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https://www.readbyqxmd.com/read/28728807/the-impact-of-team-based-primary-care-on-health-care-services-utilization-and-costs-quebec-s-family-medicine-groups
#1
Erin Strumpf, Mehdi Ammi, Mamadou Diop, Julie Fiset-Laniel, Pierre Tousignant
We investigate the effects on health care costs and utilization of team-based primary care delivery: Quebec's Family Medicine Groups (FMGs). FMGs include extended hours, patient enrolment and multidisciplinary teams, but they maintain the same remuneration scheme (fee-for-service) as outside FMGs. In contrast to previous studies, we examine the impacts of organizational changes in primary care settings in the absence of changes to provider payment and outside integrated care systems. We built a panel of administrative data of the population of elderly and chronically ill patients, characterizing all individuals as FMG enrollees or not...
July 1, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28727714/3d-morphometric-analysis-of-normal-sacroiliac-joints-a-new-classification-of-surface-shape-variation-and-the-potential-implications-in-pain-syndromes
#2
Mary Kristen Jesse, Christopher Kleck, Adam Williams, Brian Petersen, Deborah Glueck, Kimberly Lind, Vikas Patel
BACKGROUND: Normal sacroiliac (SI) joints vary widely in shape, and it is unclear whether SI joint morphology plays a role in the development of pain. To answer this question, we used 3D-CT surface rendering to image healthy study participants and used the resulting images to develop a classification system for SI joint morphology. In a case-control study comparing health research participants to patients with SI pain, we assessed whether the classification of SI joint morphology was associated with pain...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28724446/economic-burden-of-malaria-inpatients-during-national-malaria-elimination-programme-estimation-of-hospitalization-cost-and-its-inter-province-variation
#3
Shangfeng Tang, Da Feng, Ruoxi Wang, Bishwajit Ghose, Tao Hu, Lu Ji, Tailai Wu, Hang Fu, Yueying Huang, Zhanchun Feng
BACKGROUND: Apart from its direct impact on public health and well-being, malaria had placed significant socioeconomic burden on both individuals and whole health systems. This study was conducted to investigate the hospitalization cost of malaria and explore the inter-province variation during the National Malaria Elimination Programme in China. METHODS: Information on medical expenditure for malaria treatment was extracted from inpatient medical records in Henan, Hainan and Guangxi Province...
July 19, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28720087/resident-perceptions-of-the-impact-of-duty-hour-restrictions-on-resident-attending-interactions-an-exploratory-study
#4
Kristen A Gerjevic, Marcy E Rosenbaum, Manish Suneja
BACKGROUND: The institution of duty hour reforms by the Accreditation Council for Graduate Medical Education in 2003 has created a learning environment where residents are consistently looking for input from attending physicians with regards to balancing duty hour regulations and providing quality patient care. There is a paucity of literature regarding resident perceptions of attending physician actions or attitudes towards work hour restrictions. The purpose of this study was to identify attending physician behaviors that residents perceived as supportive or unsupportive of their compliance with duty hour regulations...
July 18, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28711284/financialisation-in-health-care-an-analysis-of-private-equity-fund-investments-in-turkey
#5
Ipek Eren Vural
The 2007-2008 global financial crisis revived interest in the impacts of financial markets and actors on our social and economic life. Nevertheless, research on health care financialisation remains scant. This article presents findings from research on one modality of financial investments in health care: global private equity funds' investments in private hospitals. Adopting a political economy approach, it analyses the drivers and impacts of the upsurge of global private equity investments in the Turkish private hospital sector amid the global financial crisis...
June 9, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28707707/evidence-for-capitation-reform-in-a-new-rural-cooperative-medical-scheme-in-pudong-new-area-shanghai-a-longitudinal-study
#6
Yanmei Wang, Zhiqun Shu, Jianjun Gu, Xiaoming Sun, Limei Jing, Jie Bai, Xuan Huang, Jiquan Lou, Qunfang Zhang, Ming Li
Currently, China has been experiencing rapid growth of medical costs, serious waste of medical resources, increasing disease burden for residents, and a medical insurance fund deficit. Therefore, an urgent problem that needs to be solved is to choose a rational payment for the insurance system. To empirically evaluate the long-term effects of capitation reform in a New Rural Cooperative Medical Scheme in Pudong New Area, we collected and analysed data regarding financing, fund operation, medical service cost, and medical care-seeking behaviour from 2011 to 2015, a duration that includes data before and after reform...
July 14, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28702874/towards-a-transparent-credible-evidence-based-decision-making-process-of-new-drug-listing-on-the-hong-kong-hospital-authority-drug-formulary-challenges-and-suggestions
#7
Carlos King Ho Wong, Olivia Wu, Bernard M Y Cheung
The aim of this article is to describe the process, evaluation criteria, and possible outcomes of decision-making for new drugs listed in the Hong Kong Hospital Authority Drug Formulary in comparison to the health technology assessment (HTA) policy overseas. Details of decision-making processes including the new drug listing submission, Drug Advisory Committee (DAC) meeting, and procedures prior to and following the meeting, were extracted from the official Hong Kong Hospital Authority drug formulary management website and manual...
July 12, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/28701898/aspects-of-family-caregiving-as-addressed-in-planned-discussions-between-nurses-patients-with-chronic-diseases-and-family-caregivers-a-qualitative-content-analysis
#8
E I Hagedoorn, W Paans, T Jaarsma, J C Keers, C van der Schans, M Louise Luttik
BACKGROUND: Caregiving by family members of elderly with chronic conditions is currently intensifying in the context of an aging population and health care reform in the Netherlands. It is essential that nurses have attention for supporting roles of family caregivers of older patients and address family caregiving aspects on behalf of the continuity of care. This study aims to explore what aspects of family caregiving were addressed during planned discussions between nurses, patients and family caregivers in the hospital...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28700194/california-public-hospitals-improved-quality-of-care-under-medicaid-waiver-program
#9
Nederah Pourat
California has 12 county-owned and operated hospital systems and 5 University of California hospitals designated as public hospitals. These organizations deliver the majority of inpatient care and a significant amount of outpatient care to Medicaid patients in the state. In 2010, California was the first state in the nation to implement a five-year Delivery System Reform Incentive Payment (DSRIP) program under the Section §1115 Medicaid "Bridge to Reform" waiver to improve the capacity of these hospitals to deliver high quality and more efficient care...
June 2017: Policy Brief
https://www.readbyqxmd.com/read/28693385/observations-from-california-s-delivery-system-reform-incentive-payment-program
#10
Ulfat Shaikh, Kenneth W Kizer
California's Delivery System Reform Incentive Payment (DSRIP) Program provided $3.3 billion over 5 years to support 21 public hospitals improve the quality of health care delivery and population health. The Institute for Population Health Improvement provided technical support and quality improvement mentorship to the California Department of Health Care Services in implementing the DSRIP Program. This report describes the following key observations on the implementation of the program: the need to reduce variability in data collection and management, memorialize decision-making processes, build broad quality improvement capacity, define and revisit improvement targets, anticipate evolution of clinical definitions and guidelines, provide frequent feedback to participating hospitals, engage frontline clinicians, balance short- and long-term improvement goals, acknowledge regulatory requirements and improvement efforts that may compete for resources, and build in shared learning and dissemination of interventions...
March 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28688994/comparison-of-30-day-emergency-department-bouncebacks-after-pediatric-versus-adult-urologic-surgery
#11
Courtney L Shepard, Julian Wan
INTRODUCTION: More pediatric patients seem to present to the emergency department (ED) for non-urgent matters after urologic procedures than adult patients. Under new and expanding healthcare reform, pediatric urologists may be penalized for these visits. We compare our 30-day postoperative bounceback rates to the ED and the acuity of the concerns in these populations. MATERIALS AND METHODS: All urology consults at our institution are maintained on a prospectively tracked database...
June 20, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28686558/-psychiatric-specialty-training-in-greece-comparative-analysis-of-educational-programs-2000-vs-2014
#12
M Margariti, Ch Papageorgiou
Modern educational programs for specialization in psychiatry should follow the developments in psychiatric science, both in the part of acquired knowledge about mental disorders and their treatment, as well as in the part of clinical practice in the diverse spectrum of modern psychiatric services. In Greece, the institutional framework for psychiatric training during specialization has yet to modernize and conform to European standards. For the moment, it is covered by a 1994 Presidential Decree, which briefly describes the time of specialization in psychiatry and the duration of clinical practice in the relevant educational subjects...
April 2017: Psychiatrikē, Psychiatriki
https://www.readbyqxmd.com/read/28684025/statutory-health-insurance-in-germany-a-health-system-shaped-by-135-years-of-solidarity-self-governance-and-competition
#13
REVIEW
Reinhard Busse, Miriam Blümel, Franz Knieps, Till Bärnighausen
Bismarck's Health Insurance Act of 1883 established the first social health insurance system in the world. The German statutory health insurance system was built on the defining principles of solidarity and self-governance, and these principles have remained at the core of its continuous development for 135 years. A gradual expansion of population and benefits coverage has led to what is, in 2017, universal health coverage with a generous benefits package. Self-governance was initially applied mainly to the payers (the sickness funds) but was extended in 1913 to cover relations between sickness funds and doctors, which in turn led to the right for insured individuals to freely choose their health-care providers...
July 3, 2017: Lancet
https://www.readbyqxmd.com/read/28674836/qualitative-analysis-of-direction-of-public-hospital-reforms-in-china
#14
Dahai Zhao, Zhiruo Zhang
Reforms in public hospitals are among the most important improvements in China's health care system over the last two decades. However, the reforms that should be implemented in public hospitals are unclear. Thus, a feasible direction of reforms in Chinese public hospitals is suggested and reliable policy suggestions are provided for the government to reform public hospitals. The data used in this study were mainly derived from a qualitative study. Focus group discussions and in-depth interviews were conducted in Shanghai, Guangdong, and Gansu between May and December 2014...
July 3, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28673344/the-association-of-health-insurance-with-institutional-delivery-and-access-to-skilled-birth-attendants-evidence-from-the-kenya-demographic-and-health-survey-2008-09
#15
Lawrence P O Were, Edwin Were, Richard Wamai, Joseph Hogan, Omar Galarraga
BACKGROUND: Healthcare financing through health insurance is gaining traction as developing countries strive to achieve universal health coverage and address the limited access to critical health services for specific populations including pregnant women and their children. However, these reforms are taking place despite limited evaluation of impact of health insurance on maternal health in developing countries including Kenya. In this study we evaluate the association of health insurance with access and utilization of obstetric delivery health services for pregnant women in Kenya...
July 3, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28671907/communication-training-adverse-events-and-quality-measures-2-retrospective-database-analyses-in-washington-state-hospitals
#16
Ian R Slade, Sara J Beck, C Bradley Kramer, Rebecca G Symons, Michael Cusumano, David R Flum, Thomas H Gallagher, Emily Beth Devine
OBJECTIVE: Washington State's HealthPact program was launched in 2011 as part of AHRQ's Patient Safety and Medical Liability Reform initiative. HealthPact delivered interdisciplinary communication training to health-care professionals with the goal of enhancing safety. We conducted 2 exploratory, retrospective database analyses to investigate training impact on the frequency of adverse events (AEs) and select quality measures across 3 time frames: pretraining (2009-2011), transition (2012), and posttraining (2013)...
June 30, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28669571/has-health-care-reform-legislation-reduced-the-economic-burden-of-hospital-readmissions-following-primary-total-joint-arthroplasty
#17
Steven M Kurtz, Edmund C Lau, Kevin L Ong, Edward M Adler, Frank R Kolisek, Michael T Manley
BACKGROUND: The purpose of this study was to determine whether the cost of readmissions after primary total hip and knee arthroplasty (THA and TKA) has decreased since the introduction of health care reform legislation and what patient, clinical, and hospital factors drive such costs. METHODS: The 100% Medicare inpatient dataset was used to identify 1,654,602 primary THA and TKA procedures between 2010 and 2014. The per-patient cost of readmissions was evaluated in general linear models in which the year of surgery and patient, clinical, and hospital factors were treated as covariates in separate models for THA and TKA...
June 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28669277/department-of-health-consultation-on-medical-examiners-and-death-certification-reforms-a-commentary-on-the-criteria-for-notification-to-be-laid-down-in-regulation
#18
Andrew Harris
The Department of Health has completed its consultation on the nature of the new medical examiner system and supporting regulations. This article considers whether the regulations for death notification to coroners are fit for purpose in the light of the medical literature on unnatural deaths and the experience of a coroner in a jurisdiction with a heavy workload from specialist hospital referrals. It concludes that they are to be welcomed, but that they should not rely on natural/unnatural death as a criterion for notification of deaths during the course of medical treatment, or refer to 'neglect'...
January 1, 2017: Medicine, Science, and the Law
https://www.readbyqxmd.com/read/28666445/challenges-for-gatekeeping-a-qualitative-systems-analysis-of-a-pilot-in-rural-china
#19
Jin Xu, Anne Mills
BACKGROUND: Gatekeeping involves a generalist doctor who controls patients' access to specialist care, and has been discussed as an important policy option to rebalance the primary care and hospital sectors in low- and middle-income countries, despite thin evidence. A gatekeeping pilot in a Chinese rural setting launched in 2013 has offered an opportunity to study the functioning of gatekeeping under such conditions. METHODS: In this qualitative study within a mixed-method evaluation of the gatekeeping pilot, we developed an innovative systems analysis method, combining the World Health Organisation categorisation of health system building blocks, the "Framework" approach of policy analysis and causal loop analysis...
July 1, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28666444/development-of-village-doctors-in-china-financial-compensation-and-health-system-support
#20
REVIEW
Dan Hu, Weiming Zhu, Yaqun Fu, Minmin Zhang, Yang Zhao, Kara Hanson, Melisa Martinez-Alvarez, Xiaoyun Liu
BACKGROUND: Since 1968, China has trained about 1.5 million barefoot doctors in a few years' time to provide basic health services to 0.8 billion rural population. China's Ministry of Health stopped using the term of barefoot doctor in 1985, and changed policy to develop village doctors. Since then, village doctors have kept on playing an irreplaceable role in China's rural health, even though the number of village doctors has fluctuated over the years and they face serious challenges...
July 1, 2017: International Journal for Equity in Health
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