Persistent Distress after Water Contamination.

Background: A chemical spill contaminated the public water supply of Charleston, West Virginia in January 2014 for at least a week. Psychological distress is common after disasters.

Methods: We surveyed the exposed population to assess psychological distress during and three months after the incident.

Making a Dent in Undiagnosed and Untreated Depression among Older West Virginians.

Importance: Depression, a serious and debilitating disease, remains under-diagnosed and inadequately treated among older adults.

Objective: To describe the prevalence of depression among older West Virginians and report the extent to which primary care providers screen Medicare beneficiaries for depression.

Methodology: Descriptive analysis using 2014 Behavioral Risk Factor Surveillance System to estimate depression prevalence; Medicare Part B claims, 2012 - 2014, to measure depression screening.

Correction: Self-Reported Household Impacts of Large-Scale Chemical Contamination of the Public Water Supply, Charleston, West Virginia, USA.

[This corrects the article DOI: 10.1371/journal.pone.

Self-reported household impacts of large-scale chemical contamination of the public water supply, Charleston, West Virginia, USA.

A January 2014 industrial accident contaminated the public water supply of approximately 300,000 homes in and near Charleston, West Virginia (USA) with low levels of a strongly-smelling substance consisting principally of 4-methylcyclohexane methanol (MCHM). The ensuing state of emergency closed schools and businesses. Hundreds of people sought medical care for symptoms they related to the incident.

Exploratory analysis of the relationship between home health agency engagement in a national campaign and reduction in acute care hospitalization in US home care patients.

Rationale, Aims And Objectives: To determine whether US home health agencies that intensively engaged with the 2010 Home Health Quality Improvement National Campaign were more likely to reduce acute care hospitalization (ACH) rates than less engaged agencies.

Method: We included all Medicare-certified agencies that accessed Campaign resources in the first month of the Campaign and also responded to an online survey of resource utilization at month two. We used the survey data and item response theory to estimate a latent construct we called engagement with the campaign.

The 2010-2011 home health quality improvement national campaign.

The purpose and goals of the 2010-2011 Home Health Quality Improvement (HHQI) National Campaign are outlined in this manuscript, including key campaign enhancements implemented since the first initiative began in 2007. A summary of the campaign's design and progress to date is also included, featuring HHQI educational and informational resources, participant incentives, and campaign evaluation.

Improving the home health acute-care hospitalization quality measure.

Objectives: (1) To demonstrate average length of service (ALOS) bias in the currently used acute-care hospitalization (ACH) home health quality measure, limiting comparability across agencies, and (2) to propose alternative ACH measures.

Data Sources/study Setting: Secondary analysis of Medicare home health service data 2004-2007; convenience sample of Medicare fee-for-service hospital discharges.

Study Design: Cross-sectional analysis and patient-level simulation.

Impact of a national campaign on hospital readmissions in home care patients.

Objective: Assess impact of nationwide home health quality improvement campaign to reduce acute care hospitalization of home health recipients.

Design: Observational pre-post comparison of self-selected participating and non-participating agencies' quality performance; survey to determine uptake of program materials.

Setting: US home health care agencies.

Quality of ambulatory care for diabetes and lower-extremity amputation.

Lower extremity amputation (LEA) is a serious complication of diabetes. We sought to determine whether quality of ambulatory care affects risk of LEA. We conducted a claims-based case-control study of 409 Medicare beneficiaries younger than age 75 with diabetes and LEA between January 1, 2003, and December 31, 2005.

Impact of the 2004 influenza vaccine shortage on repeat immunization rates.

Purpose: We assessed the impact of the severe influenza vaccine shortage of 2004 on individual physicians' immunization performance.

Methods: Using 1998-2004 Medicare claims data, we monitored the physician continuity rate (proportion of patients receiving influenza immunization from a physician in 1 year who received a subsequent immunization from the same physician the subsequent year) and other clinician rate (proportion of patients with claims from 1 physician in 1 year with a claim from another clinician the subsequent year) in West Virginia Medicare beneficiaries from 2000-2004. We examined vaccine claim trends by clinician and surveys of self-reported immunization to determine whether patients received vaccine from nonphysician clinicians or went without immunization each year.

Improving self-reporting of adverse drug events in a West Virginia hospital.

Adverse drug events significantly increase length of stay and costs of hospitalization but are underreported in health care institutions. We hypothesized that hospitals could improve the accuracy of adverse drug event self-reporting by comparing adverse drug events recorded in an occurrence reporting tool with those detected by surveillance of "rescue" drugs administered to treat adverse drug events. We conducted a prospective cohort study of all adult inpatient discharges from a 200-bed rural acute care hospital in West Virginia during a 6-month period.

e-Prescribing, efficiency, quality: lessons from the computerization of UK family practice.

Nearly all general practice physicians (GPs) in the United Kingdom (UK) have electronic health record (EHR) systems in their practices compared with perhaps 15% of primary care physicians in the United States (U.S.).

ACE inhibitor use and mortality reduction: do controlled trial results equal clinical practice?

Randomized trials have shown that angiotensin converting enzyme inhibitors (ACEIs) reduce mortality and morbidity and improve symptoms in many patients with heart failure. However, recent data show that the rate of ACEI prescriptions in West Virginia Medicare beneficiaries diagnosed with heart failure is not increasing. Data from the charts of patients who were discharged from 44 acute care hospitals during 2000 and 2001 were obtained, and these data were matched with current beneficiary data to determine if and when the patient died subsequent to the hospitalization of record.

Promoting influenza and pneumococcal immunization in older adults.

Background: Reducing the risk of influenza and pneumococcal disease in older adults is a long-standing goal of Medicare's Quality Improvement Organization (QIO) program and parallels the Joint Commission's National Patient Safety Goal 10.

Addressing The Goal: Since 1999 the West Virginia Medical Institute has worked with a statewide partnership of health organizations on a program to improve influenza and pneumonia vaccination rates in hospitalized Medicare beneficiaries. Methods included education, audit and feedback, toolkits, and training meetings.

Do mass media affect Medicare beneficiaries' use of diabetes services?

Background: Appropriate secondary preventive care for people with diabetes can reduce complications and premature death, yet many people with diabetes do not get these services. Mass media may influence individual health behavior.

Methods: In 1999, the West Virginia Medical Institute (WVMI) began a long-term radio and television campaign to educate West Virginia Medicare beneficiaries with diabetes about the importance of foot exams, eye exams, HbA1c testing, and influenza and pneumonia immunizations using messages with an "Ask your doctor about.

Using statewide audit and feedback to improve hospital care in West Virginia.

Background: Audit and feedback systems have significantly improved medical care in numerous settings, and they appear to work by stimulating competition rather than through command and control.

Methods: The West Virginia Medical Institute (WVMI), a Medicare-designated Quality Improvement Organization (QIO), periodically collected quality information on five common conditions (acute myocardial infarction [AMI], heart failure, pneumonia, stroke, and atrial fibrillation) that cause hospitalization in Medicare beneficiaries. All 44 acute care hospitals in West Virginia were offered written and orally presented reports of quality performance from 1998 through 2001.

Beta blocker use in acute myocardial infarction in West Virginia.

This article describes our study of the use of beta blocker drugs in Medicare beneficiaries hospitalized for acute myocardial infarction in West Virginia between 1999 and 2000. We contrasted findings with the responses of practicing cardiologists in the state. The survey asked cardiologists to describe their recent patterns of beta blocker usage, to comment on the severity of generally recognized contraindications to beta blocker administration, and to speculate on reasons why West Virginia's rates of beta blocker use in AMI were lower than rates in most other states.