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https://www.readbyqxmd.com/read/28535221/is-the-affordable-care-act-imploding
#1
Larry Levitt
No abstract text is available yet for this article.
May 23, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28535103/value-frameworks-for-the-patient-provider-interaction-a-comparison-of-the-asco-value-framework-versus-nccn-evidence-blocks-in-determining-value-in-oncology
#2
Bijal Shah-Manek, Joseph S Galanto, Huong Nguyen, Robert Ignoffo
BACKGROUND: To address the rising concern about oncology drug costs, the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) recently developed unique tools to help providers and patients make informed decisions about the value of an anticancer regimen. The ASCO Value Framework (AVF) allows users to generate a net health benefit (NHB) score along with drug acquisition costs for oncology regimens that have been compared in a prospective randomized clinical trial...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28534313/class-based-chronicities-of-suffering-and-seeking-help-comparing-addiction-treatment-programs-in-uganda
#3
Julia Vorhölter
Based on ethnographic fieldwork, this article looks at changing discourses and practices in the field of mental health care in Uganda. In particular, it analyzes two psychotherapeutic institutions designed to treat drug- and alcohol-addiction, and their accessibility and affordability for people from different class backgrounds. The first center is a high-class residential facility near Kampala which offers state-of-the-art addiction therapy, but is affordable only for the rich. The second center, a church-funded organization in Northern Uganda, cares mainly for people from poor, rural families who cannot afford exp/tensive treatment...
May 22, 2017: Culture, Medicine and Psychiatry
https://www.readbyqxmd.com/read/28532557/pd-first-policy-thailand-s-response-to-the-challenge-of-meeting-the-needs-of-patients-with-end-stage-renal-disease
#4
REVIEW
Piyatida Chuengsaman, Vijj Kasemsup
Providing dialysis for end-stage kidney disease (ESKD) patients nationwide in a developing country such as Thailand is challenging. Even after roll-out of the Thai Universal Coverage Scheme in 2002, treatment for ESKD was not covered and patients struggled to afford dialysis. There was an urgent need to improve financial risk protection for patients with ESKD. Advocacy by nephrologists, health economists, and civil society seeking equity in access to dialysis, and responsiveness from policy makers, led to the methodical development of the Peritoneal Dialysis (PD) First policy and marked a turning point in ESKD care in Thailand...
May 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28532553/the-potential-impact-of-public-health-interventions-in-preventing-kidney-disease
#5
REVIEW
Rohina Joshi, Oommen John, Vivekanand Jha
The years of life lost and years lived with disability resulting from chronic kidney disease (CKD) increased globally by 90% and 49.5%, respectively, between 1990 and 2013. In addition to the traditional factors, infections, low birthweight, environmental factors, and low socioeconomic status contribute to the CKD burden in low- and middle-income countries. System-level challenges such as poor appreciation of the burden, insufficient human resources, high health care costs, poor referral pathways, unreliable health information systems, and inadequate medicine supply pose barriers to CKD control...
May 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28530876/research-continuous-surveillance-of-sleep-apnea-patients-in-a-medical-surgical-unit
#6
Dana Supe, Leah Baron, Tom Decker, Kyle Parker, Jeanne Venella, Sarah Williams, Kari Beaton, John Zaleski
This report consists of two separate studies on the use of continuous capnography monitoring conducted in an effort to improve patient safety at Virtua Health System. The desire for improved patient safety is motivating continuous monitoring and improved surveillance in clinical areas not traditionally equipped for such monitoring. We explored the use of remote monitoring of capnography, using enterprise middleware, in patients recovering from surgery in a medical-surgical unit. Continuous monitoring traditionally has been used in higher-acuity settings, such as intensive care units...
May 2017: Biomedical Instrumentation & Technology
https://www.readbyqxmd.com/read/28529529/disclosure-of-traditional-and-complementary-medicine-use-and-its-associated-factors-to-medical-doctor-in-primary-care-clinics-in-kuching-division-sarawak-malaysia
#7
Anak Kelak Johny, Whye Lian Cheah, Safii Razitasham
The decision by the patients to disclose traditional and complementary medicine (TCM) use to their doctor is an important area to be explored. This study aimed to determine the disclosure of TCM use and its associated factors to medical doctor among primary care clinic attendees in Kuching Division, Sarawak. It was a cross-sectional study using questionnaire, interviewer administered questionnaire. A total of 1130 patients were screened with 80.2% reporting using TCM. Logistic regression analysis revealed that being female (AOR = 3...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28529215/innovative-program-delivery-and-determinants-of-frequent-visitation-to-a-mobile-medical-clinic-in-an-urban-setting
#8
Britton A Gibson, Jamie P Morano, Mary R Walton, Ruthanne Marcus, Alexei Zelenev, R Douglas Bruce, Frederick L Altice
The Community Health Care Van (CHCV) is a mobile medical clinic (MMC) that has served vulnerable populations in New Haven, Connecticut since 1993. This study explores utilization patterns to understand if certain populations frequently rely upon non-traditional health care within a representative MMC. Patient characteristics, services used, and visitation frequency were described and compared for 8,415 unique clients making 29,728 visits. Negative binomial regression was used to model the impact of specific indicators on visitation...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28529213/effective-strategies-for-affordable-care-act-enrollment-in-immigrant-serving-safety-net-clinics-in-new-mexico
#9
Christina M Getrich, Jacqueline M García, Angélica Solares, Miria Kano
In the new Affordable Care Act (ACA) health care environment, safety-net institutions continue to serve as important sources of culturally appropriate care for different groups of immigrant patients. This article reports on a qualitative study examining the early ACA enrollment experiences of a range of health care providers (n = 29) in six immigrant-serving safety-net clinics in New Mexico. The six clinics configured their ACA enrollment strategies differently with regard to operations, staffing, and outreach...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28529137/medicaid-participation-among-liver-transplant-candidates-after-the-affordable-care-act-medicaid-expansion
#10
Dmitry Tumin, Eliza W Beal, Khalid Mumtaz, Don Hayes, Joseph D Tobias, Timothy M Pawlik, W Kenneth Washburn, Sylvester M Black
BACKGROUND: The 2014 Medicaid expansion in participating states increased insurance coverage among people with chronic health conditions, but its implications for access to surgical care remain unclear. We investigated how Medicaid expansion influenced the insurance status of candidates for liver transplantation (LT) and transplant center payor mix. STUDY DESIGN: Data on LT candidates age 18-64 years in 2012-2013 (pre-expansion) and 2014-2015 (post-expansion) were obtained from the United Network for Organ Sharing registry...
May 18, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28528171/accountable-care-organizations-and-the-use-of-cancer-screening
#11
Christian P Meyer, Anna Krasnova, Jesse D Sammon, Stuart R Lipsitz, Joel S Weissman, Maxine Sun, Quoc-Dien Trinh
Cancer preventive services, when used appropriately, result in improved health, better quality of life and decreased costs. For these reasons, cancer preventive services represent important priorities within the Affordable Care Act (ACA). Among the many provisions to improve access to preventive services the ACA introduced Accountable Care Organizations (ACOs) as trajectory to deliver coordinated, high-quality care. In order to evaluate this benchmark, we analyzed (in 2016/Boston) screening prevalence of breast cancer, a recommended screening test according to the United States Preventive Services Task Force (USPSTF), and prostate cancer, for which screening is no longer recommended by the USPSTF, among traditional Medicare beneficiaries and those enrolled in ACOs...
May 17, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28527534/austerity-and-the-sector-wide-approach-to-health-the-mozambique-experience
#12
James Pfeiffer, Sarah Gimbel, Baltazar Chilundo, Stephen Gloyd, Rachel Chapman, Kenneth Sherr
Fiscal austerity policies imposed by the IMF have reduced investments in social services, leaving post-independence nations like Mozambique struggling to recover from civil war and high disease burden. By 2000, a sector-wide approach (SWAp) was promoted to maximize aid effectiveness. 'Like-minded' bilateral donors, from Europe and Canada, promoted a unified approach to health sector support focusing on joint planning, common basket funding, and streamlined monitoring and evaluation to improve sector coordination, amplify country ownership, and build sustainable health systems...
May 4, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28526310/working-with-influenza-like-illness-presenteeism-among-us-health-care-personnel-during-the-2014-2015-influenza-season
#13
Sophia Chiu, Carla L Black, Xin Yue, Stacie M Greby, A Scott Laney, Angela P Campbell, Marie A de Perio
BACKGROUND: Health care personnel (HCP) working while experiencing influenza-like illness (ILI) contribute to influenza transmission in health care settings. Studies focused on certain HCP occupations or work settings have demonstrated that some HCP often continue to work while ill. METHODS: Using a national nonprobability Internet panel survey of 1,914 HCP during the 2014-2015 influenza season, we calculated the frequency of working with self-reported ILI (ie, fever and cough or sore throat) and examined reasons for working with ILI by occupation and work setting...
May 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28525441/dance-your-heart-out-a-community-s-approach-to-addressing-cardiovascular-health-by-using-a-logic-model
#14
Karin L Becker
Cardiovascular health has been identified as a prioritized community health need according to recent community health needs assessment data. While the Affordable Care Act mandates that nonprofit hospitals conduct a community health needs assessment, little guidance exists on how to address the identified needs. Logic models provide systematic structure and necessary direction in how communities can start to address their identified health needs. Completing logic models in a nonlinear fashion is encouraged to employ a strengths-based approach and verify the logic...
July 2017: Family & Community Health
https://www.readbyqxmd.com/read/28524783/quantitative-analysis-of-veterinary-drugs-in-bovine-muscle-and-milk-by-liquid-chromatography-quadrupole-time-of-flight-mass-spectrometry
#15
Shizuka Saito-Shida, Takatoshi Sakai, Satoru Nemoto, Hiroshi Akiyama
A simple and reliable multiresidue method for quantitative determination of veterinary drugs in bovine muscle and milk using liquid chromatography quadrupole time-of-flight mass spectrometry (LC-QTOF-MS) was developed. Critical MS parameters such as capillary voltage, cone voltage, collision energy, desolvation gas temperature, and extraction mass window were carefully optimised to obtain the best possible sensitivity. Analytical samples were prepared using extraction with acetonitrile and hexane in the presence of anhydrous sodium sulphate and acetic acid, followed by ODS cartridge clean-up...
May 19, 2017: Food Additives & Contaminants. Part A, Chemistry, Analysis, Control, Exposure & Risk Assessment
https://www.readbyqxmd.com/read/28523475/insurance-transitions-and-changes-in-physician-and-emergency-department-utilization-an-observational-study
#16
Michael L Barnett, Zirui Song, Sherri Rose, Asaf Bitton, Michael E Chernew, Bruce E Landon
BACKGROUND: Shopping for health insurance is encouraged as a way to find the most affordable coverage that best meets an enrollee's needs. However, the extent to which individuals switch insurance and subsequent changes in health care utilization that might arise, particularly new physician visits, are not well understood. OBJECTIVE: To examine the relationship between insurance switching and new physician and emergency department visits around the time of a switch...
May 18, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28521814/access-to-healthcare-insurance-and-healthcare-services-among-syringe-exchange-program-clients-in-massachusetts-qualitative-findings-from-health-navigators-with-the-idu-i-do-care-collaborative
#17
Thomas J Stopka, Marguerite Hutcheson, Ashley Donahue
BACKGROUND: Little is known about access to health insurance among people who inject drugs (PWID) who attend syringe exchange programs (SEPs). The goal of the current study was to assess perceptions of SEP staff, including health navigators and program managers, on access to health insurance and healthcare access among SEP clients following implementation of state and federal policies to enhance universal healthcare access in Massachusetts. METHODS: Between December 2014 and January 2015, we conducted in-depth interviews (n = 14) with SEP staff, including both program managers and health navigators, to assess knowledge, attitudes, and beliefs related to health insurance enrollment and access to enhanced referrals among SEP clients...
May 18, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/28520483/effect-of-the-affordable-care-act-on-disparities-in-breastfeeding-the-case-of-maine
#18
Summer Sherburne Hawkins, Alice Noble, Christopher F Baum
OBJECTIVES: To evaluate the Affordable Care Act (ACA) breastfeeding provision and test whether changes in coverage affected women differently according to health insurance status. METHODS: We used the All-Payer Claims Database from Maine (2012-2014) to compare health insurance claims for lactation classes and breast pumps between women with private insurance and women with Medicaid (1) before the ACA breastfeeding provision, (2) after the provision came into effect, and (3) after health insurance expansion through the Marketplace...
May 18, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28515140/three-year-impacts-of-the-affordable-care-act-improved-medical-care-and-health-among-low-income-adults
#19
Benjamin D Sommers, Bethany Maylone, Robert J Blendon, E John Orav, Arnold M Epstein
Major policy uncertainty continues to surround the Affordable Care Act (ACA) at both the state and federal levels. We assessed changes in health care use and self-reported health after three years of the ACA's coverage expansion, using survey data collected from low-income adults through the end of 2016 in three states: Kentucky, which expanded Medicaid; Arkansas, which expanded private insurance to low-income adults using the federal Marketplace; and Texas, which did not expand coverage. We used a difference-in-differences model with a control group and an instrumental variables model to provide individual-level estimates of the effects of gaining insurance...
May 17, 2017: Health Affairs
https://www.readbyqxmd.com/read/28513968/the-views-of-ethics-committee-members-and-medical-researchers-on-the-return-of-individual-research-results-and-incidental-findings-ownership-issues-and-benefit-sharing-in-biobanking-research-in-a-south-indian-city
#20
Manjulika Vaz, Mario Vaz, Srinivasan K
The return of individual research results and incidental findings from biobanking research is a much debated ethical issue globally but has extensive relevance in India where the burden of out of pocket health care expenses is high for the majority. The views of 21 ethics committee (EC) members and 22 researchers from Bengaluru, India, concerning the ethics of biobanking research were sought through in-depth interviews using an unfolding case vignette with probes. A shared view among most was that individual research results which are 'actionable' or have 'clinical significance' should be returned to the sample contributors through their treating physicians...
May 17, 2017: Developing World Bioethics
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