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https://www.readbyqxmd.com/read/28445835/economic-consequences-of-legal-and-illegal-drugs-the-case-of-social-costs-in-belgium
#1
Delfine Lievens, Freya Vander Laenen, Nick Verhaeghe, Koen Putman, Lieven Pauwels, Wim Hardyns, Lieven Annemans
BACKGROUND: Legal and illegal drugs impose a considerable burden to the individual and to society. The misuse of addictive substances results in healthcare and law enforcement costs, loss of productivity and reduced quality of life. METHODS: A social cost study was conducted to estimate the substance-attributable costs of alcohol, tobacco, illegal drugs and psychoactive medication to Belgian society in 2012. The cost-of-illness framework with prevalence-based and human capital approach was applied...
April 23, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28445806/patient-engagement-at-the-margins-health-care-providers-assessments-of-engagement-and-the-structural-determinants-of-health-in-the-safety-net
#2
Mark D Fleming, Janet K Shim, Irene Yen, Ariana Thompson-Lastad, Sara Rubin, Meredith Van Natta, Nancy J Burke
Increasing "patient engagement" has become a priority for health care organizations and policy-makers seeking to reduce cost and improve the quality of care. While concepts of patient engagement have proliferated rapidly across health care settings, little is known about how health care providers make use of these concepts in clinical practice. This paper uses 20 months of ethnographic and interview research carried out from 2015 to 2016 to explore how health care providers working at two public, urban, safety-net hospitals in the United States define, discuss, and assess patient engagement...
April 20, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28445578/utility-of-a-noninvasive-2-gene-molecular-assay-for-cutaneous-melanoma-and-effect-on-the-decision-to-biopsy
#3
Laura K Ferris, Burkhard Jansen, Jonhan Ho, Klaus J Busam, Kenneth Gross, Doyle D Hansen, John P Alsobrook, Zuxu Yao, Gary L Peck, Pedram Gerami
Importance: Expression of long intergenic non-protein coding RNA 518 (LINC00518) and preferentially expressed antigen in melanoma (PRAME) genes, obtained via noninvasive adhesive patch biopsy, is a sensitive and specific method for detection of cutaneous melanoma. However, the utility of this test in biopsy decisions made by dermatologists has not been evaluated. Objective: To determine the utility of the pigmented lesion assay (PLA) for LINC00518/PRAME expression in decisions to biopsy a series of pigmented skin lesions...
April 26, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28445530/computation-of-adherence-to-medication-and-visualization-of-medication-histories-in-r-with-adherer-towards-transparent-and-reproducible-use-of-electronic-healthcare-data
#4
Alexandra Lelia Dima, Dan Dediu
Adherence to medications is an important indicator of the quality of medication management and impacts on health outcomes and cost-effectiveness of healthcare delivery. Electronic healthcare data (EHD) are increasingly used to estimate adherence in research and clinical practice, yet standardization and transparency of data processing are still a concern. Comprehensive and flexible open-source algorithms can facilitate the development of high-quality, consistent, and reproducible evidence in this field. Some EHD-based clinical decision support systems (CDSS) include visualization of medication histories, but this is rarely integrated in adherence analyses and not easily accessible for data exploration or implementation in new clinical settings...
2017: PloS One
https://www.readbyqxmd.com/read/28445523/preventive-child-health-care-at-elementary-school-age-the-costs-of-routine-assessments-with-a-triage-approach
#5
Janine Bezem, Catharina van der Ploeg, Mattijs Numans, Simone Buitendijk, Paul Kocken, Elske van den Akker
BACKGROUND: Triage in Preventive Child Health Care (PCH) assessments could further the efficient use of human resources and budgets and therefore make extra care possible for children with specific needs. We assessed the costs of routine PCH assessments with and without triage for children aged 5/6 years and 10/11 years. In a triage approach, PCH assistants conduct pre-assessments to identify children requiring follow-up assessments by a physician or nurse. In the usual approach, all children are assessed by a physician and an assistant (children aged 5/6 years) or a nurse (children aged 10/11 years)...
2017: PloS One
https://www.readbyqxmd.com/read/28445256/cost-effectiveness-analysis-of-ultrasonography-screening-for-nonalcoholic-fatty-liver-disease-in-metabolic-syndrome-patients
#6
Pochamana Phisalprapa, Siripen Supakankunti, Phunchai Charatcharoenwitthaya, Piyaporn Apisarnthanarak, Aphinya Charoensak, Chaiwat Washirasaksiri, Weerachai Srivanichakorn, Nathorn Chaiyakunapruk
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) can be diagnosed early by noninvasive ultrasonography; however, the cost-effectiveness of ultrasonography screening with intensive weight reduction program in metabolic syndrome patients is not clear. This study aims to estimate economic and clinical outcomes of ultrasonography in Thailand. METHODS: Cost-effectiveness analysis used decision tree and Markov models to estimate lifetime costs and health benefits from societal perspective, based on a cohort of 509 metabolic syndrome patients in Thailand...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28445216/opposition-to-obamacare-a-closer-look
#7
Paul R Gordon, Laurel Gray, Alex Hollingsworth, Eve C Shapiro, James E Dalen
Prior telephone surveys have reported two main reasons for opposition to the Affordable Care Act (ACA): distrust of government and opposition to the universal coverage mandate. The authors set out to elucidate the reasons for this opposition. This article describes how the authors used qualitative methods with semistructured interviewing as a principal investigative method to gather information from people they met while bicycling across the United States from April through July 2016. During this time, the authors conducted open-ended, semistructured conversations with people they met as they rode their bicycles from Washington, DC, to Seattle, Washington...
April 25, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28445024/an-economic-evaluation-of-the-enhanced-recovery-after-surgery-eras-multisite-implementation-program-for-colorectal-surgery-in-alberta
#8
Nguyen X. Thanh, Anderson W. Chuck, Tracy Wasylak, Jeannette Lawrence, Peter Faris, Olle Ljungqvist, Gregg Nelson, Leah M. Gramlich
BACKGROUND: In February 2013, Alberta Health Services established an Enhanced Recovery After Surgery (ERAS) implementation program for adopting the ERAS Society colorectal guidelines into 6 sites (initial phase) that perform more than 75% of all colorectal surgeries in the province. We conducted an economic evaluation of this initiative to not only determine its cost-effectiveness, but also to inform strategy for the spread and scale of ERAS to other surgical protocols and sites. METHODS: We assessed the impact of ERAS on patients’ health services utilization (HSU; length of stay [LOS], readmissions, emergency department visits, general practitioner and specialist visits) within 30 days of discharge by comparing pre- and post-ERAS groups using multilevel negative binomial regressions...
December 1, 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28444431/spinal-radiographs-in-those-with-back-pain-when-are-they-appropriate-to-diagnose-vertebral-fractures
#9
REVIEW
E M Clark, S R Cummings, J T Schousboe
The presence of an osteoporotic vertebral fracture improves fracture risk assessment and may change management, so it is vital for healthcare professionals to assess patients for the presence or absence of these fractures. This may be particularly important in the presence of back pain. However, the correlation between low back symptoms and spinal imaging results is poor and the pathophysiology of most low back pain is not known, leading to a common conclusion that spinal radiographs are not appropriate for the assessment of back pain...
April 25, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28444233/neighborhood-variation-in-the-price-of-cheap-tobacco-products-in-california-results-from-healthy-stores-for-a-healthy-community
#10
Lisa Henriksen, Elizabeth Andersen-Rodgers, Xueying Zhang, April Roeseler, Dennis L Sun, Trent O Johnson, Nina C Schleicher
Background.: Retail marketing surveillance research highlights concerns about lower-priced cigarettes in neighborhoods with a higher proportion of racial/ethnic minorities, but focuses almost exclusively on premium brands. To remedy this gap in the literature, the current study examines neighborhood variation in prices for the cheapest cigarettes and a popular brand of cigarillos in a large statewide sample of licensed tobacco retailers in a low-tax state. Methods.: All 61 local health departments in California trained data collectors to conduct observations in a census of eligible licensed tobacco retailers in randomly selected zip codes (n=7,393 stores, completion rate=91%)...
April 22, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/28444187/modelling-the-cost-effectiveness-pcsk9-inhibitors-vs-ezetimibe-through-ldl-c-reductions-in-a-norwegian-setting
#11
Max Korman, Torbjørn Wisløff
Aims: Despite the success of statins, there remains unmet clinical need in cardiovascular disease (CVD) prevention. New proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors reduce low-density lipoprotein cholesterol (LDL-C) by 55-65%. Two PCSK9 inhibitors, evolocumab and alirocumab, were approved for use in Norway but not yet for reimbursement through public national insurance. We aim to explore the cost-effectiveness of these compared to available treatments in a Norwegian setting...
April 21, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28444039/the-health-regionalization-process-from-the-perspective-of-the-transation-cost-theory
#12
Leyla Gomes Sancho, Daniela Savi Geremia, Sulamis Dain, Fabiano Geremia, Cláudio José Silva Leão
This study analyzes the incidence of transaction costs in the regionalization process of health policies in the Brazilian federal system. In this work, regionalized health actions contracted and agreed between federal agencies have assumed a transactional nature. A conceptual theoretical essay of reflective nature was prepared with the purpose of questioning and proposing new approaches to improve the health regionalization process. The main considerations suggest that institutional management tools proposed by the standards and regulations of the Unified Health System have a low potential to reduce transaction costs, especially due to hardships in reconciling common goals among the entities, environment surrounded by uncertainty, asymmetries and incomplete information, bounded rationality and conflict of interest...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28444007/prevalence-of-risk-factors-for-noncommunicable-diseases-in-an-indigenous-community-in-santiago-atitl%C3%A3-n-guatemala
#13
David Chen, Álvaro Rivera-Andrade, Jessica González, David Burt, Carlos Mendoza-Montano, James Patrie, Max Luna
Objective: To describe the prevalence of noncommunicable disease (NCD) risk factors and assess knowledge of those risk factors in the indigenous community of Santiago Atitlán in Guatemala, a lower-middle income country. Methods: A population-based, cross-sectional study was conducted using a modified version of the World Health Organization's STEPS protocol. Adults aged 20-65 years were surveyed regarding demographics and NCD risk factors, and the survey was followed by anthropometric and biochemical measurements...
April 20, 2017: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28443947/economic-evaluation-of-human-albumin-use-in-patients-with-nephrotic-syndrome-in-four-brazilian-public-hospitals-pharmacoeconomic-study
#14
Leonardo Augusto Kister de Toledo, Antônio Carlos Beisl Noblat, Harrison Floriano do Nascimento, Lúcia de Araújo Costa Beisl Noblat
CONTEXT AND OBJECTIVE: In 2004, the Brazilian National Health Surveillance Agency (Agência Nacional de Vigilância Sanitária, ANVISA) published a resolution establishing guidelines for albumin use. Although the published data do not indicate any definitive conclusions about the benefits of albumin use in patients with nephrotic syndrome (NS), the guidelines recommend this procedure only in cases of edema that is refractory to use of diuretics. The aim here was to analyze albumin use among patients with nephrotic syndrome...
April 20, 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28443805/-a-population-targeted-approach-to-connect-prevention-care-and-welfare-visualising-the-trend
#15
L C Lemmens, H W Drewes, M Lette, C A Baan
OBJECTIVE: To map initiatives in the Netherlands using a population-targeted approach to link prevention, care and welfare. DESIGN: Descriptive investigation, based on conversations and structured interviews. METHOD: We searched for initiatives in which providers in the areas of prevention, care and welfare together with health insurers and/or local authorities attempted to provide the 'triple aim': improving the health of the population and the quality of care, and managing costs...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28443804/25-oh-d-levels-in-relation-to-gender-overweight-insulin-resistance-and-inflammation-in-a-cross-sectional-cohort-of-northern-italian-workers-evidence-in-support-of-preventive-health-care-programs
#16
Luisella Vigna, Letizia Cassinelli, Amedea Silvia Tirelli, Irene Felicetta, Filomena Napolitano, Laura Tomaino, Michela Mutti, Claudia Eleonora Barberi, Luciano Riboldi
OBJECTIVE: In recent years, the welfare of workers and the prevention of chronic disabling diseases has become a topic of great interest. This study investigates serum levels of total 25-hydroxyvitamin D (25(OH)D) in a cohort of overweight-obese and insulin-resistant northern Italian indoor workers in apparent good health followed a nutritional education program. METHODS: An observational cross-sectional study on 385 patients (females = 291, males = 94), age range 18-69 years and body mass index (BMI) > 25 kg/m(2), was performed at the Department of Occupational Medicine Milan, Italy, latitude 45...
April 26, 2017: Journal of the American College of Nutrition
https://www.readbyqxmd.com/read/28443437/how-nurses-can-improve-quality-while-controlling-costs
#17
Caroline Shuldham
Health care is expensive, and nurses, like everyone else, must use resources responsibly. At the start of a new financial year there is usually a focus on budgets: how much was spent last year, what is available for next year and how savings will be made.
April 26, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28443266/cost-effectiveness-of-palivizumab-compared-to-no-prophylaxis-in-term-infants-residing-in-the-canadian-arctic
#18
Anna Banerji, Kaspar Ng, Theo J Moraes, Vladimir Panzov, Joan Robinson, Bonita E Lee
BACKGROUND: Hospital admissions for respiratory syncytial virus infection result in large health expenditures for Inuit infants. Palivizumab has been shown to be highly effective in reducing such admissions in preterm Inuit infants. We performed a cost-effectiveness analysis estimating the incremental cost-effectiveness ratio (ICER) for palivizumab prophylaxis per admission related to respiratory syncytial virus avoided in healthy term infants across the Canadian Arctic. METHODS: We compared universal palivizumab prophylaxis in term infants less than 6 months of age to no prophylaxis in 8 Arctic regions: the Northwest Territories, Nunavut, Nunavut without Iqaluit, the 3 subregions of Nunavut (Kitikmeot, Kivalliq and Qikiqtaaluk), the Qikiqtaaluk Region without Iqaluit, and Nunavik (northern Quebec)...
October 2016: CMAJ Open
https://www.readbyqxmd.com/read/28443222/analysis-of-hospital-volume-and-factors-influencing-economic-outcomes-in-cancer-surgery-results-from-a-population-based-study-in-korea
#19
Jung-A Lee, So-Young Kim, Keeho Park, Eun-Cheol Park, Jong-Hyock Park
OBJECTIVES: To evaluate associations between hospital volume, costs, and length of stay (LOS), and clinical and demographic outcome factors for five types of cancer resection. The main dependent variables were cost and LOS; the primary independent variable was volume. METHODS: Data were obtained from claims submitted to the Korean National Health Insurance scheme. We identified patients who underwent the following surgical procedures: pneumonectomy, colectomy, mastectomy, cystectomy, and esophagectomy...
February 2017: Osong Public Health and Research Perspectives
https://www.readbyqxmd.com/read/28442936/factors-influencing-maternal-mortality-among-rural-communities-in-southwestern-nigeria
#20
Dominic Ezinwa Azuh, Akunna Ebere Azuh, Emeka Joshua Iweala, Davies Adeloye, Moses Akanbi, Raphael C Mordi
BACKGROUND: Maternal mortality and morbidity reflect the status of population health and quality of life across nations. Poor understanding of the interplay of many antecedent factors, including sociocultural, economic and logistic factors, combined with an overwhelming poor health services delivery, is a basic challenge in several countries, particularly in rural settings where functional health care services are relatively scarce. There are still uncertainties as to the extent of this burden, owing to current challenges with information and data collation...
2017: International Journal of Women's Health
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