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Inquiry: a Journal of Medical Care Organization, Provision and Financing

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https://www.readbyqxmd.com/read/27932514/long-term-therapy-with-wu-ling-san-a-popular-antilithic-chinese-herbal-formula-did-not-prevent-subsequent-stone-surgery-a-nationwide-population-based-cohort-study
#1
San-Yuan Wu, Huey-Yi Chen, Kao-Sung Tsai, Jen-Huai Chiang, Chih-Hsin Muo, Fung-Chang Sung, Yung-Hsiang Chen, Wen-Chi Chen
Traditional Chinese herbal medicine (CHM), which is widely used to treat pain and urolithiasis, is a promising therapy for urinary stone prevention. This study investigated the clinical efficacy of a popular CHM, Wu-Ling-San (WLS), in Taiwan for the prophylaxis of recurrent nephrolithiasis as assessed by surgical stone treatment via a nationwide population-based cohort study. The National Health Insurance Research Database, 2000-2010, which included one million patient records. All patients diagnosed with stone disease at the beginning of the study...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27895218/a-new-approach-to-identify-high-burnout-medical-staffs-by-kernel-k-means-cluster-analysis-in-a-regional-teaching-hospital-in-taiwan
#2
Yii-Ching Lee, Shian-Chang Huang, Chih-Hsuan Huang, Hsin-Hung Wu
This study uses kernel k-means cluster analysis to identify medical staffs with high burnout. The data collected in October to November 2014 are from the emotional exhaustion dimension of the Chinese version of Safety Attitudes Questionnaire in a regional teaching hospital in Taiwan. The number of effective questionnaires including the entire staffs such as physicians, nurses, technicians, pharmacists, medical administrators, and respiratory therapists is 680. The results show that 8 clusters are generated by kernel k-means method...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27856783/analysis-of-actual-versus-projected-medical-claims-under-the-first-year-of-aca-mandated-coverage
#3
Michael J McCue, Jennifer R Palazzolo
For the individual market, 2014 was the first year Affordable Care Act medical claims experience data were available to set 2016 rates. Accessing Centers for Medicare and Medicaid Services rate data for 175 state insurers, this study compares projected medical claims with actual medical claims of 2014, as well as the cost and utilization of benefit categories for inpatient, outpatient, professional, and prescription drug spending. Actual costs per member per month (pmpm) were greater than projected in 2014 for inpatient, outpatient, and prescription spending but not for professional care...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27789732/new-medicaid-enrollees-see-health-and-social-benefits-in-pennsylvania-s-expansion
#4
Jeffrey K Hom, Charlene Wong, Christian Stillson, Jessica Zha, Carolyn C Cannuscio, Rachel Cahill, David Grande
Understanding how new Medicaid enrollees are approaching their own health and health care in the shifting health care landscape of the Affordable Care Act has implications for future outreach and enrollment efforts, as well as service planning for this population. The objective of this study was to explore the health care experiences and expectations of new Medicaid expansion beneficiaries in the immediate post-enrollment period. We conducted semistructured, qualitative interviews with a random sample of 40 adults in Philadelphia who had completed an application for Medicaid through a comprehensive benefits organization after January 1, 2015, when the Medicaid expansion in Pennsylvania took effect...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27683257/global-budget-payment-proposing-the-cap-framework
#5
Bradley Chen, Victoria Y Fan
To control ever-increasing costs, global budget payment has gained attention but has unclear impacts on health care systems. We propose the CAP framework that helps navigate 3 domains of difficult design choices in global budget payment: Constraints in resources (capitation vs facility-based budgeting; hard vs soft budget constraints), Agent-principal in resource allocation (individual vs group providers in resource allocation; single vs multiple pipes), and Price adjustment. We illustrate the framework with empirical examples and draw implications for policy makers...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27677519/microsimulation-modeling-of-coronary-heart-disease-maximizing-the-impact-of-nonprofit-hospital-based-interventions
#6
Peggy Vadillo Orenstein, Lu Shi
We use microsimulation to forecast changes in coronary heart disease (CHD) among adults 45 or above over a 20-year time horizon in Los Angeles County (N = 3.4 million), a county with 12 635 CHD deaths in 2010. We simulate individuals' life course and calibrate CHD trends to observed trends in the past. Using the Health Forecasting Community Health Simulation Model, we simulate CHD prevalence and CHD mortality in 2 CHD prevention scenarios: (1) "comprehensive hypertension intervention" and (2) "gradual reduction of the average adult body mass index back to the year 2000 level...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27637270/the-physical-and-psychological-health-of-migrants-in-guangzhou-china-how-does-neighborhood-matter
#7
Hongsheng Chen, Zhenjun Zhu, Dongqi Sun, Xingping Wang
This study analyzed the health of migrants in 4 types of neighborhood in the city of Guangzhou in China. The research shows that the health of internal migrants in urban villages and private housing neighborhoods is much better than those living in older inner city neighborhoods (which are known as jiefang shequ) and unit neighborhoods (which are known as danwei). The reasons behind this are the facts that the migrants in urban villages tend to be relatively young and there tend to be better social and economic conditions in the private housing neighborhood...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27637269/physicians-pharmaceutical-sales-representatives-interactions-and-conflict-of-interest-challenges-and-solutions
#8
Avinash R Patwardhan
Physician-industry relationships have come a long way since serious debates began after a 1990 Senate Committee on Labor and Human Resources report on the topic. On one side, the Sun Shine Act of 2007, now a part of the Patient Protection and Affordable Care Act that mandates disclosure of payments and gifts to the physicians, has injected more transparency into the relationships, and on the other side, numerous voluntary self-regulation guidelines have been instituted to protect patients. However, despite these commendable efforts, problem persists...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27637268/chest-pain-patients-at-veterans-hospitals-are-increasingly-more-likely-to-be-observed-than-admitted-for-short-stays
#9
Brad Wright, Amy M J O'Shea, Justin M Glasgow, Padmaja Ayyagari, Mary Vaughan Sarrazin
Observation stays are an outpatient service used to diagnose and treat patients for extended periods of time while a decision is made regarding inpatient admission or discharge. Although the use of observation stays is increasing, little is known about which patients are observed and which are admitted for similar periods of time as inpatients. The aim was to identify patient characteristics associated with being observed rather than admitted for a short stay (<48 hours) within the Veterans Health Administration (VHA)...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27530238/who-wants-long-term-care-insurance-a-stated-preference-survey-of-attitudes-beliefs-and-characteristics
#10
Benjamin T Allaire, Derek S Brown, Joshua M Wiener
Approximately half of people turning 65 years between 2015 and 2019 are projected to need long-term support and services. Yet the long-term care insurance (LTCI) market is depressed, with only 7.4 million people owning policies. The objective of this study was to provide an analysis of potential LTCI purchasers. We investigate (1) who wants to purchase LTCI, (2) what are the attitudes and beliefs among those who have a preference for LTCI, and (3) who would prefer a law mandating the purchase of LTCI and how that view relates to willingness to purchase LTC...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27444505/the-effects-of-negative-reinforcement-on-increasing-patient-adherence-to-appointments-at-king-abdullah-university-hospital-in-jordan
#11
Mohammad Alyahya, Heba H Hijazi, Farid T Nusairat
Appointment nonadherence is a health behavior that represents a burden to health care systems. On March 1, 2015, a new negative reinforcement intervention involving "service fees" for a visit without appointment was implemented at King Abdullah University Hospital in Jordan. To evaluate the effect of this intervention in improving patient adherence to medical appointment, a retrospective preintervention and postintervention analysis was used, including all patients (n = 65 535) who had scheduled appointments at 39 outpatient clinics...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27284127/differences-among-older-adults-in-the-types-of-dental-services-used-in-the-united-states
#12
Richard J Manski, Jody Schimmel Hyde, Haiyan Chen, John F Moeller
The purpose of this article is to explore differences in the socioeconomic, demographic characteristics of older adults in the United States with respect to their use of different types of dental care services. The 2008 Health and Retirement Study (HRS) collected information about patterns of dental care use and oral health from individuals aged 55 years and older in the United States. We analyze these data and explore patterns of service use by key characteristics before modeling the relationship between service use type and those characteristics...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27284126/hospital-prices-increase-in-california-especially-among-hospitals-in-the-largest-multi-hospital-systems
#13
Glenn A Melnick, Katya Fonkych
A surge in hospital consolidation is fueling formation of ever larger multi-hospital systems throughout the United States. This article examines hospital prices in California over time with a focus on hospitals in the largest multi-hospital systems. Our data show that hospital prices in California grew substantially (+76% per hospital admission) across all hospitals and all services between 2004 and 2013 and that prices at hospitals that are members of the largest, multi-hospital systems grew substantially more (113%) than prices paid to all other California hospitals (70%)...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27166413/lung-cancer-care-before-and-after-medicare-eligibility
#14
Marco D Huesch, Michael K Ong
Uninsured and underinsured near-elderly may not have timely investigation, diagnosis, or care of cancer. Prior studies suggest Medicare eligibility confers significant and substantial reductions in mortality and increases in health service utilization. We compared 2245 patients diagnosed with lung cancer at ages 64.5 to 65 years and 2512 patients aged 65 to 65.5 years, with 2492 patients aged 65.5 to 66 years (controls) in 2000 to 2005. Compared with controls, patients diagnosed with lung cancer before Medicare eligibility had no statistically significant differences in cancer stage, time to treatment, type of treatment, and survival...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27166412/prostate-cancer-care-before-and-after-medicare-eligibility
#15
Marco D Huesch, Michael K Ong
Prior studies suggest Medicare eligibility confers significant and substantial reductions in mortality and beneficial increases in health service utilization. We compared 13,882 patients diagnosed with prostate cancer at ages 63 to 64 years with 14,774 patients diagnosed at ages 65 to 66 (controls) in 2004 to 2007. Compared with controls, patients diagnosed with prostate cancer before Medicare eligibility had no statistically significant or meaningful differences in cancer stage, time to treatment, or type of treatment...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27166411/health-expenditure-concentration-and-characteristics-of-high-cost-enrollees-in-chip
#16
Bisakha Sen, Justin Blackburn, Monica S Aswani, Michael A Morrisey, David J Becker, Meredith L Kilgore, Cathy Caldwell, Chris Sellers, Nir Menachemi
Devising effective cost-containment strategies in public insurance programs requires understanding the distribution of health care spending and characteristics of high-cost enrollees. The aim was to characterize high-cost enrollees in a state's public insurance program and determine whether expenditure inequality changes over time, or with changes in cost-sharing policies or program eligibility. We use 1999-2011 claims and enrollment data from the Alabama Children's Health Insurance Program, ALL Kids. All children enrolled in ALL Kids were included in our study, including multiple years of enrollment (N = 1,031,600 enrollee-months)...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27098876/using-clinical-vignettes-to-assess-quality-of-care-for-acute-respiratory-infections
#17
Courtney A Gidengil, Jeffrey A Linder, Scott Beach, Claude M Setodji, Gerald Hunter, Ateev Mehrotra
Overprescribing of antibiotics for acute respiratory infections (ARIs) is common. Our objective was to develop and validate a vignette-based method to estimate clinician ARI antibiotic prescribing. We surveyed physicians (n = 78) and retail clinic clinicians (n = 109) between January and September 2013. We surveyed clinicians using a set of ARI vignettes and linked the responses to electronic health record data for all ARI visits managed by these clinicians during 2012. We then created a new measure of antibiotic prescribing, the comprehensive ARI management rate...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27076474/estimating-the-counterfactual-how-many-uninsured-adults-would-there-be-today-without-the-aca
#18
Linda J Blumberg, Bowen Garrett, John Holahan
Time lags in receiving data from long-standing, large federal surveys complicate real-time estimation of the coverage effects of full Affordable Care Act (ACA) implementation. Fast-turnaround household surveys fill some of the void in data on recent changes to insurance coverage, but they lack the historical data that allow analysts to account for trends that predate the ACA, economic fluctuations, and earlier public program expansions when predicting how many people would be uninsured without comprehensive health care reform...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27033565/agreement-between-hedis-performance-assessments-in-the-va-and-medicare-advantage-is-quality-in-the-eye-of-the-beholder
#19
Amal N Trivedi, Ira B Wilson, Mary E Charlton, Kenneth W Kizer
Medicare Advantage (MA) plans and the Veterans Affairs (VA) health care system assess quality of care using standardized Healthcare Effectiveness Data and Information Set (HEDIS) performance measures. Little is known, however, about the relative accuracy of quality indicators for persons receiving care in more than one health care system. Among Veterans dually enrolled in an MA plan, we examined the agreement between MA and VA HEDIS assessments. Our study tested the hypothesis that private health plans underreport quality of care relative to a fully integrated delivery system utilizing a comprehensive electronic health record...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27033564/the-impact-of-information-on-doctors-attitudes-toward-generic-drugs
#20
Aggeliki V Tsaprantzi, Petros Kostagiolas, Charalampos Platis, Vassilios P Aggelidis, Dimitris Niakas
The objective of this study is to assess the impact of information on doctors' attitudes and perceptions toward generics. A cross-sectional survey based on a specially designed 21-item questionnaire was conducted. The survey involved doctors of different specialties working in a public hospital in Greece. The analysis includes descriptive and inferential statistics, reliability and validity tests, as well as structural equation modeling to evaluate the causal model. Statistical analysis was accomplished by using SPSS 20 and Amos 20...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
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