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https://www.readbyqxmd.com/read/29043949/arthroscopic-surgery-for-knee-osteoarthritis-impact-of-health-technology-assessment-in-germany
#1
Naomi Fujita-Rohwerder, Alric Rüther, Stefan Sauerland
OBJECTIVES: This study aims to describe how a negative reimbursement decision-based on the health technology assessment (HTA) report of a nondrug intervention-affects healthcare providers in Germany. METHODS: Knee arthroscopy was chosen as an example, because as of April 2016 this procedure is no longer reimbursed for osteoarthritis, but is still covered for other indications, including meniscal lesions. The exclusion followed an HTA report prepared by the Institute for Quality and Efficiency in Health Care (IQWiG)...
October 18, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/29042408/impact-of-restricting-diagnostic-imaging-reimbursement-for-uncomplicated-low-back-pain-in-ontario-a-population-based-interrupted-time-series-analysis
#2
Benjamin Fine, Susan E Schultz, Lawrence White, David Henry
BACKGROUND: In 2012, the Ontario government withdrew public insurance coverage of imaging tests for uncomplicated low back pain. We studied the impact of this restriction on test ordering by physicians. METHODS: We compared the numbers of lumbar spine radiography, computed tomography (CT) and single-segment magnetic resonance imaging (MRI) studies ordered by physicians in the 3 years before and after the policy change. We linked claims data from the Ontario Health Insurance Program with physician details to calculate rates per test-ordering physician...
October 13, 2017: CMAJ Open
https://www.readbyqxmd.com/read/29042372/awareness-and-willingness-towards-pre-exposure-prophylaxis-against-hiv-infection-among-individuals-seeking-voluntary-counselling-and-testing-for-hiv-in-taiwan-a-cross-sectional-questionnaire-survey
#3
Yi-Chieh Lee, Sui-Yuan Chang, Kuan-Yin Lin, Lan-Hsin Chang, Wen-Chun Liu, Cheng-Hsin Wu, Hsin-Yun Sun, Chien-Ching Hung, Shan-Chwen Chang
OBJECTIVES: We aimed to investigate the awareness and willingness towards pre-exposure prophylaxis (PrEP) among individuals seeking voluntary counselling and testing (VCT) for HIV in Taiwan, where PrEP is currently not reimbursed by the insurance. METHODS: Between April and October 2016, a questionnaire interview was conducted among VCT clients to inquire about the attitudes towards PrEP against HIV infection. Multivariate logistic regression analysis was performed to identify the associated factors with willingness to initiate PrEP...
October 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29039627/beliefs-endorsement-and-application-of-homeopathy-disclosed-a-survey-among-ambulatory-care-physicians
#4
Stefan Markun, Marc Maeder, Thomas Rosemann, Sima Djalali
BACKGROUND: Explanation models for the effectiveness of homeopathy are not supported by natural sciences and the aggregated evidence from clinical trials is unconvincing. From this standpoint, placebo effects seem the most obvious explanation for the therapeutic effects experienced in homeopathy. Still, many physicians continue to prescribe homeopathic treatments. OBJECTIVES: Whether physicians who prescribe homeopathic treatments aim to achieve placebo effects or actually believe in specific effects is poorly understood...
October 17, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29038733/mining-comorbidity-patterns-using-retrospective-analysis-of-big-collection-of-outpatient-records
#5
Svetla Boytcheva, Galia Angelova, Zhivko Angelov, Dimitar Tcharaktchiev
BACKGROUND: Studying comorbidities of disorders is important for detection and prevention. For discovering frequent patterns of diseases we can use retrospective analysis of population data, by filtering events with common properties and similar significance. Most frequent pattern mining methods do not consider contextual information about extracted patterns. Further data mining developments might enable more efficient applications in specific tasks like comorbidities identification. METHODS: We propose a cascade data mining approach for frequent pattern mining enriched with context information, including a new algorithm MIxCO for maximal frequent patterns mining...
December 2017: Health Information Science and Systems
https://www.readbyqxmd.com/read/29031682/-rates-of-total-and-free-psa-prescriptions-in-france-2012-2014
#6
Philippe Tuppin, Claire Leboucher, Gabrielle Peyre-Lanquar, Pierre-Jean Lamy, Pierre Gabach, Xavier Rébillard
BACKGROUND: In 2010, the French Haute Autorité de santé (National Health Authority) confirmed the limited value of prostate cancer (PCa) screening by total prostate-specific antigen (PSA) assay. OBJECTIVE: This study was designed to determine the modalities of ordering total PSA or free PSA assays (in the absence of PCa) according to various parameters and the corresponding sums reimbursed. METHODS: Men aged 40 years and older covered by the national health insurance general scheme (73% of the French population) between 2012 and 2014 were selected...
October 11, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29031037/-evaluation-of-anti-cancer-therapies-with-reimbursement-limited-to-comprehensive-cancer-centres-using-the-european-society-for-medical-oncology-magnitude-of-clinical-benefit-scale
#7
T Büchler, B Melichar, D Vrána, R Lemstrová, J Fínek, L Dušek, K Petráková, J Prausová
BACKGROUND: The costs of oncology treatments are increasing, due to the rising prevalence of malignant diseases and the introduction of expensive novel anti-cancer agents. The new European Society for Clinical Oncology (ESMO) has recently developed a new parametric system to evaluate the clinical benefit of drugs. The Magnitude of Clinical Benefit Scale (ESMO-MCBS) compares the contribution of a novel drug based on overall and progression-free survival and quality of life with those of current treatment options...
2017: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/29029551/low-back-pain-investigation-of-biases-in-outpatient-canadian-physical-therapy
#8
Maude Laliberté, Barbara Mazer, Tatiana Orozco, Gevorg Chilingaryan, Bryn Williams-Jones, Matthew Hunt, Debbie Ehrmann Feldman
Background: Previous research suggested that physical therapy services can be influenced by patient characteristics (age, sex, socioeconomic status) or insurance status rather than their clinical need. Objective: The aim of this study was to determine whether patient-related factors (age, sex, SES) and the source of reimbursement for physical therapy services (insurance status) influence wait time for, frequency of, and duration of physical therapy for low back pain...
October 1, 2017: Physical Therapy
https://www.readbyqxmd.com/read/29026296/trends-in-health-care-resource-utilization-and-pharmacological-management-of-copd-in-taiwan-from-2004-to-2010
#9
Ying-Huang Tsai, Tsung-Ming Yang, Chieh-Mo Lin, Shu-Yi Huang, Yu-Wen Wen
RATIONALE: COPD has attracted widespread attention worldwide. The prevalence of COPD in Taiwan has been reported, but little is known about trends in health care resource utilization and pharmacologic management in COPD treatment. OBJECTIVE: The objective of this article was to study trends in health care resource utilization, pharmacologic management, and medical costs of COPD treatment in Taiwan. MATERIALS AND METHODS: Reimbursement claims in the Taiwan National Health Insurance System from 2004 to 2010 were collected...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29017542/financial-burden-of-healthcare-for-cancer-patients-with-social-medical-insurance-a-multi-centered-study-in-urban-china
#10
Wenhui Mao, Shenglan Tang, Ying Zhu, Zening Xie, Wen Chen
BACKGROUND: Cancer accounts for one-fifth of the total deaths in China and brings heavy financial burden to patients and their families. Chinese government has made strong commitment to develop three types of social medical insurance since 1997 and recently, more attempts were invested to provide better financial protection. To analyze health services utilization and financial burden of insured cancer patients, and identify the gaps of financial protection provided by insurance in urban China...
October 10, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28984659/a-cross-sectional-study-of-variations-in-reimbursement-for-breast-reconstruction-is-a-healthcare-disparity-on-the-horizon
#11
Elizabeth B Odom, Alexandra C Schmidt, Terence M Myckatyn, Donald W Buck
BACKGROUND: Despite growing demand for breast reconstruction, financial disincentives to perform breast reconstruction in patients with government-sponsored insurance plans may lead to longer wait times and decreased access to care. We identify the variation in reimbursement for implant and autologous reconstruction as a step toward understanding these financial implications, to develop safeguards to minimize effects on access to care. METHODS: Billing data were collected over a 10-year period for patients undergoing implant-based (19357) or free-flap (19364) breast reconstruction...
October 3, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28975428/a-new-efficient-method-to-monitor-precocious-puberty-nationwide-in-france
#12
Annabel Rigou, Joëlle Le Moal, Juliane Léger, Alain Le Tertre, Jean-Claude Carel
Clinical precocious puberty (PP) is a disease, reputed to be on the increase and suspected to be linked to endocrine disrupting chemicals (EDC) exposure. Population-based epidemiological data are lacking in France and scarce elsewhere. We accessed the feasibility of monitoring PP nationwide in France in this context, using a nationwide existing database, the French National Health Insurance Information System. Here, we present the method we used with a step-by-step approach to build and select the most suitable indicator...
October 3, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28975381/health-status-and-drug-use-1%C3%A2-year-before-and-1%C3%A2-year-after-skilled-nursing-home-admission-during-the-first-quarter-of-2013-in-france-a-study-based-on-the-french-national-health-insurance-information-system
#13
Alice Atramont, Dominique Bonnet-Zamponi, Isabelle Bourdel-Marchasson, Isabelle Tangre, Anne Fagot-Campagna, Philippe Tuppin
PURPOSE: Changes in prescribing practices following skilled nursing home (SNH) admission have not been clearly described in France. The study aimed to evaluate health status and drug use 1 year before and 1 year after admission to SNH. METHOD: People ≥ 65 years old admitted to SNH in the first quarter of 2013, covered by the national health insurance general scheme (69% of the population of this age) and still alive 1 year after admission were identified in a specific database (Resid-ehpad)...
October 3, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28970403/assessment-of-perceived-barriers-to-herpes-zoster-vaccination-among-geriatric-primary-care-providers
#14
Katherine Montag Schafer, Shannon Reidt
The herpes zoster vaccine is recommended for use in adults 60 years of age and older to reduce the incidence and morbidity associated with infection. Its limited uptake has been attributed to logistical barriers, but uncertain efficacy and safety in subsets of this patient population could also be contributing. The purpose of this study was to evaluate the current vaccination practices, barriers to vaccination, knowledge of vaccination reimbursement and strategies to evaluate for insurance coverage among an urban, safety net, teaching hospital, geriatric primary care provider group through a survey administered via paper and online platforms...
October 18, 2016: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/28965907/assessment-of-availability-accessibility-and-affordability-of-magnetic-resonance-imaging-services-in-ghana
#15
A D Piersson, P N Gorleku
INTRODUCTION: The aim of this study was to assess the availability, accessibility, and affordability of MRI services to patients in Ghana. METHODS: A descriptive quantitative research method which involve the use of a structured email 3-page survey questionnaire was employed, and addressed to the MRI radiographer-in-charge for completion. RESULTS: A response rate of 92% was achieved. Sixty-seven percent (8) of the facilities were located in the Greater Accra region of Ghana with most (6[75%]) being private health facilities...
November 2017: Radiography
https://www.readbyqxmd.com/read/28965800/short-and-long-term-readmission-rates-after-infrainguinal-bypass-in-a-safety-net-hospital-are-higher-than-expected
#16
Brianna M Krafcik, Sevan Komshian, Kimberly Lu, Lauren Roberts, Alik Farber, Jeffrey A Kalish, Denis Rybin, Jeffrey J Siracuse
OBJECTIVE: Readmission rates are expected to have an increasing effect on both the hospital bottom line and physician reimbursements. Safety net hospitals may be most vulnerable. We examined readmissions at 30 days, 90 days, and 1 year in a large safety net hospital to determine the magnitude and effect of short and long-term readmission rates after lower extremity infrainguinal bypass in this setting. METHODS: All nonemergent extremity infrainguinal bypass performed at a large safety net hospital between 2008 and 2016 were identified...
September 28, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28963077/payment-and-care-for-hematopoietic-cellular-transplant-patients-toward-a-specialized-medical-home-for-complex-care-patients
#17
James L Gajewski, Mark B McClellan, Navneet S Majhail, Parameswaran N Hari, Christopher N Bredeson, Richard T Maziarz, Charles F LeMaistre, Michael C Lill, Stephanie H Farnia, Krishna V Komanduri, Michael J Boo
Patient-centered medical home models are fundamental to the advanced alternative payment models (APM) defined in the Medicare Access and Children's Health Insurance Plan (CHIP) Reauthorization Act (MACRA). The patient-centered medical home is a model of health care delivery supported by alternative payment mechanisms and designed to promote coordinated medical care that is simultaneously patient-centric and population-oriented. This transformative care model requires shifting reimbursement to include a per-patient payment intended to cover services not previously reimbursed such as disease management over time...
September 26, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28961607/planning-and-implementing-immunization-billing-programs-at-state-and-local-health-departments-barriers-and-possible-solutions
#18
Rosemary Corriero, Ginger Redmon
CONTEXT: Before participating in a project funded by the Centers for Disease Control and Prevention, most state and local health departments (LHDs) were not seeking reimbursement or being fully reimbursed by insurance plans for the cost of immunization services (including vaccine costs and administration fees) they provided to insured patients. Centers for Disease Control and Prevention's Billables Project was designed to enable state and LHDs to bill public and private insurance plans for immunization services provided to insured patients...
September 28, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28958706/reforming-voluntary-drug-insurance-in-russian-healthcare-does-social-solidarity-matter
#19
Christopher J Gerry, Maria Kaneva, Liudmila Zasimova
With low take-up of both private health insurance and the existing public drug reimbursement scheme, it is thought that less than 5% of the Russian population have access to free outpatient drug treatment. This represents a major policy challenge for a country grappling with reforms of its healthcare system and experiencing low or no economic growth and significant associated reductions in spending on social services. In this paper, we draw on data from a 2011 Levada-Center survey to examine the attitudes and social solidarity of the Russian population towards drug policies in general and towards the introduction of a proposed voluntary drug insurance system in particular...
September 8, 2017: Health Policy
https://www.readbyqxmd.com/read/28946711/health-care-payments-in-vietnam-patients-quagmire-of-caring-for-health-versus-economic-destitution
#20
Andre Pekerti, Quan-Hoang Vuong, Tung Manh Ho, Thu-Trang Vuong
In the last three decades many developing and middle-income nations' health care systems have been financed via out-of-pocket payments by individuals. User fees charges, however, may not be the best approach or thenmost equitable approach to finance and/or reform health services in developing nations. This study investigates the status of Vietnam's current health system as a result of implementing user fees policies. A recent mandate by the government to increase the universal cover to 100% attempts to tackle inadequate insurance cover, one of the four major factors contributing to the high and increasing probability of destitution for Vietnamese patients (the other three being: non-residency, long stay in hospital, and high cost of treatment)...
September 25, 2017: International Journal of Environmental Research and Public Health
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