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https://www.readbyqxmd.com/read/28544070/the-importance-of-assessing-out-of-pocket-payments-when-the-financing-of-antiretroviral-therapy-is-transitioned-to-domestic-funding-findings-from-vietnam
#1
Benjamin Johns, Le Bao Chau, Kieu Huu Hanh, Nguyen Thuy Huong, Hoa Mai Do, Anh Thuy Duong, Long Hoang Nguyen
OBJECTIVE: To assess out-of-pocket payments and catastrophic health expenditures among antiretroviral therapy (ART) patients in Vietnam, and to model catastrophic payments under different copayment scenarios when the primary financing of ART changes to social health insurance. METHODS: Cross-sectional facility-based survey of 843 patients at 42 health facilities representative of 87% of ART patients in 2015. RESULTS: Because of donor and government funding, no payments were made for antiretroviral drugs...
May 19, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28533428/gps-urge-bma-to-explore-copayments-for-some-services
#2
Gareth Iacobucci
No abstract text is available yet for this article.
May 22, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28530519/does-a-one-size-fits-all-cost-sharing-approach-incentivize-appropriate-medication-use-a-roundtable-on-the-fairness-and-ethics-associated-with-variable-cost-sharing
#3
Jennifer S Graff, Chuck Shih, Thomas Barker, Gabriela Dieguez, Cheryl Larson, Helen Sherman, Robert W Dubois
BACKGROUND: Tiered formularies, in which patients pay copays or coinsurance out-of-pocket (OOP), are used to manage costs and encourage more efficient health care resource use. Formulary tiers are typically based on the cost of treatment rather than the medical appropriateness for the patient. Cost sharing may have unintended consequences on treatment adherence and health outcomes. Use of higher-cost, higher-tier medications can be due to a variety of factors, including unsuccessful treatment because of lack of efficacy or side effects, patient clinical or genetic characteristics, patient preferences to avoid potential side effects, or patient preferences based on the route of administration...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28527641/identifying-social-behavioral-health-needs-of-adults-with-sickle-cell-disease-in-the-emergency-department
#4
Sophia K Smith, Julia Johnston, Carlton Rutherford, Rachel Hollowell, Paula Tanabe
INTRODUCTION: Sickle cell disease (SCD) is a complex illness with many social-behavioral co-morbidities. The aim of this project was to describe unmet social-behavioral health needs for adults with SCD who presented to the emergency department for treatment of vaso-occlusive episodes (VOEs). METHODS: A descriptive study using 1:1 interviews during an ED visit for a VOE was conducted; a brief social behavioral health screening interview guide was used. A convenience sample of adults with SCD treated in the emergency department for a VOE were eligible for inclusion...
May 17, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28507088/impact-of-income-based-deductibles-on-drug-use-and-health-care-utilization-among-older-adults
#5
Michael R Law, Lucy Cheng, Heather Worthington, Muhammad Mamdani, Kimberlyn M McGrail, Fiona K I Chan, Sumit R Majumdar
BACKGROUND: Income-based deductibles are present in several provincial public drug plans in Canada and have been the subject of extensive debate. We studied the impact of such deductibles in British Columbia's Fair PharmaCare plan on drug and health care utilization among older adults. METHODS: We used a quasi-experimental regression discontinuity design to compare the impact of deductibles in BC's PharmaCare plan between older community-dwelling adults registered for the plan who were born in 1928 through 1939 (no deductible) and those born in 1940 through 1951 (deductible equivalent to 2% of household income)...
May 15, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28498648/extension-of-pharmacy-copayments-for-medications-resolution-of-interim-final-rule
#6
(no author information available yet)
The Department of Veterans Affairs (VA) notifies the public that an interim final rule freezing medication copayments for veterans in priority groups 2 through 8, published on December 7, 2016, was superseded by a final rule amending its regulations concerning copayments that published on December 12, 2016. The interim final rule received no public comments.
May 5, 2017: Federal Register
https://www.readbyqxmd.com/read/28492826/association-of-cost-sharing-with-use-of-home-health-services-among-medicare-advantage-enrollees
#7
Qijuan Li, Laura M Keohane, Kali Thomas, Yoojin Lee, Amal N Trivedi
Importance: Several policy proposals advocate introducing copayments for home health care in the Medicare program. To our knowledge, no prior studies have assessed this cost-containment strategy. Objective: To determine the association of home health copayments with use of home health services. Design, Setting, and Participants: A difference-in-differences case-control study of 18 Medicare Advantage (MA) plans that introduced copayments for home health care between 2007 and 2011 and 18 concurrent control MA plans...
May 8, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28487850/willingness-to-pay-for-social-health-insurance-in-central-vietnam
#8
Lan Hoang Nguyen, Anh Thuan Duc Hoang
BACKGROUND: A social health insurance (SHI) program was implemented in Vietnam in 1992. Participation is compulsory for some groups, such as formal-sector workers and voluntary for other groups. In 2013, 68% of the total population was covered by SHI, with most enrollees from compulsory groups. Enrollment has remained low among persons whose enrollment is voluntary. As a result, households face financial risk due to high out-of-pocket payments for health care. The goal of this study is to identify willingness to pay (WTP) for the SHI scheme among persons whose enrollment is voluntary and to examine factors that influence their choice...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28487458/the-impact-of-demand-management-strategies-on-parents-decision-making-for-out-of-hours-primary-care-findings-from-a-survey-in-the-netherlands
#9
Marie-Jeanne Giesen, Ellen Keizer, Julia van de Pol, Joris Knoben, Michel Wensing, Paul Giesen
OBJECTIVE: To explore the potential impact of demand management strategies on patient decision-making in medically non-urgent and urgent scenarios during out-of-hours for children between the ages of 0 and 4 years. DESIGN AND METHODS: We conducted a cross-sectional survey with paper-based case scenarios. A survey was sent to all 797 parents of children aged between 0 and 4 years from four Dutch general practitioner (GP) practices. Four demand management strategies (copayment, online advice, overview medical cost and GP appointment next morning) were incorporated in two medically non-urgent and two urgent case scenarios...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28482834/the-redistributive-effects-of-copayment-in-outpatient-prescriptions-evidence-from-lombardy
#10
Paolo Berta, Rosella Levaggi, Gianmaria Martini, Stefano Verzillo
BACKGROUND: In Italy, copayment has changed its nature and it can no longer be simply considered a system to curb inappropriate expenditure. It has become an important form of revenue for public health care provision, but it might also become a source of distortions in income and health benefits redistribution. METHODS: We use a rich administrative dataset gathering information on patients demand (whose records have been matched to income declared for tax purposes) to study the effects of an additional copayment (the so called "superticket" introduced by the Italian government in 2012) in Lombardy, the biggest Italian Region whose socio-economic dimension is comparable to that of many European countries (e...
May 8, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28465766/biologic-disease-modifying-antirheumatic-drugs-in-a-national-privately-insured-population-utilization-expenditures-and-price-trends
#11
Christopher B Atzinger, Jeff J Guo
BACKGROUND: Spending on biologic drugs is a significant driver of drug expenditures for payers in private health plans. Biologic disease-modifying antirheumatic drugs (DMARDs) are some of the most effective and costly treatments in a physician's arsenal. Understanding the total annual expenditure, the average cost per prescription, and the impact of cost-sharing is important for drug benefit managers. OBJECTIVE: To assess drug utilization, expenditures, out-of-pocket (OOP) cost, and price trends of biologic DMARDs in patients with rheumatoid arthritis (RA) in a large managed care organization...
February 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28462635/antibiotic-prescribing-for-upper-respiratory-infections-among-children-in-rural-china-a-cross-sectional-study-of-outpatient-prescriptions
#12
Zhitong Zhang, Yanhong Hu, Guanyang Zou, Mei Lin, Jun Zeng, Simin Deng, Rony Zachariah, John Walley, Joseph D Tucker, Xiaolin Wei
BACKGROUND: Overuse of antibiotics contributes to the development of antimicrobial resistance. OBJECTIVE: This study aims to assess the condition of antibiotic use at health facilities at county, township and village levels in rural Guangxi, China. METHODS: We conducted a cross-sectional study of outpatient antibiotic prescriptions in 2014 for children aged 2-14 years with upper respiratory infections (URI). Twenty health facilities were randomly selected, including four county hospitals, eight township hospitals and eight village clinics...
2017: Global Health Action
https://www.readbyqxmd.com/read/28448825/health-policy-in-the-concertaci%C3%A3-n-era-1990-2010-reforms-the-chilean-way
#13
María Soledad Martinez-Gutierrez, Cristóbal Cuadrado
The Chilean health system has experienced important transformations in the last decades with a neoliberal turn to privatization of the health insurance and healthcare market since the Pinochet reforms of the 1980s. During 20 years of center-left political coalition governments several reforms were attempted to regulate and reform such markets. This paper analyzes regulatory policies for the private health insurance and health care delivery market, adopted during the 1990-2010 period. A framework of variation in market types developed by Gingrich is adopted as analytical perspective...
June 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28418455/the-development-and-performance-of-after-hours-primary-care-in-the-netherlands-a-narrative-review
#14
Marleen Smits, Martijn Rutten, Ellen Keizer, Michel Wensing, Gert Westert, Paul Giesen
In many Western countries, hospital emergency departments are overcrowded, leading to the desire to strengthen primary care, particularly after hours. To achieve this goal, an increasing number of Western nations are reorganizing their after-hours primary care systems into large-scale primary care physician (PCP) cooperatives. This article provides an overview of the organization, performance, and development of PCP cooperatives in the Netherlands. The Dutch after-hours primary care system might offer opportunities for other countries facing problems with after-hours care and inappropriate emergency department visits...
May 16, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28418263/systematic-bias-in-predictions-of-new-drugs-budget-impact-analysis-of-a-sample-of-recent-us-drug-launches
#15
Michael S Broder, Jenelle M Zambrano, Jackie Lee, Richard S Marken
OBJECTIVE: Expectations about the budget impact of new drug launches may affect payer behavior and ultimately consumer costs. Therefore, we evaluated the accuracy of pre-launch US budget impact estimates for a sample of new drugs. METHODS: We searched for publicly available budget impact estimates made pre-launch for drugs approved in the US from 1(st) September 2010 to 1(st) September 2015 and compared them to actual sales. Accuracy was calculated as the ratio of pre-launch estimate to actual sales...
April 18, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28408172/opioid-dispensing-and-overlap-in-veterans-with-non-cancer-pain-eligible-for-medicare-part-d
#16
Katie J Suda, Bridget M Smith, Lauren Bailey, Walid F Gellad, Zhiping Huo, Muriel Burk, Francesca Cunningham, Kevin T Stroupe
OBJECTIVES: Pain is the most prevalent problem among veterans, who receive pain diagnoses 5 times more frequently than the general population. Opioids are commonly prescribed for pain, but they have potential for misuse and serious adverse events. The study objective was to evaluate opioid dispensing patterns and predictors for overlap in veterans who are eligible for Medicare Part D benefits. METHODS: A sample of male and all female veterans aged 66 years and older without cancer in 2005-2009 was included...
May 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28383439/evaluation-of-the-chronic-disease-management-program-for-appropriateness-of-medication-adherence-and-persistence-in-hypertension-and-type-2-diabetes-patients-in-korea
#17
Jung-Ae Kim, Eun-Sook Kim, Eui-Kyung Lee
The chronic disease management program (CDMP), a multilevel intervention including copayment reduction and physician incentives, was introduced in 2012 in Korea to improve blood pressure and glycemic control by strengthening the function of clinic as primary care institutions in managing hypertension and diabetes. This study, therefore, aimed to evaluate the effect of CDMP on the appropriateness of medication adherence and persistence in hypertension or type-2 diabetes patients.A pre-post retrospective study was conducted using claims cohort data from 2010 to 2013...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28377024/introducing-a-gp-copayment-in-australia-who-would-carry-the-cost-burden
#18
Rosemary Kate Elkins, Stefanie Schurer
Recent policy changes designed to contain unsustainable health expenditure growth imply that many more Australians may soon be charged a copayment to consult a GP. We explore the distributional consequences associated with a range of hypothetical GP copayment scenarios using nationally-representative Australian survey data. For each scenario, we estimate the cost burden that individuals and households across the income distribution would need to absorb to maintain their current GP service utilisation. Even when concessional patients are charged a third or a quarter of the non-concessional copayment rate, the average estimated cost burden in the lowest income quartile is typically between three and six times that of the highest, and the average cost burden for women is significantly higher than for men within every income quartile...
March 16, 2017: Health Policy
https://www.readbyqxmd.com/read/28370318/the-impact-of-change-from-copayment-to-coinsurance-on-medical-care-usage-and-expenditure-in-outpatient-setting-in-older-koreans
#19
Byoungjun Bae, Bo Ram Choi, Inmyung Song
Patient cost-sharing change was implemented on August 1, 2007, for outpatient care in the clinic setting in Korea from copayment to coinsurance. This study aims to estimate the effect of the policy change on medical care usage and expenditure in older Koreans. By using national health insurance claims data from the Health Insurance Reimbursement Assessment Service, this study analyzed the entire 137 million claims for a total of approximately 4.1 million patients aged 60 to 69 years who had been diagnosed and/or treated for outpatient care in clinics from January 1, 2007, to December 31, 2008...
April 3, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28365754/the-impact-of-health-insurance-on-maternal-health-care-utilization-evidence-from-ghana-indonesia-and-rwanda
#20
Wenjuan Wang, Gheda Temsah, Lindsay Mallick
While research has assessed the impact of health insurance on health care utilization, few studies have focused on the effects of health insurance on use of maternal health care. Analyzing nationally representative data from the Demographic and Health Surveys (DHS), this study estimates the impact of health insurance status on the use of maternal health services in three countries with relatively high levels of health insurance coverage-Ghana, Indonesia and Rwanda. The analysis uses propensity score matching to adjust for selection bias in health insurance uptake and to assess the effect of health insurance on four measurements of maternal health care utilization: making at least one antenatal care visit; making four or more antenatal care visits; initiating antenatal care within the first trimester and giving birth in a health facility...
April 1, 2017: Health Policy and Planning
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