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Kurt D Christensen, Jason L Vassy, Kathryn A Phillips, Carrie L Blout, Danielle R Azzariti, Christine Y Lu, Jill O Robinson, Kaitlyn Lee, Michael P Douglas, Jennifer M Yeh, Kalotina Machini, Natasha K Stout, Heidi L Rehm, Amy L McGuire, Robert C Green, Dmitry Dukhovny
PurposeGreat uncertainty exists about the costs associated with whole-genome sequencing (WGS).MethodsOne hundred cardiology patients with cardiomyopathy diagnoses and 100 ostensibly healthy primary care patients were randomized to receive a family-history report alone or with a WGS report. Cardiology patients also reviewed prior genetic test results. WGS costs were estimated by tracking resource use and staff time. Downstream costs were estimated by identifying services in administrative data, medical records, and patient surveys for 6 months...
March 22, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Audrey L Jones, Susan D Cochran, Arleen Leibowitz, Kenneth B Wells, Gerald Kominski, Vickie M Mays
BACKGROUND: Black and Latino minorities have traditionally had poorer access to primary care than non-Latino Whites, but these patterns could change with the Affordable Care Act (ACA). To guide post-ACA efforts to address mental health service disparities, we used a nationally representative sample to characterize baseline race-, ethnicity-, and nativity-associated differences in mental health services in the context of primary care. METHODS: Data were obtained from the Medical Expenditures Panel Survey (MEPS), a two-year panel study of healthcare use, satisfaction with care, and costs of services in the United States (US)...
March 22, 2018: Healthcare (Basel, Switzerland)
Antonio Tricoli, Giovanni Neri
This review reports the latest achievements in point-of-care (POC) sensor technologies for the monitoring of ammonia, creatinine and urea in patients suffering of chronic kidney diseases (CKDs). Abnormal levels of these nitrogen biomarkers are found in the physiological fluids, such as blood, urine and sweat, of CKD patients. Delocalized at-home monitoring of CKD biomarkers via integration of miniaturized, portable, and low cost chemical- and bio-sensors in POC devices, is an emerging approach to improve patients' health monitoring and life quality...
March 22, 2018: Sensors
Bruno Santos Assis, Jairza Maria Barreto-Medeiros Jairza, Jamile Almeida Lopes, Ana Karla Carneiro Roriz, Adriana Lima Melo, Agatha Previdell, Rita De Cássia Aquino, Lilian Barbosa Ramos
OBJECTIVE: The aim of this study was to evaluate the ingestion of micronutrients in elderly living in nursing homes. METHODS: This is a cross-sectional study, conducted with 216 individuals of both sexes, age equal or greater than 60 years, living in nursing homes for elderly in Salvador, Bahia, Brazil. Direct weighing of the food was used to get food intake, and prevalence of inadequacy was obtained using the software Multiple Source Method (MSM) and evaluated by estimated average requirement (EAR)...
February 13, 2018: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
(no author information available yet)
In the context of the White Book of Physical and Rehabilitation Medicine (PRM) in Europe, this paper deals with the future perspectives of PRM in Europe according to the actual vision of the European Bodies. All Chapters stress the big changes that Europe is facing in terms of demography, life expectancy, survival rates, disability burden, increasing prevalence of long-term health conditions, progress in technology, but also health costs and society changes in terms of requirements of wellness and quality of life together with health...
April 2018: European Journal of Physical and Rehabilitation Medicine
(no author information available yet)
In the context of the White Book on Physical and Rehabilitation Medicine (PRM) in Europe this paper deals with the scope and competencies of PRM starting from its definition as the "medicine of functioning." PRM uses the rehabilitative health strategy as its core strategy together with the curative strategy. According to the complexity of disabling health conditions, PRM also refers to prevention and maintenance and provides information to the patients and other caregivers. The rehabilitation process according to the so-called rehabilitation cycle including an assessment and definition of the (individual) rehabilitation goals, assignment to the rehabilitation program evaluation of individual outcomes...
April 2018: European Journal of Physical and Rehabilitation Medicine
(no author information available yet)
In the context of the White Book of Physical and Rehabilitation Medicine (PRM) in Europe, this paper describes the background to the context of PRM services and comprises the following: - Epidemiological Aspects of Functioning and Disability - Ethical Aspects and Human Rights - Rehabilitation and Health Systems - Economic Burden of Disability - Effects of Lack of Rehabilitation Health care service planning accounts for the burden of disability among society and the chapter describes the justification for specialist rehabilitation, the background of PRM and why making a functional diagnosis and a management plan based on function is its core competence...
April 2018: European Journal of Physical and Rehabilitation Medicine
David Cameron, Jasper Ubels, Fredrik Norström
BACKGROUND: The amount a government should be willing to invest in adopting new medical treatments has long been under debate. With many countries using formal cost-effectiveness (C/E) thresholds when examining potential new treatments and ever-growing medical costs, accurately setting the level of a C/E threshold can be essential for an efficient healthcare system. OBJECTIVES: The aim of this systematic review is to describe the prominent approaches to setting a C/E threshold, compile available national-level C/E threshold data and willingness-to-pay (WTP) data, and to discern whether associations exist between these values, gross domestic product (GDP) and health-adjusted life expectancy (HALE)...
2018: Global Health Action
David L Tirschwell, Mark Turner, David Thaler, James Choulerton, David Marks, John Carroll, Lee MacDonald, Richard W Smalling, Maria Koullick, Ning Yan Gu, Jeffrey L Saver
OBJECTIVE: Compared to medical therapy alone, percutaneous closure of patent foramen ovale (PFO) further reduces risk of recurrent ischemic strokes in carefully selected young to middle-aged patients with a recent cryptogenic ischemic stroke. The objective of this study was to evaluate the cost-effectiveness of this therapy in the context of the United Kingdom (UK) healthcare system. METHODS: A Markov cohort model consisting of 4 health states (Stable after index stroke, Post-Minor Recurrent Stroke, Post-Moderate Recurrent Stroke, and Death) was developed to simulate the economic outcomes of device-based PFO closure compared to medical therapy...
March 22, 2018: Journal of Medical Economics
Jing-Jy Wang, Yueh-Ying Yang, Mei-Yin Liu
Advancing medical technology continues to extend the average human life span, resulting in population aging globally as well as in Taiwan. The challenges posed by aging society increase not only medical and care costs but also the burden on pension funds and the social welfare system. In addition, there is currently a desperate need for many well-trained health providers as well as a friendly and comprehensive long-term care system. However, attention should not simply focus on medical payments and long-term care, as this may prolong the length of unhealthy living years for the aged and further strain national finances...
April 2018: Hu Li za Zhi the Journal of Nursing
Kalliopi Gerogianni, Aspasia Tsezou, Konstantinos Dimas
Adverse drug reactions (ADRs) affect many patients and remain a major public health problem, as they are a common cause of morbidity and mortality. It is estimated that ADRs are responsible for about 6% of hospital admissions and about 9% of hospitalization costs. Skin is the organ that is most frequently involved in ADRs. Drug-induced skin injuries vary from mild maculopapular eruptions (MPE) to severe cutaneous adverse reactions (SCARs) that are potentially life threatening. Genetic factors have been suggested to contribute to these SCARs, and most significant genetic associations have been identified in the major histocompatibility complex (MHC) genes...
March 21, 2018: Molecular Diagnosis & Therapy
Wei-Chen Lee, Hani Serag, Robert L Ohsfeldt, Karl Eschbach, Wissam Khalife, Mohamed Morsy, Kenneth D Smith, Ben G Raimer
Heart failure (HF) is one of the leading causes of hospitalization and readmissions. Our study aimed to examine racial disparities in heart failure patients including onset, mortality, length of stay (LOS), direct costs, and readmission rates. This is a secondary data analysis. We analyzed the risk-adjusted inpatient data of all patients admitted with HF to one health academic center. We compared five health outcomes among three racial groups (white, black, and Hispanic). There were 1006 adult patients making 1605 visits from 10/01/2011 to 09/30/2015...
March 21, 2018: Journal of Immigrant and Minority Health
Steven J Barad, Stephen M Howell, Joyce Tom
Background: It is controversial whether shortening the average length of hospital stay and increasing discharge from a rehabilitation facility to home with either health care or outpatient physical therapy is safe and cost-effective. Methods: We computed the average length of hospital stay; the rate of discharge to a rehabilitation facility, home with health care, or home with outpatient physical therapy; the all-cause readmission rate within 30 days of discharge per year; and cost savings for 2328 consecutive patients treated with a unilateral primary total knee replacement between 2009 and 2014...
March 2018: Arthroplasty Today
Gunjan Kumar, Josyula G Prasuna, Gaurav Seth
Background: The issue of menstrual hygiene is inadequately acknowledged in our nation. The use of sanitary pads and washing the genital area are essential practices for good menstrual hygiene. Poor menstrual hygiene may lead to itching or rashes in the perineal region, bad odor, and sometimes, major complications such as pelvic inflammatory disease and toxic shock syndrome. Therefore, the objective of this study was to assess the knowledge and practice of menstrual hygiene among reproductive age group women...
October 2017: Journal of Family Medicine and Primary Care
Meenakshi Vishwanath, Nandakumar Janakiraman, Hamed Vaziri, Ravindra Nanda, Flavio Uribe
Traumatic dental injury is considered a public dental health problem because of a high childhood incidence, high treatment costs, and prolonged treatment time. Although management guidelines for traumatized teeth have been outlined, tooth loss following trauma is occasionally unavoidable. Here, we describe the successful interdisciplinary management of a traumatized central incisor in an 11-year old boy that was extracted because of a poor prognosis and restored by the autotransplantation of an immature donor tooth into the site...
March 2018: Korean Journal of Orthodontics
Elisabeth Paul, Lucien Albert, Badibanga N'Sambuka Bisala, Oriane Bodson, Emmanuel Bonnet, Paul Bossyns, Sandro Colombo, Vincent De Brouwere, Alexandre Dumont, Dieudonné Sèdjro Eclou, Karel Gyselinck, Fatoumata Hane, Bruno Marchal, Remo Meloni, Mathieu Noirhomme, Jean-Pierre Noterman, Gorik Ooms, Oumar Mallé Samb, Freddie Ssengooba, Laurence Touré, Anne-Marie Turcotte-Tremblay, Sara Van Belle, Philippe Vinard, Valéry Ridde
This paper questions the view that performance-based financing (PBF) in the health sector is an effective, efficient and equitable approach to improving the performance of health systems in low-income and middle-income countries (LMICs). PBF was conceived as an open approach adapted to specific country needs, having the potential to foster system-wide reforms. However, as with many strategies and tools, there is a gap between what was planned and what is actually implemented. This paper argues that PBF as it is currently implemented in many contexts does not satisfy the promises...
2018: BMJ Global Health
Carlos J Chaccour, Sergi Alonso, Rose Zulliger, Joe Wagman, Abuchahama Saifodine, Baltazar Candrinho, Eusébio Macete, Joe Brew, Christen Fornadel, Hidayat Kassim, Lourdes Loch, Charfudin Sacoor, Kenyssony Varela, Cara L Carty, Molly Robertson, Francisco Saute
Background: Most of the reduction in malaria prevalence seen in Africa since 2000 has been attributed to vector control interventions. Yet increases in the distribution and intensity of insecticide resistance and higher costs of newer insecticides pose a challenge to sustaining these gains. Thus, endemic countries face challenging decisions regarding the choice of vector control interventions. Methods: A cluster randomised trial is being carried out in Mopeia District in the Zambezia Province of Mozambique, where malaria prevalence in children under 5 is high (68% in 2015), despite continuous and campaign distribution of long-lasting insecticide-treated nets (LLINs)...
2018: BMJ Global Health
Andrew M Hill, Melissa J Barber, Dzintars Gotham
Introduction: There are persistent gaps in access to affordable medicines. The WHO Model List of Essential Medicines (EML) includes medicines considered necessary for functional health systems. Methods: A generic price estimation formula was developed by reviewing published analyses of cost of production for medicines and assuming manufacture in India, which included costs of formulation, packaging, taxation and a 10% profit margin. Data on per-kilogram prices of active pharmaceutical ingredient exported from India were retrieved from an online database...
2018: BMJ Global Health
Grace Sum, Thomas Hone, Rifat Atun, Christopher Millett, Marc Suhrcke, Ajay Mahal, Gerald Choon-Huat Koh, John Tayu Lee
Background: Multimorbidity, the presence of two or more non-communicable diseases (NCD), is a costly and complex challenge for health systems globally. Patients with NCDs incur high levels of out-of-pocket expenditure (OOPE), often on medicines, but the literature on the association between OOPE on medicines and multimorbidity has not been examined systematically. Methods: A systematic review was conducted via searching medical and economics databases including Ovid Medline, EMBASE, EconLit, Cochrane Library and the WHO Global Health Library from year 2000 to 2016...
2018: BMJ Global Health
Chris Moore, Jenna Bulger, Matt Morgan, Timothy Driscoll, Alison Porter, Saiful Islam, Mike Smyth, Gavin Perkins, Bernadette Sewell, Timothy Rainer, Prabath Nanayakkara, Chukwudi Okolie, Susan Allen, Greg Fegan, Jan Davies, Theresa Foster, Nick Francis, Fang Gao Smith, Gemma Ellis, Tracy Shanahan, Robin Howe, Helen Snooks
Background: Sepsis is a common condition which kills between 36,000 and 64,000 people every year in the UK. Early recognition and management of sepsis has been shown to reduce mortality and improve the health and well-being of people with sepsis. Paramedics frequently come into contact with patients with sepsis and are well placed to provide early diagnosis and treatment.We aim to determine the feasibility of undertaking a fully powered randomised controlled trial (RCT) to test the clinical and cost-effectiveness of paramedics obtaining blood cultures from and administering IV antibiotics to patients with sepsis, so we can make a decision about whether to proceed to a fully powered randomised controlled trial, which will answer questions regarding safety and effectiveness for patients and benefit to the National Health Service (NHS)...
2018: Pilot and Feasibility Studies
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