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https://www.readbyqxmd.com/read/28097913/cost-consequence-analysis-of-different-active-flowable-hemostatic-matrices-in-cardiac-surgical-procedures
#1
D Makhija, M Rock, Y Xiong, J D Epstein, M R Arnold, O M Lattouf, D Calcaterra
BACKGROUND: A recent retrospective comparative effectiveness study found that use of FLOSEAL® Hemostatic Matrix in cardiac surgery was associated with significantly lower risks of complications, blood transfusions, surgical revisions and shorter length of surgery than use of SURGIFLO(®) Hemostatic Matrix. These outcome improvements in cardiac surgery procedures may translate to economic savings for hospitals and payers. OBJECTIVE: The objective of this study was to estimate the cost-consequence of two flowable hemostatic matrices (FLOSEAL or SURGIFLO) in cardiac surgeries for US hospitals...
January 18, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28097904/estimated-burden-of-cardiovascular-disease-and-value-based-price-range-for-evolocumab-in-a-high-risk-secondary-prevention-population-in-the-us-payer-context
#2
Peter P Toth, Mark Danese, Guillermo Villa, Yi Qian, Anne Beaubrun, Armando Lira, Jeroen P Jansen
AIM: To estimate real-world cardiovascular disease (CVD) burden and value-based price range of evolocumab for a US-context, high-risk, secondary-prevention population. MATERIALS AND METHODS: Burden of CVD was assessed using the UK-based Clinical Practice Research Datalink (CPRD) in order to capture complete CV burden including CV mortality. Patients on standard of care (SOC; high-intensity statins) in CPRD were selected based on eligibility criteria of FOURIER, a phase 3 CV outcomes trial of evolocumab, and categorized into 4 cohorts: high-risk prevalent atherosclerotic CVD (ASCVD) cohort (N = 1448), acute coronary syndrome (ACS) (N = 602), ischemic stroke (IS) (N = 151), and heart failure (HF) (N = 291) incident cohorts...
January 18, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28096826/pol-tavi-polish-registry-of-transcatheter-aortic-valve-implantation-simple-tool-great-value-rationale-and-design
#3
Joanna Zembala-John, Krzysztof Wilczek, Zdzisław Tobota, Piotr Chodór, Daniel Cieśla, Tomasz Jaźwiec, Waldemar Banasiak, Janina Stępińska, Zbigniew Kalarus, Grzegorz Opolski, Marian Zembala
Aortic stenosis (AS) is the most common valvular heart disease in adults in Europe and North America. Management of AS patients depends on accurate diagnosis of the cause and stage of the disease process: the first and definitive therapeutic choice for a growing number of elderly patients with symptomatic AS is surgical treatment. In patients not eligible for surgery, transcatheter aortic valve implantation (TAVI) constitutes a safe and effective alternative. As an innovative, costly method of treatment, it requires however careful monitoring of its course, documenting its early and long-term results, and assessment of its safety and medical-economic cost-effectiveness...
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28095976/payer-perspective-of-the-american-academy-of-sleep-medicine-clinical-practice-guideline-for-the-pharmacologic-treatment-of-chronic-insomnia
#4
Michael J Sateia, William C Sherrill, Carolyn Winter-Rosenberg, Jonathan L Heald
No abstract text is available yet for this article.
January 11, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28094189/medicaid-payer-status-is-linked-to-increased-rates-of-complications-after-treatment-of-proximal-humerus-fractures
#5
Vani J Sabesan, Graysen Petersen-Fitts, Daniel Lombardo, Daniel Briggs, James Whaley
BACKGROUND: Low socioeconomic status and Medicaid insurance as a primary payer have been associated with major disparities in resource utilization and risk-adjusted outcomes for patients undergoing total joint arthroplasty. With the expansion of Medicaid through the Affordable Care Act in 2014, examination of these disparities has become increasingly relevant for the treatment of proximal humerus fracture (PHF). METHODS: The Healthcare Cost and Utilization Project Nationwide Inpatient Sample database was used to identify patients who were treated for PHF from 2002 to 2012...
January 13, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28092207/healthcare-burden-of-depression-in-adults-with-arthritis
#6
Usha Sambamoorthi, Drishti Shah, Xiaohui Zhao
Arthritis and depression are two of the top disabling conditions. When arthritis and depression exist in the same individual, they can interact with each other negatively and pose a significant healthcare burden on the patients, their families, payers, healthcare systems, and society as a whole. Areas covered: The primary objective of this review is to summarize, identify knowledge gaps and discuss the challenges in estimating the healthcare burden of depression among individuals with arthritis. Electronic literature searches were performed on PubMed, Embase, EBSCOhost, Scopus, the Cochrane Library, and Google Scholar to identify relevant studies...
January 16, 2017: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/28081164/economic-evaluation-of-pcsk9-inhibitors-in-reducing-cardiovascular-risk-from-health-system-and-private-payer-perspectives
#7
Alejandro Arrieta, Timothy F Page, Emir Veledar, Khurram Nasir
The introduction of Proprotein covertase subtilisin/kexin type 9 (PCSK9) inhibitors has been heralded as a major advancement in reducing low-density lipoprotein cholesterol levels by nearly 50%. However, concerns have been raised on the added value to the health care system in terms of their costs and benefits. We assess the cost-effectiveness of PCSK9 inhibitors based on a decision-analytic model with existing clinical evidence. The model compares a lipid-lowering therapy based on statin plus PCSK9 inhibitor treatment with statin treatment only (standard therapy)...
2017: PloS One
https://www.readbyqxmd.com/read/28080183/palliative-care-scorecard
#8
Sheri Kittelson, Read Pierce, Jeanie Youngwerth
BACKGROUND: In response to poor healthcare quality outcomes and rising costs, healthcare reform triple aim has increased requirements for providers to demonstrate value to payers, partners, and the public. OBJECTIVE: Electronically automating measurement of the meaningful impact of palliative care (PC) programs on clinical, operational, and financial systems over time is imperative to the success of the field and the goal of development of this automated PC scorecard...
January 12, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28078407/-diagnostic-accuracy-of-outpatient-polygraphy-devices-a%C3%A2-comparison-with-inpatient-polysomnography-in-clinical-routine
#9
J Lindemann, B Augenstein, F Stupp, B Saul, M Reichert, R Riepl, F Sommer, A-S Grossi
BACKGROUND: Cardiorespiratory polysomnography (PSG) is considered the reference method for diagnosis of obstructive sleep apnea (OSA). Due to waiting times and high costs, payers increasingly request outpatient polygraphy (PG) as an alternative to inpatient PSG. The aim of the present study was to evaluate the diagnostic accuracy of different outpatient PG devices compared to stationary PSG in clinical practice. MATERIALS AND METHODS: Externally collected outpatient PG findings of 406 patients were retrospectively compared with the corresponding PSG findings...
January 11, 2017: HNO
https://www.readbyqxmd.com/read/28076260/medical-home-implementation-in-small-primary-care-practices-provider-perspectives
#10
Gilbert Gimm, Jay Want, Dan Hough, Treniese Polk, Margaret Rodan, Len M Nichols
BACKGROUND: CareFirst BlueCross BlueShield of Maryland implemented a voluntary patient-centered medical home (PCMH) program in 2011 that did not require formal certification to participate. This study assessed attitudes and awareness of PCMH programs among participating providers in Maryland and Northern Virginia. METHODS: This qualitative study used information from 13 focus groups. In addition, 39 telephone interviews were conducted. An experienced facilitator moderated the focus groups...
November 2016: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28075692/comparing-emergency-department-use-among-medicaid-and-commercial-patients-using-all-payer-all-claims-data
#11
Hyunjee Kim, K John McConnell, Benjamin C Sun
The high rate of emergency department (ED) use by Medicaid patients is not fully understood. The objective of this paper is (1) to provide context for ED service use by comparing Medicaid and commercial patients' differences across ED and non-ED health service use, and (2) to assess the extent to which Medicaid-commercial differences in ED use can be explained by observable factors in administrative data. Statistical decomposition methods were applied to ED, mental health, and inpatient care using 2011-2013 Medicaid and commercial insurance claims from the Oregon All Payer All Claims database...
January 11, 2017: Population Health Management
https://www.readbyqxmd.com/read/28073146/value-based-care-in-hepatology
#12
REVIEW
Mario Strazzabosco, John I Allen, Elizabeth O Teisberg
The migration from legacy fee-for-service reimbursement to payments linked to high value health care is accelerating in the United States because of new legislation and re-design of payments from the Centers for Medicare and Medicaid Services (CMS). Since patients with chronic diseases account for substantial use of health care resources, payers and health systems are focusing on maximizing the value of care for these patients. Since chronic liver diseases impose a major health burden worldwide affecting the health and lives of many individuals and families as well as substantial costs for individuals and payers, hepatologists must understand how they can improve their practices ...
January 10, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28072896/the-medical-home-machine
#13
Joey Berlin
Practices that achieve patient-centered medical home (PCMH) status could realize reduced costs and incentive payments from insurance payers if they see the value in contracting with a PCMH.
January 1, 2017: Texas Medicine
https://www.readbyqxmd.com/read/28070000/anesthesia-technique-and-outcomes-of-mechanical-thrombectomy-in-patients-with-acute-ischemic-stroke
#14
Kimon Bekelis, Symeon Missios, Todd A MacKenzie, Stavropoula Tjoumakaris, Pascal Jabbour
BACKGROUND AND PURPOSE: The impact of anesthesia technique on the outcomes of mechanical thrombectomy for acute ischemic stroke remains an issue of debate. We investigated the association of general anesthesia with outcomes in patients undergoing mechanical thrombectomy for ischemic stroke. METHODS: We performed a cohort study involving patients undergoing mechanical thrombectomy for ischemic stroke from 2009 to 2013, who were registered in the New York Statewide Planning and Research Cooperative System database...
January 9, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28069525/utilization-of-the-nsqip-pediatric-database-in-development-and-validation-of-a-new-predictive-model-of-pediatric-postoperative-wound-complications
#15
Ilan I Maizlin, David T Redden, Elizabeth A Beierle, Mike K Chen, Robert T Russell
BACKGROUND: Surgical wound classification, introduced in 1964, stratifies the risk of surgical site infection (SSI) based on a clinical estimate of the inoculum of bacteria encountered during the procedure. Recent literature has questioned the accuracy of predicting SSI risk based on wound classification. We hypothesized that a more specific model founded on specific patient and perioperative factors would more accurately predict the risk of SSI. STUDY DESIGN: Using all observations from the 2012 to 2014 pediatric National Quality Surgical Improvement-Pediatric (NSQIP-P) Participant Use File, patients were randomized into model creation and model verification datasets...
January 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28068956/cost-effectiveness-of-antibiotic-treatment-strategies-for-community-acquired-pneumonia-results-from-a-cluster-randomized-cross-over-trial
#16
Cornelis H van Werkhoven, Douwe F Postma, Marie-Josee J Mangen, Jan Jelrik Oosterheert, Marc J M Bonten
BACKGROUND: To determine the cost-effectiveness of strategies of preferred antibiotic treatment with beta-lactam/macrolide combination or fluoroquinolone monotherapy compared to beta-lactam monotherapy. METHODS: Costs and effects were estimated using data from a cluster-randomized cross-over trial of antibiotic treatment strategies, primarily from the reduced third payer perspective (i.e. hospital admission costs). Cost-minimization analysis (CMA) and cost-effectiveness analysis (CEA) were performed using linear mixed models...
January 10, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28068231/establishing-evidence-based-indications-for-proton-therapy-an-overview-of-current-clinical-trials
#17
Mark V Mishra, Sameer Aggarwal, Soren M Bentzen, Nancy Knight, Minesh P Mehta, William F Regine
PURPOSE: To review and assess ongoing proton beam therapy (PBT) clinical trials and to identify major gaps. METHODS AND MATERIALS: Active PBT clinical trials were identified from clinicaltrials.gov and the World Health Organization International Clinical Trials Platform Registry. Data on clinical trial disease site, age group, projected patient enrollment, expected start and end dates, study type, and funding source were extracted. RESULTS: A total of 122 active PBT clinical trials were identified, with target enrollment of >42,000 patients worldwide...
February 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28065452/value-based-approaches-for-emergency-care-in-a-new-era
#18
Laura Medford-Davis, David Marcozzi, Shantanu Agrawal, Brendan G Carr, Emily Carrier
Although emergency departments (EDs) play an integral role in the delivery of acute unscheduled care, they have not been fully integrated into broader health care reform efforts. Communication and coordination with the ambulatory environment remain limited, leaving ED care disconnected from patients' longitudinal care. In a value-based environment focused on improving quality, decreasing costs, enhancing population health, and improving the patient experience, this oversight represents a missed opportunity for emergency care...
January 5, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28065194/osteoporosis-drugs-marketed-in-the-united-states-generic-competition-pricing-structure-and-dispersion-among-payers
#19
Bander Balkhi, Enrique Seoane-Vazquez, Rosa Rodriguez-Monguio
BACKGROUND: Despite the cost of pharmaceuticals, studies assessing prices of osteoporosis drugs are lacking. This study examined trends in prices of osteoporosis drugs in the United States in the period 1988-2014, assessed pricing structure of osteoporosis drugs, and evaluated price trends before and after generic drugs market entry. METHODS: Data were derived from the U.S. Food and Drug Administration, the RedBook, the Centers for Medicare & Medicaid Services, and the Federal Supply Schedule (FSS)...
January 9, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/28065172/incorporating-environmental-outcomes-into-a-health-economic-model
#20
Kevin Marsh, Michael Ganz, Emil Nørtoft, Niels Lund, Joshua Graff-Zivin
OBJECTIVES: Traditional economic evaluations for most health technology assessments (HTAs) have previously not included environmental outcomes. With the growing interest in reducing the environmental impact of human activities, the need to consider how to include environmental outcomes into HTAs has increased. We present a simple method of doing so. METHODS: We adapted an existing clinical-economic model to include environmental outcomes (carbon dioxide [CO2] emissions) to predict the consequences of adding insulin to an oral antidiabetic (OAD) regimen for patients with type 2 diabetes mellitus (T2DM) over 30 years, from the United Kingdom payer perspective...
January 9, 2017: International Journal of Technology Assessment in Health Care
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