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https://www.readbyqxmd.com/read/29648637/medium-and-long-term-emergency-department-utilization-after-oesophagectomy-a-population-based-analysis
#1
Biniam Kidane, Binu Jacob, Vaibhav Gupta, John Peel, Refik Saskin, Thomas K Waddell, Gail E Darling
OBJECTIVES: Oesophagectomy is a complex operation with the potential for prolonged recovery. The aim of this study was to evaluate healthcare resource utilization, specifically emergency department (ED) visits within 1 year of oesophagectomy, and to identify risk factors for ED visits and frequent ED use (FEDU). METHODS: A retrospective cohort study of consecutive oesophagectomies for cancer in all Ontario hospitals was conducted using linked health data (2000-2012) including the ability to identify ED visits at non-index hospitals...
April 10, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29626237/the-utility-of-outpatient-commitment-acute-medical-care-access-and-protecting-health
#2
Steven P Segal, Stephania L Hayes, Lachlan Rimes
OBJECTIVES: This study considers whether, in an easy access single-payer health care system, patients placed on outpatient commitment-community treatment orders (CTOs) in Victoria Australia-are more likely to access acute medical care addressing physical illness than voluntary patients with and without severe mental illness. METHOD: For years 2000 to 2010, the study compared acute medical care access of 27,585  severely mentally ill psychiatrically hospitalized patients (11,424 with and 16,161 without CTO exposure) and 12,229 never psychiatrically hospitalized outpatients (individuals with less morbidity risk as they were not considered to have severe mental illness)...
April 6, 2018: Social Psychiatry and Psychiatric Epidemiology
https://www.readbyqxmd.com/read/29610252/enhancing-postdischarge-asthma-care-by-using-pharmacy-claims-and-telephone-follow-up
#3
Ronald J Teufel, Anita B Shuler, Myla D Ebeling, Kristen Morella, Annie L Andrews
BACKGROUND AND OBJECTIVES: Asthma is a common reason for hospital readmission. The majority of children are not receiving adequate preventive care after discharge. Our objective is to decrease return visits to the emergency department (ED) or hospital for asthma through a series of interventions (eg, access to real-time claims data and structured follow-up phone calls) designed to increase preventive care. METHODS: We performed a single-site quality improvement project for children 2 to 17 years old discharged with asthma from January 2010 to March 2014...
April 2, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29603492/demand-for-neurological-services-in-central-eastern-europe-a-10-year-national-survey-in-hungary
#4
Ferenc Oberfrank, András Ajtay, Dániel Bereczki
BACKGROUND: To plan neurological capacities at a national level for the next decade the current use of neurological services should be evaluated. We analyze the utilization of neurological services in Hungary, a country with a single-payer health insurance system covering the whole population. METHODS: We created a database from medical reports submitted to the National Health Insurance Fund from all hospitals and outpatient services between 2004 and 2013. The number of subjects presenting in the neurological healthcare system, and their major diagnoses by ICD-10 categories are analyzed...
March 30, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29602816/cost-effectiveness-of-bone-spect-ct-in-painful-total-knee-arthroplasty
#5
Tim Van den Wyngaert, Swetha R Palli, Ryan J Imhoff, Michael T Hirschmann
Purpose: To quantify the economic value of bone single-photon emission computed tomography (SPECT) with computed tomography (CT; SPECT/CT) versus CT or metal artifact reduction sequence (MARS) magnetic resonance imaging (MRI) for the diagnostic assessment of recurrent moderate-to-severe pain after total knee arthroplasty (TKA). Methods: An Excel-based simulation model was developed to compare bone SPECT/CT versus CT or MARS-MRI from a payer perspective. Clinical endpoints (diagnosis - delayed or otherwise, and the subsequent treatment and complications) and their corresponding cost data (2017 United States dollars) were obtained by performing a best evidence review of the published literature...
March 30, 2018: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/29598807/the-affordable-care-act-and-the-faltering-revolution-in-behavioral-health-care
#6
David A Rochefort
Often described in such terms as a "revolution" and a "game-changer" for the behavioral health sector in the United States, the Affordable Care Act has helped to enhance coverage for mental health and substance use disorders while encouraging service system innovations at the organizational level. However, tens of millions of Americans still lack health insurance, insurance companies are resisting the implementation of parity coverage rules, and inequalities in the financing and organization of care continue to worsen in key respects...
January 1, 2018: International Journal of Health Services: Planning, Administration, Evaluation
https://www.readbyqxmd.com/read/29595721/trends-in-physician-payments-for-breast-reconstruction
#7
Clifford C Sheckter, Day Yi, Hina J Panchal, Shantanu N Razdan, Andrea L Pusic, Colleen M McCarthy, Peter G Cordeiro, Joseph J Disa, Babak Mehrara, Evan Matros
BACKGROUND: Prosthetic breast reconstruction rates have risen in the United States, whereas autologous techniques have stagnated. Meanwhile, single-institution data demonstrate that physician payments for prosthetic reconstruction are rising, while payments for autologous techniques are unchanged. This study aims to assess payment trends and variation for tissue expander and free flap breast reconstruction. METHODS: The Blue Health Intelligence database was queried from 2009 to 2013, identifying women with claims for breast reconstruction...
April 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29589152/genetic-test-utilization-and-diagnostic-yield-in-adult-patients-with-neurological-disorders
#8
Tanya M Bardakjian, Ingo Helbig, Colin Quinn, Lauren B Elman, Leo F McCluskey, Steven S Scherer, Pedro Gonzalez-Alegre
To determine the diagnostic yield of different genetic test modalities in adult patients with neurological disorders, we evaluated all adult patients seen for genetic diagnostic evaluation in the outpatient neurology practice at the University of Pennsylvania between January 2016 and April 2017 as part of the newly created Penn Neurogenetics Program. Subjects were identified through our electronic medical system as those evaluated by the Program's single clinical genetic counselor in that period. A total of 377 patients were evaluated by the Penn Neurogenetics Program in different settings and genetic testing recommended...
March 28, 2018: Neurogenetics
https://www.readbyqxmd.com/read/29582674/current-procedural-terminology-coding-for-surgical-pathology-a-review-and-one-academic-center-s-experience-with-pathologist-verified-coding
#9
Audrey Deeken-Draisey, Allison Ritchie, Guang-Yu Yang, Margaret Quinn, Linda M Ernst, Ajda Guttormsen, Gyongyi Ella Simionov, Kruti P Maniar
CONTEXT: - The Current Procedural Terminology (CPT) system is a standardized numerical coding system for reporting medical procedures and services, and is the basis for reimbursement of health care providers by Medicare and other third-party payers. Accurate CPT coding is therefore crucial for appropriate compensation as well as for compliance with Medicare policies, and erroneous coding may result in loss of revenues and/or significant monetary penalties for a hospital or practice. OBJECTIVE: - To provide a review of the history, current state, and basic principles of CPT coding, in particular as it applies to the practice of surgical pathology, and to present our experience with initiating a new system of pathologist involvement in the review and verification of CPT codes, including the most common codes that require modification in our practice at the time of sign-out or post-sign-out auditing...
March 27, 2018: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/29576023/a-successful-charter-challenge-to-medicare-policy-options-for-canadian-provincial-governments
#10
Colleen M Flood, Bryan Thomas
In September 2016, a case went to trial in British Columbia that seeks to test the constitutionality of provincial laws that (1) ban private health insurance for medically necessary hospital and physician services; (2) ban extra-billing (physicians cannot charge patients more than the public tariff); and (3) require physicians to work solely for the public system or 'opt-out' and practice privately. All provinces have similar laws that have been passed to meet the requirements of federal legislation, the Canada Health Act (and thus qualify for federal funds)...
March 26, 2018: Health Economics, Policy, and Law
https://www.readbyqxmd.com/read/29566838/cost-effectiveness-of-antibiotic-prophylaxis-strategies-for-transrectal-prostate-biopsy-in-an-era-of-increasing-antimicrobial-resistance
#11
Kyueun Lee, Dimitri M Drekonja, Eva A Enns
OBJECTIVES: To determine the optimal antibiotic prophylaxis strategy for transrectal prostate biopsy (TRPB) as a function of the local antibiotic resistance profile. METHODS: We developed a decision-analytic model to assess the cost-effectiveness of four antibiotic prophylaxis strategies: ciprofloxacin alone, ceftriaxone alone, ciprofloxacin and ceftriaxone in combination, and directed prophylaxis selection based on susceptibility testing. We used a payer's perspective and estimated the health care costs and quality-adjusted life-years (QALYs) associated with each strategy for a cohort of 66-year-old men undergoing TRPB...
March 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29558251/impact-of-socioeconomic-status-on-pretreatment-weight-loss-and-survival-in-non-small-cell-lung-cancer
#12
Steven K M Lau, Bhavani S Gannavarapu, Kristen Carter, Ang Gao, Chul Ahn, Jeffrey J Meyer, David J Sher, Aminah Jatoi, Rodney Infante, Puneeth Iyengar
PURPOSE: Socioeconomic status (SES) influences health care outcomes, but the influence of primary payer on cancer-associated wasting is unknown. We hypothesized that primary payer as an indicator of SES would influence pretreatment cancer-associated weight loss and treatment outcomes. MATERIALS AND METHODS: Retrospective review of medical records identified 1,366 patients with non-small-cell lung cancer (NSCLC) consecutively treated at a tertiary care health system between January 1, 2006 and December 31, 2013...
March 20, 2018: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29548564/managing-health-expenditure-inflation-under-a-single-payer-system-taiwan-s-national-health-insurance
#13
Winnie C Yip, Yue-Chune Lee, Shu-Ling Tsai, Bradley Chen
As nations strive to achieve and sustain universal health coverage (UHC), they seek answers as to what health system structures are more effective in managing health expenditure inflation. A fundamental macro-level choice a nation has to make is whether to adopt a single- or a multiple-payer health system. Using Taiwan's National Health Insurance (NHI) as a case, this paper examines how a single-payer system manages its health expenditure growth and draws lessons for other countries whose socioeconomic development is similar to Taiwan's...
November 16, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/29547372/the-national-health-service-nhs-at-70-some-comparative-reflections
#14
Carolyn H Tuohy
As the National Health Service (NHS) turns 70, it bears comparison with another universal system celebrating an anniversary this year: Canada's 50-year-old medicare model. Each system is iconically popular, and each revolves around a profession-state accommodation. Both the popularity and the central axis of each system have been tested by external shocks in the form of periodic fiscal cycles of investment and austerity, and internal stresses generating organizational cycles of centralization and decentralization...
March 16, 2018: Health Economics, Policy, and Law
https://www.readbyqxmd.com/read/29527405/a-rational-active-site-redesign-converts-a-decarboxylase-into-a-c-c-hydratase-tethered-acetate-supports-enantioselective-hydration-of-4-hydroxystyrenes
#15
Stefan E Payer, Hannah Pollak, Silvia M Glueck, Kurt Faber
The promiscuous regio- and stereoselective hydration of 4-hydroxystyrenes catalyzed by ferulic acid decarboxylase from Enterobacter sp. (FDC_ Es ) depends on bicarbonate bound in the active site, which serves as a proton relay activating a water molecule for nucleophilic attack on a quinone methide electrophile. This "cofactor" is crucial for achieving improved conversions and high stereoselectivities for ( S )-configured benzylic alcohol products. Similar effects were observed with simple aliphatic carboxylic acids as additives...
March 2, 2018: ACS Catalysis
https://www.readbyqxmd.com/read/29516752/economic-analysis-of-braf-gene-mutation-testing-in-real-world-practice-using-claims-data-costs-of-single-gene-versus-panel-tests-in-patients-with-lung-cancer
#16
Anand A Dalal, Annie Guerin, Alex Mutebi, Kenneth W Culver
AIMS: To assess the time to BRAF testing, compare the characteristics of tested versus not-tested patients, and describe the costs for sequential versus next-generation sequencing (NGS) BRAF testing. METHODS: Patients diagnosed with lung cancer after 12/1/2013 were identified from two US claims databases; their characteristics were assessed during the 12 months before diagnosis (index date). Testing modalities were analyzed from the index date to end of continuous health plan enrollment or data availability (12/2015) based on combinations of Current Procedural Terminology (CPT) procedure codes...
March 8, 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/29513573/single-payer-plan-for-new-york-could-lead-the-country
#17
Richard N Gottfried
No abstract text is available yet for this article.
April 2018: American Journal of Public Health
https://www.readbyqxmd.com/read/29511561/cost-effectiveness-of-biological-treatment-sequences-for-fistulising-crohn-s-disease-across-europe
#18
Petra Baji, László Gulácsi, Valentin Brodszky, Zsuzsanna Végh, Silvio Danese, Peter M Irving, Laurent Peyrin-Biroulet, Stefan Schreiber, Fanni Rencz, Péter L Lakatos, Márta Péntek
Background: In clinical practice, treatment sequences of biologicals are applied for active fistulising Crohn's disease, however underlying health economic analyses are lacking. Objective: The purpose of this study was to analyse the cost-effectiveness of different biological sequences including infliximab, biosimilar-infliximab, adalimumab and vedolizumab in nine European countries. Methods: A Markov model was developed to compare treatment sequences of one, two and three biologicals from the payer's perspective on a five-year time horizon...
March 2018: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29506041/medical-research-using-governments-health-claims-databases-with-or-without-patients-consent
#19
Feng-Jen Tsai, Valérie Junod
Taking advantage of its single-payer, universal insurance system, Taiwan has leveraged its exhaustive database of health claims data for research purposes. Researchers can apply to receive access to pseudonymized (coded) medical data about insured patients, notably their diagnoses, health status and treatments. In view of the strict safeguards implemented, the Taiwanese government considers that this research use does not require patients' consent (either in the form of an opt-in or in the form of an opt-out)...
March 1, 2018: Journal of Public Health
https://www.readbyqxmd.com/read/29502935/robotic-versus-video-assisted-thoracoscopic-lung-resection-during-early-program-development
#20
Manraj N Kaur, Feng Xie, Andrea Shiwcharan, Lisa Patterson, Yaron Shargall, Christian Finley, Colin Schieman, Terry Dalimonte, Christine Fahim, Waël C Hanna
BACKGROUND: The objective of this study is to compare robotic portal (RP) to video-assisted thoracoscopic surgery (VATS) pulmonary resections for early stage non-small cell lung cancer with respect to health care resource utilization during the first year of a robotic surgery program in thoracic oncology. METHODS: Patients who underwent anatomic lung resections using RP (n = 42) or VATS (n = 96) for early stage non-small cell lung cancer between April 2014 and March 2015 at a single institution were identified...
March 2, 2018: Annals of Thoracic Surgery
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