Section on Uniformed Services Program最新文献

{"title":"Hydroxyurea Use for Sickle Cell Anemia Patients is Underutilized Even Within a Universal Health Care System","authors":"Kirsten Miller-Jaster, Apryl Susi, Cade M. Nylund, K. Lieuw, Gregory H Gorman","doi":"10.1542/PEDS.147.3_MEETINGABSTRACT.1044","DOIUrl":"https://doi.org/10.1542/PEDS.147.3_MEETINGABSTRACT.1044","url":null,"abstract":"Background: Sickle cell anemia (SCA) is a common hematologic disease in the US which results in severe morbidity and mortality affecting the African American population. Hydroxyurea is a safe and efficacious drug that decreases ischemic events and end-organ damage. Hydroxyurea was found in a randomized placebo controlled trial (BABY HUG) to be beneficial to children and was strongly recommended for pediatric use in 2014. There is concern that this therapy, now considered standard of care, remains underutilized. Objective: We aim to describe …","PeriodicalId":143776,"journal":{"name":"Section on Uniformed Services Program","volume":"85 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125729844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ebstein's Anomaly and Left Ventricular Non-Compaction in Association With A Novel MYH7 Gene Mutation","authors":"Blake T Cirks, Joseph W. May, M. Mulreany, M. Needleman, C. Turner, L. Hellwig","doi":"10.1542/PEDS.147.3_MEETINGABSTRACT.1037","DOIUrl":"https://doi.org/10.1542/PEDS.147.3_MEETINGABSTRACT.1037","url":null,"abstract":"","PeriodicalId":143776,"journal":{"name":"Section on Uniformed Services Program","volume":"163 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132495036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Access to Care in a Single-Provider Military Treatment Facility","authors":"A. M. Carlson, Richard Allen Leonidas, C. Perkins","doi":"10.1542/PEDS.147.3_MEETINGABSTRACT.1045","DOIUrl":"https://doi.org/10.1542/PEDS.147.3_MEETINGABSTRACT.1045","url":null,"abstract":"BACKGROUND: Military Health System (MHS) beneciaries have historically reported greater dissatisfaction with access to care than their civilian counterparts At Osan Air Base in South Korea, the pediatric clinic of1,200 patients is staffed by a single pediatrician, making improvements in access challenging Commandinterest in increasing the number of command-sponsored children on base made improving access to carecrucial OBJECTIVE: Our objective was to improve third-next-available future appointment booking time to 4 0days and acute to 1 5 days without decreasing the average number of relative value units (RVUs) per week METHODS: We conducted plan-do-study-act (PDSA) cycles aimed at increasing access to care for future andacute visits Baseline pre-intervention data was obtained via chart reviews of medical records from August toSeptember 2019 We based initial clinical interventions on RESET for Pediatrics developed by Fairchild ABPediatrics, including turning off cross-booking and scrubbing appointments Subsequent interventionsincluded switching acutes to the afternoon, offering virtual visits, and changing the future/acute appointment ratio to 70/30 from 60/40 We implemented these interventions in four PDSA cycles and followed third-next-available dates in clinic from October 2019 to February 2020 To analyze the benet of improved access, wenoted changes in patient satisfaction and tracked RVUs earned per week RESULTS: The baseline third-next-available appointment was an average of 10 7 days for future and 2 9 days for acute appointments After thefull intervention period, the third-next-available future appointment had decreased to 4 0 days for future and1 1 for acute visits Third-next-available decreased in a step-wise fashion with each intervention until January,when the provider was out of clinic for two weeks, but continued to decline in February Average number ofRVUs per week pre- and post-intervention were not signicantly different, at 19 45±3 95 and 19 01±0 91,respectively Patient satisfaction with ease of making an appointment increased from 68 9% pre-interventionto 87 6% post-intervention CONCLUSIONS The interventions improved access in our single-provider clinic andthe goal for third-next-available future and acute appointments was met in December 2019 and February2020, respectively Both measures increased signicantly in January, when the provider was out for two weeks,but quickly continued to decline in February The number of RVUs per week was maintained despite openingup access signicantly in clinic and switching many appointments to virtuals Patient satisfaction increasedsignicantly during the study period Limitations on this data include that 132 patients were redistributed tofamily medicine in October;however, the proportional decrease in empaneled patients was small comparedto the signicant decreases in third-next-available appointment times Additionally, the post-intervention data was only collected until February due to the COVID-","PeriodicalId":143776,"journal":{"name":"Section on Uniformed Services Program","volume":"5 28","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131436581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhibition Of Oxidative Phosphorylation In Medullary Thyroid Cancer Cells Affects mRNA Levels Of Genes Controlling Cancer Cell Proliferation And Apoptosis.","authors":"Sarah M Reynolds, Aneeta D Patel, Maria Cecelia Mendonca Torres, Kirk Jensen, V. Vasko","doi":"10.1542/PEDS.147.3_MEETINGABSTRACT.1049","DOIUrl":"https://doi.org/10.1542/PEDS.147.3_MEETINGABSTRACT.1049","url":null,"abstract":"","PeriodicalId":143776,"journal":{"name":"Section on Uniformed Services Program","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131593035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}