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https://www.readbyqxmd.com/read/27916434/competition-policy-for-health-care-provision-in-norway
#1
Kurt R Brekke, Odd Rune Straume
Competition policy has played a very limited role for health care provision in Norway. The main reason is that Norway has a National Health Service (NHS) with extensive public provision and a wide set of sector-specific regulations that limit the scope for competition. However, the last two decades, several reforms have deregulated health care provision and opened up for provider competition along some dimensions. For specialised care, the government has introduced patient choice and (partly) activity (DRG) based funding, but also corporatised public hospitals and allowed for more private provision...
November 23, 2016: Health Policy
https://www.readbyqxmd.com/read/27914125/having-a-physician-rather-than-a-place-as-a-usual-source-of-care-would-be-better-from-2012-korea-health-panel-data
#2
Kyeong Min Kim, Hyunsoo Jeon, Jae Ho Lee
A usual source of care (USC) in primary care improves health care quality and can result in improved health. However, current research about the type of USC (place only vs. physician with a place) is insufficient as an evidence to support the value of primary care. We analyzed data from the 2012 Korea Health Panel survey of adults aged 18 years or older (n = 11,873) who reported whether having a USC or not to compare the effects by type of USC on medical care use and out-of-pocket costs. Descriptive analysis showed significant differences in the distributions of sociodemographic and health status factors except frequency of outpatient visit by type of USC...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27906931/repeal-and-replace-of-affordable-care-a-complex-but-not-an-impossible-task
#3
Laxmaiah Manchikanti, Joshua A Hirsch
The Affordable Care Act (ACA), signature legislation of President Obama, was arguably the most consequential and comprehensive health care reform since Medicare was introduced as part of President Lyndon B. Johnson's great society. It has been claimed that many of the law's reforms are now so integrated in the health system that full repeal would be impractical, while others including President Elect Trump have rejected that idea and called for full repeal and replacement claiming ACA law cannot be fixed. A tsunami of increasing regulatory burden over the past 8 years, the current health care milieu has moved independent practitioners towards hospital employment in great numbers...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27906761/surgical-education-and-health-care-reform-defining-the-role-and-value-of-trainees-in-an-evolving-medical-landscape
#4
Oluwadamilola M Fayanju, Reena Aggarwal, Rebeccah B Baucom, Cristina R Ferrone, David Massaro, Kyla P Terhune
OBJECTIVE: Health care reform and surgical education are often separated functionally. However, especially in surgery, where resident trainees often spend twice as much time in residency and fellowship than in undergraduate medical education, one must consider their contributions to health care. SUMMARY BACKGROUND DATA: In this short commentary, we briefly review the status of health care in the United States as well as some of the recent and current changes in graduate medical education that pertain to surgical trainees...
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27896623/effect-of-the-new-maternity-insurance-scheme-on-medical-expenditures-for-caesarean-delivery-in-wuxi-china-a-retrospective-pre-post-reform-case-study
#5
Chun Chen, Zhihong Cheng, Ping Jiang, Mei Sun, Qi Zhang, Jun Lv
Aiming to control rising medical expenditures and help improve China's healthcare systems, this study examined whether a cap-based medical insurance scheme with shared financial interest between the insurance and healthcare providers is effective in containing hospitals' C-section medical expenditures. We used 6547 caesarean delivery case records from a teaching tertiary-level general public hospital located in Wuxi, China (2004-2013), and used the Chow test to investigate the possibility of significant variation in mean medical expenditures for caesarean deliveries pre- and post-reform...
November 28, 2016: Frontiers of Medicine
https://www.readbyqxmd.com/read/27893519/effects-of-hospital-systems-on-medical-home-transformation-in-primary-care-residency-training-practices
#6
Kyle Knierim, Tristen Hall, Douglas Fernald, Thomas J Staff, Emilie Buscaj, Jessica Cornett Allen, Mary Onysko, W Perry Dickinson
Most primary care residency training practices have close financial and administrative relationships with teaching hospitals and health systems. Many residency practices have begun integrating the core principles of the patient-centered medical home (PCMH) into clinical workflows and educational experiences. Little is known about how the relationships with hospitals and health systems affect these transformation efforts. Data from the Colorado Residency PCMH Project were analyzed. Results show that teaching hospitals and health systems have significant opportunities to influence residency practices' transformation, particularly in the areas of supporting team-based care, value-based payment reforms, and health information technology...
November 23, 2016: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27893028/out-of-pocket-spending-and-financial-burden-among-medicare-beneficiaries-with-cancer
#7
Amol K Narang, Lauren Hersch Nicholas
Importance: Medicare beneficiaries with cancer are at risk for financial hardship given increasingly expensive cancer care and significant cost sharing by beneficiaries. Objectives: To measure out-of-pocket (OOP) costs incurred by Medicare beneficiaries with cancer and identify which factors and services contribute to high OOP costs. Design, Setting, and Participants: We prospectively collected survey data from 18 166 community-dwelling Medicare beneficiaries, including 1409 individuals who were diagnosed with cancer during the study period, who participated in the January 1, 2002, to December 31, 2012, waves of the Health and Retirement Study, a nationally representative panel study of US residents older than 50 years...
November 23, 2016: JAMA Oncology
https://www.readbyqxmd.com/read/27889367/use-or-abuse-a-qualitative-study-of-emergency-physicians-views-on-use-of-observation-stays-at-three-hospitals-in-the-united-states-and-england
#8
Graham P Martin, Brad Wright, Azeemuddin Ahmed, Jay Banerjee, Suzanne Mason, Damian Roland
STUDY OBJECTIVE: Accumulating evidence has shown increasing use of observation stays for patients presenting to emergency departments and requiring diagnostic evaluation or time-limited treatment plans, but critics suggest that this expansion arises from hospitals' concerns to maximize revenue and shifts costs to patients. Perspectives of physicians making decisions to admit, observe, or discharge have been absent from the debate. We examine the views of emergency physicians in the United States and England on observation stays, and what influences their decisions to use observation services...
November 23, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27888964/stigma-as-a-structural-power-in-mental-health-care-reform-an-ethnographic-study-among-mental-health-care-professionals-in-belgium
#9
Charlotte Sercu, Piet Bracke
The growing interest among scholars and professionals in mental health stigma is closely related to different mental health care reforms. This article explores professionals' perceptions of the dehospitalization movement in the Belgian context, paying particular attention to the meaning of stigma. Combined participant observation and semi-structured interviews were used to both assess and contextualize the perceptions of 43 professionals. The findings suggest that stigma may function as a structural barrier to professionals' positive evaluation of de-hospitalization, depending on the framework they are working in...
December 2016: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/27881254/health-technology-assessment-international-reference-pricing-and-budget-control-tools-from-china-s-perspective-what-are-the-current-developments-and-future-considerations
#10
Liling Koh, Christoph Glaetzer, Shu Chuen Li, Meng Zhang
BACKGROUND: China is investing considerably in health care reforms to address issues in its health care system. An example is access to innovative drugs, which remains challenging because it is largely dependent on patient self-pay. Recognizing this, the government has invested considerably in its basic medical insurance. As health care expenditure increases, there are growing concerns on budget control. Several health policy tools have been discussed recently such as health technology assessment, international reference pricing, and hospital budget control tools, which can be viewed as addressing the affordability concerns of the government budget...
May 2016: Value in Health Regional Issues
https://www.readbyqxmd.com/read/27878712/much-ado-about-nothing-the-financial-impact-of-physician-owned-specialty-hospitals
#11
Sujoy Chakravarty
The U.S. hospital industry has recently witnessed a number of policy changes aimed at aligning hospital payments to costs and these can be traced to significant concerns regarding selection of profitable patients and procedures by physician-owned specialty hospitals. The policy responses to specialty hospitals have alternated between payment system reforms and outright moratoriums on hospital operations including one in the recently enacted Affordable Care Act. A key issue is whether physician-owned specialty hospitals pose financial strain on the larger group of general hospitals through cream-skimming of profitable patients, yet there is no study that conducts a systematic analysis relating such selection behavior by physician-owners to financial impacts within hospital markets...
June 2016: Int J Health Econ Manag
https://www.readbyqxmd.com/read/27875111/improving-rural-health-how-system-level-innovation-and-policy-reform-can-enhance-health-outcomes-across-the-united-states
#12
Suhas Gondi, Kavita Patel
The United States is hailed as providing the most advanced health care the world has to offer. With cutting-edge medical devices, groundbreaking procedures, and innovative technologies, our hospitals and medical centers define what the global community sees as modern biomedicine. Engineers and clinicians continue to push and reshape this standard with new inventions enabled by a rapidly developing knowledge base. However, the fruit of this advancement has not benefited Americans equally. Millions still face significant obstacles to access health care, and our rural communities in particular have been left behind (see also "The Challenge of Rural Health Care")...
November 2016: IEEE Pulse
https://www.readbyqxmd.com/read/27871497/possible-consequences-of-regionally-based-bundled-payments-for-diabetic-amputations-for-safety-net-hospitals-in-texas
#13
Karina Newhall, David Stone, Ryan Svoboda, Philip Goodney
OBJECTIVE: Ongoing health reform in the United States encourages quality-based reimbursement methods such as bundled payments for surgery. The effect of such changes on high-risk procedures is unknown, especially at safety net hospitals. This study quantified the burden of diabetes-related amputation and the potential financial effect of bundled payments at safety net hospitals in Texas. METHODS: We performed a cross-sectional analysis of diabetic amputation burden and charges using publically available data from Centers for Medicare and Medicaid and the Texas Department of Health from 2008 to 2012...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27867828/evaluating-the-effectiveness-of-public-hospital-reform-from-the-perspective-of-efficiency-and-quality-in-guangxi-china
#14
Shuai Jiang, Wei-Min Wu, Pengqian Fang
The evaluation of hospital reform effectiveness in health care reform is very important and beneficial since it helps the government to understand the current situation of pilot county public hospitals and smoothly start the reform in all county hospitals. This study used sample hospitals data from 2010 to 2012 to evaluate the effectiveness of public hospital reform through comparisons between 2010 and 2012 in hospital operating efficiency, clinical terminal quality, the average medical expense of patients, patient and medical staff overall satisfaction...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27863191/impact-of-health-insurance-expansion-on-the-treatment-of-colorectal-cancer
#15
Andrew P Loehrer, Zirui Song, Alex B Haynes, David C Chang, Matthew M Hutter, John T Mullen
Purpose Colorectal cancer is the third most common cancer and the third leading cause of cancer deaths in the United States. Lack of insurance coverage has been associated with more advanced disease at presentation, more emergent admissions at time of colectomy, and lower survival relative to privately insured patients. The 2006 Massachusetts health care reform serves as a unique natural experiment to assess the impact of insurance expansion on colorectal cancer care. Methods We used the Hospital Cost and Utilization Project State Inpatient Databases to identify patients with colorectal cancer with government-subsidized or self-pay (GSSP) or private insurance admitted to a hospital between 2001 and 2011 in Massachusetts (n = 17,499) and three control states (n = 144,253)...
December 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27862986/analysing-the-emergency-department-patient-journey-discovery-of-bottlenecks-to-emergency-department-patient-flow
#16
Sankalp Khanna, Justin Boyle, Norm Good, Anthony Bell, James Lind
OBJECTIVE: Despite significant workflow reform to comply with the federally mandated National Emergency Access Target (NEAT), Australian public hospitals continue to face significant barriers in achieving good ED patient flow. This study was undertaken to identify and analyse the impact of individual waypoints on an ED patient's journey and identify which waypoints act as bottlenecks to a hospital's 4 h ED disposition performance. METHODS: This study involves retrospective analysis and simulation employing 2 years of ED administrative data from a sample of two major and two large metropolitan hospitals in Queensland, Australia...
November 8, 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/27862564/between-meaning-and-duty-leaders-uses-and-misuses-of-ethical-arguments-in-generating-engagement
#17
Benjamin Olivares Bøgeskov, Lise Dam Rasmussen, Elvi Weinreich
AIM: To identify, record and determine from the perspective of an argumentation theory whether and how nurse leaders use or possibly misuse ethical arguments to motivate and engage their staff when daily practice is affected by reforms. BACKGROUND: In some cases, health reforms based on New Public Management theories have met resistance, especially when perceived as contrary to nurses' professional and personal ethical values, creating a motivational challenge for nurse leaders...
November 16, 2016: Journal of Nursing Management
https://www.readbyqxmd.com/read/27856087/hemodialysis-hospitalizations-and-readmissions-the-effects-of-payment-reform
#18
Kevin F Erickson, Wolfgang C Winkelmayer, Glenn M Chertow, Jay Bhattacharya
BACKGROUND: In 2004, the Centers for Medicare & Medicaid Services changed reimbursement for physicians and advanced practitioners caring for patients receiving hemodialysis from a capitated to a tiered fee-for-service system, encouraging increased face-to-face visits. This early version of a pay-for-performance initiative targeted a care process: more frequent provider visits in hemodialysis. Although more frequent provider visits in hemodialysis are associated with fewer hospitalizations and rehospitalizations, it is unknown whether encouraging more frequent visits through reimbursement policy also yielded these benefits...
November 14, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27853190/they-know-me-here-patients-perspectives-on-their-nursing-home-experiences
#19
Ruth M Tappen
Perspectives from patients who reside in nursing homes can inform administrators and providers about the patient experience in long-term care. In a study of preferences for care in the nursing home or hospital should an acute change in condition occur, nursing home residents offered spontaneous descriptions of their experiences in the nursing home and during their prior hospital stays. This article offers background information about nursing home reform and standards, and contemporary reports on the patient experience in nursing homes...
January 31, 2016: Online Journal of Issues in Nursing
https://www.readbyqxmd.com/read/27849349/health-systems-tackling-social-determinants-of-health-promises-pitfalls-and-opportunities-of-current-policies
#20
Krisda H Chaiyachati, David T Grande, Jaya Aysola
Although improving the quality and delivery of clinical care is a critical mission for health systems, they are increasingly being tasked with improving the overall health of patients. This new directive is reflected in the growing number of health sector efforts in population health-a concept intertwined with social forces that impact patient care and health outcomes: the social determinants of health. Three policies that have the potential to help health systems intervene on social determinants of health are: 1) the Internal Revenue Service-mandated Community Health Needs Assessment for nonprofit hospitals, 2) value-based payment reform, and 3) CMS' Accountable Health Communities program...
November 1, 2016: American Journal of Managed Care
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