2016 12 01.
[Is] ISSN:1879-0046
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:AIM: The complex interplay of externalizing and internalizing problems in substance use risk is not well understood. This study tested whether the relationship of conduct problems and several internalizing disorders with future substance use is redundant, incremental, or interactive in adolescents. METHODS: Two semiannual waves of data from the Happiness and Health Study were used, which included 3383 adolescents (M age=14.1years old; 53% females) in Los Angeles who were beginning high school at baseline. Logistic regression models tested the likelihood of past six-month alcohol, tobacco, marijuana, and any substance use at follow-up conditional on baseline conduct problems, symptoms of one of several internalizing disorders (i.e., Social Phobia and Major Depressive, Generalized Anxiety, Panic, and Obsessive-Compulsive Disorder), and their interaction adjusting for baseline use and other covariates. FINDINGS: Conduct problems were a robust and consistent risk factor of each substance use outcome at follow-up. When adjusting for the internalizing-conduct comorbidity, depressive symptoms were the only internalizing problem whose risk for alcohol, tobacco, and any substance use was incremental to conduct problems. With the exception of social phobia, antagonistic interactive relationships between each internalizing disorder and conduct problems were found when predicting any substance use; internalizing symptoms was a more robust risk factor for substance use in teens with low (vs. high) conduct problems. CONCLUSIONS: Although internalizing and externalizing problems both generally increase risk of substance use, a closer look reveals important nuances in these risk pathways, particularly among teens with comorbid externalizing and internalizing problems.
[Mh] Termos MeSH primário: Depressão/complicações
Transtornos Mentais/complicações
Comportamento Problema/psicologia
Transtornos Relacionados ao Uso de Substâncias/etiologia
[Mh] Termos MeSH secundário: Adolescente
Depressão/psicologia
Feminino
Seres Humanos
Los Angeles
Masculino
Transtornos Mentais/psicologia
Fatores de Risco
Instituições Acadêmicas
Transtornos Relacionados ao Uso de Substâncias/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180122
[Lr] Data última revisão:
180122
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161107
[St] Status:MEDLINE


  5 / 5161 MEDLINE  
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[PMID]:29215837
[Au] Autor:Sanko S; Ito T; Guggenheim A; Eckstein M
[Ti] Título:A New Tradition: Nurse practitioner unit helps L.A. Fire Department meet increased demand.
[So] Source:JEMS;42(2):59-62, 2017 02.
[Is] ISSN:0197-2510
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Serviços Médicos de Emergência/recursos humanos
Profissionais de Enfermagem
Papel do Profissional de Enfermagem
Qualidade da Assistência à Saúde
[Mh] Termos MeSH secundário: Seres Humanos
Los Angeles
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE


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[PMID]:28742776
[Au] Autor:Sun K; Hong F; Wang Y; Agopian VG; Yan M; Busuttil RW; Steadman RH; Xia VW
[Ad] Endereço:From the *Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; and †Department of Anesthesiology and Perioperative Medicine and ‡Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California.
[Ti] Título:Venovenous Bypass Is Associated With a Lower Incidence of Acute Kidney Injury After Liver Transplantation in Patients With Compromised Pretransplant Renal Function.
[So] Source:Anesth Analg;125(5):1463-1470, 2017 11.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Although the hemodynamic benefits of venovenous bypass (VVB) during liver transplantation (LT) are well appreciated, the impact of VVB on posttransplant renal function is uncertain. The aim of this study was to determine if VVB was associated with a lower incidence of posttransplant acute kidney injury (AKI). METHODS: Medical records of adult (≥18 years) patients who underwent primary LT between 2004 and 2014 at a tertiary hospital were reviewed. Patients who required pretransplant renal replacement therapy and intraoperative piggyback technique were excluded. Patients were divided into 2 groups, VVB and non-VVB. AKI, determined by the Acute Kidney Injury Network criteria, was compared between the 2 groups. Propensity match was used to control selection bias that occurred before VVB and multivariable logistic regression was used to control confounding factors during and after VVB. RESULTS: Of 1037 adult patients who met the study inclusion criteria, 247 (23.8%) received VVB. A total of 442 patients (221 patients in each group) were matched. Aftermatch patients were further divided according to a predicted probability AKI model using preoperative creatinine (Cr), VVB, and intraoperative variables into 2 subgroups: normal and compromised pretransplant renal functions. In patients with compromised pretransplant renal function (Cr ≥1.2 mg/dL), the incidence of AKI was significantly lower in the VVB group compared with the non-VVB group (37.2% vs 50.8%; P = .033). VVB was an independent risk factor negatively associated with AKI (odds ratio, 0.1; 95% confidence interval, 0.1-0.4; P = .001). Renal replacement in 30 days and 1-year recipient mortality were not significantly different between the 2 groups. The incidence of posttransplant AKI was not significantly different between the 2 groups in patients with normal pretransplant renal function (Cr <1.2 mg/dL). CONCLUSIONS: In this large retrospective study, we demonstrated that utilization of intraoperative VVB was associated with a significantly lower incidence of posttransplant AKI in patients with compromised pretransplant renal function. Further studies to assess the role of intraoperative VVB in posttransplant AKI are warranted.
[Mh] Termos MeSH primário: Lesão Renal Aguda/epidemiologia
Veia Axilar/cirurgia
Doença Hepática Terminal/cirurgia
Circulação Extracorpórea/métodos
Nefropatias/epidemiologia
Rim/fisiopatologia
Transplante de Fígado/efeitos adversos
Veia Safena/cirurgia
[Mh] Termos MeSH secundário: Lesão Renal Aguda/diagnóstico
Lesão Renal Aguda/mortalidade
Lesão Renal Aguda/prevenção & controle
Veia Axilar/fisiopatologia
Doença Hepática Terminal/diagnóstico
Doença Hepática Terminal/mortalidade
Doença Hepática Terminal/fisiopatologia
Circulação Extracorpórea/efeitos adversos
Circulação Extracorpórea/mortalidade
Feminino
Hemodinâmica
Seres Humanos
Incidência
Estimativa de Kaplan-Meier
Nefropatias/diagnóstico
Nefropatias/mortalidade
Nefropatias/fisiopatologia
Transplante de Fígado/mortalidade
Modelos Logísticos
Los Angeles/epidemiologia
Masculino
Registros Médicos
Meia-Idade
Análise Multivariada
Razão de Chances
Pontuação de Propensão
Fatores de Proteção
Estudos Retrospectivos
Fatores de Risco
Veia Safena/fisiopatologia
Centros de Atenção Terciária
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180109
[Lr] Data última revisão:
180109
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000002311


  7 / 5161 MEDLINE  
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[PMID]:29224755
[Au] Autor:Yu H; Mamey MR; Russell CJ
[Ad] Endereço:Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
[Ti] Título:Factors associated with 30-day all-cause hospital readmission after tracheotomy in pediatric patients.
[So] Source:Int J Pediatr Otorhinolaryngol;103:137-141, 2017 Dec.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine factors associated with post-tracheotomy hospital readmission within 30 days of discharge. METHODS: Children 18 years and younger who underwent tracheotomy at Children's Hospital Los Angeles (CHLA) between 1/1/2005 and 12/31/2013 with at least 30 days of follow-up at CHLA were identified through ICD-9 procedure codes. Patient characteristics and covariates were obtained by linking manual chart review and administrative data. We used multivariate logistic regression to identify the independent association between risk factors and the primary outcome of 30-day all-cause same-hospital readmission. RESULTS: Of the 273 patients included, the median age at admission was 6 months [interquartile range (IQR): 1-51 months]. Among this primarily male (60.8%) and Hispanic (66.3%) cohort with a high proportion of discharge on positive pressure ventilation (47.1%), the 30-day readmission rate was 22% (n = 60). Of the readmissions, 92% (n = 55) were unplanned and 64% (n = 35) were associated with acute respiratory illnesses. Multivariate regression analysis demonstrated that, among patients ≤12 months, discharge on positive pressure ventilation [adjusted odds ratio (aOR) = 2.88, 95% confidence interval (CI) = 1.19-6.97] was associated with increased odds of readmission, while gastrostomy tube placement during the tracheotomy hospitalization (aOR = 0.42, 95% CI = 0.19-0.96) and prematurity (aOR = 0.35, 95% CI = 0.15-0.83) were associated with decreased odds of readmission. In patients >1 year of age, increased length of hospitalization (aOR = 1.01 per hospital day, 95% CI = 1-1.02) and presence of comorbid malignancy (aOR = 6.03, 95% CI = 1.25-29.16) were associated with increased odds of readmission. CONCLUSIONS: Over one-fifth of children undergoing tracheotomy had an unplanned hospital readmission within 30 days after discharge. Because the majority of readmissions were unplanned and due to acute respiratory illnesses, future research should investigate how discharge procedures and improved care coordination may lower readmission rates in high-risk patients (e.g., patients discharged on positive pressure ventilation).
[Mh] Termos MeSH primário: Readmissão do Paciente/estatística & dados numéricos
Traqueotomia/efeitos adversos
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Estudos de Coortes
Comorbidade
Feminino
Seres Humanos
Lactente
Modelos Logísticos
Los Angeles
Masculino
Alta do Paciente/estatística & dados numéricos
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180104
[Lr] Data última revisão:
180104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171212
[St] Status:MEDLINE


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[PMID]:28990748
[Au] Autor:McBride K; Reynoso A; Alunan T; Gutierrez B; Bacong A; Moon M; Bacigalupo A; Benjamin AE; Wallace SP; Kietzman KG
[Ad] Endereço:Department of Health Policy and Management, UCLA Fielding School of Public Health.
[Ti] Título:Cal MediConnect Enrollment: Why Are Dual-Eligible Consumers in Los Angeles County Opting Out?
[So] Source:Policy Brief UCLA Cent Health Policy Res;2017(7):1-8, 2017 09 01.
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Los Angeles County has the state's lowest rate of consumer enrollment in Cal MediConnect, a program that is responsible for the delivery and coordination of medical, behavioral health, and long-term services and support benefits for individuals who are dually eligible for Medicare and Medi-Cal. This policy brief examines the factors that influence consumer decisions and may contribute to low enrollment rates. Influential factors include consumer knowledge of health care options, perception of choice, and disruption of existing care. Differences in decision making by age, complexity of health care needs, race/ethnicity, immigration status, and primary language are also noted. Policy recommendations include engaging consumers in the planning and dissemination of information about their health care options, optimizing consumer choice and implementing the least disruptive pathway to enrollment, and recognizing and responding to the great diversity of dual-eligible consumers in Los Angeles County.
[Mh] Termos MeSH primário: Comportamento do Consumidor
Elegibilidade Dupla ao MEDICAID e MEDICARE
Serviços de Saúde/utilização
[Mh] Termos MeSH secundário: California
Definição da Elegibilidade
Emigrantes e Imigrantes
Grupos Étnicos
Seres Humanos
Los Angeles
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:171011
[St] Status:MEDLINE


  9 / 5161 MEDLINE  
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[PMID]:28985872
[Au] Autor:Ou R; Ramos G; Bowles C; Juo YY; Shemin RJ; Benharash P
[Ad] Endereço:Division of Cardiac Surgery, Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, California.
[Ti] Título:Are nonemergent cardiac operations performed during off-time associated with worse outcome?
[So] Source:J Surg Res;218:348-352, 2017 Oct.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: With the implementation of value-based health care, it is of increasing interest to understand whether performing elective surgeries during off-time impacts surgical outcomes. The objective of this study was to evaluate the impact of start times on nonemergent cardiac operations. METHODS: The institutional Society of Thoracic Surgeons was used to identify all adult nonemergent cardiac operations performed between January 2008 and December 2015 at our institution. "Off-time" is defined as either operation "late starts," that is, an incision time after 3 PM and before 7 AM, or procedures occurring during the weekends. Univariate and multivariate logistic regression analyses were performed to examine its impact on in-hospital mortality and major adverse events. Available cost data were directly obtained from the departmental BIOME database. RESULTS: Of the 3406 cardiac operations included in the study, 2933 (86.1%) were normal-start and 473 (13.9%) were off-time-start operations. After adjusting for patient and operative characteristics, late operating room start times were not associated with increased in-hospital mortality (P = 0.28, confidence interval [CI] 95% = 0.99-1.03), readmissions (P = 0.21, CI 95% = 0.99-1.07), or major adverse events (P = 0.07, CI 95% = 1.00-1.12). In addition, there was no significant impact on total hospital cost (9.0% increase, P = 0.07). CONCLUSIONS: These findings suggest that late operating room start times are not associated with increased mortality or other complications in a tertiary-care academic medical center. Our findings should be considered during operative scheduling to optimize resource distribution and patient care strategies.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Cardíacos/mortalidade
Procedimentos Cirúrgicos Eletivos/mortalidade
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Los Angeles/epidemiologia
Masculino
Meia-Idade
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171008
[St] Status:MEDLINE


  10 / 5161 MEDLINE  
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[PMID]:28967953
[Au] Autor:Arboleda VA; Garner OB
[Ad] Endereço:Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA.
[Ti] Título:Ensuring the Quality of Point-of-Care Testing in a Large and Decentralized Ambulatory Care Setting.
[So] Source:Am J Clin Pathol;148(4):336-344, 2017 Oct 01.
[Is] ISSN:1943-7722
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives: In this project, we assessed the breadth, quality, trends, and outcomes of point-of-care (POC) testing and regulatory compliance in 200 University of California, Los Angeles (UCLA) Health system outpatient clinics. Methods: We retrospectively extracted clinic POC test orders, results, and e-prescription data from the UCLA electronic health record over a 1-year period. Results: Over 100,000 total tests were performed, encompassing 10 POC tests. Initially, 40% of clinics did not have complete licensure, but after implementation of the POC team, this metric improved to 100% licensure within 6 months. Most clinics used two or fewer POC tests, resulted fewer than 200 tests per year, and performed little to no external quality control measures. Our data analytics approach showed that peak POC testing occurred in January 2015, driven by influenza and urinalysis testing, and that both the testing and resulting clinical decision making do not routinely follow society guidelines. Conclusions: This decentralization of laboratory testing presents challenges to ensuring quality POC testing. Optimization and analysis of informatics data allow for the identification of POC test utilization trends, areas of improvement for clinical workflows, and increased education on national guidelines.
[Mh] Termos MeSH primário: Instituições de Assistência Ambulatorial/normas
Testes Imediatos/normas
Garantia da Qualidade dos Cuidados de Saúde
[Mh] Termos MeSH secundário: Seres Humanos
Los Angeles
Controle de Qualidade
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171020
[Lr] Data última revisão:
171020
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171003
[St] Status:MEDLINE
[do] DOI:10.1093/ajcp/aqx081



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BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde