And a higher rate of Homebirth moms say «I understood the normalcy of birth and took care of myself and had a positive outlook», and had a bad
outcome than hospital birth moms.
Hospitals that spend more on initial care following patient emergencies have better
outcomes than hospitals that spend less at first and rely more on additional forms of long - term care, according to a new study co-authored by MIT economists.
Not exact matches
But now that Obamacare is ensuring health care providers get paid for better
outcomes rather
than the number of visits a patient makes to the doctor, you can be sure
hospitals will be using data to make sure they're delivering the best treatment they can.
Such risks and uncertainties include, but are not limited to: our ability to achieve our financial, strategic and operational plans or initiatives; our ability to predict and manage medical costs and price effectively and develop and maintain good relationships with physicians,
hospitals and other health care providers; the impact of modifications to our operations and processes; our ability to identify potential strategic acquisitions or transactions and realize the expected benefits of such transactions, including with respect to the Merger; the substantial level of government regulation over our business and the potential effects of new laws or regulations or changes in existing laws or regulations; the
outcome of litigation, regulatory audits, investigations, actions and / or guaranty fund assessments; uncertainties surrounding participation in government - sponsored programs such as Medicare; the effectiveness and security of our information technology and other business systems; unfavorable industry, economic or political conditions, including foreign currency movements; acts of war, terrorism, natural disasters or pandemics; our ability to obtain shareholder or regulatory approvals required for the Merger or the requirement to accept conditions that could reduce the anticipated benefits of the Merger as a condition to obtaining regulatory approvals; a longer time
than anticipated to consummate the proposed Merger; problems regarding the successful integration of the businesses of Express Scripts and Cigna; unexpected costs regarding the proposed Merger; diversion of management's attention from ongoing business operations and opportunities during the pendency of the Merger; potential litigation associated with the proposed Merger; the ability to retain key personnel; the availability of financing, including relating to the proposed Merger; effects on the businesses as a result of uncertainty surrounding the proposed Merger; as well as more specific risks and uncertainties discussed in our most recent report on Form 10 - K and subsequent reports on Forms 10 - Q and 8 - K available on the Investor Relations section of www.cigna.com as well as on Express Scripts» most recent report on Form 10 - K and subsequent reports on Forms 10 - Q and 8 - K available on the Investor Relations section of www.express-scripts.com.
In the study that established the difference, researchers looking at people two years after they first showed up at a
hospital for care found that they scored significantly better on most
outcome measures
than a comparable group in the West....
Other
than furthering the schism between the medical and natural childbirth camps, news that elective induction at 39 weeks prevents adverse
outcomes could place a strain on
hospitals.
Flint and colleagues suggested that when midwives get to know the women for whom they provide care, interventions are minimised.22 The Albany midwifery practice, with an unselected population, has a rate for normal vaginal births of 77 %, with 35 % of women having a home birth.23 A review of care for women at low risk of complications has shown that continuity of midwifery care is generally associated with lower intervention rates
than standard maternity care.24 Variation in normal birth rates between services (62 % -80 %), however, seems to be greater
than outcome differences between «high continuity» and «traditional care» groups at the same unit.25 26 27 Use of epidural analgesia, for example, varies widely between Queen Charlotte's
Hospital, London, and the North Staffordshire NHS Trust.
(Now, if there's a doctor who's doing mostly normal deliveries and getting worse
than average
outcomes, that's a matter for his colleagues,
hospital, etc..)
When no
hospital is available at all, as in the poorest parts of the world,
outcomes are a hundred times worse
than US
hospital birth.
Surrrrre the
outcomes in Ethiopia are better
than the USA... That's why my patients from Ethiopia were so excited to get to have their babies in a
hospital.
The most recent large scale study comparing
outcomes for mother and baby reported in the British Medical Journal last month showed that for women who had previously given birth, adverse
outcomes were less common among planned home births (1 per 1,000)
than among planned
hospital births (2.3 per 1,000).
When this 20 % risk of death is compared to the 0.02 % rate of cord prolapse during labor at homebirth that might have a better
outcome if it happened in
hospital, this means that a low risk woman has a 1000 times higher chance of having a life threatening complication either to her life or her fetus / newborns life at planned
hospital birth,
than if she plans to have an attended homebirth with a well - trained practitioner.
Rates of obstetrical intervention are high in U.S.
hospitals, and we found large absolute differences in the risks of these interventions between planned out - of -
hospital births and in -
hospital births.38 In contrast, serious adverse fetal and neonatal
outcomes are infrequent in all the birth settings we assessed, and the absolute differences in risk that we observed between planned birth locations were correspondingly small; for example, planned out - of -
hospital births were associated with an excess of less
than 1 fetal death per 1000 deliveries in multivariate and propensity - score - adjusted analyses.
An odds ratio of more
than 1 indicates that the risk of the
outcome is increased with planned out - of -
hospital birth as compared with planned
hospital birth.
A study reported in the BMJ found that women whose pregnancies were low - risk suffered far fewer severe negative
outcomes from home
than hospital births, especially after the first pregnancy.
To investigate whether perinatal
outcomes among interracial Asian - white couples are different
than among Asian - Asian and white - white couples.This was a retrospective study of Asian, white, and Asian - white couples delivered at the Lucile Packard Children's
Hospital from 2000 - 2005.
So a team of Dutch researchers decided to test whether low risk women at the onset of labour with planned home birth have a higher rate of rare but severe
outcomes (known as severe acute maternal morbidity or SAMM)
than those with planned
hospital births.
A randomised control trial conducted in BC [30] found home visits in early labour to be more effective
than telephone triage in reducing the number of women attending the
hospital for assessment before they are in labour and those attending before 3 cm cervical dilation, although the home visits had no impact on CS rates or birth
outcomes.
However, they have vastly less control over the
outcome than would be possible in a
hospital.
«unnecessary inductions, or too early inductions, or less
than good
outcomes due to c sections» these are not required in
hospital pregnancies «it takes a while for the painkillers to wear off in the baby...» you don't have to use painkillers in a
hospital.
Does nine times higher death rate of breech babies in homebirth according to MANA stats
than the death rate of breech births in
hospitals count as a proven negative
outcome or not?
And this inflammatory use of a «relative percentage risk» rather
than relative risk or absolute risk... for example, even if assuming the writer's awkward data is valid, you can to look at infant living rates and see 99.6 % vs 98.4 %, which means there's only a 1.2 % higher risk of bad
outcome from at - home birth
than hospital.
Homebirth is in America as Homebirth in America does, yet the Homebirth advocates who are looking at the actually data are making excuses about the worse
outcomes as they speculate that it is either due to the high risks births that were included, or because they must have been farther away from the
hospital than just 5 minutes, or just ignoring the
outcomes data and focusing on the low intervention data.
The actual data is suggestive of a low risk of bad
outcomes for homebirthers, but they are clearly at higher risk
than hospital birth!
This is an important finding because it helps us interpret the case reports of poor
outcomes with water birth — poor
outcomes do occur with water birth, but they are no more likely to occur with water birth
than with conventional
hospital delivery.
Women in the planned home - birth group were significantly less likely
than those who planned a midwife - attended
hospital birth to have obstetric interventions (e.g., electronic fetal monitoring, relative risk [RR] 0.32, 95 % CI 0.29 — 0.36; assisted vaginal delivery, RR 0.41, 95 % 0.33 — 0.52) or adverse maternal
outcomes (e.g., third - or fourth - degree perineal tear, RR 0.41, 95 % CI 0.28 — 0.59; postpartum hemorrhage, RR 0.62, 95 % CI 0.49 — 0.77).
The risk of all adverse maternal
outcomes assessed was significantly lower among the women who planned a home birth
than among those who planned a physician - attended
hospital birth (Table 3).
Primiparous women (t = 1.99, P < 0.05) and multiparous women (t = 5.56, P < 0.001) with a planned home birth scored better on the perinatal
outcome index
than those with planned
hospital birth.
In multiparous women, perinatal
outcome was significantly better for planned home births
than for planned
hospital births, with or without control for background variables.
Without control for this background, the perinatal
outcome in primiparous women was significantly better for planned home births
than for planned
hospital births.
The I2 value was greater
than 50 % for 10
outcomes (antenatal hospitalisation, amniotomy, augmentation, opiate analgesia, attendance at birth by known carer, intact perineum, perineum requiring suturing, duration of postnatal
hospital stay, duration of neonatal stay, breastfeeding initiation, and greater
than 30 % for a further six (antepartum haemorrhage, induction of labour, episiotomy, five - minute Apgar score less
than seven, preterm birth, admission to neonatal care).
It has been shown to save government money and provide better
outcomes than the array of government services homeless individuals use without supportive housing, including homeless shelters, substance abuse treatment, psychiatric
hospitals,
hospital emergency rooms, jail and prisons.
For this reason, the study avoids a basic problem in comparing
hospital outcomes — that patients admitted to one
hospital may be significantly less healthy, on average,
than the patients admitted to another.
The
Hospital for Special Surgery study is the first to provide evidence that an intervention during surgery can improve
outcomes in patients with sleep apnea who often fare worse
than patients without this condition.
A University of Rochester - led study, published in the August issue of Health Affairs, shows complication rates can vary as much as five-fold among
hospitals, prompting researchers to call for the development of a national quality reporting system to improve maternal
outcomes for more
than 4 million women who give birth each year.
Researchers examined
outcome data for more
than 6,500 midwife - attended water births in the United States and found that newborns born in water were no more likely to experience low Apgar scores, require transfer to the
hospital after birth or be hospitalized in their first six weeks of life,
than newborns who were not born in water.
The article opened with «
hospitals across the United States are throwing away less -
than - perfect organs and denying the sickest people lifesaving transplants out of fear that poor surgical
outcomes will result in a federal crackdown.
Minimally invasive surgery, which uses a few small incisions rather
than one large incision, has been associated with better
outcomes than open surgery, including fewer surgical site infections, less pain and shorter
hospital stays.
Sam Watson adds: «Our study indicates that ensuring very preterm babies, particularly those born at less
than 27 weeks, are delivered in
hospitals with high volume neonatal units improves their
outcome, but there could be a knock - on effect on other patient groups if smaller neonatal units are closed.
«The results of this study were of particular interest because more
than half of the pregnant women with migraine experienced some type of adverse birth
outcome, suggesting that these pregnancies should be considered high risk,» said study author Matthew S. Robbins, M.D., director of inpatient services at Montefiore Headache Center, chief of neurology at Jack D. Weiler
Hospital of Montefiore, and associate professor of clinical neurology at Albert Einstein College of Medicine.
The study, which appears in the New England Journal of Medicine, examined records from more
than 4,600 patients with out - of -
hospital cardiac arrest involving paramedics from 55 emergency medical services (EMS) agencies at 10 North American sites participating in the North American Resuscitation
Outcomes Consortium (ROC), to which UT Southwestern and the Dallas - Fort Worth ROC Network is the largest contributor.
True to our mission and values, the McLean
Hospital community of more
than 2,000 faculty and staff strives to deliver ever better compassionate care, conduct pioneering research designed to translate discoveries into better
outcomes, and provide...
«The results of our review show that should change, as people with sleep disorders may be more likely to have another stroke or other negative
outcomes than people without sleep problems, such as having to go to a nursing home after leaving the
hospital.»
But as we have so much fear around the unknowns of childbirth and we move away from our families, as birth has moved into
hospitals bound to certain practices needed to keep their institutions running, and the disparities in maternal and infant
outcomes based on race become clear, doulas are more important
than ever.
There are many studies that show that perinatal
outcomes for low risk women in planned home birth are as good or better
than those from planned
hospital births.
However, countries who have midwives as the leaders of maternity care and where home birth is considered among the norm experience better birth
outcomes than countries where birth is facilitated in
hospital settings with obstetricians.
Research shows that
hospitals that treat more
than 20 ovarian cancer cases a year and surgeons who operate on more
than 10 cases a year have significantly better patient
outcomes than lower volume
hospitals and surgeons, according to the Valley Health System.
The doctors at Green Forest Veterinary
Hospital believe that in some cases using herbal remedies produces improved
outcomes and fewer side effects
than many pharmaceutical products.
Inmar's healthcare solutions are in place in more
than 33,000
hospitals, health systems and pharmacies, enhancing operations, protecting profitability and improving patient
outcomes.
Mothers were eligible to participate if they did not require the use of an interpreter, and reported one or more of the following risk factors for poor maternal or child
outcomes in their responses to routine standardised psychosocial and domestic violence screening conducted by midwives for every mother booking in to the local
hospital for confinement: maternal age under 19 years; current probable distress (assessed as an Edinburgh Depression Scale (EDS) 17 score of 10 or more)(as a lower cut - off score was used
than the antenatal validated cut - off score for depression, the term «distress» is used rather
than «depression»; use of this cut - off to indicate those distressed approximated the subgroups labelled in other trials as «psychologically vulnerable» or as having «low psychological resources» 14); lack of emotional and practical support; late antenatal care (after 20 weeks gestation); major stressors in the past 12 months; current substance misuse; current or history of mental health problem or disorder; history of abuse in mother's own childhood; and history of domestic violence.