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https://www.readbyqxmd.com/read/29145584/critical-lessons-from-high-value-oncology-practices
#1
Douglas W Blayney, Melora K Simon, Beatrice Podtschaske, Scott Ramsey, Margaret Shyu, Craig Lindquist, Arnold Milstein
Importance: Cancer care is expensive. Cancer care provided by practice organizations varies in total spending incurred by patients and payers during treatment episodes and in quality of care, and this unnecessary variation contributes to the high cost. Objective: To use the variation in total spending and quality of care to assess oncology practice attributes distinguishing "high value" that may be tested and adopted by others to produce similar results. Design, Setting, and Participants: "Positive deviance" was used in this exploratory mixed-methods (quantitative and qualitative) analysis of interview results...
November 16, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/29145548/supported-discharge-teams-for-older-people-in-hospital-acute-care-hospital-a-randomised-controlled-trial
#2
Matthew Parsons, John Parsons, Paul Rouse, Avinesh Pillai, Sean Mathieson, Rochelle Parsons, Christine Smith, Tim Kenealy
Background: Supported Discharge Teams aim to help with the transition from hospital to home, whilst reducing hospital length-of-stay. Despite their obvious attraction, the evidence remains mixed, ranging from strong support for disease-specific interventions to less favourable results for generic services. Objective: To determine whether older people referred to a Supported Discharge Team have: (i) reduced length-of-stay in hospital; (ii) reduced risk of hospital readmission; and (iii) reduced healthcare costs...
November 14, 2017: Age and Ageing
https://www.readbyqxmd.com/read/29145407/predicting-mortality-and-hospitalization-of-older-adults-by-the-multimorbidity-frailty-index
#3
Yao-Chun Wen, Liang-Kung Chen, Fei-Yuan Hsiao
BACKGROUND: Existing operational definitions of frailty are personnel-costly and time-consuming, resulting in estimates with a small sample size that cannot be generalized to the population level. The objectives were to develop a multimorbidity frailty index using Taiwan's claim database, and to understand its ability to predict adverse event. METHODS: This is a retrospective cohort study. Subjects aged 65 to 100 years who have full National Health Insurance coverage in 2005 were included...
2017: PloS One
https://www.readbyqxmd.com/read/29145359/racial-ethnic-health-disparities-among-rural-adults-united-states-2012-2015
#4
Cara V James, Ramal Moonesinghe, Shondelle M Wilson-Frederick, Jeffrey E Hall, Ana Penman-Aguilar, Karen Bouye
PROBLEM/CONDITION: Rural communities often have worse health outcomes, have less access to care, and are less diverse than urban communities. Much of the research on rural health disparities examines disparities between rural and urban communities, with fewer studies on disparities within rural communities. This report provides an overview of racial/ethnic health disparities for selected indicators in rural areas of the United States. REPORTING PERIOD: 2012-2015...
November 17, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/29145353/cdc-grand-rounds-improving-medication-adherence-for-chronic-disease-management-innovations-and-opportunities
#5
Andrea B Neiman, Todd Ruppar, Michael Ho, Larry Garber, Paul J Weidle, Yuling Hong, Mary G George, Phoebe G Thorpe
Adherence to prescribed medications is associated with improved clinical outcomes for chronic disease management and reduced mortality from chronic conditions (1). Conversely, nonadherence is associated with higher rates of hospital admissions, suboptimal health outcomes, increased morbidity and mortality, and increased health care costs (2). In the United States, 3.8 billion prescriptions are written annually (3). Approximately one in five new prescriptions are never filled, and among those filled, approximately 50% are taken incorrectly, particularly with regard to timing, dosage, frequency, and duration (4)...
November 17, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29145327/current-practice-and-usual-care-of-major-cervical-disorders-in-korea-a-cross-sectional-study-of-korean-health-insurance-review-and-assessment-service-national-patient-sample-data
#6
A Ryeon Choi, Joon-Shik Shin, Jinho Lee, Yoon Jae Lee, Me-Riong Kim, Min-Seok Oh, Eun-Jung Lee, Sungchul Kim, Mia Kim, In-Hyuk Ha
Neck pain is a highly common condition and is the 4th major cause of years lived with disability. Previous literature has focused on the effect of specific treatments, and observations of actual practice are lacking to date. This study examined Korean health insurance review and assessment service (HIRA) claims data to the aim of assessing prevalence and comparing current medical practice and costs of cervical disorders in Korea.Current practice trends were determined through assessment of prevalence, total expenses, per-patient expense, average days in care, average days of visits, sociodemographic characteristics, distribution of medical costs, and frequency of treatment types of high frequency cervical disorders (cervical sprain/strain, cervical intervertebral disc displacement [IDD], and cervicalgia)...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145300/cost-effectiveness-analysis-of-neonatal-screening-of-critical-congenital-heart-defects-in-china
#7
Ruoyan Gai Tobe, Gerard R Martin, Fuhai Li, Akinori Moriichi, Bin Wu, Rintaro Mori
BACKGROUND: Pulse oximetry screening is a highly accurate tool for the early detection of critical congenital heart disease (CCHD) in newborn infants. As the technique is simple, noninvasive, and inexpensive, it has potentially significant benefits for developing countries. The aim of this study is to provide information for future clinical and health policy decisions by assessing the cost-effectiveness of CCHD screening in China. METHODS AND FINDINGS: We developed a cohort model to evaluate the cost-effectiveness of screening all Chinese newborns annually using 3 possible screening options compared to no intervention: pulse oximetry alone, clinical assessment alone, and pulse oximetry as an adjunct to clinical assessment...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29144866/challenges-in-the-clinical-application-of-the-american-society-of-clinical-oncology-value-framework-a-medicare-cost-benefit-analysis-in-chronic-lymphocytic-leukemia
#8
Erlene K Seymour, Charles A Schiffer, Jonas A de Souza
PURPOSE: The ASCO Value Framework calculates the value of cancer therapies. Given costly novel therapeutics for chronic lymphocytic leukemia, we used the framework to compare net health benefit (NHB) and cost within Medicare of all regimens listed in the National Comprehensive Cancer Network (NCCN) guidelines. METHODS: The current NCCN guidelines for chronic lymphocytic leukemia were reviewed. All referenced studies were screened, and only randomized controlled prospective trials were included...
November 16, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29144857/a-review-of-tribal-best-practices-in-substance-abuse-prevention
#9
Allyson Kelley, Morgan Witzel, Bethany Fatupaito
American Indian youth experience higher rates of substance use than non-American Indian youth. Researchers, clinicians, and treatment programs embrace evidence-based practices (EBPs) and practice based evidence (PBE) as a primary method for addressing substance abuse and advancing behavioral health. However, less is known about the use of tribal best practices (TBPs) and how they are implemented in American Indian substance use prevention contexts. OBJECTIVE: The main objective of this systematic review was to determine how TBPs are implemented and shared in the context of tribal substance use prevention...
November 16, 2017: Journal of Ethnicity in Substance Abuse
https://www.readbyqxmd.com/read/29144719/real-world-health-plan-claims-analysis-of-differences-in-healthcare-utilization-and-total-cost-in-patients-suffering-from-cluster-headaches-and-those-without-headache-related-conditions
#10
Michael Polson, Todd C Lord, Themmi M Evangelatos, Maria Lopes, Briana L Santaniello
BACKGROUND: According to the World Health Organization, headache disorders are underappreciated by many health systems. These disorders have a substantial impact on quality of life, yet the true correlation between headache conditions and increased total healthcare utilization is not well understood. This study further explores the impact of headache conditions on healthcare utilization. OBJECTIVES: To assess differences in healthcare utilization and total cost in patients suffering from cluster headaches (CH) compared with patients without headache-related conditions...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29144718/the-emerging-role-of-gammacore%C3%A2-in-the-management-of-cluster-headache-expert-panel-recommendations
#11
Stephen D Silberstein, Anne H Calhoun, Christina Treppendahl, David W Dodick, Alan M Rapoport, Avinash Mamidi, Peter Vargas, Thomas H Ebert, Stewart J Tepper
A panel of 9 experts, including neurologists, other headache specialists, and medical and pharmacy directors, from 4 health plans (1 integrated delivery network and 3 plans with commercial, Medicare, and Medicaid lines of business), convened to discuss cluster headache (CH). Topics covered included the current treatment landscape, treatment challenges, economic impact of disease, and gaps in care for patients with CH. One major challenge in the management of CH is that it is underrecognized and frequently misdiagnosed, leading to delays in and suboptimal treatment for patients who suffer from this painful and disabling condition...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29144599/assessing-social-values-for-california-s-efforts-to-reduce-the-overuse-of-unnecessary-medical-care
#12
Susan L Perez, Desiree Backman, Marge Ginsburg
BACKGROUND: A partnership of large health-care purchasers created a workgroup to reduce the overuse of harmful and wasteful medical care in California. OBJECTIVE: Employ a civic engagement process to identify the social values important to the public in considering different strategies to reduce overuse. INTERVENTION: Use of deliberation techniques for 3 case examples that explore possible strategies: physician oversight, physician compensation, increased patient cost-sharing or taking no definitive action...
November 16, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/29144586/relationship-between-hospital-level-percentage-of-midwife-attended-births-and-obstetric-procedure-utilization
#13
Laura Attanasio, Katy B Kozhimannil
INTRODUCTION: Research has shown good outcomes among individual low-risk women who receive perinatal care from midwives, yet little is known about how hospital-level variation in midwifery care relates to procedure use and maternal health. This study aimed to document the association between the hospital-level proportion of midwife-attended births and obstetric procedure utilization. METHODS: This analysis used 2 data sources: Healthcare Cost and Utilization Project State Inpatient Database data for New York in 2014, and New York State Department of Health data on the percentage of midwife-attended births at hospitals in the state in 2014...
November 16, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29144535/a-health-economic-outcome-evaluation-of-an-internet-based-mobile-supported-stress-management-intervention-for-employees
#14
David Daniel Ebert, Fanny Kählke, Claudia Buntrock, Matthias Berking, Filip Smit, Elena Heber, Harald Baumeister, Burkhardt Funk, Heleen Riper, Dirk Lehr
Objective This study aimed to estimate and evaluate the cost-effectiveness and cost-benefit of a guided internet- and mobile-supported occupational stress-management intervention (iSMI) for employees from the employer's perspective alongside a randomized controlled trial. Methods A sample of 264 employees with elevated symptoms of perceived stress (Perceived Stress Scale, PSS-10 ≥22) was randomly assigned either to the iSMI or a waitlist control (WLC) group with unrestricted access to treatment as usual. The iSMI consisted of seven sessions of problem-solving and emotion-regulation techniques and one booster session...
November 16, 2017: Scandinavian Journal of Work, Environment & Health
https://www.readbyqxmd.com/read/29144116/-the-importance-of-biosimilars-medicines-for-private-and-statutory-health-insurance
#15
B Bretthauer
Patented biopharmaceuticals generate huge costs for private and statutory health insurance. Exactly ten years ago, off-patent biopharmaceuticals, also referred to as 'biosimilars medicines', became available as a more cost-efficient and therapeutically equivalent alternative in Germany and Europe. Following their approval by all the relevant authorities, biosimilars medicines can therefore be applied in the same way as previously patented biopharmaceuticals.
December 15, 2016: Versicherungsmedizin
https://www.readbyqxmd.com/read/29144113/-can-we-transfer-the-mechanisms-of-the-generics-market-to-biosimilars
#16
Ch O Jacke, F Wild
Personalized medicines such as biologics and their generic equivalents, biosimilars, are pouring onto the pharmaceutical markets. Data of 16 private health insurance companies were used to describe the market shares of selected biosimilars available in 2014 and 2015. The purpose of this study focuses on the question of whether market access of biosimilars will lead to a price competition of the expense of innovation competition. The results show that prescriptions of biosimilars made up 37% of total prescriptions in 2015 compared to 35% in 2014, and that their share of prescription costs went up from 21% to 23% in the same period...
December 15, 2016: Versicherungsmedizin
https://www.readbyqxmd.com/read/29143960/predicting-frequent-emergency-department-use-among-children-with-epilepsy-a-retrospective-cohort-study-using-electronic-health-data-from-2-centers
#17
Zachary M Grinspan, Anup D Patel, Baria Hafeez, Erika L Abramson, Lisa M Kern
OBJECTIVE: Among children with epilepsy, to develop and evaluate a model to predict emergency department (ED) use, an indicator of poor disease control and/or poor access to care. METHODS: We used electronic health record data from 2013 to predict ED use in 2014 at 2 centers, benchmarking predictive performance against machine learning algorithms. We evaluated algorithms by calculating the expected yearly ED visits among the 5% highest risk individuals. We estimated the breakeven cost per patient per year for an intervention that reduced ED visits by 10%...
November 16, 2017: Epilepsia
https://www.readbyqxmd.com/read/29143910/the-effect-of-sms-text-message-reminders-on-attendance-at-a-community-adult-mental-health-service-clinic-do-sms-reminders-really-increase-attendance
#18
Lucy Moran, Kieran O'Loughlin, Brendan D Kelly
BACKGROUND: Non-attendance at outpatient clinics is common and costly. AIMS: This study aimed to determine if sending SMS ('short message service' or text message) reminders to patients before appointments reduced non-attendance. METHODS: We collected outpatient data at Ballyfermot and Lucan Community Adult Mental Health Service, Dublin, Ireland during 6-month periods (a) immediately prior to the introduction of SMS reminders for outpatient appointments; (b) immediately following the introduction of SMS reminders; and (c) two and a half years later...
November 16, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29143707/effect-of-multi-micronutrient-fortified-rice-on-cognitive-performance-depends-on-premix-composition-and-cognitive-function-tested-results-of-an-effectiveness-study-in-cambodian-schoolchildren
#19
Marion Fiorentino, Marlène Perignon, Khuov Kuong, Richard de Groot, Megan Parker, Kurt Burja, Marjoleine A Dijkhuizen, Sek Sokhom, Chhoun Chamnan, Jacques Berger, Frank T Wieringa
OBJECTIVE: Even though current policy is strongly focused on the crucial first '1000 days', it might be still possible to enhance cognitive function during the pre-adolescent and adolescent years by improving micronutrient status. In Cambodia, nutritional status is poor. Provision of rice fortified with micronutrients through a school meal programme (SMP) could be a cost-effective strategy to help improve health and school performance. The present study aimed to evaluate the effect of three different micronutrient-fortified rice formulations on cognitive function in Cambodian children...
November 16, 2017: Public Health Nutrition
https://www.readbyqxmd.com/read/29143681/economic-evaluation-of-hcv-testing-approaches-in-low-and-middle-income-countries
#20
REVIEW
Jake R Morgan, Maria Servidone, Philippa Easterbrook, Benjamin P Linas
BACKGROUND: Hepatitis C virus (HCV) infection represents a major public health burden with diverse epidemics worldwide, but at present, only a minority of infected persons have been tested and are aware of their diagnosis. The advent of highly effective direct acting antiviral (DAA) therapy, which is becoming available at increasingly lower costs in low and middle income countries (LMICs), represents a major opportunity to expand access to testing and treatment. However, there is uncertainty as to the optimal testing approaches and who to prioritize for testing...
November 1, 2017: BMC Infectious Diseases
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