keyword
MENU ▼
Read by QxMD icon Read
search

Insurance reimbursement

keyword
https://www.readbyqxmd.com/read/28341166/-identification-of-neurodegenerative-diseases-in-administrative-databases-in-france-a-systematic-review-of-the-literature
#1
REVIEW
A Gallini, F Moisan, G Maura, L Carcaillon-Bentata, E Leray, J Haesebaert, A Bruandet, E Moutengou, L Luciano, A Weill, B Marin, V Gardette
BACKGROUND: Given the health, social and economic burden of neurodegenerative diseases (ND), the development of epidemiologic studies is required. Administrative databases, such as the French national health insurance database (SNIIRAM) could represent an opportunity for researchers. ND could be presumed from drug reimbursement data, hospital stays or registration of a chronic condition. The aim of this study was to describe, in French administrative databases, algorithms used to identify Alzheimer's disease and associated disorders (ADAD), Parkinson's disease and associated disorders (PDAD), multiple sclerosis (MS), and amyotrophic lateral sclerosis (ALS)...
March 21, 2017: Revue D'épidémiologie et de Santé Publique
https://www.readbyqxmd.com/read/28340547/the-complexities-of-struggling-to-live-life
#2
Samereh Abdoli, Lynda R Hardy, Joanne Hall
Purpose The purpose of the study was to explore and describe perceptions and experiences of young adults with type 1 diabetes mellitus (T1DM) living in Appalachia, Tennessee. Methods Qualitative descriptive analysis of in-depth interviews of 9 young adults (male = 3, female = 6) 18 to 30 years of age living in Appalachian counties in Tennessee provided the basis of identifying the salient concerns from the perspective of this diverse group related to living daily with T1DM. Data analysis was facilitated by using NVivo 11 Pro and consisted of iterative review of the accounts in 3 phases: immersion, reduction, and interpretation...
April 2017: Diabetes Educator
https://www.readbyqxmd.com/read/28335754/the-structural-and-health-policy-environment-for-delivering-integrated-hiv-and-substance-use-disorder-treatments-in-puerto-rico
#3
Jared A Leff, Diana Hernández, Paul A Teixeira, Pedro C Castellón, Daniel J Feaster, Allan E Rodriguez, Jorge L Santana-Bagur, Sandra Miranda De León, José Vargas Vidot, Lisa R Metsch, Bruce R Schackman
BACKGROUND: HIV prevalence in Puerto Rico is nearly twice that of the mainland United States, a level that was substantially fueled by injection drug use. Puerto Rico has a longstanding history of health provision by the public sector that directly affects how HIV and substance use disorder (SUD) treatment services are provided and funded. As part of pre-implementation research for a randomized trial of a community-level intervention to enhance HIV care access for substance users in San Juan, Puerto Rico, we sought to understand the structural and health policy environment for providing HIV and SUD treatments...
March 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28333819/practice-bulletin-no-177-obstetric-analgesia-and-anesthesia
#4
(no author information available yet)
Labor causes severe pain for many women. There is no other circumstance in which it is considered acceptable for an individual to experience untreated severe pain that is amenable to safe intervention while the individual is under a physician's care. Many women desire pain management during labor and delivery, and there are many medical indications for analgesia and anesthesia during labor and delivery. In the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labor...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28333811/practice-bulletin-no-177-summary-obstetric-analgesia-and-anesthesia
#5
(no author information available yet)
Labor causes severe pain for many women. There is no other circumstance in which it is considered acceptable for an individual to experience untreated severe pain that is amenable to safe intervention while the individual is under a physician's care. Many women desire pain management during labor and delivery, and there are many medical indications for analgesia and anesthesia during labor and delivery. In the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labor...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28328245/-performance-indicators-of-maxillofacial-surgery-inpatient-departments
#6
Gyula Marada, Ákos Nagy, Andor Sebestyén, Antal Zemplényi, Márta Radnai, Imre Boncz
INTRODUCTION: In Hungary, the number and structure of the maxillofacial surgery departments underwent significant changes in recent decades. AIM: The aim of our study was to present the actual performance indicators of maxillofacial inpatient departments and based on the available data to compare the departments. METHOD: The study was based on the number of beds founded by the National Health Insurance Fund. Performance data were supplied by the National Health Insurance Fund Administration...
March 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28322095/therapeutic-inertia-and-intensified-treatment-in-diabetes-mellitus-prescription-patterns-a-nationwide-population-based-study-in-taiwan
#7
Li-Ying Huang, Hseng-Long Yeh, Ming-Chin Yang, Wen-Yi Shau, Syi Su, Mei-Shu Lai
Objective To measure therapeutic inertia by characterizing prescription patterns using secondary data obtained from the nationwide diabetes mellitus pay-for-performance (DM-P4P) programme in Taiwan. Methods Using reimbursement claims from Taiwan's National Health Insurance Research Database, a nationwide retrospective cohort study was undertaken of patients with diabetes mellitus who participated in the DM-P4P programme from 2006-2008. Glycosylated haemoglobin results were used to evaluate modifications in therapy in response to poor diabetes control...
December 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/28316544/a-review-on-methods-of-risk-adjustment-and-their-use-in-integrated-healthcare-systems
#8
Christin Juhnke, Susanne Bethge, Axel C Mühlbacher
INTRODUCTION: Effective risk adjustment is an aspect that is more and more given weight on the background of competitive health insurance systems and vital healthcare systems. The objective of this review was to obtain an overview of existing models of risk adjustment as well as on crucial weights in risk adjustment. Moreover, the predictive performance of selected methods in international healthcare systems should be analysed. THEORY AND METHODS: A comprehensive, systematic literature review on methods of risk adjustment was conducted in terms of an encompassing, interdisciplinary examination of the related disciplines...
October 26, 2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28304182/insurance-reimbursement-for-complementary-healthcare-services
#9
James Whedon, Tor D Tosteson, Anupama Kizhakkeveettil, Melissa Nagare Kimura
INTRODUCTION: Insurance reimbursement for clinical services provided by complementary healthcare professionals in the United States likely differs by provider specialty. It is hypothesized that a lower likelihood of insurance reimbursement demonstrates that complementary healthcare services are not utilized to an optimal level and are not financially accessible to all who may need or want these services. The purpose of this project was to evaluate the likelihood of insurance reimbursement for complementary healthcare services compared with other complementary services and with conventional primary care medical services in New Hampshire...
March 17, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/28303314/-genetic-tests-for-controlling-treatment-with-antidepressants
#10
T Bschor, C Baethge, C Hiemke, B Müller-Oerlinghausen
In clinical practice, there is a need for a more individualized selection of antidepressants and adequate dosage. The investigation of pharmacokinetically relevant genes is a promising approach to assist this selection. In the past 2 years, two commercially available tests have been subject of advertisement, a test from Stada, which analyses variants of the cytochrome P450 isoenzymes CYP2D6 and CYP2C19 and a test from HMNC Brain Health, which analyses variants of the ABCB1 gene. The costs for both kits are not covered by the statutory health insurance and it is therefore proposed that the patients are invoiced directly in the form of individual healthcare payment...
March 16, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28299592/the-effect-of-a-celebrity-health-disclosure-on-demand-for-health-care-trends-in-brca-testing-and-subsequent-health-services-use
#11
Megan C Roberts, Stacie B Dusetzina
In May 2013, an internationally renowned celebrity-Angelina Jolie-disclosed her receipt of BRCA1/BRCA2 (BRCA) testing and subsequent double mastectomy in a highly publicized editorial. Publicity surrounding celebrity health services use increases awareness of important health issues and demand for health services. We aimed to describe BRCA testing trends before and after Jolie's disclosure, breast cancer-related services use following testing, and test reimbursement trends. MarketScan Commercial Claims data were used to compare trends in BRCA testing before and after Jolie's health disclosure using an interrupted time series model among women aged 18-64...
March 15, 2017: Journal of Community Genetics
https://www.readbyqxmd.com/read/28285755/-the-human-and-economic-burden-of-cancer-in-france-in-2014-based-on-the-sniiram-national-database
#12
Philippe Tuppin, Laurence Pestel, Solène Samson, Anne Cuerq, Sébastien Rivière, Stéphane Tala, Pierre Denis, Jérôme Drouin, Claude Gissot, Christelle Gastaldi-Ménager, Anne Fagot-Campagna
INTRODUCTION: The national health insurance information system (Sniiram) can be used to estimate the national medical and economic burden of cancer. This study reports the annual rates, characteristics and expenditure of people reimbursed for cancer. METHODS: Among 57 million general health scheme beneficiaries (86% of the French population), people managed for cancer were identified using algorithms based on hospital diagnoses and full refund for long-term cancer...
March 9, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28284397/optimizing-the-diagnosis-and-management-of-dravet-syndrome-recommendations-from-a-north-american-consensus-panel
#13
Elaine C Wirrell, Linda Laux, Elizabeth Donner, Nathalie Jette, Kelly Knupp, Mary Anne Meskis, Ian Miller, Joseph Sullivan, Michelle Welborn, Anne T Berg
OBJECTIVES: To establish standards for early, cost-effective, and accurate diagnosis; optimal therapies for seizures; and recommendations for evaluation and management of comorbidities for children and adults with Dravet syndrome, using a modified Delphi process. METHODS: An expert panel was convened comprising epileptologists with nationally recognized expertise in Dravet syndrome and parents of children with Dravet syndrome, whose experience and understanding was enhanced by their active roles in Dravet syndrome associations...
March 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28279715/characteristics-and-changes-in-invasive-meningococcal-disease-epidemiology-in-france-2006-2015
#14
I Parent du Chatelet, A E Deghmane, D Antona, E Hong, L Fonteneau, M K Taha, D Lévy-Bruhl
OBJECTIVES: This work aimed to describe the epidemiology of invasive meningococcal disease (IMD) in France, 2006-2015, including group- and genotype-specific disease burden, incidence trends before and after introduction of meningococcal C conjugate vaccines (MCCV) in 2010, and factors influencing the case fatality rate. METHODS: Mandatory notification data on incidence and IMD case characteristics were used. Genotyping of invasive strains and whole genome sequencing were performed by the French National Reference Center...
March 7, 2017: Journal of Infection
https://www.readbyqxmd.com/read/28277812/considerations-on-bringing-warehoused-hcv-patients-into-active-care-following-interferon-free-direct-acting-antiviral-drug-approval
#15
Aleksandra Palak, Christine Livoti, Céline Audibert
OBJECTIVES: Until recently, lack of efficacious and tolerable hepatitis C virus (HCV) treatments prompted patient warehousing until better treatment options became available. We investigated whether the introduction of ledipasvir/sofosbuvir precipitated patient return to clinics, thereby changing HCV clinic dynamics. METHODS: Online questionnaire responses indicated the volume of HCV patients followed, the proportion of warehoused patients and those who were proactively offered new options, methods for identifying and contacting patients, and insurance authorization/reimbursement-related information...
March 9, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28272424/restricted-use-of-erythropoiesis-stimulating-agent-is-safe-and-associated-with-deferred-dialysis-initiation-in-stage-5-chronic-kidney-disease
#16
Szu-Yu Pan, Wen-Chih Chiang, Ping-Min Chen, Heng-Hsiu Liu, Yu-Hsiang Chou, Tai-Shuan Lai, Chun-Fu Lai, Yen-Ling Chiu, Wan-Yu Lin, Yung-Ming Chen, Tzong-Shinn Chu, Shuei-Liong Lin
The effect of erythropoiesis-stimulating agent (ESA) on dialysis initiation in advanced chronic kidney disease (CKD) patients is not clear. We retrospectively analyzed the outcome of dialysis initiation in a stage 5 CKD cohort with ESA reimbursement limited to the maximal standardized monthly ESA dose equivalent to epoetin beta 20,000 U by the National Health Insurance program. Totally 423 patients were followed up for a median of 1.37 year. A time-dependent Cox regression model, adjusted for monthly levels of estimated glomerular filtration rate (eGFR) and hemoglobin, was constructed to investigate the association between ESA and outcome...
March 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28272277/value-based-payment-reform-and-the-medicare-access-and-chip-reauthorization-act-macra-of-2015-a-primer-for-plastic-surgeons
#17
Lee Squitieri, Kevin C Chung
In 2015, the U.S. Congress passed the Medicare Access and CHIP (Children's Health Insurance Program) Reauthorization Act (MACRA), which effectively repealed the Centers for Medicare and Medicaid Services (CMS) sustainable growth rate (SGR) formula and established the CMS Quality Payment Program (QPP). MACRA represents an unparalleled acceleration toward value-based payment models and a departure from traditional volume-driven fee-for-service reimbursement. The QPP includes two paths for provider participation: the merit-based incentive payment system (MIPS) and advanced alternative payment models (APMs)...
March 6, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28263706/effect-of-health-insurance-on-direct-hospitalisation-costs-for-in-patients-with-ischaemic-stroke-in-china
#18
Ma Yong, Xiong Xianjun, Li Jinghu, Fang Yunyun
Objectives The aim of the present study was to determine the direct medical costs of hospitalisations for ischaemic stroke (IS) in-patients with different types of health insurance in China and to analyse the demographic characteristics of hospitalised patients, based on data supplied by the China Health Insurance Research Association (CHIRA).Methods A nationwide and cross-sectional sample of IS in-patients with International Classifications of Diseases 10th Revision (ICD-10) Code I63 who were ensured under either the Basic Medical Insurance Scheme for Employees (BMISE) or the Basic Medical Insurance Scheme for Urban Residents (BMISUR) was extracted from the CHIRA claims database...
March 7, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28261487/drug-pricing-and-reimbursement-decision-making-systems-in-mongolia
#19
Gereltuya Dorj, Bruce Sunderland, Tsetsegmaa Sanjjav, Gantuya Dorj, Byambatsogt Gendenragchaa
BACKGROUND: It is essential to allocate available resources equitably in order to ensure accessibility and affordability of essential medicines, especially in less fortunate nations with limited health funding. Currently, transparent and evidence based research is required to evaluate decision making regarding drug registration, drug pricing and reimbursement processes in Mongolia. OBJECTIVE: To assess the drug reimbursement system and discuss challenges faced by policy-makers and stakeholders...
2017: Journal of Pharmaceutical Policy and Practice
https://www.readbyqxmd.com/read/28257434/determinants-of-geographic-inequalities-in-hpv-vaccination-in-the-most-populated-region-of-france
#20
Delphine Héquet, Roman Rouzier
BACKGROUND: In France, there are recommendations and reimbursements for human papillomavirus (HPV) vaccination but no HPV vaccination programs. Therefore, vaccination is largely determined by parents' initiative, which can lead to inequalities. The objective of this study was to determine the factors associated with poorer vaccination coverage rates in the most populated region of France. METHODS: The data of this study were obtained from the National Health Insurance between 2011 and 2013...
2017: PloS One
keyword
keyword
119127
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"