collection
https://read.qxmd.com/read/30625065/focusing-on-population-health-at-scale-joining-policy-and-technology-to-improve-health
#41
JOURNAL ARTICLE
Aaron McKethan, Seth A Berkowitz, Mandy Cohen
Progress in biomedical innovation and technology has resulted in unprecedented improvements in human health. But population health is influenced by more than medical technology or health care services. Socioeconomic, psychosocial, and behavioral factors — including access to basic needs such as..
January 10, 2019: New England Journal of Medicine
https://read.qxmd.com/read/30601748/facing-opioids-in-the-shadow-of-the-hiv-epidemic
#42
JOURNAL ARTICLE
Caroline M Parker, Jennifer S Hirsch, Helena B Hansen, Charles Branas, Sylvia Martins
The United States is in the midst of an opioid crisis. An estimated 2.1 million Americans had an opioid use disorder in 2016. The rate of opioid overdose deaths has increased by 500% since 1999, and each day an estimated 115 Americans die from opioid overdose. Despite the proven effectiveness of..
January 3, 2019: New England Journal of Medicine
https://read.qxmd.com/read/30601741/walking-away-from-conveyor-belt-medicine
#43
JOURNAL ARTICLE
Fabrizio Elia, Franco Aprà
The phone rings in our emergency department. It’s a call from a community hospital, which is sending us a 70-year-old patient in need of an urgent procedure. His aortic endoprosthesis, inserted a few years back, appears to be out of place. His aortic aneurysm, which had been stable, is much larger..
January 3, 2019: New England Journal of Medicine
https://read.qxmd.com/read/30601710/addressing-a-core-gap-in-cancer-care-the-nci-moonshot-program-to-help-oncology-patients-stop-smoking
#44
JOURNAL ARTICLE
Robert T Croyle, Glen D Morgan, Michael C Fiore
Despite making great progress in caring for people with cancer, the oncology community has often neglected to capitalize on a highly feasible, readily available, and cost-effective strategy for increasing the success of cancer treatment and rates of recovery — smoking cessation. Effective..
February 7, 2019: New England Journal of Medicine
https://read.qxmd.com/read/30601709/two-year-evaluation-of-mandatory-bundled-payments-for-joint-replacement
#45
JOURNAL ARTICLE
Michael L Barnett, Andrew Wilcock, J Michael McWilliams, Arnold M Epstein, Karen E Joynt Maddox, E John Orav, David C Grabowski, Ateev Mehrotra
BACKGROUND: In 2016, Medicare implemented Comprehensive Care for Joint Replacement (CJR), a national mandatory bundled-payment model for hip or knee replacement in randomly selected metropolitan statistical areas. Hospitals in such areas receive bonuses or pay penalties based on Medicare spending per hip- or knee-replacement episode (defined as the hospitalization plus 90 days after discharge). METHODS: We conducted difference-in-differences analyses using Medicare claims from 2015 through 2017, encompassing the first 2 years of bundled payments in the CJR program...
January 17, 2019: New England Journal of Medicine
https://read.qxmd.com/read/30586522/emergency-departments-a-24-7-365-option-for-combating-the-opioid-crisis
#46
JOURNAL ARTICLE
Gail D'Onofrio, Ryan P McCormack, Kathryn Hawk
Emergency departments (EDs) administer lifesaving interventions all day every day and all night every night. In addition to rapidly resuscitating and stabilizing patients with acute illness and injury, emergency physicians are charged with identifying the appropriate level and type of care within..
December 27, 2018: New England Journal of Medicine
https://read.qxmd.com/read/30586517/harder-to-treat-than-leukemia-opioid-use-disorder-in-survivors-of-cancer
#47
JOURNAL ARTICLE
Alison Wakoff Loren
Ms. M. was a 24-year-old with chronic myeloid leukemia in blast phase who received an allogeneic hematopoietic cell transplant from an unrelated donor. She developed acute graft-versus-host disease (GVHD) of the gastrointestinal tract that evolved into overlap syndrome with severe chronic GVHD of..
December 27, 2018: New England Journal of Medicine
https://read.qxmd.com/read/30575483/the-major-causes-of-death-in-children-and-adolescents-in-the-united-states
#48
JOURNAL ARTICLE
Rebecca M Cunningham, Maureen A Walton, Patrick M Carter
In 2016, children and adolescents (1 to 19 years of age) represented a quarter of the total estimated U.S. population; reflecting relatively good health, they accounted for less than 2% of all U.S. deaths. By 2016, death among children and adolescents had become a rare event. Declines in deaths..
December 20, 2018: New England Journal of Medicine
https://read.qxmd.com/read/30575482/training-in-sexual-and-gender-minority-health-expanding-education-to-reach-all-clinicians
#49
JOURNAL ARTICLE
Kevin L Ard, Alex S Keuroghlian
"If a man says he is a woman, does that mean he is mentally ill?" The staff member asking this question was attending a mandatory training session on health care for sexual and gender minority (SGM) patients at an urban hospital. She spoke timidly and seemed genuinely curious. We explained that..
December 20, 2018: New England Journal of Medicine
https://read.qxmd.com/read/30575478/the-problem-for-children-in-america
#50
EDITORIAL
Edward W Campion
Children in America are dying or being killed at rates that are shameful. The sad fact is that a child or adolescent in the United States is 57% more likely to die by the age of 19 years than those in other wealthy nations. In 2016, there were more than 20,000 deaths of Americans 1 to 19 years of..
December 20, 2018: New England Journal of Medicine
https://read.qxmd.com/read/30575468/macra-s-patient-relationship-codes-measuring-accountability-for-costs
#51
JOURNAL ARTICLE
Samuel U Takvorian, Justin E Bekelman, Matthew J Press
The new patient relationship categories and codes may be one of the least known but most important provisions of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). As of January 1, 2018, clinicians may voluntarily submit these billing-code modifiers to help Medicare determine the..
December 13, 2018: New England Journal of Medicine
https://read.qxmd.com/read/30575465/influenza-cataclysm-1918
#52
JOURNAL ARTICLE
David M Morens, Jeffery K Taubenberger
This year marks the centennial of a true pandemic cataclysm: an influenza pandemic that killed 50 million to 100 million people globally — arguably the single deadliest event in recorded human history. It is an event worth contemplating, since evidence suggests that another pandemic at least as..
December 13, 2018: New England Journal of Medicine
https://read.qxmd.com/read/30575461/the-future-of-health-care-reform-a-view-from-the-states-on-where-we-go-from-here
#53
JOURNAL ARTICLE
David K Jones, Christina Pagel, Christopher F Koller
The future of U.S. health care reform is muddier now than at any point in the past two decades. Health care was one of the most important issues for voters in the 2018 election, but there is little reason to believe that substantive national action is likely any time soon. The Trump administration..
December 6, 2018: New England Journal of Medicine
https://read.qxmd.com/read/30575456/toward-precision-policy-the-case-of-cardiovascular-care
#54
JOURNAL ARTICLE
Rishi K Wadhera, Deepak L Bhatt
The U.S. health care system is in the midst of a transition toward delivery of high-value rather than volume-based health care. As part of this shift, policies that offer incentives to physicians and hospitals to deliver better-quality care at lower cost are being implemented nationwide...
December 6, 2018: New England Journal of Medicine
https://read.qxmd.com/read/30566376/the-anti-trans-memo-abandoning-doctors-and-patients
#55
JOURNAL ARTICLE
Jocelyn Samuels, Mara Keisling
In October 2018, the New York Times reported on an effort under way by the Department of Health and Human Services (HHS) to redefine gender as a "biological, immutable condition determined by a person’s genitalia at birth." If that effort succeeds, it will, at a minimum, restrict federal..
January 10, 2019: New England Journal of Medicine
https://read.qxmd.com/read/30554549/adolescent-vaping-and-nicotine-use-in-2017-2018-u-s-national-estimates
#56
LETTER
Richard Miech, Lloyd Johnston, Patrick M O'Malley, Jerald G Bachman, Megan E Patrick
To the Editor: A rapid increase in the prevalence of vaping among adolescents has aroused public health concern. Adolescents who "vape" use a device such as an electronic cigarette to inhale a heated aerosol, which typically contains nicotine. In 2017, vaping was the most common use of any..
January 10, 2019: New England Journal of Medicine
https://read.qxmd.com/read/30517063/-thisisourlane-firearm-safety-as-health-care-s-highway
#57
JOURNAL ARTICLE
Megan L Ranney, Marian E Betz, Cedric Dark
On November 6, 2018, in response to a position paper on firearm injuries and death from the American College of Physicians, the National Rifle Association (NRA) fired off a tweet admonishing "self-important anti-gun doctors to stay in their lane." Physicians — many of whom are also gun owners —..
December 5, 2018: New England Journal of Medicine
https://read.qxmd.com/read/30403948/getting-rid-of-stupid-stuff
#58
JOURNAL ARTICLE
Melinda Ashton
Many health care organizations are searching for ways to engage employees and protect against burnout, and involvement in meaningful work has been reported to serve both functions. According to Bailey and Madden, it is easy to damage employees’ sense of meaningfulness by presenting them with..
November 8, 2018: New England Journal of Medicine
https://read.qxmd.com/read/30403946/neisseria-gonorrhoeae-rising-infection-rates-dwindling-treatment-options
#59
JOURNAL ARTICLE
Susan Blank, Demetre C Daskalakis
Gonorrhea infection is the second most commonly reported notifiable condition in the United States, and case rates have been increasing since 2009. In 2017, a total of 555,608 cases of gonorrhea were reported nationally, the largest number since 1991 and an 18.6% increase over 2016 (see graph). In..
November 8, 2018: New England Journal of Medicine
https://read.qxmd.com/read/30403935/immunotherapy-combinations-in-multiple-myeloma-known-unknowns
#60
JOURNAL ARTICLE
Nicole J Gormley, Richard Pazdur
In November 2017, the Food and Drug Administration (FDA) required labeling changes for the commercially marketed programmed cell death 1 (PD-1) inhibitor pembrolizumab and the thalidomide-analogue immunomodulatory agents. These changes included information regarding increased mortality observed in..
November 8, 2018: New England Journal of Medicine
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