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https://www.readbyqxmd.com/read/28547934/endo-laparoscopic-inguinal-hernia-repair-what-is-its-role
#1
REVIEW
Anil Sharma, Priyank Chelawat
Hernia repair techniques vary greatly depending upon the setting, surgeons, insurance reimbursement systems, resources, and logistical capabilities. Open mesh repair is the most frequently used technique. Choosing the best technique for inguinal hernia repair is a challenge. There is no single technique to manage every type of hernia. Today, laparoscopy and robotics are at the forefront of advanced surgical tools and offer a range of options for general surgeons who are critically evaluating new procedures...
May 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28544284/the-national-healthcare-system-claims-databases-in-france-sniiram-and-egb-powerful-tools-for-pharmacoepidemiology
#2
Julien Bezin, Mai Duong, Régis Lassalle, Cécile Droz, Antoine Pariente, Patrick Blin, Nicholas Moore
The French health care system is based on universal coverage by one of several health care insurance plans. The SNIIRAM database merges anonymous information of reimbursed claims from all these plans, linked to the national hospital-discharge summaries database system (PMSI) and the national death registry. It now covers 98.8% of the French population, over 66 million persons, from birth (or immigration) to death (or emigration), making it possibly the world's largest continuous homogeneous claims database...
May 24, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28537451/low-dose-aspirin-reduces-breast-cancer-risk-in-women-with-diabetes-a-nationwide-retrospective-cohort-study-in-taiwan
#3
Yi-Sun Yang, Edy Kornelius, Jeng-Yuan Chiou, Yung-Rung Lai, Shih-Chang Lo, Chiung-Huei Peng, Chien-Ning Huang
PURPOSE: Low-dose aspirin is commonly used for preventing cardiovascular disease in people with diabetes, but its association with cancer remains controversial. This study used a nationwide population-based reimbursement database to investigate the relationship between low-dose aspirin use and breast cancer incidence in women with diabetes. METHODS: This retrospective cohort study was conducted using data retrieved from the National Health Insurance Research Database in Taiwan from January 1, 1998 to December 31, 2011...
May 24, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28536768/quality-measures-and-pediatric-radiology-suggestions-for-the-transition-to-value-based-payment
#4
REVIEW
Richard E Heller, Brian D Coley, Stephen F Simoneaux, Daniel J Podberesky, Marta Hernanz-Schulman, Richard L Robertson, Lane F Donnelly
Recent political and economic factors have contributed to a meaningful change in the way that quality in health care, and by extension value, are viewed. While quality is often evaluated on the basis of subjective criteria, pay-for-performance programs that link reimbursement to various measures of quality require use of objective and quantifiable measures. This evolution to value-based payment was accelerated by the 2015 passage of the Medicare Access and CHIP (Children's Health Insurance Program) Reauthorization Act (MACRA)...
June 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28516332/prevalence-and-mortality-of-patients-with-multiple-sclerosis-in-france-in-2012-a-study-based-on-french-health-insurance-data
#5
Stéphanie Foulon, Géric Maura, Marie Dalichampt, François Alla, Marc Debouverie, Thibault Moreau, Alain Weill
Data on the prevalence of multiple sclerosis (MS) in France are scarce. National and regional updated estimates are needed to better plan health policies. In this nationwide study, we provided estimates of the prevalence of MS in France in 2012 and mortality rate in 2013. MS cases were identified in the French national health insurance database (SNIIRAM-PMSI) using reimbursement data for disease-modifying treatment, long-term disease status for MS, disability pension for MS, and hospitalisation for MS (MS ICD-10 code: G35)...
May 17, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28516194/-current-legal-and-jurisdictional-questions-from-the-perspective-of-the-german-federal-association-for-geriatrics-practical-report
#6
REVIEW
Dirk van den Heuvel, Carsten Klein
The article discusses the questions of the arbitration bodies according to § 111b SGB V (Volume V of the Social Insurance Code) in the individual federal states from the perspective of geriatric rehabilitation hospitals. The content of the agreement of reimbursement between a rehabilitation hospital and health insurance will be targeted as well as the question whether the entire content of the agreements of reimbursement can be negotiated at the arbitration body. In addition, the authors describe the consequences of the jurisprudence of the Federal Social Court on § 301 I...
May 17, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28511946/national-incidence-of-patient-safety-indicators-in-the-total-hip-arthroplasty-population
#7
Joseph E Tanenbaum, Derrick M Knapik, Glenn D Wera, Steven J Fitzgerald
BACKGROUND: The Centers for Medicare & Medicaid Services use the incidence of patient safety indicators (PSIs) to determine health care value and hospital reimbursement. The national incidence of PSI has not been quantified in the total hip arthroplasty (THA) population, and it is unknown if patient insurance status is associated with PSI incidence after THA. METHODS: All patients in the Nationwide Inpatient Sample (NIS) who underwent THA in 2013 were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification codes...
April 12, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28510514/door-is-open-for-hras-to-make-a-comeback
#8
Jan Greene
For four years, businesses that wanted to reimburse employees for their health insurance premiums rather than buying their coverage for them were told that that was no longer allowed under the ACA. But the health reimbursement arrangement (HRA) is back, brought back to life by provisions tucked into last year's 21st Century Cure Act.
March 2017: Managed Care
https://www.readbyqxmd.com/read/28508011/mandated-health-insurance-and-provider-reimbursement-via-private-insurance-evidence-from-the-massachusetts-health-reform
#9
Andrew Friedson, Allison Marier
In 2006, Massachusetts passed a reform that required individuals to purchase health insurance and provided subsidized health insurance to low-income individuals. The US Patient Protection and Affordable Care Act (ACA) was modeled after this reform, making Massachusetts an ideal place to look at potential outcomes from the ACA. Postreform, the proportion of the health-insured population in Massachusetts greatly increased, which potentially changed physician reimbursement for procedures as usage of care, particularly preventative care for children increased...
January 2017: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/28507206/real-world-data-on-prognostic-factors-for-overall-survival-in-egfr-mutation-positive-advanced-non-small-cell-lung-cancer-patients-treated-with-first-line-gefitinib
#10
Zong-Han Yao, Wei-Yu Liao, Chao-Chi Ho, Kuan-Yu Chen, Jin-Yuan Shih, Jin-Shing Chen, Zhong-Zhe Lin, Chia-Chi Lin, James Chih-Hsin Yang, Chong-Jen Yu
BACKGROUND: This study aimed to identify independent prognostic factors for overall survival (OS) of patients with advanced non-small cell lung cancer (NSCLC) harboring an activating epidermal growth factor receptor (EGFR) mutation and receiving gefitinib as first-line treatment in real-world practice. MATERIALS AND METHODS: We enrolled 226 patients from June 2011 to May 2013. During this period, gefitinib was the only EGFR-tyrosine kinase inhibitor reimbursed by the Bureau of National Health Insurance of Taiwan...
May 15, 2017: Oncologist
https://www.readbyqxmd.com/read/28506974/assessment-of-reimbursement-in-a-community-hospital-based-pharmacist-managed-outpatient-transition-clinic
#11
Jinjie Huang, Ruthan Tattersall, Kristin Morse, Julia Nickerson-Troy, Elizabeth Clements, Lindsay Celauro, Amanda Lovell
PURPOSE: The assessment of reimbursement for and time spent on patient visits in a newly implemented, outpatient pharmacist-managed transition clinic (TC) was studied. METHODS: A retrospective chart review was conducted on clinic visits that occurred during January 1 to December 31, 2015. Patients who had at least one TC visit during the study period were included. Any visit with no response from insurance by March 31, 2016, was excluded. Services provided by the TC were billed using a facility fee billing model...
June 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28499291/a-survey-of-25-north-carolina-health-departments-districts-on-knowledge-attitudes-and-current-practices-to-seeking-reimbursement-from-third-party-payers-for-sexually-transmitted-disease-services
#12
Cheryl L Kovar, Susan Carter
BACKGROUND: North Carolina Administrative Code 10A Chapter 41A.0204 (a) states "local health departments shall provide diagnosis, testing, treatment, follow-up, and preventive services for syphilis, gonorrhea, chlamydia, … These services shall be provided upon request and at no charge to the patient." Although health departments/districts may bill governmental or nongovernmental insurance providers for sexually transmitted disease (STD) services, current billing practices are unknown...
June 2017: Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/28495231/descriptive-study-of-the-parkinsonian-population-in-the-north-of-france-epidemiological-analysis-and-healthcare-consumption
#13
N Carriere, D Verloop, C Dupont, V Fontaine, M Tir, P Krystkowiak, A Blanchard, L Defebvre, M-M Defebvre
BACKGROUND: The "neurodegenerative diseases plan" under elaboration for the Hauts-de-France region requires better knowledge of the patient population and care pathways. In France, the prevalence of Parkinson's disease (PD) has been estimated from cohorts to be about 1-3 per 1000 inhabitants, but exhaustive data are scarce for the general population. The purpose of this study was to evaluate the prevalence of PD in the Hauts-de-France region and to assess PD-related healthcare consumption...
May 8, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28494776/aggregated-n-of-1-trials-for-unlicensed-medicines-for-small-populations-an-assessment-of-a-trial-with-ephedrine-for-myasthenia-gravis
#14
Stephanie S Weinreich, Charlotte Vrinten, Marja R Kuijpers, Alexander F Lipka, Kirsten J M Schimmel, Erik W van Zwet, Christine Gispen-de Wied, Yechiel A Hekster, Jan J G M Verschuuren, Martina C Cornel
BACKGROUND: Inexpensive medicines with a long history of use may currently be prescribed off-label for rare indications. Reimbursement is at the discretion of health insurance companies, and may be unpredictable. The example addressed was ephedrine as add-on treatment for myasthenia gravis. Stakeholders from academia, a patient organization, the Dutch National Health Care Institute (NHCI) and Dutch Medicines Evaluation Board (MEB) advised on the trial design. The NHCI and MEB agreed to provide scientific advice on the suitability of the evidence generated by the trial, for regulatory decisions...
May 12, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28491334/increasing-the-rate-of-living-donor-kidney-transplantation-in-ontario-donor-and-recipient-identified-barriers-and-solutions
#15
Leah E Getchell, Susan Q McKenzie, Jessica M Sontrop, Jade S Hayward, Megan K McCallum, Amit X Garg
PURPOSE OF REVIEW: To hear from living kidney donors and recipients about what they perceive are the barriers to living donor kidney transplantation, and how patients can develop and lead innovative solutions to increase the rate and enhance the experiences of living donor kidney transplantation in Ontario. SOURCES OF INFORMATION: A one-day patient-led workshop on March 10th, 2016 in Toronto, Ontario. METHODS: Participants who were previously engaged in priority-setting exercises were invited to the meeting by patient lead, Sue McKenzie...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28488260/cessation-of-extracorporeal-photopheresis-in-chronic-lung-allograft-dysfunction-effects-on-clinical-outcome-in-adults
#16
Cécile A Robinson, Lars Huber, Christian Murer, Macé Schuurmans, Malcolm Kohler, Günther Hofbauer, Christian Benden
BACKGROUND: Extracorporeal photopheresis (ECP) has been reported to be safe and the ultimate treatment option in lung transplant recipients with chronic lung allograft dysfunction (CLAD), the main overall cause of mortality in lung transplant recipients. However, ECP is not reimbursed in selected health jurisdictions, and reimbursement by health insurance providers is a major issue. In Switzerland, ECP is not recognised by the health authorities as a therapy option for CLAD; thus by the end of 2014, ECP had to be stopped in the majority of adult lung transplant recipients cared for at the University Hospital Zurich because of lack of continuous funding...
May 10, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28486876/somatic-symptoms-are-sensitive-in-predicting-interstitial-cystitis-bladder-pain-syndrome
#17
I-Chun Chen, MingHuei Lee, Shang-Liang Wu, Hsuan-Hung Lin, Kun-Min Chang, HsiuYing Lin
Objectives Somatic symptoms are somatic complaints accompanied by disproportionate thoughts, feelings, and behaviors related to such symptoms. The study investigated five International Classification of Diseases, Ninth Revision, Clinical Modification diagnoses hallmarked by somatic symptoms. The study hypothesized an increased risk of interstitial cystitis/bladder pain syndrome in patients with somatic symptoms. Methods The raw data were obtained from a nationwide health insurance reimbursement database over a 12-year period from 2002 to 2013...
January 2017: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/28485129/evaluation-of-algorithms-to-identify-incident-cancer-cases-by-using-french-health-administrative-databases
#18
Aya Ajrouche, Candice Estellat, Yann De Rycke, Florence Tubach
PURPOSE: Administrative databases are increasingly being used in cancer observational studies. Identifying incident cancer in these databases is crucial. This study aimed to develop algorithms to estimate cancer incidence by using health administrative databases and to examine the accuracy of the algorithms in terms of national cancer incidence rates estimated from registries. METHODS: We identified a cohort of 463 033 participants on 1 January 2012 in the Echantillon Généraliste des Bénéficiaires (EGB; a representative sample of the French healthcare insurance system)...
May 9, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28483892/a-hepatitis-c-treatment-program-based-in-a-safety-net-hospital-patient-centered-medical-home
#19
Karen E Lasser, Alexandra Heinz, Leandra Battisti, Alexandria Akoumianakis, Ve Truong, Judith Tsui, Glorimar Ruiz, Jeffrey H Samet
Hepatitis C virus (HCV) infection is a major public health problem. Urban safety-net hospitals are a prime location for HCV treatment delivery. Showing that physicians in primary care settings can deliver HCV infection care is important to expand treatment; models doing so in the era of newer oral HCV medications are needed. This article describes an innovative and successful HCV primary care treatment program in a patient-centered medical home based at an urban, safety-net hospital. The program is public health oriented in that a central team member is a public health social worker who performs population management and addresses underlying social determinants of health to facilitate engagement in HCV treatment...
May 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28479767/reimbursements-and-frequency-of-tests-in-privately-insured-testicular-cancer-patients-in-the-united-states-implications-to-national-guidelines
#20
Mohamed H Kamel, Austin Barber, Rodney Davis, Omer A Raheem, Nabil Bissada, Alaa Eldin A Abdelmaksoud, Ehab Eltahawy
OBJECTIVES: The objective of this study was to assess the frequency of utilization and reimbursement of the common diagnostic tests and treatment modalities used in testicular cancer care. METHODS: LifeLink™ (IMS Health, Danbury, CT, USA) Claims Database was used. We identified 877 subjects with a primary diagnosis of testicular cancer (ICD 186.9) between 2007 and 2012. Median reimbursement and frequency of the diagnostic/treatment modalities used were recorded...
April 2017: Urology Annals
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