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https://www.readbyqxmd.com/read/28418455/the-development-and-performance-of-after-hours-primary-care-in-the-netherlands-a-narrative-review
#1
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...
April 18, 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
#2
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
#3
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...
April 10, 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
#4
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
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/28345498/the-effects-of-payments-for-pharmaceuticals-a-systematic-literature-review
#8
Katarzyna Kolasa, Marta Kowalczyk
The existence of different forms of out-of-pocket payments (OOPs) for pharmaceuticals across the globe provokes the question whether they can achieve more negative or positive consequences. A systematic literature review was conducted to assess the association between drug cost sharing and health care services utilization, health care costs as well as health outcomes. Studies published in The Cochrane Library, PubMed, Embase were searched with such keywords as: drug, pharmaceutical, cost sharing, out of pocket, co-payments paired with the following: impact, health outcomes, health care costs and utilization...
March 27, 2017: Health Economics, Policy, and Law
https://www.readbyqxmd.com/read/28345445/the-role-of-patient-financial-assistance-programs-in-reducing-costs-for-cancer-patients
#9
Leah L Zullig, Steven Wolf, Lisa Vlastelica, Veena Shankaran, S Yousuf Zafar
BACKGROUND: Limited transparency exists regarding eligibility and benefits for patient financial assistance programs (PAPs). OBJECTIVE: To describe oral anticancer medication costs, insurance coverage, and the degree of financial assistance provided by PAPs. METHODS: This was a retrospective study of prescription anticancer medication costs and PAP coverage. The study used data from an academic cancer center's specialty pharmacy. Medication, cost, and coverage data were collected from the specialty pharmacy database for prescriptions filled from January 2013 to November 2015...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28314467/association-between-copayment-medication-adherence-and-outcomes-in-the-management-of-patients-with-diabetes-and-heart-failure
#10
REVIEW
George Gourzoulidis, Georgia Kourlaba, Panagiotis Stafylas, Gregory Giamouzis, John Parissis, Nikolaos Maniadakis
OBJECTIVE: To determine the association between copayment, medication adherence and outcomes in patients with Heart failure (HF) and Diabetes Mellitus (DM). METHODS: PubMed, Scopus and Cochrane databases were searched using combinations of four sets of key words for: drug cost sharing; resource use, health and economic outcomes; medication adherence; and chronic disease. RESULTS: Thirty eight studies were included in the review. Concerning the direct effect of copayment changes on outcomes, the scarcity and diversity of data, does not allow us to reach a clear conclusion, although there is some evidence indicating that higher copayments may result in poorer health and economic outcomes...
April 2017: Health Policy
https://www.readbyqxmd.com/read/28304237/cervical-disc-arthroplasty-with-the-prestige-lp-disc-versus-anterior-cervical-discectomy-and-fusion-at-2-levels-results-of-a-prospective-multicenter-randomized-controlled-clinical-trial-at-24-months
#11
Matthew F Gornet, Todd H Lanman, J Kenneth Burkus, Scott D Hodges, Jeffrey R McConnell, Randall F Dryer, Anne G Copay, Hui Nian, Frank E Harrell
OBJECTIVE The authors compared the efficacy and safety of arthroplasty using the Prestige LP cervical disc with those of anterior cervical discectomy and fusion (ACDF) for the treatment of degenerative disc disease (DDD) at 2 adjacent levels. METHODS Patients from 30 investigational sites were randomized to 1 of 2 groups: investigational patients (209) underwent arthroplasty using a Prestige LP artificial disc, and control patients (188) underwent ACDF with a cortical ring allograft and anterior cervical plate...
March 17, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28296574/high-initiation-of-adjuvant-hormonal-therapy-among-uninsured-stages-i-iii-breast-cancer-patients-treated-in-a-safety-net-healthcare-system
#12
Caitlin C Murphy, Jasmin A Tiro, Gary W Jean, Bijal A Balasubramian, Carlos A Alvarez
OBJECTIVE: Despite benefits of adjuvant hormonal therapy (AHT), many eligible breast cancer patients do not complete therapy as recommended. Patterns of AHT use have not been well studied among uninsured breast cancer patients who fall into coverage gaps or are ineligible for public insurance programs. METHODS: We identified 291 patients newly diagnosed with stages I-III hormone receptor-positive breast cancer from January 2008 to December 2012. All patients were treated at a safety-net healthcare system and enrolled in an income-based medical assistance program that fills AHT prescriptions at low cost...
March 15, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28282021/utilization-of-clinical-preventive-services-for-cancer-and-heart-disease-among-insured-adults-united-states-2015
#13
Anjel Vahratian, Stephen J Blumberg
Data from the National Health Interview Survey •Two-thirds of insured adults aged 50-75 were screened for colorectal cancer within the recommended intervals. •Insured women aged 30-39 (90.5%) were more likely than their older peers to be screened for cervical cancer within the recommended intervals. •Seventy-three percent of insured women aged 50-74 had a mammogram in the past 2 years. •The percentage of insured adults who had a cardiovascular risk screening (blood pressure, blood sugar) within the recommended intervals significantly increased with advancing age for both men and women...
March 2017: NCHS Data Brief
https://www.readbyqxmd.com/read/28272310/the-cost-of-cost-sharing-the-impact-of-medicaid-benefit-design-on-influenza-vaccination-uptake
#14
Charles Stoecker, Alexandra M Stewart, Megan C Lindley
Prior research indicates that cost-sharing and lack of insurance coverage reduce preventive services use among low-income persons. State Medicaid policy may affect the uptake of recommended adult vaccinations. We examined the impact of three aspects of Medicaid benefit design (coverage for vaccines, prohibiting cost-sharing, and copayment amounts) on vaccine uptake in the fee-for-service Medicaid population 19-64 years old. We combined previously published reports to obtain state Medicaid policy information from 2003 and 2012...
March 6, 2017: Vaccines
https://www.readbyqxmd.com/read/28264955/reference-pricing-changes-the-choice-architecture-of-health-care-for-consumers
#15
James C Robinson, Timothy T Brown, Christopher Whaley
Reference pricing in health insurance creates incentives for patients to select for nonemergency services providers that charge relatively low prices and still offer high quality of care. It changes the "choice architecture" by offering standard coverage if the patient chooses cost-effective providers but requires considerable consumer cost sharing if more expensive alternatives are selected. The short-term impact of reference pricing has been to shift patient volumes from hospital-based to freestanding surgical, diagnostic, imaging, and laboratory facilities...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28264938/delivery-innovations
#16
(no author information available yet)
The need for innovations in care delivery is recognized by providers, payers, and patients alike. Hospitals, physicians, and other clinicians are experimenting with new models of care designed to better meet patients' needs, reduce administrative burdens, and lower costs. The Affordable Care Act placed the Medicare and Medicaid programs at the center of a national effort to experiment with delivery and payment models designed to improve care and contain costs. These public-sector efforts have often aligned with private initiatives, such as the use of reference pricing-in which an insurer will only pay for a service at the price available from the lowest-cost provider...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28248070/medicaid-copayments
#17
Melissa D Berry
No abstract text is available yet for this article.
December 27, 2016: Issue Brief of the Health Policy Tracking Service
https://www.readbyqxmd.com/read/28230447/effect-of-medicaid-policy-changes-on-medication-adherence-differences-by-baseline-adherence
#18
Krutika Amin, Joel F Farley, Matthew L Maciejewski, Marisa E Domino
BACKGROUND: In 2001, the North Carolina (NC) Medicaid program reduced the number of days prescription supply that enrollees could fill from 100 days to 34 days and increased copayments for brand-name medications. Previous work has shown that a change in these policies led to a decrease in medication adherence from 2.9 to 8.0 percentage points in specific populations with chronic conditions. Studies have also shown that days supply limits and copayment increases have heterogeneous effects based on enrollees' baseline characteristics, including baseline adherence...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28203554/the-13-year-experience-of-performing-pancreaticoduodenectomy-in-a-mid-volume-municipal-hospital
#19
Hongbeom Kim, Jung Kee Chung, Young Joon Ahn, Hae Won Lee, In Mok Jung
PURPOSE: Pancreaticoduodenectomy (PD) is a complex surgery associated with high morbidity, mortality, and cost. Municipal hospitals have their important role in the public health and welfare system. The purpose of this study was to identify the feasibility as well as the cost-effectiveness of performing PD in a mid-volume municipal hospital based on 13 years of experience with PD. METHODS: From March 2003 to November 2015, 183 patients underwent PD at Seoul Metropolitan Government - Seoul National University Boramae Medical Center...
February 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28192676/crossing-boundaries
#20
Leighton Ku, Erika Steinmetz, Tyler Bysshe, Brian K Bruen
OBJECTIVES: Previous state interagency collaborations have led to successful tobacco cessation initiatives. The objective of this study was to assess the roles and interaction of state Medicaid and public health agency efforts to support tobacco cessation for low-income Medicaid beneficiaries. METHODS: We interviewed Medicaid and state public health agency officials in 8 states in September and October 2015 about collaborations in policy development and implementation for Medicaid tobacco cessation, including Medicaid coverage policies, quitlines, and monitoring...
March 2017: Public Health Reports
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