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Frontiers in Rehabilitation Sciences 2022The purpose of this study was to review and evaluate existing research that used risk adjusters in disability research. Risk adjustment controls for individual...
The purpose of this study was to review and evaluate existing research that used risk adjusters in disability research. Risk adjustment controls for individual characteristics of persons when examining outcomes. We have conducted a systematic review and an evaluation of existing studies that included risk adjusters for outcomes of people with disabilities receiving services (home or community based). The process included coding each study according to the type(s) of risk adjusters employed and their relation to the specific population and outcomes within a framework. Panels were utilized to prioritize the risk adjusters. Findings indicate that four risk adjusters can be tentatively recommended as potential candidate risk adjusters: chronic conditions, functional disability, mental health status, and cognitive functioning. Holistic Health and Functioning far outweighed other outcomes studied to date. Further, there is a need for testing recommended risk adjusters across multiple outcomes and different populations of people with disabilities.
PubMed: 36188939
DOI: 10.3389/fresc.2022.830175 -
Frontiers in Psychology 2023Borderline personality disorder (BPD) is a complex mental disorder with core symptoms like interpersonal instability, emotion dysregulation, self-harm, and impulsive...
INTRODUCTION
Borderline personality disorder (BPD) is a complex mental disorder with core symptoms like interpersonal instability, emotion dysregulation, self-harm, and impulsive decision-making. Previous neuropsychological studies have found impairment in the decision-making of patients with BPD related to impulsivity. In our study, we focus on a better, more nuanced understanding of impulsive decision-making in BPD with the help of Rogers' decision-making test that simulates a gambling situation.
METHODS
A novelty of our study is that we excluded from further analysis non-compliant participants based on their performance. Outlier participants on the measures proportion of good choices and average of wager choice number were filtered out to represent the population that understood the basic premise of the task and showed minimal motivation to gain rewards. Thus participants often choosing the less likely color or frequently choosing the first bet amount available (to probably speed up the test) were omitted from further analysis. Another novelty is that we assessed and reported six variables that examine Deliberation Time, Quality of Decision, Risk-taking, Overall proportion bet, Delay aversion, and Risk adjustment. Forty-three women with BPD participated in the study, and 16 non-compliant were excluded. As for the healthy control group, 42 women participated in the study, and four non-compliant were excluded. Thus, we compared the data of 27 patients with BPD with 38 healthy controls.
RESULTS
Our results show that there are significant differences amongst the groups regarding the Quality of Decision Making ( (1,63) = 5.801, = 0.019) and Risk Adjustment ( (1,63) = 6.522, = 0.013). We also found significant interactions between group and winning probability regarding Risk Taking ( (4,252) = 4.765 = 0.001) and Overall proportion of bets, i.e., the average proportion of bets relative to the total score of the subject ( (4,252) = 4.505, = 0.002).
DISCUSSION
Our results show that the two groups use different decision-making strategies that can have various associations with everyday life situations.
PubMed: 37599767
DOI: 10.3389/fpsyg.2023.1109238 -
Rhode Island Medical Journal (2013) Sep 2020In 2020, the COVID-19 pandemic has ravaged the world. Individuals with end-stage kidney disease (ESKD) are at higher risk due to impaired immunity, comorbid conditions,... (Review)
Review
In 2020, the COVID-19 pandemic has ravaged the world. Individuals with end-stage kidney disease (ESKD) are at higher risk due to impaired immunity, comorbid conditions, and dependence on travel to medical care settings. We review the salient features of COVID-19 in this population, including the risk of infection, disease course, changes in dialysis unit management, use of investigatory medications, access considerations, home dialysis, and capacity planning.
Topics: Betacoronavirus; COVID-19; Comorbidity; Coronavirus Infections; Disease Transmission, Infectious; Hemodialysis Units, Hospital; Hemodialysis, Home; Humans; Infection Control; Kidney Failure, Chronic; Organizational Innovation; Pandemics; Pneumonia, Viral; Renal Dialysis; Risk Adjustment; SARS-CoV-2
PubMed: 32900009
DOI: No ID Found -
JACC. Cardiovascular Interventions Dec 2020
Topics: Benchmarking; Cardiac Catheterization; Child; Hospital Mortality; Humans; Surgeons; Treatment Outcome
PubMed: 33357523
DOI: 10.1016/j.jcin.2020.09.049 -
Antimicrobial Stewardship & Healthcare... 2023The standardized antimicrobial administration ratio (SAAR) is the metric for reporting antimicrobial use that hospitals will be mandated to use in 2024. We highlight...
The standardized antimicrobial administration ratio (SAAR) is the metric for reporting antimicrobial use that hospitals will be mandated to use in 2024. We highlight limitations of the SAAR and caution against efforts to use it for public reporting and financial reimbursement. Before the SAAR is ready for public reporting, it needs to include patient-level risk adjustment and antimicrobial resistance data as well as improved hospital location options and revised antimicrobial agent groupings to appropriately reflect and incentivize important stewardship work.
PubMed: 37113208
DOI: 10.1017/ash.2023.143 -
JACC. Heart Failure May 2023
Topics: Humans; Heart Failure; Quality of Health Care; Heart Transplantation
PubMed: 37137659
DOI: 10.1016/j.jchf.2023.01.025 -
Deutsches Arzteblatt International Feb 2021
Topics: Humans; Risk Adjustment
PubMed: 33835009
DOI: 10.3238/arztebl.m2021.0056 -
Schizophrenia Research. Cognition Sep 2024Schizophrenia spectrum disorders (SSD) are associated with pervasive cognitive impairments, including deficits in decision-making under risk. However, there is...
Schizophrenia spectrum disorders (SSD) are associated with pervasive cognitive impairments, including deficits in decision-making under risk. However, there is inconclusive evidence regarding specific mechanisms underlying altered decision-making patterns. In this study, participants (33 SSD and 28 non-SSD) completed the Columbia Card Task, an explicit risk-taking task, to better understand risk preference and adjustment in dynamic decision-making. We found that while there is no group difference in overall risk-taking, risk preference, or optimal decision-making, risk adjustment to contextual factors (e.g., loss probability) is blunted in SSD. We also found associations between risk-taking/suboptimal decision-making and disorganized symptoms, excited symptoms, and role functioning, but no associations between decision-making and working memory. These results suggest that during a complex, dynamic risk-taking task, individuals with SSD exhibit less adaption to changing information about risk, which may reflect risk imperception.
PubMed: 38764743
DOI: 10.1016/j.scog.2024.100314 -
Medical Journal of the Islamic Republic... 2022Capitation payment is the best-known strategy for paying providers in primary health care. Since health care needs and personal characteristics play an essential role... (Review)
Review
Capitation payment is the best-known strategy for paying providers in primary health care. Since health care needs and personal characteristics play an essential role in health care utilization and resource spending, there is a growing tendency on risk adjustment models among health researchers. The objective of this systematic review was to examine the weights used for risk adjustment in primary health care capitation payment. We systematically searched Scopus, ProQuest, Web of Science, and PubMed in March 2018. Two authors independently apprised the included articles and they also evaluated, identified, and categorized different factors on capitation payments mentioned in the included studies. A total of 742 studies were identified and 12 were included in the systematic review after the screening process. Risk factors for capitation adjustment included age, gender, and income with the weighted average being 1.76 and 1.03, respectively. Moreover, the weighted average disease incidence adjusted clinical groups (ACGs), diagnostic cost groups (DCGs), principal in patient diagnostic cost groups (PIP-DCGs), and hierarchical coexisting conditions (HCCs) were reported as 1.31, 24.7-.99, 10.4-.65, and 11.7-1.01, respectively. In low-income countries, the most effective factors used in capitation adjustment are age and sex. Moreover, the most applied factor in high-income countries is adjusted clinical groups, and income factors can have a better impact on the reduction of costs in low-income countries. Each country can select its most efficient factors based on the weight of the factor, income level, and geographical condition.
PubMed: 35999922
DOI: 10.47176/mjiri.36.2