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

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https://www.readbyqxmd.com/read/30239238/the-effect-of-china-s-national-essential-medicine-policy-on-health-expenses-evidence-from-a-national-study
#1
Qian Li, Fei Chen, Min Yang, Liyong Lu, Jay Pan, Xiaosong Li, Qun Meng
To increase use of medical service across the country, the Chinese government has tried to improve equity in health care access and reduce patients' medical expenses. For this purpose, the National Essential Medicine Policy (NEMP) was introduced in 2009 to mandate the distribution of medicines to health care facilities at a low cost and without profit. This study aims to evaluate the effect of the essential medicine policy on average per-visit expenses for outpatient and inpatient services. The annual national surveillance system data covering all the grassroots-level primary health care facilities (PHFs) in 2675 counties and 31 provinces in China during 2008 to 2012 were used in this study...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/30222018/assessing-the-quality-of-nursing-homes-in-managed-care-organizations-integrating-ltss-for-dually-eligible-beneficiaries
#2
Carrie Graham, Leslie Ross, Edward Bozell Bueno, Charlene Harrington
Little is known about the quality of nursing homes in managed care organizations (MCOs) networks. This study (1) described decision-making criteria for selecting nursing home networks and (2) compared selected quality indicators of network and nonnetwork nursing homes. The sample was 17 MCOs participating in a California demonstration that provided integrated long-term services and supports to dually eligible enrollees in 2017. The findings showed that the MCOs established a broad network of nursing homes, with only limited attention to using quality criteria...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/30215263/expanding-understanding-of-community-health-worker-programs-a-cross-sectional-survey-on-the-work-satisfaction-and-livelihoods-of-chws-in-madagascar
#3
Aurélie Brunie, Sarah Mercer, Mario Chen, Tokinirina Andrianantoandro
With health worker shortages in rural areas, community health workers (CHWs) are instrumental to the sustainability of primary health care and to the ability to meet health needs. Identifying appropriate operational models and incentive structures is an important element of long-term success. This article reports on CHWs' work demands and affective response to their volunteer work within the broader context of their livelihoods in Madagascar. A cross-sectional survey of 874 CHWs, called Agents de Santé Communautaire (ACs), from 14 districts across 5 regions was conducted in June 2015...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/30188235/effects-of-the-affordable-care-act-on-health-care-access-and-self-assessed-health-after-3-years
#4
Charles Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, Daniela Zapata
Using data from the Behavioral Risk Factor Surveillance System, we examine the causal impact of the Affordable Care Act on health-related outcomes after 3 years. We estimate difference-in-difference-in-differences models that exploit variation in treatment intensity from 2 sources: (1) local area prereform uninsured rates from 2013 and (2) state participation in the Medicaid expansion. Including the third postreform year leads to 2 important insights. First, gains in health insurance coverage and access to care from the policy continued to increase in the third year...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/30175669/preferred-provider-relationships-between-medicare-advantage-plans-and-skilled-nursing-facilities-reduce-switching-out-of-plans-an-observational-analysis
#5
Elizabeth M Goldberg, Laura M Keohane, Vincent Mor, Amal N Trivedi, Hye-Young Jung, Momotazur Rahman
Unlike traditional Medicare, Medicare Advantage (MA) plans contract with specific skilled nursing facilities (SNFs). Patients treated in an MA plan's preferred SNF may benefit from enhanced coordination and have a lower likelihood of switching out of their plan. Using 2011-2014 Medicare enrollment data, the Medicare Healthcare Effectiveness Data and Information Set, and the Minimum Data Set, we examined Medicare enrollees who were newly admitted to SNFs in 2012-2013. We used the Centers for Medicare & Medicaid Services star rating to distinguish between MA plans and show how SNF concentration experienced by patients varies between patients in plans with different star ratings...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/30175643/financial-impact-of-incentive-spirometry
#6
Adam E M Eltorai, Grayson L Baird, Joshua Pangborn, Ashley Szabo Eltorai, Valentin Antoci, Katherine Paquette, Kevin Connors, Jacqueline Barbaria, Kimberly J Smeals, Barbara Riley, Shyam A Patel, Saurabh Agarwal, Terrance T Healey, Corey E Ventetuolo, Frank W Sellke, Alan H Daniels
Despite largely unproven clinical effectiveness, incentive spirometry (IS) is widely used in an effort to reduce postoperative pulmonary complications. The objective of the study is to evaluate the financial impact of implementing IS. The amount of time nurses and RTs spend each day doing IS-related activities was assessed utilizing an online survey distributed to the relevant national nursing and respiratory therapists (RT) societies along with questionnaire that was prospectively collected every day for 4 weeks at a single 10-bed cardiothoracic surgery step-down unit...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/30175638/higher-predictive-value-positive-for-mma-than-aca-mtm-eligibility-criteria-among-racial-and-ethnic-minorities-an-observational-study
#7
Yanru Qiao, Christina A Spivey, Junling Wang, Ya-Chen Tina Shih, Jim Y Wan, Julie Kuhle, Samuel Dagogo-Jack, William C Cushman, Marie A Chisholm-Burns
The objective of this study was to examine positive predictive value (PPV) of medication therapy management (MTM) eligibility criteria under Medicare Modernization Act (MMA) and Affordable Care Act (ACA) in identifying patients with medication utilization issues across racial and ethnic groups. The study analyzed Medicare data (2012-2013) for 2 213 594 beneficiaries. Medication utilization issues were determined based on medication utilization measures mostly developed by Pharmacy Quality Alliance. MMA was associated with higher PPV than ACA in identifying individuals with medication utilization issues among non-Hispanic blacks (blacks) and Hispanics than non-Hispanic whites (whites)...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/30168364/linking-structural-capabilities-and-workplace-climate-in-community-health-centers
#8
Grant R Martsolf, Scott Ashwood, Mark W Friedberg, Hector P Rodriguez
Many strategies to improve health care quality focus on improving the structural capabilities of primary care practices, including quality infrastructure and registry use, which are critical to managing chronic diseases. However, improving structural capabilities requires practices to expend significant resources and can be especially disruptive to community health centers (CHCs) serving high proportions of socioeconomically vulnerable patients. We explore the relationship between the structural capabilities and workplace climate in CHCs...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/30156927/an-artifact-for-evaluating-the-quality-of-health-service-providers-evidence-from-brazil
#9
Lúcia Helena da Silva Mendes, Luiz Cláudio Sampaio Mendes, Lilian Lucy Dos Santos, Carlos Otávio Senff, Claudimar Pereira da Veiga, Luiz Carlos Duclós
The aim of this article is to present an artifact for evaluating the quality and performance of service providers in the field of health care: the UNIPLUS Program. To verify the scientific nature of the artifact and ensure that it meets the criteria set by the community and the environment, the premises of Design Science Research (DSR) were used. As this research field lacks empirical evidence, the artifact was tested from 2013 to 2015 with 25 health care service providers from different categories, with an emphasis on hospitals and clinics located in 7 cities in the south of Brazil...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/30141704/the-role-of-assisted-living-capacity-on-nursing-home-financial-performance
#10
Justin Lord, Ganisher Davlyatov, Kali S Thomas, Kathryn Hyer, Robert Weech-Maldonado
The rapid growth of the assisted living industry has coincided with decreased levels of nursing home occupancy and financial performance. The purpose of this article is to examine the relationships among assisted living capacity, nursing home occupancy, and nursing home financial performance. In addition, we explore whether the relationship between assisted living capacity and nursing home financial performance is mediated by nursing home occupancy. This research utilized publicly available secondary data, for the state of Florida from 2003 through 2015...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/30132349/social-network-analysis-in-the-legislative-process-in-the-korean-medical-device-industry
#11
Munjae Lee, Kichan Yoon, Kyu-Sung Lee
This study analyzes the legislation process of the Korean government regarding the development of the medical device industry in the perspective of the issue network. It also aims to identify the difference in network structure between conservative and progressive governments and analyze major issues and stakeholders. It examines the network structure in the legislation process of the government to develop and support the medical device industry through social network analysis (SNA). This study conducted a policy network structure analysis of the conservative and progressive governments...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/30129383/longitudinal-evaluation-on-the-operation-index-applied-to-public-hospitals-in-pudong-new-district-of-shanghai-china
#12
Shanshan Liu, Jiaoling Huang, Yanting Li, Jincheng Fan, Hong Liang, Jiquan Lou, Yuan Jing, Yimin Zhang
The public hospital reform has lasted 5 years in China; however, the operation development status and trends of public hospitals have not been systematically evaluated in Pudong New District. We first applied the technology of longitudinal index to assess the development of public hospitals there. The quantitative data were mainly gathered by taking health statistics database from 2009 to 2014. The results showed that overall operating index presented a down-up trend, with the highest point in 2014 and the lowest point in 2012...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/30111269/direct-medical-cost-of-hospitalization-for-acute-stroke-in-lebanon-a-prospective-incidence-based-multicenter-cost-of-illness-study
#13
Rachel R Abdo, Halim M Abboud, Pascale G Salameh, Najo A Jomaa, Rana G Rizk, Hassan H Hosseini
Stroke is a major social and health problem posing heavy burden on national economies. We provided detailed financial data on the direct in-hospital cost of acute stroke care in Lebanon and evaluated its drivers. This was an observational, quantitative, prospective, multicenter, incidence-based, bottom-up cost-of-illness study. Medical and billing records of stroke patients admitted to 8 hospitals in Beirut over 1 year were analyzed. Direct medical costs were calculated, and cost drivers were assessed using a multivariable linear regression analysis...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/30111268/four-needles-in-a-haystack-a-systematic-review-assessing-quality-of-health-care-in-specialty-practice-by-practice-type
#14
Shellie D Ellis, Saleema A Karim, Rachel R Vukas, Daniel Marx, Jalal Uddin
Specialists, who represent 60% of physicians in the United States, are consolidating into large group practices, but the degree to which group practice type facilitates the delivery of high quality of care in specialty settings is unknown. We conducted a systematic literature review to identify the impact of group practice type on the quality of care among specialty providers. The search resulted in 913 articles, of which only 4 met inclusion criteria. Studies were of moderate methodological quality. From the limited evidence available, we hypothesize that solo specialists deliver care that is inferior to their peers in group practice, whether measured by patient satisfaction ratings or adherence to guideline-based care...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/30111267/malpractice-environment-vs-direct-litigation-what-drives-nursing-home-exit
#15
R Tamara Konetzka, Hari Sharma, Jeongyoung Park
An ongoing concern about medical malpractice litigation is that it may induce provider exit, potentially affecting consumer welfare. The nursing home sector is subject to substantial litigation activity but remains generally understudied in terms of the effects of litigation, due perhaps to a paucity of readily available data. In this article, we estimate the association between litigation and nursing home exit (closure or change in ownership), separating the impact of malpractice environment from direct litigation...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/30095016/consumers-perceptions-about-pharmaceutical-care-provided-by-community-pharmacists-in-china-in-relation-to-over-the-counter-drugs-a-qualitative-study
#16
Hong Chen, Carolina Oi Lam Ung, Peilian Chi, Jihong Wu, Daisheng Tang, Hao Hu
While patient-centered care is highly anticipated nowadays, investigation of consumers' perceptions and expectations about pharmacist's pharmaceutical care when providing over-the-counter (OTC) drugs is sparse. This article aimed to explore consumers' perceptions regarding the pharmaceutical care that community pharmacists provide in relation to OTC drugs. Semistructured interviews were conducted with consumers recruited (N = 97) in Yinchuan City, China. The 4 main themes that emerged were expectations on pharmaceutical care, attitude toward pharmacist's competence, experience of self-medication, and suggestions for improving pharmaceutical care...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/30052104/medicare-advantage-enrollment-and-beneficiary-risk-scores-difference-in-differences-analyses-show-increases-for-all-enrollees-on-account-of-market-wide-changes
#17
Tamara Beth Hayford, Alice Levy Burns
Medicare adjusts payments to Medicare Advantage (MA) insurers using risk scores that summarize the relationship between fee-for-service (FFS) Medicare spending and beneficiaries' demographic characteristics and documented health conditions. Research shows that MA insurers have increasingly documented conditions more thoroughly than traditional Medicare-resulting in higher payments to insurers-but little is known about what factors contribute to diverging risk scores. We apportion that divergence between market-wide increases and increases that vary with length of MA enrollment...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/30047811/is-variation-in-resident-centered-care-and-quality-performance-related-to-health-system-factors-in-veterans-health-administration-nursing-homes
#18
Jennifer L Sullivan, Ryann L Engle, Denise Tyler, Melissa K Afable, Katelyn Gormley, Michael Shwartz, Omonyêlé Adjognon, Victoria A Parker
The purpose of this research was to explore and compare common health system factors for 5 Community Living Centers (ie Veterans Health Administration nursing homes) with high performance on both resident-centered care and clinical quality and for 5 Community Living Centers (CLC) with low performance on both resident-centered care and quality. In particular, we were interested in "how" and "why" some Community Living Centers were able to deliver high levels of resident-centered care and high quality of care, whereas others did not demonstrate this ability...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/30047810/nursing-home-chain-affiliation-and-its-impact-on-specialty-service-designation-for-alzheimer-disease
#19
Justin Blackburn, Qing Zheng, David C Grabowski, Richard Hirth, Orna Intrator, David G Stevenson, Jane Banaszak-Holl
Specialty care units (SCUs) in nursing homes (NHs) grew in popularity during the 1990s to attract residents while national policies and treatment paradigms changed. Alzheimer disease has consistently been the dominant form of SCU. This study explored the extent to which chain affiliation, which is common among NHs, affected SCU bed designation. Using data from the Online Survey Certification and Reporting (OSCAR) from 1996 through 2010 with 207 431 NH-year observations, we described trends and compared chain-affiliated NHs with independent NHs...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/30043655/the-affordable-care-act-attenuates-financial-strain-according-to-poverty-level
#20
Ryan M McKenna, Brent A Langellier, Héctor E Alcalá, Dylan H Roby, David T Grande, Alexander N Ortega
We use data from the 2011-2016 National Health Interview Survey to examine how the Patient Protection and Affordable Care Act (ACA) has influenced disparities in health care-related financial strain, access to care, and utilization of services by categories of the Federal Poverty Level (FPL). We use multivariable regression analyses to determine the ACA's effects on these outcome measures, as well as to determine how changes in these measures varied across different FPL levels. We find that the national implementation of the ACA's insurance expansion provisions in 2014 was associated with improvements in health care-related financial strain, access, and utilization...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
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