The Growing Problem of Hepatitis C Virus Infection: The Case of West Virginia.

Hepatitis C virus (HCV) is one of the most significant public health problems currently facing the United States, especially in West Virginia. If it is undetected and left untreated, the likelihood of sustaining a treatment response decreases. While early identification has been identified as a critical focus in trying to obtain better health outcomes, new drug treatments appear promising, if somewhat expensive.

Still an Epidemic: The Burnout Syndrome in Hospital Registered Nurses.

The number of registered nurses (RNs) in the United States is roughly 3 times the number of physicians and surgeons, making RNs a critically important component of the US health care system. Registered nurse burnout-the state of emotional exhaustion in which the individual feels overwhelmed by work to the point of feeling fatigued, unable to face the demands of the job, and unable to engage with others-is a real concern, having been reported in many hospitals. The purpose of this research was to examine the causes and consequences of burnout syndrome among RNs in US hospitals and its role in the RN shortage in hospitals.

Medical Scribes: The Future for Medical Data Input in Emergency Departments.

Despite their widespread use, electronic medical records have created frustrations for physicians, especially those working in busy hospital emergency departments. After a brief discussion of the causes of the problems, a potential solution-the use of medical scribes-is presented. The extant literature regarding results obtained following the implementation of medical scribes in emergency departments is reviewed and some conclusions regarding the future of this phenomenon are presented.

International Classification of Diseases, Tenth Revision Implementation: Is the Workforce Ready?

After many delays, the United States finally implemented the International Classification of Diseases, Tenth Revision, Clinical Modification/Procedural Coding System on October 1, 2015, bringing the United States into line with other industrialized nations, most of which had been using the International Classification of Diseases, Tenth Revision for many years. We outline the benefits and challenges to the preparatory activities of the International Classification of Diseases, Tenth Revision, Clinical Modification/Procedural Coding System implementation for the US health care industry. To ease the transition, the Centers for Medicare & Medicaid Services allowed health care facilities to submit test claims prior to the implementation date and delivered feedback on the acceptability of those claims.

Insurance Companies Adapting to Trends by Adopting Medical Tourism.

Health care costs in the United States are rising every year, and patients are seeking new ways to control their expenditures and save money. Going abroad to receive health care is a cheaper alternative than receiving the same or similar care at home. Insurance companies are beginning to realize the benefits of medical tourism for both themselves and their beneficiaries and have therefore started to introduce medical tourism plans for their clients as an option for their beneficiaries.

Maryland's All-Payer Health Care System: A Light at the End of a Tunnel.

The state of Maryland, in collaboration with the Centers for Medicare & Medicaid Services, developed the first all-payer system model in the Unites States in 1971 and 35 years later in response to financial pressures undertook to modernize this program. The focus of the modernized program was to improve overall per-capita expenditure, quality of care, and the outcome of Marylanders' health. The financial status of Maryland hospitals was declining because of the rate setting of the Health Services Cost Review Commission while hospital admission rates and spending were increasing.

Use of Smartphones for Clinical and Medical Education.

Smartphone use in clinical settings and in medical education has been on the rise, benefiting both health care and health care providers. Studies have shown, however, that some health care facilities and providers are reluctant to switch to smartphones due to the threat of mixing personal apps with clinical care applications and the possibility that distraction created by smartphone use could lead to medication errors and errors linked to procedures, treatments, or tests. The purpose of this research was to examine the effects of smartphones in a clinical setting and for medical education, to determine their overall impact.

Can mHealth Revolutionize the Way We Manage Adult Obesity?

Obesity is the largest driver of chronic preventable diseases, accounting for an estimated $147 billion or 10 percent of total US healthcare costs in 2008. It has been forecasted that 42 percent of Americans will be obese by 2030. Mobile health (mHealth) technologies target and may modify the behavioral factors that lead to obesity to promote a healthy lifestyle.

Is There a Trade-off Between Quality and Profitability in United States Nursing Homes?

Nursing home residents across the United States rely on quality care and effective services. Nursing homes provide skilled nurses and nursing aides who can provide services 24 hours a day for individuals who could not perform these tasks for themselves. Not-for-profit (NFP) versus for-profit (FP) nursing homes have been examined for utilization and efficacy; however, it has been shown that NFP nursing homes generally offer higher quality care and generate greater profit margins compared with FP nursing homes.

Access to Behavioral Health Care Services in New Jersey.

Patients with health insurance may find that obtaining an initial appointment for behavioral healthcare is an arduous process. A stratified sample of licensed New Jersey psychiatrists and psychologists was surveyed by telephone. Results revealed that patient access to care under 10 large insurance plans in New Jersey varies by plan, but overall was difficult.

Concierge Medicine: A Viable Business Model for (Some) Physicians of the Future?

Concierge medicine is a medical management structure that has been in existence since the 1990s. Essentially, a typical concierge medical practice limits its number of patients and provides highly personalized attention that includes comprehensive annual physicals, same-day appointments, preventive and wellness care, and fast, 24/7 response time. Concierge medicine has become popular among both physicians and patients/consumers who are frustrated by the limitations imposed by managed care organizations.

Renal Dialysis and its Financing.

The incidence of end-stage renal disease (ESRD) and its associated comorbidities such as diabetes and hypertension continue to increase as the population ages. As most ESRD patients qualify for Medicare coverage, the U.S.

Costs, Staffing, and Services of Assisted Living in the United States: A Literature Review.

Assisted-living facilities (ALFs), which provide a community for residents who require assistance throughout their day, are an important part of the long-term-care system in the United States. The costs of ALFs are paid either out of pocket, by Medicaid, or by long-term-care insurance. Monthly costs of ALFs have increased over the past 5 years on an average of 4.

Accountable care organizations: financial advantages of larger hospital organizations.

Accountable care organizations (ACOs) are groups of providers who agree to accept the responsibility for elevating the health status of a defined group of patients, with the goal of enabling people to take charge of their health and enroll in shared decision making with providers. The large initial investment required (estimated at $1.8 million) to develop an ACO implies that the participation of large health care organizations, especially hospitals and health systems, is required for success.

The PGP demonstrations: were they sufficient to justify accountable care organizations?

The Physician Group Practice (PGP) Demonstration Project was designed to try to establish whether high-quality healthcare can be delivered to Medicare patients, while simultaneously lowering overall Medicare costs. In this project, participating healthcare organizations were provided a portion of any savings achieved, provided that certain quality goals were also achieved. The results of this project were used to provide evidence as to the feasibility of Accountable Care Organizations (ACOs), a healthcare delivery approach, which is rapidly becoming more prevalent.

Adoption of the ICD-10 standard in the United States: the time is now.

The United States is facing a revolution in the health care system soon when the present coding system (International Classification of Diseases, Ninth Revision) will be replaced with what has for some years been the international standard: International Statistical Classification of Diseases, 10th Revision (ICD-10). The ICD-10 system will provide a tremendous opportunity for better capturing information in the increasingly complex delivery of health care. Although the transition to ICD-10 will undoubtedly result in substantial short-term costs, the long-term benefits make the transition imperative.

The US Organization for Economic Cooperation and Development Health Care spending chasm: better understanding some of the reasons for the gap and some suggestions as to how it might be narrowed.

Comparisons of health care spending between the United States and the rest of the world are frequently made. This article examines macrolevel secondary data comparing health care spending in the United States and other OECD countries, but this comparison does not necessarily present a complete picture. This article puts the US OECD health care spending gap into better context by examining the implications of population differences, quality-of-life spending, obesity trends, and defensive medicine and their contribution to US health care costs.

'Phantom networks' of managed behavioral health providers: an empirical study of their existence and effect on patients in two New Jersey counties.

Managed care organizations often tout the availability of clinicians in their provider networks, yet their clients seeking mental healthcare may find it difficult to obtain such care in a timely and effective manner. Using comprehensive data from two counties in New Jersey, the authors examine the prevalence of phantom networks of managed care providers of behavioral health services and the effects of such networks on patients' wait times and the availability of therapists treating children.

Hospitalists at an academic medical center, part 2: guidelines and suggestions for the successful expansion of a voluntary pilot hospitalist program.

Previously, the authors discussed the successful introduction of a pilot hospitalist program at an academic medical center. Here they examine best practices for the expansion of such a program. Many studies have shown hospitalists to be associated with improvements in hospital quality indicators such as decreased length of stay, but the conditions necessary for the expansion of a hospitalist program have received considerably less attention.

Hospitalists at an academic medical center, part 1: impact of a voluntary pilot hospitalist program.

The use of hospitalists-physicians who limit their practice largely or exclusively to hospital inpatient care-has been a growing trend in the United States. The authors examine some pressures affecting an academic medical center and present the results of a hospitalist pilot project there. Based on the criteria of reduced patient length of hospital stay, hospital financial savings, physician satisfaction, and payer interest, the pilot hospitalist program was successful within 6 months.

Consumers' perceptions and opinions of sports injuries: an exploratory empirical study.

Millions of individuals in the United States play some sports or are involved in strenuous physical activities on a regular basis. Unfortunately, many suffer injuries due to these activities. The authors devised this study to determine consumers' perceptions and opinions associated with the injuries that they or someone they know sustained.

Overall outpatient satisfaction and its components: perceived changes at the Huntington VA Medical Center over five years.

The number of veterans obtaining healthcare services at Huntington Veteran's Administration Medical Center (HVAMC) had significantly increased over the five-year span from fiscal year 2000 through fiscal year 2004. The authors' purpose in this study was to determine changes in outpatient satisfaction levels at HVAMC over that five-year period. The authors assessed the following specific measures of patient satisfaction: courtesy, access, patient preferences, coordination of care, education and information, emotional support, overall quality, pharmacy services, and overall satisfaction.

Pharmacy layout: What are consumers' perceptions?

The physical layout of a retail pharmacy can play a significant role in the development of the customers' perceptions which can have a positive (or negative) impact on its sales potential. Compared to most general merchandise stores, pharmacies are more concerned about safety and security issues due to the nature of their products. This paper will discuss these aspects as well as the physical and professional environments of retail pharmacies that influence the perceptions of customers and how these vary whether chain, independent, or hospital pharmacies.

What do consumers and healthcare providers in West Virginia think of long-term care?

In recent years, the media has portrayed long-term care in a negative light, with exposè news stories on skilled nursing facilities, personal care homes, and hospitals that provide long-term care. There have been few positive news stories to counter the negative ones, and there is concern that the public perception of long-term care is inaccurate. The authors conducted the following study to evaluate how the West Virginia consumer perceives and defines long-term care and if there is a difference in that perception as compared with healthcare workers' perceptions and definitions of long-term care.