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https://www.readbyqxmd.com/read/28644939/an-economic-analysis-of-mac-versus-walant-a-trigger-finger-release-surgery-case-study
#1
Jason L Codding, Suneel B Bhat, Asif M Ilyas
BACKGROUND: There has been recent interest in wide awake hand surgery, also referred to as "wide awake local anesthesia with no tourniquet" (WALANT) surgery. Using a model of single trigger finger release (TFR) surgery, a hypothesis was made that WALANT would result in decreased hospital time and cost than patients receiving sedation with monitored anesthetic care (MAC). METHODS: Consecutive cases of single TFR surgery with MAC were compared with WALANT. All surgeries were performed in the same manner, at the same facility, and by the same surgeon...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28641586/access-education-and-policy-awareness-predictors-of-influenza-vaccine-acceptance-among-vha-healthcare-workers
#2
Jennifer Lipkowitz Eaton, David C Mohr, Kathleen M McPhaul, Richard A Kaslow, Richard A Martinello
OBJECTIVE To identify predictors of influenza vaccine acceptance among VHA healthcare workers (HCWs), with emphasis on modifiable factors related to promotion campaigns. DESIGN Survey. SETTING National single-payer healthcare system with 140 hospitals and 321,000 HCWs. PARTICIPANTS National voluntary sample of HCWs in the Veterans Health Administration (VHA) system. METHODS We invited a random sample of 5% of all VHA HCWs to participate. An 18-item intranet-based survey inquired about occupation, vaccination status, employer policy, and local campaign efforts...
June 23, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28622186/a-90-day-bundled-payment-for-primary-single-level-lumbar-discectomy-decompression-what-does-big-data-say
#3
Nikhil Jain, Sohrab S Virk, Frank M Phillips, Elizabeth Yu, Safdar N Khan
Episode-based bundling may become the major form of reimbursement for many elective spine procedures. As the amount for a 90-day episode of care is not known for a lumbar discectomy, we analyzed the previous reimbursements from Commercial payers (2007-Q2 2015), Medicare Advantage (2007-Q2 2015), and Medicare (2005-2012) for a primary single-level lumbar discectomy/decompression. Distribution of payments among various service providers was studied and a 90-day bundle was simulated. Depending on the payer type, the average facility costs constituted 59...
June 15, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28612498/china-s-health-care-system-reform-progress-and-prospects
#4
Ling Li, Hongqiao Fu
This paper discusses the progress and prospects of China's complex health care reform beginning in 2009. The Chinese government's undertaking of systemic reform has achieved laudable achievements, including the expansion of social health insurance, the reform of public hospitals, and the strengthening of primary care. An innovative policy tool in China, policy experimentation under hierarchy, played an important role in facilitating these achievements. However, China still faces gaps and challenges in creating a single payer system, restructuring the public hospitals, and establishing an integrated delivery system...
June 14, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28609324/results-of-the-2015-scoliosis-research-society-survey-on-single-versus-dual-attending-surgeon-approach-for-adult-spinal-deformity-surgery
#5
Justin K Scheer, Rajiv K Sethi, Lloyd A Hey, Michael O LaGrone, Malla Keefe, Henry E Aryan, Thomas J Errico, Vedat Deviren, Robert A Hart, Virginie Lafage, Frank Schwab, Michael D Daubs, Christopher P Ames
STUDY DESIGN: An electronic survey administered to Scoliosis Research Society (SRS) membership. OBJECTIVE: To characterize surgeon practices and views regarding the use of two attending surgeons for adult spinal deformity (ASD) surgery. SUMMARY OF BACKGROUND DATA: The use of two experienced attending surgeons can decrease the operative time, estimated blood loss, and perioperative complication rates. However, the current practice patterns for the use of two attending surgeons remains unknown...
June 15, 2017: Spine
https://www.readbyqxmd.com/read/28606975/drivers-of-expenditure-on-primary-care-prescription-drugs-in-10-high-income-countries-with-universal-health-coverage
#6
Steven G Morgan, Christine Leopold, Anita K Wagner
BACKGROUND: Managing expenditures on pharmaceuticals is important for health systems to sustain universal access to necessary medicines. We sought to estimate the size and sources of differences in expenditures on primary care medications among high-income countries with universal health care systems. METHODS: We compared data on the 2015 volume and cost per day of primary care prescription drug therapies purchased in 10 high-income countries with various systems of universal health care coverage (7 from Europe, in addition to Australia, Canada and New Zealand)...
June 12, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28600199/financing-of-vaccine-delivery-in-primary-care-practices
#7
Mandy A Allison, Sean T O'Leary, Megan C Lindley, Lori A Crane, Laura P Hurley, Brenda L Beaty, Michaela Brtnikova, Andrea Jimenez-Zambrano, Christine Babbel, Stephen Berman, Allison Kempe
OBJECTIVES: Vaccines represent a significant portion of primary care practices' expenses. Our objectives were to determine among Pediatric (Ped) and Family Medicine (FM): 1) relative payment for vaccine purchase and administration and estimated profit margin by payer type, 2) strategies used to reduce vaccine purchase costs and increase payment, and 3) whether practices have stopped providing vaccines due to finances. METHODS: A national survey conducted April-September 2011 among Ped and FM in private, single-specialty practices...
June 6, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28579446/incidence-and-risk-factors-for-blood-transfusion-in-total-joint-arthroplasty-analysis-of-a-statewide-database
#8
James Slover, Jessica A Lavery, Ran Schwarzkopf, Richard Iorio, Joseph Bosco, Heather T Gold
BACKGROUND: Significant attempts have been made to adopt practices to minimize blood transfusion after total joint arthroplasty (TJA) because of transfusion cost and potential negative clinical consequences including allergic reactions, transfusion-related lung injuries, and immunomodulatory effects. We aimed to evaluate risk factors for blood transfusion in a large cohort of TJA patients. METHODS: We used the all-payer California Healthcare Cost and Utilization Project data from 2006 to 2011 to examine the trends in utilization of blood transfusion among arthroplasty patients (n = 320,746)...
May 4, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28579384/managing-molars-with-severe-molar-incisor-hypomineralization-a-cost-effectiveness-analysis-within-german-healthcare
#9
Karim Elhennawy, Paul-Georg Jost-Brinkmann, David John Manton, Sebastian Paris, Falk Schwendicke
OBJECTIVES: Dentists have a range of options for managing molars with severe molar-incisor hypomineralization (MIH), each with different long-term implications. The cost-effectiveness of managing molars with severe MIH was assessed. METHODS: A mixed public-private-payer perspective within German healthcare was adopted. Individuals with one to four severely MIH-affected molars were followed over their lifetime. We compared: (1) removal of the tooth/teeth and orthodontic alignment of the second and third molars (Ex/Ortho); (2) restoration of the tooth using resin composite (Comp); (3) restoration using an indirect metal crown after temporizing it using a preformed metal crown (PMC/IR)...
June 1, 2017: Journal of Dentistry
https://www.readbyqxmd.com/read/28557929/medical-students-call-for-single-payer-national-health-insurance
#10
Andrew M Harrison
No abstract text is available yet for this article.
June 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28553037/a-comparison-of-practice-pattern-and-outcome-of-twice-weekly-and-thrice-weekly-hemodialysis-patients
#11
T Mukherjee, G Devi, S Geetha, N J Anchan, S Sankarasubbaiyan
Renal replacement therapy (RRT) options and practice varies in countries worldwide and is influenced by patients' choice, nephrologists' practice patterns, health system, payer practice, public policy, and socioeconomic factors. In India, hemodialysis (HD) remains the dominant RRT modality, and the practice is largely influenced by socioeconomics of the region of practice since third party payer is limited. Resource stretch to maximize outcome benefit is essential and HD session twice weekly is an improvized and cost-effective clinical practice...
May 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28548543/systematic-review-of-clinical-guidance-documents-for-autism-spectrum-disorder-diagnostic-assessment-in-select-regions
#12
Melanie Penner, Evdokia Anagnostou, Lana Y Andoni, Wendy J Ungar
Clinical guidance documents play an important role in ensuring access to high-quality autism spectrum disorder diagnostic assessment practices. The objective was to perform a systematic review of professional association and government clinical guidance documents for autism spectrum disorder diagnostic assessment, analyzing their quality and content. The government search was limited to English-speaking, single-payer, publicly funded health systems. A quality appraisal was conducted by two appraisers using the Appraisal of Guidelines Research and Evaluation, second edition tool...
May 1, 2017: Autism: the International Journal of Research and Practice
https://www.readbyqxmd.com/read/28530524/is-real-world-evidence-used-in-p-t-monographs-and-therapeutic-class-reviews
#13
Jason T Hurwitz, Mary Brown, Jennifer S Graff, Loretta Peters, Daniel C Malone
BACKGROUND: Payers are faced with making coverage and reimbursement decisions based on the best available evidence. Often these decisions apply to patient populations, provider networks, and care settings not typically studied in clinical trials. Treatment effectiveness evidence is increasingly available from electronic health records, registries, and administrative claims. However, little is known about when and what types of real-world evidence (RWE) studies inform pharmacy and therapeutic (P&T) committee decisions...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28526230/shared-decision-making-in-taiwan
#14
Hsun-Hsiang Liao, Huey-Wen Liang, Hou-Chaung Chen, Ching-I Chang, Pa-Chun Wang, Chung-Liang Shih
The paper aims to introduce the current status of shared decision making (SDM) in Taiwan under its mixed health care system and single-payer health insurance system. With experiences in promoting both evidence based medicine and patient safety, the Joint Commission of Taiwan has implemented a nationwide SDM program under the aegis of the Ministry of Health and Welfare since 2016, incorporating multiple approaches such as developing patient decision aids (PDAs), executing the Medical Decision Aids Campaign, establishing a SDM platform, and integrating SDM in clinical practice...
May 17, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28523719/cardiovascular-events-associated-with-second-line-anti-diabetes-treatments-analysis-of-real-world-korean-data
#15
K H Ha, B Kim, H Choi, D J Kim, H C Kim
AIM: To compare the risks of cardiovascular disease (CVD) and all-cause mortality associated with sulfonylurea (SU), dipeptidyl peptidase-4 inhibitor (DPP4i) and thiazolidinedione (TZD) as add-on medications to metformin (MET) therapy in people with Type 2 diabetes. METHODS: We identified 40 263 individuals who used SU (n = 11 582), DPP4i (n = 26 623) or TZD (n = 2058) in addition to MET between January 2013 and June 2015 from the database of the Korean National Health Insurance, the single-payer healthcare system in South Korea...
May 19, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28523483/modeling-the-long-term-cost-effectiveness-of-ideglira-in-patients-with-type-2-diabetes-who-are-failing-to-meet-glycemic-targets-on-basal-insulin-alone-in-the-netherlands
#16
Barnaby Hunt, Divina Glah, Maarten van der Vliet
INTRODUCTION: Insulin degludec/liraglutide (IDegLira) is the first basal insulin and glucagon-like peptide-1 receptor agonist (GLP-1 RA) in a single pen injection device, and a once-daily treatment option for patients with type 2 diabetes mellitus (T2DM) who are uncontrolled on basal insulin and require treatment intensification. The objective of this analysis was to evaluate the long-term cost-effectiveness of IDegLira versus basal-bolus therapy (insulin glargine U100 + 3× daily insulin aspart) for patients with T2DM uncontrolled on basal insulin [HbA1c >53 mmol/mol (>7%)] in the Netherlands...
May 18, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28501373/evaluating-appropriate-use-of-pediatric-echocardiograms-for-chest-pain-in-outpatient-clinics
#17
Reid C Chamberlain, Jonathan H Pelletier, Sarah Blanchard, Christoph P Hornik, Kevin D Hill, Michael J Campbell
BACKGROUND: Echocardiography is often used in the evaluation of pediatric chest pain, but the incidence of cardiac pathology is low. In 2014, the American College of Cardiology published appropriate use criteria (AUC) for echocardiography including recommendations for pediatric chest pain. We evaluated the frequency and diagnostic yield of echocardiograms performed for each AUC indication and cost associated with echocardiograms performed for indications meeting the "rarely appropriate" criteria...
May 10, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28498196/identifying-increased-risk-of-readmission-and-in-hospital-mortality-using-hospital-administrative-data-the-ahrq-elixhauser-comorbidity-index
#18
Brian J Moore, Susan White, Raynard Washington, Natalia Coenen, Anne Elixhauser
OBJECTIVE: We extend the literature on comorbidity measurement by developing 2 indices, based on the Elixhauser Comorbidity measures, designed to predict 2 frequently reported health outcomes: in-hospital mortality and 30-day readmission in administrative data. The Elixhauser measures are commonly used in research as an adjustment factor to control for severity of illness. DATA SOURCES: We used a large analysis file built from all-payer hospital administrative data in the Healthcare Cost and Utilization Project State Inpatient Databases from 18 states in 2011 and 2012...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28495247/hospital-variation-in-treatment-and-outcomes-in-acute-coronary-syndromes-insights-from-the-alberta-contemporary-acute-coronary-syndrome-patients-invasive-treatment-strategies-coapt-study
#19
Kevin R Bainey, Padma Kaul, Paul W Armstrong, Anamaria Savu, Cynthia M Westerhout, Colleen M Norris, Neil Brass, Dean Traboulsi, Blair O'Neill, Jayan Nagendran, Imtiaz Ali, Merril Knudtson, Robert C Welsh
BACKGROUND: We examined variation in hospital treatment and its relationship to clinical outcome in a large population-based cohort of ACS patients within a single payer-government funded health care system. METHODS: Patients hospitalized in 106 hospitals in Alberta, Canada with a primary diagnosis of ACS were included (July 1, 2010-March 31, 2013) with comparisons made across the three cardiac catheterization-capable hospitals (Sites A-C). Cox proportional-hazard regression models were used to examine the multivariable-adjusted association between site and 1-year death or repeat cardiovascular (CV) hospitalization (primary endpoint)...
May 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28493177/what-is-single-payer-health-care-a-review-of-definitions-and-proposals-in-the-u-s
#20
Jodi L Liu, Robert H Brook
BACKGROUND: Single-payer systems have been proposed as a health care reform alternative in the United States. However, there is no consensus on the definition of single-payer. Most definitions characterize single-payer as one entity that collects funds and pays for health care on behalf on an entire population. Increased flexibility for state health care reform may provide opportunities for state-based single-payer systems to be considered. OBJECTIVE: To explore the concept of single-payer and to describe the contents of single-payer health care proposals...
May 10, 2017: Journal of General Internal Medicine
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