keyword
MENU ▼
Read by QxMD icon Read
search

Payer

keyword
https://www.readbyqxmd.com/read/29158454/direct-medical-costs-of-motorcycle-crashes-in-ontario
#1
Daniel Pincus, David Wasserstein, Avery B Nathens, Yu Qing Bai, Donald A Redelmeier, Walter P Wodchis
BACKGROUND: There is no reliable estimate of costs incurred by motorcycle crashes. Our objective was to calculate the direct costs of all publicly funded medical care provided to individuals after motorcycle crashes compared with automobile crashes. METHODS: We conducted a population-based, matched cohort study of adults in Ontario who presented to hospital because of a motorcycle or automobile crash from 2007 through 2013. For each case, we identified 1 control absent a motor vehicle crash during the study period...
November 20, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/29157888/quality-measurement-affecting-surgical-practice-utility-versus-utopia
#2
REVIEW
Leonard R Henry, Urs W von Holzen, Michael J Minarich, Ashley N Hardy, Wilbur A Beachy, M Susan Franger, Roderich E Schwarz
The Triple Aim: improving healthcare quality, cost and patient experience has resulted in massive healthcare "quality" measurement. For many surgeons the origins, intent and strengths of this measurement barrage seems nebulous-though their shortcomings are noticeable. This article reviews the major organizations and programs (namely the Centers for Medicare and Medicaid Services) driving the somewhat burdensome healthcare quality climate. The success of this top-down approach is mixed, and far from convincing...
November 11, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29157786/the-seasonal-variability-of-surgical-site-infections-in-knee-and-hip-arthroplasty
#3
Chris A Anthony, Ryan A Peterson, Daniel K Sewell, Linnea A Polgreen, Jacob E Simmering, John J Callaghan, Philip M Polgreen
BACKGROUND: Surgical site infections (SSIs) after total knee (TKA) and total hip (THA) arthroplasty are devastating to patients and costly to healthcare systems. The purpose of this study is to investigate the seasonality of TKA and THA SSIs at a national level. METHODS: All data were extracted from the National Readmission Database for 2013 and 2014. Patients were included if they had undergone TKA or THA. We modeled the odds of having a primary diagnosis of SSI as a function of discharge date by month, payer status, hospital size, and various patient co-morbidities...
November 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29155612/health-reform-and-utilization-of-high-volume-hospitals-for-complex-cancer-operations
#4
Andrew P Loehrer, David C Chang, Zirui Song, George J Chang
PURPOSE: Underinsured patients are less likely to receive complex cancer operations at hospitals with high surgical volumes (high-volume hospitals, or HVHs), which contributes to disparities in care. To date, the impact of insurance coverage expansion on site of complex cancer surgery remains unknown. METHODS: Using the 2006 Massachusetts coverage expansion as a natural experiment, we searched the Hospital Cost and Utilization Project state inpatient databases for Massachusetts and control states (New York, New Jersey, and Florida) between 2001 and 2011 to evaluate changes in the utilization of HVHs for resections of bladder, esophageal, stomach, pancreatic, rectal, or lung cancer after the expansion of insurance coverage...
November 20, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29155190/use-of-routine-home-health-care-and-deviations-from-an-uncomplicated-recovery-pathway-after-radical-prostatectomy
#5
Deborah R Kaye, John Syrjamaki, Chad Ellimootil, Edward W Schervish, M Hugh Solomon, Susan Linsell, James E Montie, David C Miller, James M Dupree
OBJECTIVE: To evaluate the statistical association between routine home health use after prostatectomy, short-term surgical outcomes, and payments. METHODS: We identified all men who underwent a robotic radical prostatectomy from 04/01/2014 through 10/31/2015 in the Michigan Urological Surgery Improvement Collaborative (MUSIC) with insurance from Medicare or a large commercial payer. We calculated rates of "routine" home care use after prostatectomy by urology practice...
November 16, 2017: Urology
https://www.readbyqxmd.com/read/29154018/improving-patient-access-to-hepatitis-c-virus-treatment
#6
Milena M McLaughlin, Kevin T Marx, Colleen Terriff
OBJECTIVES: To discuss the current barriers to hepatitis C virus (HCV) treatment; to provide information and resources to assist health care providers with the prior authorization process; to provide resources for potential access to medications if a patient's third-party payer may not be an option; and to discuss the pharmacist's vital role as a patient advocate and considerations once medications are approved. SUMMARY: Access to HCV medications is often restricted by third-party payers...
November 16, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/29153740/cost-effectiveness-of-transcatheter-aortic-valve-implantation-in-patients-with-aortic-stenosis-in-japan
#7
Satoshi Kodera, Arihiro Kiyosue, Jiro Ando, Issei Komuro
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a less invasive treatment for elderly patients with aortic stenosis. However, the cost of TAVI is a major issue. This study analyzed the cost effectiveness of TAVI in Japan. METHODS: We developed an economic model to evaluate the quality-adjusted life years (QALYs) and costs of TAVI, surgical aortic valve replacement (SAVR), and medical therapy over a 10-year time horizon from the perspective of Japanese public healthcare payers...
November 16, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29152993/program-experiences-of-adults-with-autism-their-families-and-providers-findings-from-a-focus-group-study
#8
Kaitlin H Koffer Miller, Mary Mathew, Stacy L Nonnemacher, Lindsay L Shea
A growing number of individuals with autism spectrum disorder are aging into adulthood. In the United States, Medicaid is the primary payer for services for adults with autism spectrum disorder, yet there are few funded programs that provide dedicated supports to this population. This study examined the experiences of adults with autism spectrum disorder in two Medicaid-funded programs in Pennsylvania through focus groups. Researchers conducted 20 focus groups with a total of 36 adults with autism spectrum disorder, 32 family members, 32 direct care staff, and 20 program administrators...
February 1, 2017: Autism: the International Journal of Research and Practice
https://www.readbyqxmd.com/read/29151390/reflections-on-the-nice-decision-to-reject-patient-production-losses
#9
James Shearer, Sarah Byford, Steve Birch
OBJECTIVES: Patient production losses occur when individuals' capacities to work, whether paid or unpaid, are impaired by illness, treatment, disability, or death. There is controversy about whether and how to include patient production losses in economic evaluations in health care. Patient production losses have not previously been considered when evaluating medications for reimbursement under the U.K. National Health Service. Proposals for value-based assessment of health technologies in the United Kingdom created renewed interest in whether and how to include costs from a wider societal perspective, such as patient production losses, within economic evaluation of healthcare interventions...
November 20, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/29150957/randomized-controlled-clinical-two-center-study-using-xenogeneic-block-grafts-loaded-with-recombinant-human-bone-morphogenetic-protein-2-or-autogenous-bone-blocks-for-lateral-ridge-augmentation
#10
Daniel S Thoma, Michael Payer, Norbert Jakse, Stefan P Bienz, Jürg Hüsler, Patrick R Schmidlin, Ui-Won Jung, Christoph H F Hämmerle, Ronald E Jung
OBJECTIVES: to test whether or not the use of a xenogeneic block loaded with recombinant human bone morphogenetic protein-2 (rhBMP-2) results in different bone quantity and quality compared to an autogenous bone block. MATERIALS AND METHODS: 24 patients with insufficient bone volume for implant placement were randomly assigned to two treatment modalities: a xenogeneic bone block loaded with rhBMP-2 (test) or an autogenous bone block (control). The horizontal ridge width was evaluated prior to augmentation, after augmentation and at 4 months...
November 18, 2017: Journal of Clinical Periodontology
https://www.readbyqxmd.com/read/29150151/evaluating-short-and-long-term-impacts-of-a-medicaid-lock-in-program-on-opioid-and-benzodiazepine-prescriptions-dispensed-to-beneficiaries
#11
Rebecca B Naumann, Stephen W Marshall, Jennifer L Lund, Nisha C Gottfredson, Christopher L Ringwalt, Asheley C Skinner
BACKGROUND: Insurance-based "lock-in" programs (LIPs) have become a popular strategy to address controlled substance (CS) (e.g., opioid) misuse. However, little is known about their impacts. We examined changes in CS dispensing to beneficiaries in the 12-month North Carolina Medicaid LIP. METHODS: We analyzed Medicaid claims linked to Prescription Drug Monitoring Program (PDMP) records for beneficiaries enrolled in the LIP between October 2010 and September 2012 (n=2702)...
November 6, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29149882/cost-effectiveness-analysis-of-the-introduction-of-s-1-therapy-for-first-line-metastatic-breast-cancer-treatment-in-japan-results-from-the-randomized-phase-iii-select-bc-trial
#12
Takeru Shiroiwa, Takashi Fukuda, Kojiro Shimozuma, Mitsuko Mouri, Yasuhiro Hagiwara, Takuya Kawahara, Shozo Ohsumi, Yasuo Hozumi, Yoshiaki Sagara, Yasuo Ohashi, Hirofumi Mukai
BACKGROUND: This study evaluated the cost-effectiveness of replacing standard intravenous therapy (taxane) with oral S-1 therapy for first-line metastatic breast cancer treatment. METHODS: This cost-effectiveness analysis was based on data from a randomized phase III trial (SELECT BC). As cost-effectiveness was a secondary endpoint of the SELECT BC trial, some of the randomized patients participated in an EQ-5D survey (N = 391) and health economic survey (N = 146)...
November 17, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29147645/real-world-cure-rates-for-hepatitis-c-virus-treatments-that-include-simeprevir-and-or-sofosbuvir-are-comparable-to-clinical-trial-results
#13
Kian Bichoupan, Neeta Tandon, James F Crismale, Joshua Hartman, David Del Bello, Neal Patel, Sweta Chekuri, Alyson Harty, Michel Ng, Keith M Sigel, Meena B Bansal, Priya Grewal, Charissa Y Chang, Jennifer Leong, Gene Y Im, Lawrence U Liu, Joseph A Odin, Nancy Bach, Scott L Friedman, Thomas D Schiano, Ponni V Perumalswami, Douglas T Dieterich, Andrea D Branch
AIM: To assess the real-world effectiveness and cost of simeprevir (SMV), and/or sofosbuvir (SOF)-based therapy for chronic hepatitis C virus (HCV) infection. METHODS: The real-world performance of patients treated with SMV/SOF ± ribavirin (RBV), SOF/RBV, and SOF/RBV with pegylated-interferon (PEG) were analyzed in a consecutive series of 508 patients with chronic HCV infection treated at a single academic medical center. Patients with genotypes 1 through 4 were included...
November 12, 2017: World Journal of Virology
https://www.readbyqxmd.com/read/29145934/economic-evaluations-on-antimicrobial-stewardship-programme-a-systematic-review
#14
Nor Haizan Ibrahim, Khalidah Maruan, Hasryn Azzuar Mohd Khairy, Yet Hoi Hong, Ahmad Fauzi Dali, Chin Fen Neoh
PURPOSE: To systematically review studies on cost-effectiveness of implementing Antimicrobial stewardship programmes (ASP) in the hospital setting. METHODS: A systematic literature search was performed using electronic databases, such as EMBASE, PubMed/Medline, CINAHL, NHS and CEA Registry from 2000 until 2017. The quality of each included study was assessed using Joanna Briggs Institute Critical Appraisal Checklist for Economic Evaluations and Consolidated Health Economic Evaluation Reporting Standards Statement checklist...
2017: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29145584/critical-lessons-from-high-value-oncology-practices
#15
Douglas W Blayney, Melora K Simon, Beatrice Podtschaske, Scott Ramsey, Margaret Shyu, Craig Lindquist, Arnold Milstein
Importance: Cancer care is expensive. Cancer care provided by practice organizations varies in total spending incurred by patients and payers during treatment episodes and in quality of care, and this unnecessary variation contributes to the high cost. Objective: To use the variation in total spending and quality of care to assess oncology practice attributes distinguishing "high value" that may be tested and adopted by others to produce similar results. Design, Setting, and Participants: "Positive deviance" was used in this exploratory mixed-methods (quantitative and qualitative) analysis of interview results...
November 16, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/29144720/cost-effectiveness-of-gammacore-non-invasive-vagus-nerve-stimulation-for-acute-treatment-of-episodic-cluster-headache
#16
Mkaya Mwamburi, Eric J Liebler, Andrew T Tenaglia
Cluster headache is a debilitating disease characterized by excruciatingly painful attacks that affects 0.15% to 0.4% of the US population. Episodic cluster headache manifests as circadian and circannual seasonal bouts of attacks, each lasting 15 to 180 minutes, with periods of remission. In chronic cluster headache, the attacks occur throughout the year with no periods of remission. While existing treatments are effective for some patients, many patients continue to suffer. There are only 2 FDA-approved medications for episodic cluster headache in the United States, while others, such as high-flow oxygen, are used off-label...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29144717/review-of-non-invasive-vagus-nerve-stimulation-gammacore-efficacy-safety-potential-impact-on-comorbidities-and-economic-burden-for-episodic-and-chronic-cluster-headache
#17
Mkaya Mwamburi, Eric J Liebler, Andrew T Tenaglia
The FDA has cleared gammaCore (non-invasive vagus nerve stimulator [nVNS]) for the treatment of episodic cluster headache (eCH). With the exception of subcutaneous sumatriptan, all other treatments are used off label and have many limitations. The FDA approval process for devices differs from that of drugs. We performed a review of the literature to evaluate new evidence on various aspects of gammaCore treatment and impact. The ACute Treatment of Cluster Headache Studies (ACT1 and ACT2), both double-blind sham-controlled randomized trials, did not meet the primary endpoints of the trials but each demonstrated significant superiority of gammaCore among patients with eCH...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29144165/gene-therapy-evidence-value-and-affordability-in-the-us-health-care-system
#18
Grace Hampson, Adrian Towse, Steven D Pearson, William B Dreitlein, Chris Henshall
AIMS: To explore the challenges presented by gene therapies, discuss potential solutions, and present policy recommendations. METHODS: A review of the literature and series of expert interviews were conducted and discussed at a Policy Forum convened by The Institute for Clinical and Economic Review (ICER). The Policy Forum was attended by independent experts and senior representatives from 20 payer organizations and life sciences companies. RESULTS: Three categories of challenges are identified: evidence generation, assessing value and affordability...
November 16, 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/29143383/who-performs-colonoscopy-workforce-trends-over-space-and-time
#19
Jan M Eberth, Michele J Josey, Lee R Mobley, Davidson O Nicholas, Donna B Jeffe, Cassie Odahowski, Janice C Probst, Mario Schootman
PURPOSE: With the increased availability of colonoscopy to average risk persons due to insurance coverage benefit changes, we sought to identify changes in the colonoscopy workforce. We used outpatient discharge records from South Carolina between 2001 and 2010 to examine shifts over time and in urban versus rural areas in the types of medical providers who perform colonoscopy, and the practice settings in which they occur, and to explore variation in colonoscopy volume across facility and provider types...
November 16, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/29140942/minority-pediatric-patients-with-inflammatory-bowel-disease-demonstrate-an-increased-length-of-stay
#20
Edward L Barnes, Bharati Kochar, Millie D Long, Christopher F Martin, Michael D Kappelman
BACKGROUND: Genetic and other biological factors may lead to differences in disease behavior among children with inflammatory bowel disease of different races, which may be further modified by disparities in care delivery. Using the Kids' Inpatient Database, we aimed to evaluate differences in the management of pediatric patients with inflammatory bowel disease by race, focusing on length of stay (LOS). METHODS: We performed a cross-sectional analysis using 2000 to 2012 data from the Kids' Inpatient Database, a nationally representative database...
December 2017: Inflammatory Bowel Diseases
keyword
keyword
22260
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"