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https://www.readbyqxmd.com/read/28231356/using-ethical-frameworks-in-times-of-transition-and-uncertainty
#1
Eileen M Sullivan-Marx
Health care policy is never easy and always fraught with concerns about quality, access, and cost. Currently, uncertainty abounds regarding new federal and state policies on the horizon for older adult care and quality. Empirics undergird most policy-making decisions regarding risk/benefit, cost, and knowing the best action to put in place for the best results. However, in times of great change in policy direction and political viewpoints, empirical knowledge must be combined with ethical knowledge for planning and implementation...
March 1, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/28231239/surveillance-for-health-care-access-and-health-services-use-adults-aged-18-64-years-behavioral-risk-factor-surveillance-system-united-states-2014
#2
Catherine A Okoro, Guixiang Zhao, Jared B Fox, Paul I Eke, Kurt J Greenlund, Machell Town
PROBLEM/CONDITION: As a result of the 2010 Patient Protection and Affordable Care Act, millions of U.S. adults attained health insurance coverage. However, millions of adults remain uninsured or underinsured. Compared with adults without barriers to health care, adults who lack health insurance coverage, have coverage gaps, or skip or delay care because of limited personal finances might face increased risk for poor physical and mental health and premature mortality. PERIOD COVERED: 2014...
February 24, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/28230459/estimated-cost-effectiveness-cost-benefit-and-risk-reduction-associated-with-an-endocrinologist-pharmacist-diabetes-intense-medical-management-tune-up-clinic
#3
Jan D Hirsch, Mark Bounthavong, Anisa Arjmand, David R Ha, Christine L Cadiz, Andrew Zimmerman, Heather Ourth, Anthony P Morreale, Steven V Edelman, Candis M Morello
BACKGROUND: In 2012 U.S. diabetes costs were estimated to be $245 billion, with $176 billion related to direct diabetes treatment and associated complications. Although a few studies have reported positive glycemic and economic benefits for diabetes patients treated under primary care physician (PCP)-pharmacist collaborative practice models, no studies have evaluated the cost-effectiveness of an endocrinologist-pharmacist collaborative practice model treating complex diabetes patients versus usual PCP care for similar patients...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230458/progression-to-type-2-diabetes-and-its-effect-on-health-care-costs-in-low-income-and-insured-patients-with-prediabetes-a-retrospective-study-using-medicaid-claims-data
#4
Jun Wu, Eileen Ward, Tiffaney Threatt, Z Kevin Lu
BACKGROUND: Prediabetes is a high-risk factor for progression to diabetes. Without lifestyle changes, such as weight loss and moderate physical activity, 15%-30% of people with prediabetes are projected to develop type 2 diabetes within 5 years. Progression to diabetes increases the financial burden significantly for patients and health care systems. Populations with low socioeconomic status are associated with a higher risk of diabetes. However, knowledge is limited about the effect of transition to diabetes on future costs incurred in low-income populations...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230457/comparative-effectiveness-of-rapid-acting-insulins-in-adults-with-diabetes
#5
Patrick N Racsa, Yunus Meah, Jeffrey J Ellis, Kimberly R Saverno
BACKGROUND: Although there are a variety of insulin products and new delivery modalities available, the absence of direct clinical and economic comparisons can make treatment planning and formulary decision making difficult. Direct comparisons between insulin aspart and insulin lispro from a large heterogeneous population are not available. OBJECTIVE: To assess differences in clinical outcomes, medication adherence, utilization, and total health care costs between aspart and lispro and vial versus pen modalities for administering these short-acting insulin analogs...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230454/adherence-persistence-and-health-care-costs-for-patients-receiving-dipeptidyl-peptidase-4-inhibitors
#6
Karen L Rascati, Karen Worley, Yunus Meah, Damian Everhart
BACKGROUND: The dipeptidyl peptidase-4 (DPP-4) inhibitors are among the newer, yet more established, classes of diabetes medications. OBJECTIVE: To compare adherence, persistence, and health care costs among patients taking DPP-4 inhibitors. METHODS: Claims were extracted from Humana Medicare Advantage Prescription Drug (MAPD) or commercial plans for patients aged > 18 years with ≥ 1 prescription filled for a DPP-4 inhibitor between July 1, 2011, and March 31, 2013...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230451/positive-medication-changes-resulting-from-comprehensive-and-noncomprehensive-medication-reviews-in-a-medicare-part-d-population
#7
Allison Buhl, Jill Augustine, Ann M Taylor, Rose Martin, Terri L Warholak
BACKGROUND: Health care organizations face the challenge of reducing costs while improving health outcomes. Currently, more than 39 million seniors are enrolled in a Medicare Part D prescription benefit plan, many of whom also qualify for medication therapy management (MTM) services. MTM programs provide valuable services designed to prevent or resolve medication-related problems (MRPs). Two core components of all MTM programs include comprehensive medication reviews (CMRs) with followup interventions and focused non-CMR interventions...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230446/economic-impact-of-treatment-duration-and-persistence-with-basal-insulin-in-previously-insulin-naive-users
#8
Samaneh Kalirai, Ran Duan, Dongju Liu, Beverly L Reed
BACKGROUND: Although insulin is a well-established therapy that is associated with improved clinical outcomes, adherence and persistence with insulin regimens are poor in patients with type 2 diabetes mellitus (T2DM). Diabetes-related health care costs and the impact of insulin persistence patterns on these health care costs have been previously studied; however, these aspects of insulin therapy have limited data beyond the first year of use and have not been characterized among patients previously naive to basal insulin...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230421/medicare-expenditure-correlates-of-atrophy-and-cerebrovascular-disease-in-older-adults
#9
Briana S Last, Maria-José García Rubio, Carolyn W Zhu, Stephanie Cosentino, Jennifer J Manly, Charles DeCarli, Yaakov Stern, Adam M Brickman
: Background/Study Context: Magnetic resonance imaging (MRI) markers of cerebrovascular disease and atrophy are common in older adults and are associated with cognitive and medical burden. However, the extent to which they are related to health care expenditures has not been examined. We studied whether increased Medicare expenditures were associated with brain markers of atrophy and cerebrovascular disease in older adults. METHODS: A subset of participants (n = 592; mean age = 80 years; 66% women) from the Washington Heights Inwood Columbia Aging Project (WHICAP), a community-based observational study of aging in upper Manhattan, received high-resolution MRI and had Medicare expenditure data on file...
March 2017: Experimental Aging Research
https://www.readbyqxmd.com/read/28228937/predictors-of-total-morbidity-burden-on-days-3-5-and-8-after-cardiac-surgery
#10
Julie Sanders, Jackie Cooper, Michael G Mythen, Hugh E Montgomery
BACKGROUND: Post-operative morbidity affects up to 36% of cardiac surgical patients. However, few countries reliably record morbidity outcome data, despite patients wanting to be informed of all the risks associated with surgery. The Cardiac Post-Operative Morbidity Score (C-POMS) is a new tool for describing and scoring (0-13) total morbidity burden after cardiac surgery, derived by noting the presence/absence of 13 morbidity domains on days 3, 5, 8 and 15. Identifying modifiable C-POMS risk factors may suggest targets for intervention to reduce morbidity and healthcare costs...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28228788/safety-and-efficacy-of-vertebroplasty-in-the-treatment-of-osteoporotic-vertebral-compression-fractures-a-prospective-multicenter-international-randomized-controlled-study
#11
Paolo Tranquilli Leali, Federico Solla, Gianluca Maestretti, Massimo Balsano, Carlo Doria
BACKGROUND: Vertebral compression fractures (VCFs) treated non-operatively can diminish function and quality of life, and lead to chronic health effects. The short-term safety and effectiveness of vertebroplasty for symptomatic VCFs are well-documented, but long-term follow-up is needed. PURPOSE: The aim of this paper was to analyse a multicenter international experience of 200 compression fractures treated with percutaneous vertebroplasty (VP) and compare the results of this procedure with the result of 200 patients treated conservatively...
September 2016: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/28228660/estimating-the-economic-consequences-of-an-increased-medication-adherence-due-to-a-potential-improvement-in-the-inhaler-technique-with-spiromax-%C3%A2-compared-with-turbuhaler-%C3%A2-in-patients-with-moderate-to-severe-chronic-obstructive-pulmonary-disease-in-spain
#12
Josep Darbà, Gabriela Ramírez, Juan L García-Rivero, Sagrario Mayoralas, José Francisco Pascual, Diego Vargas, Adi Bijedic
OBJECTIVE: The objective of this study was to estimate the economic impact of the introduction of DuoResp(®) Spiromax(®), budesonide/formoterol fixed-dose combination (FDC), focusing on an increase in medication adherence due to an enhancement of the inhalation technique for the treatment of COPD patients in Spain and 5 regions including Andalusia, Catalonia, Galicia, Madrid, and Valencia. METHODS: A 4-year budget impact model was developed for the time period of 2015-2018...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28228631/relationship-between-health-promotion-volunteer-experience-and-medical-costs-hoken-hodouin-activities-in-suzaka-nagano
#13
Haruhiko Imamura, Yoshitaka Murakami, Tomonori Okamura, Yuji Nishiwaki
Objectives This study demonstrated the relationship between experience as a health promotion volunteer (Hoken-hodouin) and medical costs in Japan. The study area was Suzaka City (March 2016 population: 51,637) in Nagano Prefecture, Japan, where a total of about 300 women have been engaged and trained as health promotion volunteers since 1958.Methods A cross-sectional survey was conducted in 2014 using a self-administered questionnaire, which included items on experiences as a health promotion volunteer, age at engagement, leadership status, and satisfaction with the experience...
2017: [Nihon Kōshū Eisei Zasshi] Japanese Journal of Public Health
https://www.readbyqxmd.com/read/28228464/current-uses-of-dietary-therapy-for-patients-with-far-advanced-ckd
#14
REVIEW
Norio Hanafusa, Bereket Tessema Lodebo, Joel D Kopple
For several decades, inquiry concerning dietary therapy for nondialyzed patients with CKD has focused mainly on its capability to retard progression of CKD. However, several studies published in recent years indicate that, independent of whether diet can delay progression of CKD, well designed low-protein diets may provide a number of benefits for people with advanced CKD who are close to requiring or actually in need of RRT. Dietary therapy may both maintain good nutritional status and safely delay the need for chronic dialysis in such patients, offering the possibility of improving quality of life and reducing health care costs...
February 22, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28228369/feasibility-of-implementing-a-patient-centered-postoperative-wound-monitoring-program-using-smartphone-images-a-pilot-protocol
#15
Sara Fernandes-Taylor, Rebecca L Gunter, Kyla M Bennett, Lola Awoyinka, Shahrose Rahman, Caprice C Greenberg, K Craig Kent
BACKGROUND: Surgical site infections (SSI) represent a significant public health problem as the most common nosocomial infection and a leading cause of unplanned hospital readmissions among surgical patients. Many develop following hospital discharge and often go unrecognized by patients. Telemedicine offers the opportunity to leverage the mobile technology to remotely monitor wound recovery in the transitional period between hospital discharge and routine clinic follow-up. However, many existing telemedicine platforms are episodic, replacing routine follow-up, rather than equipped for continued monitoring; they include only low-risk patient populations and those who already have access to and comfort with the necessary technology; and transmit no visual information...
February 22, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28228314/pre-hospital-acute-coronary-syndrome-care-in-kerala-india-a-qualitative-analysis
#16
Amisha Patel, P P Mohanan, Dorairaj Prabhakaran, Mark D Huffman
OBJECTIVE: Ischemic heart disease is the leading cause of death in India. Many of these deaths are due to acute coronary syndromes (ACS), which require prompt symptom recognition, care-seeking behavior, and transport to a treatment facility in the critical pre-hospital period. In India, little is known about pre-hospital management of individuals with ACS. We aim to understand the facilitators, barriers, and context of optimal pre-hospital ACS care to provide opportunities to reduce pre-hospital delays and improve acute cardiovascular care...
January 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28228230/expanding-professional-pharmacy-services-in-european-community-setting-is-it-cost-effective-a-systematic-review-for-health-policy-considerations
#17
REVIEW
Clémence Perraudin, Olivier Bugnon, Nathalie Pelletier-Fleury
OBJECTIVE: To synthesize cost-effectiveness analyses on professional pharmacy services (PPS) performed in Europe in order to contribute to current debates on their funding and reimbursement. METHODS: Systematic review in PubMed, Embase and the Centre for Reviews and Dissemination databases to identify full economic evaluation studies of PPS in community setting from 2004. FINDINGS: Twenty-one studies were included, conducted in the United-Kingdom (n=13), the Netherlands (n=3), Spain (n=2), Belgium (n=1), France (n=1) and Denmark (n=1)...
December 2016: Health Policy
https://www.readbyqxmd.com/read/28228140/should-co-payments-for-financially-deprived-patients-be-lowered-primary-care-physicians-perspectives-using-a-mixed-methods-approach-in-a-survey-study-in-tokyo
#18
Machiko Inoue, Yuko Kachi
BACKGROUND: Japan's stagnant economy has produced increasing income disparities, and the effect of poverty on health and health-care utilization is a significant issue. Co-payments could be a trade-off for patients when seeking medical care and limit health-care utilization. We sought primary care physicians' experiences in dealing with financially deprived patients and their perspectives about reducing co-payments by low-income patients. METHODS: We used a convergent mixed-methods approach in a mail survey; it was distributed to 1989 primary care physicians practicing in areas with the highest proportions of socially disadvantaged individuals in Tokyo...
February 22, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28228128/leveraging-the-private-sector-for-child-health-a-qualitative-examination-of-caregiver-and-provider-perspectives-on-private-sector-care-for-childhood-pneumonia-in-uttar-pradesh-india
#19
Aurélie Brunie, Rachel Lenzi, Anamika Lahiri, Rasa Izadnegahdar
BACKGROUND: The private health sector is a primary source of curative care for childhood illnesses in many low- and middle-income countries. Therefore ensuring appropriate private sector care is an important step towards improving outcomes from illnesses like pneumonia, which is the leading infectious cause of childhood mortality worldwide. This study aimed to provide evidence on private sector care for childhood pneumonia in Uttar Pradesh, India, by simultaneously exploring providers' knowledge and practices and caregivers' experiences...
February 22, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28225697/who-should-ration
#20
Philip M Rosoff
A principal component of physician decision making is judging what interventions are clinically appropriate. Due to the inexorable and steady increase of health care costs in the US, physicians are constantly being urged to exercise judicious financial stewardship with due regard for the financial implications of what they prescribe. When applied on a case-by-case basis, this otherwise reasonable approach can lead to either inadvertent or overt and arbitrary restriction of interventions for some patients rather than others on the basis of clinically irrelevant characteristics such as ethnicity, gender, age, or skin color...
February 1, 2017: AMA Journal of Ethics
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