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https://www.readbyqxmd.com/read/28328670/the-trauma-ecosystem-the-impact-and-economics-of-new-trauma-centers-on-a-mature-statewide-trauma-system
#1
David J Ciesla, Etienne E Pracht, Pablo T Leitz, David A Spain, Joseph J Tepas, Kristan L Staudenmayer
INTRODUCTION: Florida serves as a model for the study of trauma system performance. Between 2010 and 2104, 5 new trauma centers were opened along side 20 existing centers. The purpose of this study was to explore the impact of trauma system expansion on system triage performance and trauma center patient profiles. METHODS: A statewide dataset was queried for all injury related discharges from adult acute care hospitals using ICD-9 codes for 2010 and 2014. The dataset, inclusion criteria, and definitions of high-risk injury were chosen to match those used by the Florida department of health in its trauma registry...
March 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28328015/pcsk9-inhibitor-access-barriers-issues-and-recommendations-improving-the-access-process-for-patients-clinicians-and-payers
#2
REVIEW
Seth J Baum, Peter P Toth, James A Underberg, Paul Jellinger, Joyce Ross, Katherine Wilemon
The proprotein convertase subtilisin/kexin type 9 inhibitors or monoclonal antibodies likely represent the greatest advance in lipid management in 30 years. In 2015 the US Food and Drug Administration approved both alirocumab and evolocumab for high-risk patients with familial hypercholesterolemia (FH) and clinical atherosclerotic cardiovascular disease requiring additional lowering of low-density lipoprotein cholesterol. Though many lipid specialists, cardiovascular disease prevention experts, endocrinologists, and others prescribed the drugs on label, they found their directives denied 80% to 90% of the time...
March 22, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28325551/patient-related-risk-factors-for-infection-following-knee-arthroscopy-an-analysis-of-over-700-000-patients-from-two-large-databases
#3
Jourdan M Cancienne, Harrison S Mahon, Ian J Dempsey, Mark D Miller, Brian C Werner
BACKGROUND: To determine patient-related risk factors for infection following knee arthroscopy using two large databases. METHODS: A private-payer (PP) and Medicare national insurance database were queried for patients undergoing simple knee arthroscopy procedures from 2005 to 2015. Patients undergoing concomitant open or complex procedures with grafts were excluded. Postoperative infection within 90days was assessed using ICD-9 and CPT codes. A multivariate logistic regression analysis was utilized to evaluate patient-related risk factors for postoperative infection...
March 18, 2017: Knee
https://www.readbyqxmd.com/read/28324221/insuring-care-paperwork-insurance-rules-and-clinical-labor-at-a-u-s-transgender-clinic
#4
Marieke van Eijk
What is a clinician to do when people needing medical care do not have access to consistent or sufficient health insurance coverage and cannot pay for care privately? Analyzing ethnographically how clinicians at a university-based transgender clinic in the United States responded to this challenge, I examine the U.S. health insurance system, insurance paperwork, and administrative procedures that shape transgender care delivery. To buffer the impact of the system's failure to provide sufficient health insurance coverage for transgender care, clinicians blended administrative routines with psychological therapy, counseled people's minds and finances, and leveraged the prestige of their clinic in attempts to create space for gender nonconforming embodiments in gender conservative insurance policies...
March 21, 2017: Culture, Medicine and Psychiatry
https://www.readbyqxmd.com/read/28323690/organizational-structural-design-in-spine-care
#5
Alok D Sharan, Gregory D Schroeder, Michael E West, Alexander R Vaccaro
For a company to provide high value to its customers, its organization design is critical. As health care transitions to a value-based model, it is critical that spinal care organizations are structured in such a way that they can maximize value to both the patient and the payers. This article will discuss the 3 most common ways that an organization can be structured, and the benefits and problems of each design in spinal care.
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323512/evaluating-the-costs-of-glycemic-response-with-canagliflozin-versus-dapagliflozin-and-empagliflozin-as-add-on-to-metformin-in-patients-with-type-2-diabetes-mellitus-in-the-united-arab-emirates
#6
Agata Schubert, Anders T Buchholt, Antoine C El Khoury, Ahmed Kamal, Vanessa Taieb
OBJECTIVE: This study evaluates the cost of achieving glycemic control with 3 sodium glucose co-transporter 2 (SGLT2) inhibitors, canagliflozin, dapagliflozin, and empagliflozin, in patients with type 2 diabetes mellitus (T2DM) from the payer perspective in the United Arab Emirates (UAE). METHODS: A systematic literature review identified randomized controlled trials of antihyperglycemic agents as add-on to metformin in patients with T2DM of 26 ± 4 weeks in duration, published by 10 September 2014...
March 21, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28322480/re-thinking-the-different-perspectives-that-can-be-used-when-eliciting-preferences-in-health
#7
Aki Tsuchiya, Verity Watson
The 2003 Health Economics paper by Dolan, Olsen, Menzel and Richardson on 'An inquiry into the different perspectives that can be used when eliciting preferences in health' presents a conceptual framework of six perspectives along two dimensions: preferences (personal, social, and socially inclusive personal) and context (ex ante and ex post). The objective of our paper is to re-think this framework. We ask four questions concerning: the patient, or the user of the treatment; the payer of the treatment; the assessor of the value of treatment; and the timing of the illness and the nature of its risk...
March 21, 2017: Health Economics
https://www.readbyqxmd.com/read/28321550/ethical-implications-of-the-electronic-health-record-in-the-service-of-the-patient
#8
Lois Snyder Sulmasy, Ana María López, Carrie A Horwitch
Electronic health records (EHRs) provide benefits for patients, physicians, and clinical teams, but also raise ethical questions. Navigating how to provide care in the digital age requires an assessment of the impact of the EHR on patient care and the patient-physician relationship. EHRs should facilitate patient care and, as an essential component of that care, support the patient-physician relationship. Billing, regulatory, research, documentation, and administrative functions determined by the operational requirements of health care systems, payers, and others have resulted in EHRs that are better able to satisfy such external functions than to ensure that patient care needs are met...
March 20, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28319617/biosimilars-in-psoriasis-the-future-or-not
#9
Roselyn Kellen, Gary Goldenberg
As patents for the biologic agents reach their expiration dates, dermatologists must prepare for the coming of biosimilars. These agents have been deemed "highly similar" to their reference products in a process outlined by the US Food and Drug Administration (FDA). In 2016, the FDA approved 3 biosimilars for various indications including plaque psoriasis and psoriatic arthritis. However, biosimilars are not the same as small-molecule generics because they have a complex manufacturing process that makes it impossible to produce identical products to their reference products...
February 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/28318119/rural-hospital-employment-of-physicians-and-use-of-cesareans-and-nonindicated-labor-induction
#10
Shailendra Prasad, Peiyin Hung, Carrie Henning-Smith, Michelle Casey, Katy Kozhimannil
OBJECTIVE: Workforce issues constrain obstetric care services in rural US hospitals, and one strategy hospitals use is to employ physicians to provide obstetric care. However, little is known about the relationship between hospital employment of maternity care physicians and use of obstetric care procedures in rural hospitals. We examined the association between obstetric physician employment and use of cesareans and nonindicated labor induction. STUDY DESIGN: We conducted a cross-sectional analysis of a telephone survey of all 306 rural hospitals providing obstetric care in 9 states from November 2013 to March 2014 and linked the survey data (N = 263, 86% response rate) to all-payer childbirth data on maternity care utilization from 2013 Statewide Inpatient Database (SID) hospital discharge data...
March 20, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28306419/does-the-ranking-of-surgeons-in-a-publicly-available-online-platform-correlate-with-objective-outcomes
#11
Kimon Bekelis, Symeon Missios, Shannon Coy, Jeremiah N Johnson
OBJECTIVE The accuracy of public reporting in health care, especially from private vendors, remains an issue of debate. The authors investigated the association of the publicly reported physician complication rates in an online platform with real-world adverse outcomes of the same physicians for patients undergoing posterior lumbar fusion. METHODS The authors performed a cohort study involving physicians performing posterior lumbar fusions between 2009 and 2013 who were registered in the Statewide Planning and Research Cooperative System database...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28306169/economic-burden-of-relapsed-or-refractory-multiple-myeloma-results-from-an-international-trial
#12
Don Robinson, Robert Z Orlowski, Michael Stokes, Jianming He, Samuel Huse, Abhishek Chitnis, Britte Kranenburg, Annette Lam
OBJECTIVE: The direct cost of relapsed or refractory multiple myeloma (RRMM) is documented; indirect costs are being explored. Healthcare payers seek cost offsets from therapies that improve clinical outcomes but challenge budgets; employers seek lower absenteeism and better productivity. Study goals were to: 1) Identify direct and indirect economic factors of RRMM and, 2) Explore longitudinal relationships between clinical, economic, and health-related quality of life (HRQoL) assessments...
March 17, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28301684/economic-evaluation-of-nivolumab-as-a-second-line-treatment-for-advanced-renal-cell-carcinoma-from-us-and-chinese-perspectives
#13
Xiao Min Wan, Liu Bao Peng, Jin An Ma, Yuan Jian Li
BACKGROUND: Nivolumab is a new standard of care for patients with metastatic renal cell carcinoma (mRCC) and provides an overall survival benefit of 5.40 months in comparison with everolimus. This study evaluated the cost-effectiveness of nivolumab for the second-line treatment of mRCC from the perspective of US payers and identified the range of drug costs for which the addition of nivolumab to standard therapy could be considered cost-effective from a Chinese perspective. METHODS: A partitioned survival model was constructed to estimate lifetime costs, life-years, and quality-adjusted life-years (QALYs)...
March 16, 2017: Cancer
https://www.readbyqxmd.com/read/28301618/dermatologists-collaborating-with-payers-to-optimize-coverage-policies
#14
David A Amato, William N Malatestinic, Matthew C Palmgren, Steven R Feldman
Dermatologists are frustrated by payer constraints that limit their ability to optimize patient treatment. They can benefit from understanding the payer formulary process and places in that process where they can exert influence. <p>Collaboration between dermatologists and payers could improve access to medication not only for individual patients, but for the entire dermatologic patient population.</p> <p><em>J Drugs Dermatol. 2017;16(3):228-232.</em></p>.
March 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28301397/the-michigan-trauma-quality-improvement-program-results-from-a-collaborative-quality-initiative
#15
Mark R Hemmila, Jill L Jakubus, Anne H Cain-Nielsen, John P Kepros, Wayne E Vander Kolk, Wendy L Wahl, Judy N Mikhail
BACKGROUND: American College of Surgeons verified trauma centers and a third party payer within the state of Michigan built a regional collaborative quality initiative (CQI). The Michigan Trauma Quality Improvement Program began as a pilot in 2008 and expanded to a formal program in 2011. Here, we examine the performance of the collaborative over time with regard to patient outcomes, resource utilization, and process measures. METHODS: Data from the initial 23 hospitals that joined the CQI in 2011 were analyzed...
March 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28301213/academic-radiologist-subspecialty-identification-using-a-novel-claims-based-classification-system
#16
Andrew B Rosenkrantz, Wenyi Wang, Danny R Hughes, Luke A Ginocchio, David A Rosman, Richard Duszak
OBJECTIVE: The objective of the present study is to assess the feasibility of a novel claims-based classification system for payer identification of academic radiologist subspecialties. MATERIALS AND METHODS: Using a categorization scheme based on the Neiman Imaging Types of Service (NITOS) system, we mapped the Medicare Part B services billed by all radiologists from 2012 to 2014, assigning them to the following subspecialty categories: abdominal imaging, breast imaging, cardiothoracic imaging, musculoskeletal imaging, nuclear medicine, interventional radiology, and neuroradiology...
March 16, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28300982/primary-healthcare-in-portugal-10-years-of-contractualization-of-health-services-in-the-region-of-lisbon
#17
Baltazar Ricardo Monteiro, Ana Maria Silva Azenha Pisco, Fátima Candoso, Sónia Bastos, Magda Reis
Contractualization consists in the development and implementation of a documented agreement whereby one party (payer) provides compensation to the other party (provider) in exchange for a set of health services to a targeted population. We describe, through a case study, the history and the process of implementation of primary health care contractualization (since 1992) in Portugal, emphasizing the consolidation and future challenges of the primary healthcare reform started in 2005. This article resorts to a case study to reflect on the results obtained in the Cluster of Health Centers of the Northern West, Regional Administration of Lisbon and Tagus Valley, between 2009 and 2015, following implementation of contractualization...
March 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28300853/the-international-dermatology-outcome-measures-ideom-initiative-a-review-and-update
#18
Scott A Elman, Joseph F Merola, April W Armstrong, Kristina Callis Duffin, John Latella, Amit Garg, Alice B Gottlieb
<p>The International Dermatology Outcome Measures (IDEOM) group, comprising patients, physicians, health economists, industry partners, payers, and regulatory agencies, was established to develop unified and validated patient-centered outcome measures in dermatology in response to increasing demand to quantify effectiveness of treatments and performance outcomes among providers. IDEOM has chosen to start with psoriasis outcome measures, and then apply its methodology to other dermatologic diseases. In this paper, we review the background and progress to date of IDEOM, including an update of IDEOM activities as of our 2016 meeting in Washington DC, USA...
February 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28299963/cost-effectiveness-analysis-on-the-use-of-fidaxomicin-and-vancomycin-to-treat-clostridium-difficile-infection-in-france
#19
Maureen Watt, Aurélien Dinh, Alban Le Monnier, Patrick Tilleul
BACKGROUND: Fidaxomicin is a macrocyclic antibiotic with proven efficacy against Clostridium difficile infection (CDI) in adults. It was licensed in France in 2012, but, due to higher acquisition costs compared with existing treatments, healthcare providers require information on its cost/benefit profile. OBJECTIVE: To compare healthcare costs and health outcomes of fidaxomicin and vancomycin, as reference treatment for CDI. METHODS: A Markov model was used to simulate the treatment pathway, over 1 year, of adult patients with CDI receiving fidaxomicin or vancomycin...
March 16, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28299620/patient-acuity-and-operative-technique-associated-with-post-colectomy-mortality-across-new-york-state-an-analysis-of-160-792-patients-over-20%C3%A2-years
#20
Ryan Lamm, Steven N Mathews, Jie Yang, Jihye Park, Mark Talamini, Aurora D Pryor, Dana Telem
This study sought to characterize in-hospital post-colectomy mortality in New York State. One hundred sixty thousand seven hundred ninety-two patients who underwent colectomy from 1995 to 2014 were analyzed from the all-payer New York Statewide Planning and Research Cooperative System (SPARCS) database. Linear trends of in-hospital mortality rate over 20 years were calculated using log-linear regression models. Chi-square tests were used to compare categorical variables between patients. Multivariable regression models were further used to calculate risk of in-hospital mortality associated with specific demographics, co-morbidities, and perioperative complications...
March 15, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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