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health care costs

P Maxwell Courtney, David C Markel
With renewed focus on achieving value for patients in total hip and knee arthroplasty, payors, hospitals, and physicians strive to provide quality care while minimizing cost. Large registry datasets have gained popularity in the United States to track implant survivorship and outcomes after joint replacement. Partnerships among surgeons, insurers, and health systems have improved on earlier administrative datasets from Medicare to measure quality and outcomes. Participation in state and national registries can help surgeons and hospitals gain a financial advantage in several insurers' quality programs and alternative payment models...
October 24, 2016: Journal of Knee Surgery
Gordon Gong, Cassandra C Huey, Coleman Johnson, Debra Curti, Billy U Philips
One of the goals of the Affordable Care Act aims to provide affordable health insurance through the health insurance exchange marketplace (the Marketplace). This study explores enrollments in the Marketplace in Texas and in rural vs urban areas in the East, South, and West regions of the state. Data are derived from the US Census Bureau and the Department of Health and Human Services. A total of 92.7% of eligible non-elderly adult Texans (NEATs) had enrolled in Marketplace insurance as of February 2015. Rural residents were less likely than urban residents to use the Marketplace...
October 1, 2016: Texas Medicine
Emmi Helle, Sture Andersson, Unto Häkkinen, Jutta Järvelin, Janne Eskelinen, Eero Kajantie
BACKGROUND: Early term birth is associated with increased need for hospital care during the early postnatal period. The objective of this study was to assess the morbidity and health care-related costs during the first 3 years of life in children born early term. METHODS: Data come from a population-based birth cohort study in the municipalities of Helsinki, Espoo, and Vantaa, Finland using data from the national medical birth register and outpatient, inpatient, and primary care registers...
October 24, 2016: Paediatric and Perinatal Epidemiology
Awadh Kishor Pandit, Deepti Vibha, Achal Kumar Srivastava, Garima Shukla, Vinay Goyal, Madhuri Behari
Use of complementary and alternative medicine (CAM; bǔ chōng yǔ tì dài yī xué) in Parkinson disease (PD) ranged 40-70%. The objective of this study was to determine the frequency, types and factors associated with the use of CAM in Indian PD patients. PD patients, fulfilling UKPD-Society brain-bank diagnostic-criteria, attending Movement-disorders clinic of a tertiary-care teaching hospital in India from 1st May to 15th December 2012 were enrolled. Information on socio-demographic, clinical data and treatment along with factors (source of information, benefits, harms, reason for use and cost) associated with CAM use were recorded...
October 2016: Journal of Traditional and Complementary Medicine
Claudia Chaufan, Andrew J Karter, Howard H Moffet, Judy Quan, Melissa M Parker, Jenna Kruger, Dean Schillinger, Alicia Fernandez
OBJECTIVES: Language barriers negatively impact health care access and quality for US immigrants. Latinos are the second largest immigrant group and the largest, fastest growing minority. Health care systems need simple, low cost and accurate tools that they can use to identify physicians with Spanish language competence. We sought to address this need by validating a simple and low-cost tool already in use in a major health plan. DESIGN SETTING PARTICIPANTS: A web-based survey conducted in 2012 among physicians caring for patients in a large, integrated health care delivery system...
October 20, 2016: Ethnicity & Disease
Leo F Buckley, Enrique Seoane-Vazquez, Judy W M Cheng, Ahmed Aldemerdash, Irene M Cooper, Lina Matta, Danika S Medina, Mandeep R Mehra, Kristina Navarro-Velez, Elaine L Shea, Joanne R Weintraub, Lynne W Stevenson, Akshay S Desai
Innovative treatment strategies for decompensated heart failure (HF) are required to achieve cost savings and improvements in outcomes. We developed a decision analytic model from a hospital perspective to compare 2 strategies for the treatment of decompensated HF, ambulatory diuretic infusion therapy, and hospitalization (standard care), with respect to total HF hospitalizations and costs. The ambulatory diuretic therapy strategy included outpatient treatment with high doses of intravenous loop diuretics in a specialized HF unit whereas standard care included hospitalization for intravenous loop diuretic therapy...
November 1, 2016: American Journal of Cardiology
Alexander Konnopka, Hans-Helmut König, Claudia Kaufmann, Nina Egger, Beate Wild, Joachim Szecsenyi, Wolfgang Herzog, Dieter Schellberg, Rainer Schaefert
BACKGROUND: Collaborative group intervention (CGI) in patients with functional somatic syndromes (FSS) has been shown to improve mental quality of life. OBJECTIVE: To analyse incremental cost-utility of CGI compared to enhanced medical care in patients with FSS. METHODS: An economic evaluation alongside a cluster-randomised controlled trial was performed. 35 general practitioners (GPs) recruited 300 FSS patients. Patients in the CGI arm were offered 10 group sessions within 3months and 2 booster sessions 6 and 12months after baseline...
November 2016: Journal of Psychosomatic Research
Racquel E Kohler, Jared Tomlinson, Tiyamike Eletima Chilunjika, Sven Young, Mina Hosseinipour, Clara N Lee
PURPOSE: Low- and middle-income countries face a disproportionate burden of death and disability from injuries, many of which are due to road traffic accidents or falls. Lower extremity injuries in particular have implications not only for physical disabilities affecting work and school performance, but also for quality of life (QOL) of the individual. This qualitative study explores the psychosocial impact and QOL changes due to lower extremity injuries among trauma patients in central Malawi...
October 22, 2016: Quality of Life Research
Andrés F Henao-Martínez, Kathryn Colborn, Gabriel Parra-Henao
Chagas disease is a complex tropical parasitic infection. It affects a significant portion of the population in Latin America, especially in areas of poverty and poor access to health care. It also affects immigrants in high-income countries who lack access to health care due to their legal status. Millions of people are at risk of contracting the disease, and approximately 30 % of chronically infected patients will develop cardiomyopathy. The cost of caring for patients that have been infected is substantial...
October 22, 2016: Parasitology Research
Carlos Gómez-Restrepo, Salomé Naranjo-Lujan, Martín Rondón, Andrés Acosta, Patricia Maldonado, Carlos Arango Villegas, Jaime Hurtado, Juan Carlos Hernández, María Del Pilar Angarita, Marcela Peña, Miguel Ángel Saavedra, Hoover Quitian
OBJECTIVES: In Colombia, some studies have estimated medical costs associated to traffic accidents. It is required to assess results by city or region and determine the influence of variables such as alcohol consumption. The main objective of this study is to identify health care costs associated to traffic accidents in Bogota, and determine whether alcohol consumption can increase them. DESIGN: and settings: Cross sectional costs study conducted in patients over 18 years treated in the emergency rooms of 6 different hospitals in Bogota, Colombia...
October 19, 2016: Journal of Clinical Epidemiology
Helen Killaspy, Stefan Priebe, Stephen Bremner, Paul McCrone, Sarah Dowling, Isobel Harrison, Joanna Krotofil, Peter McPherson, Sima Sandhu, Maurice Arbuthnott, Sarah Curtis, Gerard Leavey, Geoff Shepherd, Sandra Eldridge, Michael King
BACKGROUND: Little research has been done into the effectiveness of mental health supported accommodation services. We did a national survey to investigate provision and costs of services and assess service user quality of life and outcomes across England. METHODS: We randomly sampled three types of services from 14 nationally representative regions-residential care, supported housing, and floating outreach-and recruited up to ten service users per service. Service quality and costs and service users' quality of life, autonomy, and satisfaction with care were assessed in a standardised manner with validated tools and compared by multilevel modelling...
October 19, 2016: Lancet Psychiatry
Jack J Olney, Paula Braitstein, Jeffrey W Eaton, Edwin Sang, Monicah Nyambura, Sylvester Kimaiyo, Ellen McRobie, Joseph W Hogan, Timothy B Hallett
BACKGROUND: With expanded access to antiretroviral therapy (ART) in sub-Saharan Africa, HIV mortality has decreased, yet life-years are still lost to AIDS. Strengthening of treatment programmes is a priority. We examined the state of an HIV care programme in Kenya and assessed interventions to improve the impact of ART programmes on population health. METHODS: We created an individual-based mathematical model to describe the HIV epidemic and the experiences of care among adults infected with HIV in Kenya...
October 19, 2016: Lancet HIV
Amanda Reichard, Michelle Stransky, Kimberly Phillips, Monica McClain, Charles Drum
BACKGROUND: While it is commonly accepted that disparities in unmet need for care vary by age, race/ethnicity, income, education, and access to care, literature documenting unmet needs experienced by adults with different types of disabilities is developing. OBJECTIVE: The main objective was to determine whether subgroups of people with disabilities are more likely than people without disabilities to delay/forgo necessary care, in general and among the insured. METHODS: We used pooled Medical Expenditure Panel Survey data (2004-2010) to examine delaying or forgoing medical, dental, and pharmacy care among five disability subgroups (physical, cognitive, visual, hearing, multiple) and the non-disabled population...
September 13, 2016: Disability and Health Journal
Sonia Johnson, Luke Sheridan Rains, Steven Marwaha, John Strang, Thomas Craig, Tim Weaver, Paul McCrone, Michael King, David Fowler, Stephen Pilling, Louise Marston, Rumana Z Omar, Meghan Craig, Mark Hinton
BACKGROUND: Around 35-45 % of people in contact with services for a first episode of psychosis are using cannabis. Cannabis use is associated with delays in remission, poorer clinical outcomes, significant increases in the risk of relapse, and lower engagement in work or education. While there is a clear need for effective interventions, so far only very limited benefits have been achieved from psychological interventions. Contingency management (CM) is a behavioural intervention in which specified desired behavioural change is reinforced through financial rewards...
October 22, 2016: Trials
Tim Stokes, Elizabeth J Shaw, Janette Camosso-Stefinovic, Mari Imamura, Lovney Kanguru, Julia Hussein
BACKGROUND: Maternal mortality remains a major international health problem in low- and middle-income countries (LMIC), and most could have been prevented by quality improvement interventions already demonstrated to be effective, such as clinical guideline implementation strategies. The aim of this systematic review was to synthesise qualitative evidence on guideline implementation strategies to improve obstetric care practice in LMIC in order to identify barriers and enablers to their successful implementation...
October 22, 2016: Implementation Science: IS
Angela Dawson, Deborah Bateson, Jane Estoesta, Elizabeth Sullivan
BACKGROUND: Improving access to safe abortion is an essential strategy in the provision of universal access to reproductive health care. Australians are largely supportive of the provision of abortion and its decriminalization. However, the lack of data and the complex legal and service delivery situation impacts upon access for women seeking an early termination of pregnancy. There are no systematic reviews from a health services perspective to help direct health planners and policy makers to improve access comprehensive medical and early surgical abortion in high income countries...
October 22, 2016: BMC Health Services Research
Stephanie Agtarap, Adriel Boals, Pamela Holtz, Kenleigh Roden-Foreman, Evan E Rainey, Camilo Ruggero, Ann Marie Warren
BACKGROUND: Depression is a common mental health outcome after traumatic injury, negatively impacting physical outcomes and increasing the cost of care. Research shows that the presence and quality of support is a leading protective factor against depression post-injury; however, research is vague on the directional effects of both factors over the course of recovery. METHODS: 130 patients admitted to a Level I Trauma Center were recruited to a prospective study examining overall outcomes one-year after injury...
October 11, 2016: Journal of Affective Disorders
Poul Jennum, Anne Sabers, Jakob Christensen, Rikke Ibsen, Jakob Kjellberg
PURPOSE: Epilepsy surgery has been a standard treatment for refractory epilepsies that cannot be controlled by standard medical treatment. We aimed to evaluate the health and social consequences of resective surgery relative to controls from a study of national data. METHODS: Using the Danish National Patient Registry we identified all subjects with an epilepsy diagnosis between 1996 and 2009 and compared them with a group of patients with an epilepsy diagnosis who had had neither epilepsy surgery nor a vagus stimulation diagnosis by the index date, and who were matched by gender, index year for epilepsy diagnosis, and index year for epilepsy surgery...
October 6, 2016: Seizure: the Journal of the British Epilepsy Association
C Teljeur, P S Moran, S Walshe, S M Smith, F Cianci, L Murphy, P Harrington, M Ryan
AIMS: To systematically review the evidence on the costs and cost-effectiveness of self-management support interventions for people with diabetes. BACKGROUND: Self-management support is the provision of education and supportive interventions to increase patients' skills and confidence in managing their health problems, potentially leading to improvements in HbA1c levels in people with diabetes. METHODS: Randomized controlled trials, observational studies or economic modelling studies were eligible for inclusion in the review...
October 22, 2016: Diabetic Medicine: a Journal of the British Diabetic Association
Joanne E Brady, Danielle K Liffmann, Anthony Yartel, Natalie Kil, Alex D Federman, Joseph Kannry, Cynthia Jordan, Omar I Massoud, David R Nerenz, Kimberly A Brown, Bryce D Smith, Claudia Vellozzi, David B Rein
BACKGROUND: From December 2012-March 2014, three randomized trials, each implementing a unique intervention in primary care settings (mail recruitment [repeated-mailing], an electronic health record best practice alert [BPA], and patient-solicitation [patient-solicitation]), evaluated HCV antibody testing, diagnosis, and costs for each of the interventions compared to standard-of-care testing. Multilevel multivariable models were used to estimate the adjusted risk ratio (aRR) for receiving an HCV antibody test, and costs were estimated using activity-based costing...
October 22, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
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