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https://www.readbyqxmd.com/read/29452920/patient-centered-medical-homes-did-not-improve-access-to-timely-follow-up-after-ed-visit
#1
Shih-Chuan Chou, Craig Rothenberg, Alicia Agnoli, Ilse Wiechers, Jason Lott, Jennifer Voorhees, Steven L Bernstein, Arjun K Venkatesh
BACKGROUND: Patients newly insured through coverage expansion under the Affordable Care Act (ACA) may have difficulty obtaining timely primary care follow-up appointments after emergency department (ED) discharge. We evaluated the association between availability of timely follow-up appointment with practice access improvements, including patient-centered medical home (PCMH) designations or extended-hours appointments. METHODS: We performed a secret-shopper audit of primary care practices in greater New Haven, Connecticut...
February 4, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29452563/code-red-the-essential-yet-neglected-role-of-emergency-care-in-health-law-reform
#2
Shaun Ossei-Owusu
The United States' health care system is mired in uncertainty. Public opinion on the Patient Protection and Affordable Care Act ("ACA") is undeniably mixed and politicized. The individual mandate, tax subsidies, and Medicaid expansion dominate the discussion. This Article argues that the ACA and reform discourse have given short shrift to a more static problem: the law of emergency care. The Emergency Medical Treatment and Active Labor Act of 1986 ("EMTALA") requires most hospitals to screen patients for emergency medical conditions and provide stabilizing treatment regardless of patients' insurance status or ability to pay...
November 2017: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29452560/health-care-efficiencies-consolidation-and-alternative-models-vs-health-care-and-antitrust-regulation-irreconcilable-differences
#3
Michael W King
Despite the U.S. substantially outspending peer high income nations with almost 18% of GDP dedicated to health care, on any number of statistical measurements from life expectancy to birth rates to chronic disease, 1 the U.S. achieves inferior health outcomes. In short, Americans receive a very disappointing return on investment on their health care dollars, causing economic and social strain. 2 Accordingly, the debates rage on: what is the top driver of health care spending? Among the culprits: poor communication and coordination among disparate providers, paperwork required by payors and regulations, well-intentioned physicians overprescribing treatments, drugs and devices, outright fraud and abuse, and medical malpractice litigation...
November 2017: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29452336/invited-commentary-male-reproductive-system-congenital-malformations-and-the-risk-of-autism-spectrum-disorder
#4
Laura A Schieve, Stuart K Shapira
Autism spectrum disorder (ASD) is a prevalent developmental disorder. Studies indicate that while ASD etiology has a genetic component, the risk is polygenic, with gene-environment interactions being likely. The prenatal period is a critical exposure window for nongenetic risk factors. Previous studies have found positive associations between congenital malformations (all types) and ASD; a few also found specific associations between genitourinary system malformations and ASD; and one study found an association between hypospadias and ASD...
February 14, 2018: American Journal of Epidemiology
https://www.readbyqxmd.com/read/29451078/oncologists-perceptions-of-drug-affordability-using-nccn-evidence-blocks-results-from-a-national-survey
#5
Bijal Shah-Manek, William Wong, Arliene Ravelo, Marco DiBonaventura
BACKGROUND: The increasing prevalence of cancer coupled with approvals of new drugs and technologies used in therapy have brought increased scrutiny to the cost and value of treatments in oncology. To address the rising concern about oncology drug costs, several organizations have developed value frameworks to help assess the value of oncology regimens. The objective of this study was to assess oncologists' perceptions, awareness, and knowledge of all oncology value frameworks in the United States and to understand oncologists' perceptions of affordability in the context of National Comprehensive Cancer Network (NCCN) Evidence Blocks...
February 16, 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29450525/association-of-the-affordable-care-act-dependent-coverage-provision-with-prenatal-care-use-and-birth-outcomes
#6
Jamie R Daw, Benjamin D Sommers
Importance: The effect of the Affordable Care Act (ACA) dependent coverage provision on pregnancy-related health care and health outcomes is unknown. Objective: To determine whether the dependent coverage provision was associated with changes in payment for birth, prenatal care, and birth outcomes. Design, Setting, and Participants: Retrospective cohort study, using a differences-in-differences analysis of individual-level birth certificate data comparing live births among US women aged 24 to 25 years (exposure group) and women aged 27 to 28 years (control group) before (2009) and after (2011-2013) enactment of the dependent coverage provision...
February 13, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29447397/barriers-and-facilitators-of-diabetes-services-in-nepal-a-qualitative-evaluation
#7
Nicole Ide, James P LoGerfo, Biraj Karmacharya
For the past three decades, the burden of diabetes in Nepal has been steadily increasing, with an estimated 3% annual increase since the year 2000. Although the burden is increasing, the methods of addressing the challenge have remained largely unchanged. This study sought to assess the current state of diabetes services provided by health facilities and to identify the major barriers that people with diabetes commonly face in Nepal. For this qualitative study, we selected five health facilities of varying levels and locations...
February 13, 2018: Health Policy and Planning
https://www.readbyqxmd.com/read/29446641/persistent-mania-following-cessation-of-corticosteroids
#8
M G Roxanas
OBJECTIVES: The aims of this study are to describe two patients whose manic symptoms persisted for several months after the cessation of corticosteroids, to review the literature and to suggest treatment. METHODS: The presentation of two elderly patients with persistent manic symptoms following cessation of corticosteroids several months previously afforded the author the opportunity to examine them carefully, investigate and treat them. RESULTS: The patients were investigated to rule out other causes and were treated with sodium valproate and quetiapine (in the second patient)...
February 1, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/29445721/young-adults-selection-and-use-of-dependent-coverage-under-the-affordable-care-act
#9
Weiwei Chen
The dependent coverage expansion under the Affordable Care Act (ACA) required health insurance policies that cover dependents to offer coverage for policyholder' children up to age 26. It has been well documented that the provision successfully reduced the uninsured rate among the young adults. However, less is known about whether dependent coverage crowded out other insurance types and whether young adults used dependent coverage as a fill-in-the-gap short-term option. Using data from the Survey of Income and Program Participation 2008 Panel, the paper assesses dependent coverage uptake and duration before and after the ACA provision among young adults aged 19-26 versus those aged 27-30...
2018: Frontiers in Public Health
https://www.readbyqxmd.com/read/29444674/the-gendered-experience-with-respect-to-health-seeking-behaviour-in-an-urban-slum-of-kolkata-india
#10
Moumita Das, Federica Angeli, Anja J S M Krumeich, Onno C P van Schayck
BACKGROUND: Empirical evidence shows that the relationship between health-seeking behaviour and diverse gender elements, such as gendered social status, social control, ideology, gender process, marital status and procreative status, changes across settings. Given the high relevance of social settings, this paper intends to explore how gender elements interact with health-seeking practices among men and women residing in an Indian urban slum, in consideration of the unique socio-cultural context that characterises India's slums...
February 14, 2018: International Journal for Equity in Health
https://www.readbyqxmd.com/read/29443647/system-level-health-care-integration-and-the-costs-of-cancer-care-across-the-disease-continuum
#11
Deborah R Kaye, Hye Sung Min, Edward C Norton, Zaojun Ye, Jonathan Li, James M Dupree, Chad Ellimoottil, David C Miller, Lindsey A Herrel
PURPOSE: Policy reforms in the Affordable Care Act encourage health care integration to improve quality and lower costs. We examined the association between system-level integration and longitudinal costs of cancer care. METHODS: We used linked SEER-Medicare data to identify patients age 66 to 99 years diagnosed with prostate, bladder, esophageal, pancreatic, lung, liver, kidney, colorectal, breast, or ovarian cancer from 2007 to 2012. We attributed each patient to one or more phases of care (ie, initial, continuing, and end of life) according to time from diagnosis until death or end of study interval...
February 13, 2018: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29443596/national-health-accounts-a-framework-for-understanding-health-care-financing
#12
Daniel Waldo
Over the course of the past century, the challenges facing the United States in its consumption of health care goods and services have not changed very much. What is being consumed, who is paying for it, and how much is affordable are questions that arise in every cycle of the debate-if they ever go dormant. National Health Accounts are one tool to use in the search for answers to these questions and to the challenges behind the questions. The accounts cannot (and do not pretend to) address every aspect of the debate, but they provide an important context...
February 14, 2018: Health Affairs
https://www.readbyqxmd.com/read/29440236/the-consequences-of-patient-charges-for-prescription-drugs-in-canada-a-cross-sectional-survey
#13
Michael R Law, Lucy Cheng, Ashra Kolhatkar, Laurie J Goldsmith, Steven G Morgan, Anne M Holbrook, Irfan A Dhalla
BACKGROUND: Many Canadians face substantial out-of-pocket charges for prescription drugs. Prior work suggests that this causes some patients to not take their medications as prescribed; however, we have little understanding of whether charges for prescription medicines lead patients to forego basic needs or to use more health care services. Our study aimed to quantify the consequences of patient charges for medicines in Canada. METHODS: As part of the 2016 Canadian Community Health Survey, we designed and fielded cross-sectional questions to 28 091 Canadians regarding prescription drug affordability, consequent use of health care services and trade-offs with other expenditures...
February 5, 2018: CMAJ Open
https://www.readbyqxmd.com/read/29439108/hard-promises-has-the-aca-made-health-care-more-affordable
#14
Jonathan Oberlander
No abstract text is available yet for this article.
January 2018: North Carolina Medical Journal
https://www.readbyqxmd.com/read/29438568/haemodynamic-assessment-and-support-in-sepsis-and-septic-shock-in-resource-limited-settings
#15
David Misango, Rajyabardhan Pattnaik, Tim Baker, Martin W D√ľnser, Arjen M Dondorp, Marcus J Schultz
Background: Recommendations for haemodynamic assessment and support in sepsis and septic shock in resource-limited settings are largely lacking. Methods: A task force of six international experts in critical care medicine, all of them members of the Global Intensive Care Working Group of the European Society of Intensive Care Medicine and with extensive bedside experience in resource-limited intensive care units, reviewed the literature and provided recommendations regarding haemodynamic assessment and support, keeping aspects of efficacy and effectiveness, availability and feasibility and affordability and safety in mind...
February 9, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29438192/changes-in-health-insurance-coverage-associated-with-the-affordable-care-act-among-adults-with-and-without-a-cancer-history-population-based-national-estimates
#16
Amy J Davidoff, Gery P Guy, Xin Hu, Felisa Gonzales, Xuesong Han, Zhiyuan Zheng, Helen Parsons, Donatus U Ekwueme, Ahmedin Jemal
BACKGROUND: The Affordable Care Act (ACA) improved health care coverage accessibility by expanding Medicaid eligibility, creating insurance Marketplaces, and subsidizing premiums. We examine coverage changes associated with ACA implementation, comparing adults with and without a cancer history. METHODS: We included nonelderly adults from the 2012 to 2015 National Health Interview Survey. Using information on state Medicaid policies (2013), expansion decisions (2015), family structure, income, insurance offers, and current coverage, we assigned adults in all 4 years to mutually exclusive eligibility categories including: Medicaid-eligible pre-ACA; expansion eligible for Medicaid; and Marketplace premium subsidy eligible...
March 2018: Medical Care
https://www.readbyqxmd.com/read/29436303/trends-in-insurance-status-among-patients-diagnosed-with-cancer-before-and-after-implementation-of-the-affordable-care-act
#17
Haley A Moss, Laura J Havrilesky, S Yousuf Zafar, Gita Suneja, Junzo Chino
PURPOSE: The Affordable Care Act (ACA) aimed to increase insurance coverage through key provisions such as expansion of Medicaid eligibility and enforcement of an individual mandate. The objective of this study is to examine the impact of the ACA on insurance rates among patients newly diagnosed with colon, lung, or breast cancer. METHODS: Using the SEER database, patients younger than age 65 years diagnosed with colon, lung, or breast cancer between 2008 and 2014 were identified...
February 2018: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29434014/how-can-social-media-lead-to-co-production-co-delivery-of-new-services-for-the-elderly-population-a-qualitative-study
#18
Hadi Daneshvar, Stuart Anderson, Robin Williams, Hajar Mozaffar
BACKGROUND: The future of health care services in the European Union faces the triple challenges of aging, fiscal restriction, and inclusion. Co-production offers ways to manage informal care resources to help them cater for the growing needs of elderly people. Social media (SM) is seen as a critical enabler for co-production. OBJECTIVE: The objective of this study was to investigate how SM-private Facebook groups, forums, Twitter, and blogging-acts as an enabler of co-production in health and care by facilitating its four underlying principles: equality, diversity, accessibility, and reciprocity...
February 12, 2018: JMIR Human Factors
https://www.readbyqxmd.com/read/29433953/affordable-care-act-impact-on-medicaid-coverage-of-smoking-cessation-treatments
#19
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
https://www.readbyqxmd.com/read/29431620/legitimacy-in-bioethics-challenging-the-orthodoxy
#20
William R Smith
Several prominent writers including Norman Daniels, James Sabin, Amy Gutmann, Dennis Thompson and Leonard Fleck advance a view of legitimacy according to which, roughly, policies are legitimate if and only if they result from democratic deliberation, which employs only public reasons that are publicised to stakeholders. Yet, the process described by this view contrasts with the actual processes involved in creating the Affordable Care Act (ACA) and in attempting to pass the Health Securities Act (HSA). Since the ACA seems to be legitimate, as the HSA would have been had it passed, they seem to be counterexamples to this view...
February 5, 2018: Journal of Medical Ethics
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