Which modifiable health risks are associated with changes in productivity costs?

The purpose of this retrospective, longitudinal study was to assess longitudinal associations between modifiable health risks and workplace absenteeism and presenteeism and to estimate lost productivity costs. Across the 4-year study period (2007-2010), 17,089 unique employees from a large US computer manufacturer with a highly technical workforce completed at least 1 health risk assessment. Generalized estimating equation models were used to estimate the mean population-level absenteeism and presenteeism for 11 modifiable health risks and adjust for 9 sociodemographic and employment-related factors.

Effect of a postdischarge virtual ward on readmission or death for high-risk patients: a randomized clinical trial.

Importance: Hospital readmissions are common and costly, and no single intervention or bundle of interventions has reliably reduced readmissions. Virtual wards, which use elements of hospital care in the community, have the potential to reduce readmissions, but have not yet been rigorously evaluated.

Objective: To determine whether a virtual ward-a model of care that uses some of the systems of a hospital ward to provide interprofessional care for community-dwelling patients-can reduce the risk of readmission in patients at high risk of readmission or death when being discharged from hospital.

The effect of a collaborative pharmacist-hospital care transition program on the likelihood of 30-day readmission.

Purpose: The effect of a collaborative pharmacist-hospital care transition program on the likelihood of 30-day readmission was evaluated.

Methods: This retrospective cohort study was conducted in two acute care hospitals within the same hospital system in the southeastern United States. One hospital initiated a care transition program in January 2011; the other hospital did not have such a program.

The role of matched controls in building an evidence base for hospital-avoidance schemes: a retrospective evaluation.

Objective: To test whether two hospital-avoidance interventions altered rates of hospital use: "intermediate care" and "integrated care teams."

Data Sources/study Setting: Linked administrative data for England covering the period 2004 to 2009.

Study Design: This study was commissioned after the interventions had been in place for several years.

Counterheroism, common knowledge, and ergonomics: concepts from aviation that could improve patient safety.

Context: Many safety initiatives have been transferred successfully from commercial aviation to health care. This article develops a typology of aviation safety initiatives, applies this to health care, and proposes safety measures that might be adopted more widely. It then presents an economic framework for determining the likely costs and benefits of different patient safety initiatives.

Predictive risk modelling in health: options for New Zealand and Australia.

Predictive risk models (PRMs) are case-finding tools that enable health care systems to identify patients at risk of expensive and potentially avoidable events such as emergency hospitalisation. Examples include the PARR (Patients-at-Risk-of-Rehospitalisation) tool and Combined Predictive Model used by the National Health Service in England. When such models are coupled with an appropriate preventive intervention designed to avert the adverse event, they represent a useful strategy for improving the cost-effectiveness of preventive health care.

Predicting who will use intensive social care: case finding tools based on linked health and social care data.

Background: the costs of delivering health and social care services are rising as the population ages and more people live with chronic diseases.

Objectives: to determine whether predictive risk models can be built that use routine health and social care data to predict which older people will begin receiving intensive social care.

Design: analysis of pseudonymous, person-level, data extracted from the administrative data systems of local health and social care organisations.

"Impactibility models": identifying the subgroup of high-risk patients most amenable to hospital-avoidance programs.

Context: Predictive models can be used to identify people at high risk of unplanned hospitalization, although some of the high-risk patients they identify may not be amenable to preventive care. This study describes the development of "impactibility models," which aim to identify the subset of at-risk patients for whom preventive care is expected to be successful.

Methods: This research used semistructured interviews with representatives of thirty American organizations that build, use, or appraise predictive models for health care.

Enhancing the sensitivity of a sustained attention task to frontal damage: convergent clinical and functional imaging evidence.

Despite frequent reports of poor concentration following traumatic brain injury, studies have generally failed to find disproportionate time-on-task decrements using vigilance measures in this patient group. Using a rather different definition, neuropsychological and functional imaging research has however linked sustained attention performance to right prefrontal function--a region likely to be compromised by such injuries. These studies have emphasised more transitory lapses of attention during dull and ostensibly unchallenging activities.

Coffee in the cornflakes: time-of-day as a modulator of executive response control.

Previous self-report based research has revealed a heightened propensity to slips-of-action in the early morning and at the end of the day. Here, we examined performance variability among healthy young adults as a function of time-of-day on a clinical task that is sensitive to absent-minded slips in brain-injured groups. We found significantly higher error rates at 1 pm and 7 pm compared with 1 am and 7 pm, and significant correlations between errors and two subjective sleepiness scales.