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https://www.readbyqxmd.com/read/28721607/access-to-high-cost-cancer-medicines-through-the-lens-of-an-australian-senate-inquiry-defining-the-goods-at-stake
#1
Narcyz Ghinea, Miles Little, Wendy Lipworth
Cancer is a major burden on populations and health systems internationally. The development of innovative cancer medicines is seen as a significant part of the solution. These new cancer medicines are, however, expensive, leading to limited or delayed access and disagreements among stakeholders about which medicines to fund. There is no obvious resolution to these disagreements, with stakeholders holding firmly to divergent positions. Access to cancer medicines was recently explored in Australia in a Senate Inquiry into the Availability of New, Innovative, and Specialist Cancer Drugs in Australia...
July 18, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28716585/ascertainment-of-alaska-native-stroke-incidence-2005-2009-lessons-for-assessing-the-global-burden-of-stroke
#2
Bernadette Boden-Albala, James Allen, Eric T Roberts, Lisa Bulkow, Brian Trimble
BACKGROUND: Stroke is a critical public health issue in the United States and globally. System models to optimally capture stroke incidence in rural and culturally diverse communities are needed. The epidemiological transition to a western lifestyle has been associated with an increased burden of vascular risk factors among Alaska Native (AN) people. The burden of stroke in AN communities remains understudied. METHODS: The Alaska Native Stroke Registry (ANSR) was designed to screen and capture all stroke cases between 2005 and 2009 through its integration into the existing single-payer Alaska Tribal Health System infrastructure...
July 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28707110/what-factors-are-associated-with-90-day-episode-of-care-payments-for-younger-patients-with-total-joint-arthroplasty
#3
Shweta Pathak, Cecilia M Ganduglia, Samir S Awad, Wenyaw Chan, John M Swint, Robert O Morgan
BACKGROUND: Total joint arthroplasty (TJA) has been identified as a procedure with substantial variations in inpatient and postacute care payments. Most studies in this area have focused primarily on the Medicare population and rarely have characterized the younger commercially insured populations. Understanding the inpatient and postdischarge care service-component differences across 90-day episodes of care and factors associated with payments for younger patients is crucial for successful implementation of bundled payments in TJA in non-Medicare populations...
July 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28700509/does-physician-leadership-affect-hospital-quality-operational-efficiency-and-financial-performance
#4
Michael C Tasi, Aakash Keswani, Kevin J Bozic
BACKGROUND: With payers and policymakers' focus on improving the value (health outcomes achieved per health care dollar spent) of health care delivery, physicians are increasingly taking on senior leadership/management positions in health care organizations (Carsen & Xia, 2006). Little research has been done to understand the impact of physician leadership on the delivery of care. PURPOSE: The aim of this study was to examine whether hospital systems led by physicians were associated with better U...
July 11, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28696250/american-heart-association-s-call-to-action-for-payment-and-delivery-system-reform
#5
REVIEW
Vincent J Bufalino, Scott A Berkowitz, Timothy J Gardner, Ileana L Piña, Madeleine Konig
The healthcare system is undergoing a transition from paying for volume to paying for value. Clinicians, as well as public and private payers, are beginning to implement alternative delivery and payment models, such as the patient-centered medical home, accountable care organizations, and bundled payment arrangements. Implementation of these new models will necessitate delivery system transformation and will actively involve all fields of medical care, in particular medicine and surgery. This call to action, on behalf of the American Heart Association's Expert Panel on Payment and Delivery System Reform, serves to offer support and direction for further involvement by the American Heart Association...
July 10, 2017: Circulation
https://www.readbyqxmd.com/read/28693479/pharmacoeconomic-analysis-of-antifungal-therapy-for-primary-treatment-of-invasive-candidiasis-caused-by-candida-albicans-and-non-albicans-candida-species
#6
Huang-Tz Ou, Tsung-Ying Lee, Yee-Chun Chen, Claudie Charbonneau
BACKGROUND: Cost-effectiveness studies of echinocandins for the treatment of invasive candidiasis, including candidemia, are rare in Asia. No study has determined whether echinocandins are cost-effective for both Candida albicans and non-albicans Candida species. There have been no economic evaluations that compare non-echinocandins with the three available echinocandins. This study was aimed to assess the cost-effectiveness of individual echinocandins, namely caspofungin, micafungin, and anidulafungin, versus non-echinocandins for C...
July 10, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28684152/access-disparities-to-magnet-hospitals-for-patients-undergoing-neurosurgical-operations
#7
REVIEW
Symeon Missios, Kimon Bekelis
BACKGROUND: Centers of excellence focusing on quality improvement have demonstrated superior outcomes for a variety of surgical interventions. We investigated the presence of access disparities to hospitals recognized by the Magnet Recognition Program of the American Nurses Credentialing Center (ANCC) for patients undergoing neurosurgical operations. METHODS: We performed a cohort study of all neurosurgery patients who were registered in the New York Statewide Planning and Research Cooperative System (SPARCS) database from 2009 to 2013...
July 3, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28676155/characteristics-and-spending-patterns-of-high-cost-non-elderly-adults-in-massachusetts
#8
Jose F Figueroa, Austin B Frakt, Zoe M Lyon, Xiner Zhou, Ashish K Jha
BACKGROUND: Given that health care costs in Massachusetts continue to grow despite great efforts to contain them, we seek to understand characteristics and spending patterns of the costliest non-elderly adults in Massachusetts based on type of insurance. METHODS: We used the Massachusetts All-Payer Claims Database (APCD) from 2012 and analyzed demographics, utilization patterns and spending patterns across payers (Medicaid, Medicaid managed care, and private insurers) for high cost patients (those in the top 10% of spending) and non-high cost patients (the remaining 90%)...
June 21, 2017: Healthcare
https://www.readbyqxmd.com/read/28661799/accountable-care-organizations-and-oral-health-accountability
#9
Melanie E Mayberry
Accountable care organizations agree to be accountable for the cost and outcomes of an attributed population. However, in many, no provisions have been made to account for oral health. There are several social, medical, and financial implications for health care provider and payer systems and health care outcomes when oral health is not accounted for in patient management. How can an organization strive to improve population health without including the oral health system? Total systemic health for a population must include oral health...
May 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28658482/association-of-expanded-medicaid-coverage-with-hospital-length-of-stay-after-injury
#10
Jeremy L Holzmacher, Kerry Townsend, Caleb Seavey, Stephanie Gannon, Mary Schroeder, Stephen Gondek, Lois Collins, Richard L Amdur, Babak Sarani
Importance: The expansion of Medicaid eligibility under the Affordable Care Act is a state-level decision that affects how patients with traumatic injury (trauma patients) interact with locoregional health care systems. Washington, DC; Maryland; and Virginia represent 3 unique payer systems with liberal, moderate, and no Medicaid expansion, respectively, under the Affordable Care Act. Characterizing the association of Medicaid expansion with hospitalization after injury is vital in the disposition planning for these patients...
June 28, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28646519/the-association-of-health-literacy-with-preventable-ed-visits-a-cross-sectional-study
#11
Meenakshi P Balakrishnan, Jill Boylston Herndon, Jingnan Zhang, Thomas Payton, Jonathan Shuster, Donna L Carden
BACKGROUND: Policy-makers argue that emergency department (ED) visits for conditions preventable with high-quality outpatient care contribute to waste in the healthcare system. However, access to ambulatory care is uneven, especially for vulnerable populations like minorities, the poor and those with limited health literacy. The impact of limited health literacy on ED visits that are preventable with timely, high-quality ambulatory care is unknown. OBJECTIVE: To determine the association of health literacy and preventable ED visits...
June 24, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28644939/an-economic-analysis-of-mac-versus-walant-a-trigger-finger-release-surgery-case-study
#12
Jason L Codding, Suneel B Bhat, Asif M Ilyas
BACKGROUND: There has been recent interest in wide awake hand surgery, also referred to as "wide awake local anesthesia with no tourniquet" (WALANT) surgery. Using a model of single trigger finger release (TFR) surgery, a hypothesis was made that WALANT would result in decreased hospital time and cost than patients receiving sedation with monitored anesthetic care (MAC). METHODS: Consecutive cases of single TFR surgery with MAC were compared with WALANT. All surgeries were performed in the same manner, at the same facility, and by the same surgeon...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28642108/investing-in-new-technology-in-pulmonary-medicine-navigating-the-tortuous-path-to-success
#13
REVIEW
Robert Kruklitis, Kim French, Michael Joseph Cangelosi, Kevin L Kovitz
The introduction of new technologies offers the promise to advance medicine. This occurs alongside improved efforts to control costs of health care by hospital administrators, the Centers for Medicare & Medicaid Services' (CMS) pivot to value programs, and commercial payers' efforts to reduce reimbursement. These trends present a challenge for the pulmonologist, among others, who must navigate increasingly complex and highly scrutinized evaluation processes used to secure new technology (NT). Health-care providers are turning toward value assessments while simultaneously tasked with the mission of offering state of the art technologies and services...
June 20, 2017: Chest
https://www.readbyqxmd.com/read/28641586/access-education-and-policy-awareness-predictors-of-influenza-vaccine-acceptance-among-vha-healthcare-workers
#14
Jennifer Lipkowitz Eaton, David C Mohr, Kathleen M McPhaul, Richard A Kaslow, Richard A Martinello
OBJECTIVE To identify predictors of influenza vaccine acceptance among VHA healthcare workers (HCWs), with emphasis on modifiable factors related to promotion campaigns. DESIGN Survey. SETTING National single-payer healthcare system with 140 hospitals and 321,000 HCWs. PARTICIPANTS National voluntary sample of HCWs in the Veterans Health Administration (VHA) system. METHODS We invited a random sample of 5% of all VHA HCWs to participate. An 18-item intranet-based survey inquired about occupation, vaccination status, employer policy, and local campaign efforts...
June 23, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28639740/declining-rates-of-hip-fracture-in-end-stage-renal-disease-analysis-from-the-2003-2011-nationwide-inpatient-sample
#15
Sun Moon Kim, Sai Liu, Jin Long, Maria E Montez-Rath, Mary B Leonard, Glenn M Chertow
The incidence of hip fracture in patients with end-stage renal disease (ESRD) is considerably higher than that in the general age- and sex-matched population. Although medical therapy for chronic kidney disease mineral bone disorder (CKD-MBD) has changed considerably over the last decade, rates of hip fracture in the entire ESRD population have not been well-characterized. Herein, we evaluated temporal trends in rates of hip fracture, in-hospital mortality, and costs of associated hospital stay in ESRD. We identified hospitalizations for hip fracture from 2003 to 2011 using the Nationwide Inpatient Sample, a representative national database inclusive of all ages and payers...
June 22, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28625585/access-disparities-to-magnet-hospitals-for-ischemic-stroke-patients
#16
REVIEW
Kimon Bekelis, Symeon Missios, Todd A MacKenzie
Access disparities to centers of excellence can have detrimental consequences for population health. We investigated the presence of racial disparities in the access of stroke patients to hospitals recognized by the Magnet Recognition Program of the American Nurses Credentialing Center (ANCC). We performed a cohort study of all ischemic stroke patients who were registered in the New York Statewide Planning and Research Cooperative System (SPARCS) database from 2009 to 2013. We examined the association of African-American race with Magnet status hospitalization after ischemic stroke...
June 15, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28612498/china-s-health-care-system-reform-progress-and-prospects
#17
Ling Li, Hongqiao Fu
This paper discusses the progress and prospects of China's complex health care reform beginning in 2009. The Chinese government's undertaking of systemic reform has achieved laudable achievements, including the expansion of social health insurance, the reform of public hospitals, and the strengthening of primary care. An innovative policy tool in China, policy experimentation under hierarchy, played an important role in facilitating these achievements. However, China still faces gaps and challenges in creating a single payer system, restructuring the public hospitals, and establishing an integrated delivery system...
June 14, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28609229/results-and-implications-of-routine-hiv-testing-in-the-inpatient-setting-a-descriptive-analysis
#18
Jamie L Mignano, Lucy Miner, Kristin Siedl, Travis Brown, Christina Cafeo, Lisa Rowen, Robert R Redfield, Mangla Gulati
Policy changes and scientific advances have guided new methods of diagnosing and managing HIV that reduce mortality, morbidity, and transmission. In a high HIV prevalence urban setting, a hospital initiative was implemented to routinely perform HIV testing and provide linkage to care for those with positive results and for individuals with a prior diagnosis of HIV. Maryland's unique all-payer model presents an opportunity to implement population health initiatives in health systems. The rationale, methodology, results and lessons learned from this approach will be discussed...
June 13, 2017: Population Health Management
https://www.readbyqxmd.com/read/28554337/assessing-value-budget-impact-and-affordability-in-asia
#19
Grace Hampson, Chris Henshall, Adrian Towse
OBJECTIVES: The aim of this study was to explore definitions of value and the use of budget impact and affordability considerations in health technology assessment (HTA) in the Asia region, particularly in relation to high cost technologies. METHODS: Issues were debated by senior representatives from HTA and payer systems in Asian countries, delegates from industry, and invited experts at the 2016 meeting of the HTAi Asia Policy Forum (HAPF). A premeeting survey was used to gather data on how value is assessed and budget impact calculations are used within current processes, as well as current approaches to managing affordability...
May 30, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/28552044/assessing-the-utilization-of-total-ankle-replacement-in-the-united-states
#20
Sudheer Reddy, Lane Koenig, Berna Demiralp, Jennifer T Nguyen, Qian Zhang
BACKGROUND: Total ankle arthroplasty (TAR) has been shown to be a cost-effective procedure relative to conservative management and ankle arthrodesis. Although its use has grown considerably over the last 2 decades, it is less common than arthrodesis. The purpose of this investigation was to analyze the cost and utilization of TAR across hospitals. METHODS: Our analytical sample consisted of Medicare claims data from 2011 and 2012 for Inpatient Prospective Payment System hospitals...
June 2017: Foot & Ankle International
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