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Ignacio Aznar-Lou, Anton Pottegård, Ana Fernández, María Teresa Peñarrubia-María, Antoni Serrano-Blanco, Ramón Sabés-Figuera, Montserrat Gil-Girbau, Marta Fajó-Pascual, Patricia Moreno-Peral, Maria Rubio-Valera
OBJECTIVE: Copayment policies aim to reduce the burden of medication expenditure but may affect adherence and generate inequities in access to healthcare. The objective was to evaluate the impact of two copayment measures on initial medication non-adherence (IMNA) in several medication groups and by income level. DESIGN: A population-based study was conducted using real-world evidence. SETTING: Primary care in Catalonia (Spain) where two separate copayment measures (fixed copayment and coinsurance) were introduced between 2011 and 2013...
March 15, 2018: BMJ Quality & Safety
Ashley H Snyder, Carol S Weisman, Guodong Liu, Douglas Leslie, Cynthia H Chuang
OBJECTIVES: The Affordable Care Act (ACA) contraceptive coverage mandate issued in August 2012 requires most private health insurance plans to cover all U.S. Food and Drug Administration-approved contraceptive methods without cost sharing. We evaluate the impact of this policy on out-of-pocket costs and use of long-acting reversible contraceptives (LARCs) and other prescription methods through 2014. METHODS: Data from Truven Health MarketScan were used to examine out-of-pocket costs and contraceptive use patterns for all reversible prescription contraceptives before and after the implementation of the contraceptive mandate for privately insured women ages 13 to 45...
March 2, 2018: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Erin Brantley, Jessica Greene, Brian Bruen, Erika Steinmetz, Leighton Ku
Introduction: Smoking rates for Medicaid beneficiaries have remained flat in recent years. Medicaid may support smokers in quitting by covering a broad array of tobacco cessation services without barriers such as copays. This study examines the impact of increasing generosity in Medicaid tobacco cessation coverage policies on smoking and cessation behaviors. Methods: We used 2010 and 2015 National Health Interview Survey data merged with information on state tobacco, Medicaid cessation, and Medicaid eligibility policies to estimate state fixed effects models of cessation medication use, counseling use, quit attempts, and current smoking...
March 7, 2018: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
Maria Chiara Corti, Francesco Avossa, Elena Schievano, Pietro Gallina, Eliana Ferroni, Natalia Alba, Matilde Dotto, Cristina Basso, Silvia Tiozzo Netti, Ugo Fedeli, Domenico Mantoan
BACKGROUND: The Italian National Health Service (NHS) provides universal coverage to all citizens, granting primary and hospital care with a copayment system for outpatient and drug services. Financing of Local Health Trusts (LHTs) is based on a capitation system adjusted only for age, gender and area of residence. We applied a risk-adjustment system (Johns Hopkins Adjusted Clinical Groups System, ACG® System) in order to explain health care costs using routinely collected administrative data in the Veneto Region (North-eastern Italy)...
March 4, 2018: European Journal of Internal Medicine
Kimberley Jacobs, Molly Posa, Whitney Spellicy, Jaclyn Otero, Maria Kelly
BACKGROUND: Pediatric exposure to influenza-infected adult caregivers (AC) is a significant risk factor for developing influenza. Poor access to vaccines contributes to low adult vaccination rates. We offered adult vaccination at regularly scheduled pediatric office visits and examined barriers to improve future vaccination rates. METHODS: Via a retrospective chart review, we identified ACs who received an influenza vaccination at one of three pediatric clinics within an academic center from August 2015 to May 2016...
March 2, 2018: Pediatric Infectious Disease Journal
Jonathan D Porath, Arjun P Meka, Chelsea Morrow, Rahul Iyengar, Eytan Shtull-Leber, Angela Fagerlin, William J Meurer
BACKGROUND: Diagnostic testing is common during emergency department visits. Little is understood about patient preferences for such testing. We hypothesized that a patient's willingness to undergo diagnostic testing is influenced by the potential benefit, risk, and personal cost. METHODS: We conducted a cross sectional survey among emergency department patients for diagnostic testing in 2 hypothetical scenarios: chest pain (CP) and mild traumatic brain injury (mTBI)...
March 5, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Yusuke Matsuyama, Toru Tsuboya, Shun-Ichiro Bessho, Jun Aida, Ken Osaka
Healthcare utilization after natural disasters remains understudied. In general, people in Japan pay 10%-30% of total amount of costs, according to their health insurance plan. A policy exempting survivors from copayments was introduced after the Great East Japan Earthquake in March 2011, which had a magnitude of 9.0 on the Richter scale and followed by devastating tsunamis. Among the disaster-affected areas, Miyagi prefecture experienced the largest number of deaths and the greatest extent of damage. However, the exemption was suspended in Miyagi prefecture from April, 2013, because of the huge governmental financial burden due to the immensity of damage from the disaster...
2018: Tohoku Journal of Experimental Medicine
Matthew F Gornet, Anne G Copay, Katrine M Sorensen, Francine W Schranck
BACKGROUND CONTEXT: Health-related quality-of-life outcomes have been collected with the Medical Outcomes Study (MOS) Short Form 36 (SF-36) survey. Boston University School of Public Health has developed algorithms for the conversion of SF-36 to VR-12 physical component summary (PCS) and mental component summary (MCS). PURPOSE: The purpose of this study is to investigate the conversion of the SF-36 to VR-12 PCS and MCS scores. STUDY DESIGN: Preoperative and postoperative SF-36 were collected from patients who underwent lumbar and/or cervical surgery from a single surgeon between August 1998 and January 2013...
February 28, 2018: Spine Journal: Official Journal of the North American Spine Society
Szu-Jui Fan, Ning Lu, Hui-Chih Chang, Chao-Hsiun Tang, Kuo-Cherh Huang
The aim of the nationwide retrospective matched cohort study was to evaluate health service utilization and medical costs between patients with schizophrenia who received long-acting injectable (LAI) risperidone and those who took risperidone orally. Data were sourced from the 2008 to 2013 Psychiatric Inpatient Medical Claim Dataset in Taiwan. The sample selection process was performed by propensity score matching. Finally, there were 691 patients in the exposed cohort and 1382 patients in the unexposed cohort...
February 27, 2018: International Clinical Psychopharmacology
Andrew B Rosenkrantz, Gelareh Sadigh, Ruth C Carlos, Ezequiel Silva, Richard Duszak
PURPOSE: The aim of this study was to characterize out-of-pocket patient costs for advanced imaging across the US private insurance marketplace. METHODS: Using the 2017 CMS Health Insurance Marketplace Benefits and Cost Sharing Public Use File, which details coverage policies for qualified health plans on federally facilitated marketplaces, measures of out-of-pocket costs for advanced imaging and other essential health benefits were analyzed for all 18,429 plans...
February 21, 2018: Journal of the American College of Radiology: JACR
Kyu-Tae Han, Seung Ju Kim, Sun Jung Kim, Ji Won Yoo, Eun-Cheol Park
BACKGROUND: The South Korean government introduced a policy in 2 phases, in September 2005 and in January 2010, for reducing copayments for patients with critical diseases, including stroke, to prevent excessive medical expenditures and to ease economic barriers. Previous studies of the effect of this policy were focused primarily on cancer. Therefore, we investigated the relationship between this policy and 1-year mortality after surgery among patients with stroke. METHODS: We used data from the Korean National Health Insurance sampling cohort (n = 2173 in 2003-2012) and performed an interrupted time series analysis...
February 19, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Sara B McMenamin, Sara W Yoeun, Helen A Halpin
INTRODUCTION: Four sections of the Affordable Care Act address the expansion of Medicaid coverage for recommended smoking-cessation treatments for: (1) pregnant women (Section 4107), (2) all enrollees through a financial incentive (1% Federal Medical Assistance Percentage increase) to offer comprehensive coverage (Section 4106), (3) all enrollees through Medicaid formulary requirements (Section 2502), and (4) Medicaid expansion enrollees (Section 2001). The purpose of this study is to document changes in Medicaid coverage for smoking-cessation treatments since the passage of the Affordable Care Act and to assess how implementation has differentially affected Medicaid coverage policies for: pregnant women, enrollees in traditional Medicaid, and Medicaid expansion enrollees...
February 9, 2018: American Journal of Preventive Medicine
V Brook White, Kendall K Walsh, Kimberly Showers Foss, Lisa Amacker-North, Stacy Lenarcic, Lindsay McNeely, Richard L White
Genetic testing is important for comprehensive cancer care. Commercial analysis of the BRCA1/2 genes has been available since 1996, and testing for hereditary breast and ovarian cancer syndrome is well established. The National Comprehensive Cancer Network (NCCN) guidelines identify individuals for whom BRCA1/2 analysis is appropriate and define management recommendations for mutation carriers. Despite recommendations, not all who meet NCCN criteria undergo genetic testing. We assess the frequency that individuals meeting NCCN criteria decline BRCA1/2 analysis, as well as factors that affect the decision-making process...
January 1, 2018: American Surgeon
Dong Wook Shin, Sohyun Chun, Young Il Kim, Seung Joon Kim, Jung Soo Kim, SeMin Chong, Young Sik Park, Sang-Yun Song, Jin Han Lee, Hee Kyung Ahn, Eun Young Kim, Sei Hoon Yang, Myoung Kyu Lee, Deog Gon Cho, Tae Won Jang, Ji Woong Son, Jeong-Seon Ryu, Moon-June Cho
Lung cancer specialists play an important role in designing and implementing lung cancer screening. We aimed to describe their 1) attitudes toward low-dose lung computed tomography (LDCT) screening, 2) current practices and experiences of LDCT screening and 3) attitudes and opinions towards national lung cancer screening program (NLCSP). We conducted a national web-based survey of pulmonologists, thoracic surgeons, medical oncologists, and radiological oncologists who are members of Korean Association for Lung Cancer (N = 183)...
2018: PloS One
Debbie Matchett, Michel Haddad, Jennifer Volland
Consumers are increasingly becoming the voice and impetus for hospital organizational change in the United States. This is in part due to their increased stake in cost sharing with hospitals, health systems, and the ambulatory setting and revisions to health plans with higher deductibles and copays. With customers wanting services better, faster, and more economical than in the past, organizations need to break the ceiling on improvement levels for exceeding expectations of patient experience. Of interest is the hospital critical care area, because of the heightened patient needs, support, and resources that are required in this acute setting...
March 2018: Dimensions of Critical Care Nursing: DCCN
Lourdes Lostao, Siegfried Geyer, Romana Albaladejo, Almudena Moreno-Lostao, Elena Ronda, Enrique Regidor
BACKGROUND: In Germany copayment for medical consultation was eliminated in 2013, and in Spain universal health coverage was partly restricted in 2012. This study shows the relationship between income and the use of health services before and after these measures in each country. METHODS: Data were taken from the 2009 and 2014 Socio-Economic Panel conducted in Germany, and from the 2009 and 2014 European Health Surveys in Spain. The health services investigated were physician consultations and hospital admissions, and the measure of socioeconomic position used was household income...
January 27, 2018: International Journal for Equity in Health
Miguel Angel Fernández García, Antonio Olry de Labry Lima, Ingrid Ferrer Lopez, Clara Bermúdez-Tamayo
Background: To analyse trends in the rates of consumption of benzodiazepine (BZD) anxiolytics, BZD hypnotics and non-BZD hypnotics and the association with contextual factors. Methods: Descriptive time series study. Units of analysis were monthly dose per inhabitant per day (DID) and dose per medical card per day(DCD) of benzodiazepine(BZD anxiolytics(BZD-A), BZD hypnotics(BZD-H) and non-BZD hypnotics(Non-BZD-H) between January 2006-December 2015. We analysed 6 primary healthcare districts(PHD) and used defined daily doses (DDDs) to calculate the monthly DIDs(overall and by ATC group)...
2018: Journal of Pharmaceutical Policy and Practice
Richard Ofori-Asenso, Avtar Jakhu, Andrea J Curtis, Ella Zomer, Manoj Gambhir, Maarit Jaana Korhonen, Mark Nelson, Andrew Tonkin, Danny Liew, Sophia Zoungas
Background: Older individuals (aged ≥65 years) are commonly prescribed statins but may experience a range of barriers in adhering to therapy. The factors associated with poor statin adherence and/or discontinuation among this population have not been comprehensively reviewed. Methods: We conducted a systematic review to identify English articles published through December 12, 2016 that reported factors associated with nonadherence and/or discontinuation of statins among older persons...
January 19, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Melissa D Berry
No abstract text is available yet for this article.
December 26, 2017: Issue Brief of the Health Policy Tracking Service
JaeJin An, Fang Niu, Adam Turpcu, Yamina Rajput, T Craig Cheetham
PURPOSE: (1) To assess long-term adherence to American Diabetes Association guideline-recommended retinal screening among population with diabetes in the United States. (2) To determine factors associated with long-term adherence to routine eye screening exams. METHODS: A retrospective cohort study was conducted in adult patients with diabetes identified from January 2009 to December 2010. Patients were followed until disenrollment, death, or study end date (December 2013)...
January 15, 2018: Ophthalmic Epidemiology
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