Quel est le rôle de la Commission ?

Elle évalue les systèmes de paiement pour améliorer l'efficacité des soins.

Comment la Commission collecte-t-elle des données ?

Elle utilise des études, des rapports et des données de facturation des hôpitaux.

Quels types de soins sont évalués ?

Tous les soins hospitaliers et ambulatoires sont pris en compte.

Qui compose la Commission ?

Elle est composée d'experts en santé, économistes et représentants des patients.

Quels critères sont utilisés pour l'évaluation ?

Les critères incluent la qualité des soins, les coûts et l'accès aux services.

Quels problèmes la Commission cherche-t-elle à résoudre ?

Elle vise à réduire les inégalités d'accès et à améliorer la qualité des soins.

Comment la Commission évalue-t-elle l'accès aux soins ?

Elle analyse les données sur l'utilisation des services de santé par les populations.

Quels indicateurs de performance sont utilisés ?

Les indicateurs incluent les taux de réadmission et la satisfaction des patients.

Comment les résultats sont-ils communiqués ?

Les résultats sont publiés dans des rapports accessibles au public et aux décideurs.

Quels sont les impacts des recommandations de la Commission ?

Elles influencent les politiques de paiement et les pratiques de soins de santé.

Quel est le rôle de la prévention dans l'évaluation ?

La prévention est essentielle pour réduire les coûts et améliorer la santé publique.

Comment la Commission promeut-elle la prévention ?

Elle recommande des programmes de prévention et des incitations financières.

Quels types de programmes sont soutenus ?

Les programmes de vaccination et de dépistage sont souvent soutenus.

Comment la prévention impacte-t-elle les coûts ?

Une meilleure prévention peut réduire les hospitalisations et les coûts à long terme.

Quels sont les obstacles à la prévention ?

Les obstacles incluent le manque de financement et l'accès limité aux services.

Comment la Commission influence-t-elle les traitements ?

Elle recommande des ajustements de paiement pour encourager des traitements efficaces.

Quels traitements sont souvent réévalués ?

Les traitements coûteux et ceux avec des résultats variables sont souvent réévalués.

Comment les hôpitaux s'adaptent-ils aux recommandations ?

Ils modifient leurs pratiques et protocoles pour répondre aux nouvelles directives.

Quels sont les défis pour les hôpitaux ?

Les hôpitaux doivent équilibrer coûts, qualité des soins et conformité aux recommandations.

Comment la Commission évalue-t-elle l'efficacité des traitements ?

Elle analyse les résultats cliniques et les coûts associés à chaque traitement.

Quelles complications sont surveillées par la Commission ?

Les complications liées aux soins hospitaliers, comme les infections nosocomiales.

Comment les complications affectent-elles les paiements ?

Les complications peuvent entraîner des pénalités financières pour les hôpitaux.

Quels sont les impacts des complications sur les patients ?

Les complications peuvent prolonger l'hospitalisation et affecter la récupération.

Comment la Commission évalue-t-elle les complications ?

Elle analyse les taux de complications et les compare aux normes de soins.

Quelles mesures sont prises pour réduire les complications ?

Des protocoles de soins améliorés et des formations pour le personnel sont mises en place.

Quels facteurs de risque sont pris en compte ?

Les facteurs incluent l'âge, les comorbidités et les conditions socio-économiques.

Comment les facteurs de risque influencent-ils les paiements ?

Les hôpitaux reçoivent des ajustements de paiement basés sur les risques des patients.

Quels outils sont utilisés pour évaluer les risques ?

Des modèles statistiques et des bases de données de santé sont utilisés.

Comment la Commission aborde-t-elle les inégalités ?

Elle analyse les disparités d'accès et de résultats en fonction des facteurs de risque.

Quels sont les impacts des facteurs de risque sur les soins ?

Ils peuvent influencer la qualité des soins et les résultats pour les patients.

Commission d'évaluation du paiement à l'activité (USA)

Understanding triage assessment of acuity by emergency nurses at initial adult patient presentation: A qualitative systematic review.

Nov 2023

DOI: 10.1016/j.ienj.2023.101334 PMID: 37716173

Nurses make complex triage decisions within emergency departments, which significantly affect patient outcomes. Understanding how nurses make these decisions and why they deviate from triage algorithm... This qualitative systematic review aimed to understand decision-making processes emergency nurses use to make acuity decisions during triage assessment at initial patient presentation.... Medline, CINAHL and Academic Search Complete were systematically searched to 15th December 2022. Data were analysed using thematic synthesis. Established themes were reviewed with GRADE-CERQual to eva... 28 studies were included in the review. Data analysis uncovered three superordinate themes of holistic reasoning, situational awareness, and informed decision-making. The findings show nurses value ho... This review presents new perspectives on nurses' decision-making processes about patient's acuity. Nurses holistically gather information about patients before translating that information into acuity...

Humans Adult Triage Decision Making Emergency Nursing +2 autres

Association between initial presenting level of consciousness and patient acuity - A potential application for secondary triage in emergency ambulance calls.

Sep 2023

DOI: 10.1016/j.auec.2022.11.002 PMID: 36496330

Conscious state assessment is important for the triage of emergency patients. In this study, we measured the association between ambulance patients' conscious state and high versus lower acuity, with ... Data were analysed from one year of emergency ambulance incidents in Perth, Western Australia. Patient conscious state at the time of paramedic arrival was compared to acuity (based on paramedic asses... The proportion of high acuity patients increased with each step across the consciousness scale. Applying conscious state as a binary predictor of acuity, the largest increases occurred moving the thre... Based on these proportions of high acuity patients, it is reasonable to consider patients with any altered conscious state a high priority. The value of conscious state assessment for predicting acuit...

Humans Triage Ambulances Consciousness Retrospective Studies +1 autres

Use of a Large Language Model to Assess Clinical Acuity of Adults in the Emergency Department.

01 May 2024

DOI: 10.1001/jamanetworkopen.2024.8895 PMID: 38713466

The introduction of large language models (LLMs), such as Generative Pre-trained Transformer 4 (GPT-4; OpenAI), has generated significant interest in health care, yet studies evaluating their performa... To determine whether an LLM can accurately assess clinical acuity in the emergency department (ED).... This cross-sectional study identified all adult ED visits from January 1, 2012, to January 17, 2023, at the University of California, San Francisco, with a documented Emergency Severity Index (ESI) ac... The potential of the LLM to classify acuity levels of patients in the ED based on the ESI across 10 000 patient pairs. Using deidentified clinical text, the LLM was queried to identify the patient wit... Accuracy score was calculated to evaluate the performance of both LLMs across the 10 000-pair sample. A 500-pair subsample was manually classified by a physician reviewer to compare performance betwee... From a total of 251 401 adult ED visits, a balanced sample of 10 000 patient pairs was created wherein each pair comprised patients with disparate ESI acuity scores. Across this sample, the LLM correc... In this cross-sectional study of 10 000 pairs of ED visits, the LLM accurately identified the patient with higher acuity when given pairs of presenting histories extracted from patients' first ED docu...

Humans Emergency Service, Hospital Cross-Sectional Studies Adult Male +5 autres

Redirection of low-acuity emergency department patients to nearby medical clinics using an electronic medical support system: effects on emergency department performance indicators.

13 Sep 2024

DOI: 10.1186/s12873-024-01080-0 PMID: 39272018

Overcrowded emergency departments (EDs) are associated with higher morbidity and mortality and suboptimal quality-of-care. Most ED flow management strategies focus on early identification and redirect... We performed a retrospective observational study in the ED of a Canadian tertiary trauma center where a redirection process for low-acuity patients was implemented. The process was based on a clinical... Of 242,972 ED attendees over the study period, 9546 (8% of 121,116 post-intervention patients) were redirected to a nearby primary medical clinic. After the redirection process was implemented, length... Implementing a redirection process for low-acuity ED patients based on a clinical support system was associated with improvements in two of four ED performance indicators....

Humans Retrospective Studies Female Male Triage +11 autres

"I do not know the advantages of having a general practitioner" - a qualitative study exploring the views of low-acuity emergency patients without a regular general practitioner toward primary care.

15 May 2024

DOI: 10.1186/s12913-024-10977-2 PMID: 38750500

Emergency departments (ED) worldwide have to cope with rising patient numbers. Low-acuity consulters who could receive a more suitable treatment in primary care (PC) increase caseloads, and lack of PC... Qualitative semi-structured telephone interviews were conducted with 32 low-acuity ED consulters with no self-reported attachment to a GP. Participants were recruited from three EDs in the city center... Interviewed patients reported heterogeneous factors contributing to their PC utilization behavior and underlying views and experiences. Participants most prominently voiced a rare need for medical ser... Understanding reasons of low-acuity ED patients for GP non-utilization can play an important role in the design and implementation of patient-centered care interventions for PC integration. Increasing... German Clinical Trials Register: DRKS00023480; date: 2020/11/27....

Humans Qualitative Research Male Primary Health Care Female +8 autres

The potential of virtual triage AI to improve early detection, care acuity alignment, and emergent care referral of life-threatening conditions.

2024

DOI: 10.3389/fpubh.2024.1362246 PMID: 38807993

To evaluate the extent to which patient-users reporting symptoms of five severe/acute conditions requiring emergency care to an AI-based virtual triage (VT) engine had no intention to get such care, a... A dataset of 3,022,882 VT interviews conducted over 16 months was evaluated to quantify and describe patient-users reporting symptoms of five potentially life-threatening conditions whose pre-triage h... Healthcare intent data was obtained for 12,101 VT patient-user interviews. Across all five conditions a weighted mean of 38.5% of individuals whose VT indicated a condition requiring emergency care ha... AI-based VT may offer a vehicle for early detection and care acuity alignment of severe evolving pathology by engaging patients who believe their symptoms are not serious, and for accelerating care re...

Humans Triage Female Male Referral and Consultation +8 autres

Predicting Visual Acuity in Patients Treated for AMD.

20 Jun 2022

DOI: 10.3390/diagnostics12061504 PMID: 35741314

The leading diagnostic tool in modern ophthalmology, Optical Coherence Tomography (OCT), is not yet able to establish the evolution of retinal diseases. Our task is to forecast the progression of reti...

Prediction of Visual Acuity in Patients With Microbial Keratitis.

01 Feb 2023

DOI: 10.1097/ICO.0000000000003129 PMID: 36256452

The purpose of this study was to predict visual acuity (VA) 90 days after presentation for patients with microbial keratitis (MK) from data at the initial clinical ophthalmic encounter.... Patients with MK were identified in the electronic health record between August 2012 and February 2021. Random forest (RF) models were used to predict 90-day VA < 20/40 [visual impairment (VI)]. Predi... One thousand seven hundred ninety-one patients were identified. The presenting logMAR VA was on average 0.86 (Snellen equivalent and standard deviation = 20/144 ± 12.6 lines) in the affected or worse ... RF modeling yielded good sensitivity and specificity to predict VI at 90 days which could guide clinicians about the risk of poor vision outcomes for patients with MK....

Humans Visual Acuity Keratitis Vision, Low

Refractive Surgery Patient Characteristics Associated With Satisfaction Scores.

Aug 2024

DOI: 10.3928/1081597X-20240611-02 PMID: 39120021

To determine factors influencing patient satisfaction scores in recipients of refractive surgery.... In this prospective survey-based study, patients who had refractive surgery at an outpatient refractive clinic completed a survey of selected questions from the Press Ganey survey and the National Eye... Fifty-three patients were recruited over a 3-year period. Most were male (55%) and middle aged (mean age: 34 years). Eleven percent underwent photorefractive keratectomy surgery and the rest had laser... This study found persistent high patient satisfaction score across a variation of characteristics, suggesting that optimal scores are mainstay after refractive surgery procedures with excellent visual...

Humans Prospective Studies Male Patient Satisfaction Female +12 autres

Lung function trajectories in patients with idiopathic pulmonary fibrosis.

24 Aug 2023

DOI: 10.1186/s12931-023-02503-5 PMID: 37612608

Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing interstitial lung disease characterised by decline in lung function. We evaluated trajectories of forced vital capacity (FVC) and diffusi... Patients with IPF that was diagnosed or confirmed at the enrolling centre in the previous 6 months were enrolled into the IPF-PRO Registry between June 2014 and October 2018. Patients were followed pr... Of 1002 patients in the registry, 941 had ≥ 1 FVC and/or DLco measurement after enrolment. The median (Q1, Q3) follow-up period was 35.1 (18.9, 47.2) months. Overall, mean estimated declines in FVC an... Data from the IPF-PRO Registry suggest a constant rate of decline in lung function over a prolonged period, supporting the inexorably progressive nature of IPF. A graphical abstract summarising the da... NCT01915511....

Female Humans Male Idiopathic Pulmonary Fibrosis Lung +3 autres

Commission d'évaluation du paiement à l'activité (USA) : Questions médicales fréquentes

Termes MeSH sélectionnés :

Questions fréquentes et termes MeSH associés

Diagnostic 5

Symptômes 5

Prévention 5

Traitements 5

Complications 5

Facteurs de risque 5

Contenu validé par Dr Olivier Menir

Auteurs principaux

Sources (10000 au total)