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https://www.readbyqxmd.com/read/28904909/office-based-andrology-and-male-infertility-procedures-a-cost-effective-alternative
#1
Manaf Alom, Matthew Ziegelmann, Josh Savage, Tanner Miest, Tobias S Köhler, Landon Trost
BACKGROUND: From 2014-2016, our clinical practice progressively incorporated several male infertility and andrology procedures performed under local anesthesia, including circumcision, hydrocelectomy, malleable penile prostheses, orchiectomy, penile plication, spermatocelectomy, testicular prostheses, varicocelectomy, vasectomy reversal (VR), and testicular and microepididymal sperm aspiration (TESE/MESA). Given the observed outcomes and potential financial and logistical benefits of this approach for surgeons and patients, we sought to describe our initial experience...
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28900839/behavioral-health-integration-into-primary-care-a-microsimulation-of-financial-implications-for-practices
#2
Sanjay Basu, Bruce E Landon, John W Williams, Asaf Bitton, Zirui Song, Russell S Phillips
BACKGROUND: New payments from Medicare encourage behavioral health services to be integrated into primary care practice activities. OBJECTIVE: To evaluate the financial impact for primary care practices of integrating behavioral health services. DESIGN: Microsimulation model. PARTICIPANTS: We simulated patients and providers at federally qualified health centers (FQHCs), non-FQHCs in urban and rural high-poverty areas, and practices outside of high-poverty areas surveyed by the National Association of Community Health Centers, National Ambulatory Medical Care Survey, National Health and Nutrition Examination Survey, and National Health Interview Survey...
September 12, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28894408/deep-brain-stimulation-dbs-for-movement-disorders-an-experience-in-hospital-universiti-sains-malaysia-husm-involving-12-patients
#3
Lim Liang Hooi, Diana Noma Fitzrol, Senthil Kumar Rajapathy, Tan Yew Chin, Sanihah Abdul Halim, Regunath Kandasamy, Wan Mohd Nazaruddin Wan Hassan, Badrisyah Idris, Abdul Rahman Izaini Ghani, Zamzuri Idris, John Tharakan, Sarun Nunta-Aree, Jafri Malin Abdullah
Deep brain stimulation (DBS) was first introduced in 1987 to the developed world. As a developing country Malaysia begun its movement disorder program by doing ablation therapy using the Radionics system. Hospital Universiti Sains Malaysia a rural based teaching hospital had to take into consideration both health economics and outcomes in the area that it was providing neurosurgical care for when it initiated its Deep Brain Stimulation program. Most of the patients were from the low to medium social economic groups and could not afford payment for a DBS implant...
March 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/28891235/financial-arrangements-for-health-systems-in-low-income-countries-an-overview-of-systematic-reviews
#4
REVIEW
Charles S Wiysonge, Elizabeth Paulsen, Simon Lewin, Agustín Ciapponi, Cristian A Herrera, Newton Opiyo, Tomas Pantoja, Gabriel Rada, Andrew D Oxman
BACKGROUND: One target of the Sustainable Development Goals is to achieve "universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all". A fundamental concern of governments in striving for this goal is how to finance such a health system. This concern is very relevant for low-income countries. OBJECTIVES: To provide an overview of the evidence from up-to-date systematic reviews about the effects of financial arrangements for health systems in low-income countries...
September 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28887347/pharmacists-supporting-population-health-in-patient-centered-medical-homes
#5
Antoinette B Coe, Hae Mi Choe
PURPOSE: The integral role of pharmacists in supporting population health initiatives in the patient-centered medical home (PCMH) model of care is described. SUMMARY: Population health initiatives focus on the health outcomes of a group of patients; in the PCMH model, such groups of patients, known as panels, may be defined as patients assigned to a care team or provider. The basic characteristics of the PCMH model include physician-led, team-based practice; coordinated and integrated care within the PCMH and in the patient's community; provision of safe, evidence-based, high-quality care; incorporation of health information technology and continuous quality improvement strategies into panel identification, documentation, and care processes; improved access to care (e...
September 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28885654/what-is-the-best-setting-for-receiving-dialysis-vascular-access-repair-and-maintenance-services
#6
Audrey M El-Gamil, Al Dobson, Nikolay Manolov, Joan E DaVanzo, Gerald A Beathard, Terry Foust Litchfield, Brook Cowin
INTRODUCTION: Advances in dialysis vascular access (DVA) management have changed where beneficiaries receive this care. The effectiveness, safety, quality, and economy of different care settings have been questioned. This study compares patient outcomes of receiving DVA services in the freestanding office-based center (FOC) to those of the hospital outpatient department (HOPD). It also examines whether outcomes differ for a centrally managed system of FOCs (CMFOC) compared to all other FOCs (AOFOC)...
September 2, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28885293/surgeon-reimbursement-relative-to-hospital-payments-for-spinal-fusion-trends-from-10-year-medicare-analysis
#7
Nikhil Jain, Frank M Phillips, Adam L Shimer, Safdar N Khan
STUDY DESIGN: Retrospective, economic analysis OBJECTIVE.: To analyze the trend in hospital charge and payment adjusted to corresponding surgeon charge and payment for cervical and lumbar fusions in a Medicare sample population from 2005-2014. SUMMARY OF BACKGROUND DATA: Previous studies have reported trends and variation in hospital charges and payments for spinal fusion, but none have incorporated surgeon data in analysis. Knowledge of the fiscal relationship between hospitals and surgeons over time will be important for stakeholders as we move toward bundled payments...
September 6, 2017: Spine
https://www.readbyqxmd.com/read/28885240/advancing-value-based-population-health-management-through-payer-provider-partnerships-improving-outcomes-for-children-with-complex-conditions
#8
Pamela Peele, Donna Keyser, John Lovelace, Deborah Moss
Population health management (PHM) approaches to improve cost and quality remain limited. To address this gap, stakeholders within an integrated delivery and financing system in Western Pennsylvania designed, implemented, and tested a value-based care model for children with medically complex conditions that could be scaled across the broader pediatric population. The model included: (1) a multilevel, interdisciplinary infrastructure; (2) actionable analytics reports to guide continuous quality improvement; (3) alternative provider payments; (4) consumer-directed spending accounts; and (5) shared savings with practices...
September 1, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28872536/improved-safety-and-cost-savings-from-reductions-in-cast-saw-burns-after-simulation-based-education-for-orthopaedic-surgery-residents
#9
Donald S Bae, Hayley Lynch, Katherine Jamieson, C Winnie Yu-Moe, Christopher Roussin
BACKGROUND: The purpose of this investigation was to characterize the clinical efficacy and cost-effectiveness of simulation training aimed at reducing cast-saw injuries. METHODS: Third-year orthopaedic residents underwent simulation-based instruction on distal radial fracture reduction, casting, and cast removal using an oscillating saw. The analysis compared incidences of cast-saw injuries and associated costs before and after the implementation of the simulation curriculum...
September 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28872535/the-opportunity-awaits-to-lead-orthopaedic-telehealth-innovation-aoa-critical-issues
#10
Montri D Wongworawat, Gary Capistrant, John M Stephenson
Telehealth is a way to provide health-care services to a patient from a provider who is at another location. The most common methods include a live interactive visit with the patient, interpretation of imaging, and monitoring of patient progress. Principally, telehealth is a way of providing a service rather than a type of service. It is about patient care, not data care.Examples of orthopaedic applications include conducting patient examinations, interpreting imaging studies, and providing postoperative care...
September 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28865646/addressing-adverse-childhood-experiences-through-the-affordable-care-act-promising-advances-and-missed-opportunities
#11
Aditi Srivastav, Gerry Fairbrother, Lisa A Simpson
Adverse childhood experiences (ACEs) occur when children are exposed to trauma and/or toxic stress and may have a lifelong effect. Studies have shown that ACEs are linked with poor adult health outcomes and could eventually raise already high health care costs. National policy interest in ACEs has recently increased, as many key players are engaged in community-, state-, and hospital-based efforts to reduce factors that contribute to childhood trauma and/or toxic stress in children. The Affordable Care Act (ACA) has provided a promising foundation for advancing the prevention, diagnosis, and management of ACEs and their consequences...
September 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28845476/opioid-prescription-drug-use-and-expenditures-in-us-outpatient-physician-offices-evidence-from-two-nationally-representative-surveys
#12
Zaina P Qureshi, M Rifat Haider, Rosa Rodriguez-Monguio, Nikki R Wooten, Ruslan V Nikitin, Sarah Ball, Kelly Barth, Ronit Elk, Ronnie Horner, Charles Bennett
BACKGROUND: Opioids are widely prescribed for their analgesic properties. Chronic opioid use is a persistent problem in the US. Nevertheless, little is known about its prescribing and utilization patterns and overall expenditures. OBJECTIVE: This study examined secular trends in opioid prescription drug utilization and expenditures, along with factors associated with opioid prescription drug use in US physician offices. METHODS: National Ambulatory Medical Care Survey (NAMCS) and Medical Expenditure Panel Survey (MEPS) data (2006-2010), both nationally representative surveys, were used to assess the trend, predictors of opioid prescription among US adults (more than 18 years) and the opioid-associated expenditures as a whole and borne by the patients in outpatient settings...
2017: Cancer Ther Oncol Int J
https://www.readbyqxmd.com/read/28839525/annuity-payments-can-increase-patient-access-to-innovative-cell-and-gene-therapies-under-england-s-net-budget-impact-test
#13
Jesper Jørgensen, Panos Kefalas
Background: Cell and gene therapies have the potential to provide therapeutic breakthroughs, but the high costs of researching, developing, manufacturing and delivering them translate into prices that may challenge healthcare budgets. Various measures exist that aim to address the affordability challenge, including reducing price, limiting patient numbers and/or linking remuneration to product performance. Objective: To explore how the net budget impact test recently introduced in England can affect patient access to high-value, one-off cell and gene therapies, and how managed entry agreements can improve access...
2017: Journal of Market Access & Health Policy
https://www.readbyqxmd.com/read/28836120/return-to-work-in-employees-on-sick-leave-due-to-neck-or-shoulder-pain-a-randomized-clinical-trial-comparing-multidisciplinary-and-brief-intervention-with-one-year-register-based-follow-up
#14
Line Thorndal Moll, Ole Kudsk Jensen, Berit Schiøttz-Christensen, Christina Malmose Stapelfeldt, David Høyrup Christiansen, Claus Vinther Nielsen, Merete Labriola
Purpose The aim of this study was to evaluate the effect of a multidisciplinary intervention (MDI) compared to a brief intervention (BI) with respect to return to work (RTW), pain and disability in workers on sick leave because of neck or shoulder pain. Methods 168 study participants with sickness absence for 4-16 weeks due to neck or shoulder pain were enrolled in a hospital-based clinical study and randomized to either MDI or BI. The primary outcome was RTW obtained by a national registry on public transfer payments...
August 23, 2017: Journal of Occupational Rehabilitation
https://www.readbyqxmd.com/read/28818283/understanding-readmissions-following-operations-of-the-thyroid-and-parathyroid-glands
#15
Karole Collier, John Sataloff, Chris Wirtalla, Lindsay Kuo, Giorgos C Karakousis, Rachel R Kelz
BACKGROUND: In anticipation of bundled-payment models for thyroid and parathyroid disease, a better understanding of resource utilization following surgery is required. We sought to characterize the use of hospital services following such operations using an analysis of readmissions. METHODS: Patients age 18+years who underwent a thyroid or parathyroid operation in CA or NY (2008-2011) were classified by procedure type. Primary outcome was readmission within 90 days...
September 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28817861/population-health-management-and-cancer-screening
#16
Bradley Kamstra, Mark K Huntington
Population health management (PHM) is a new health care model being implemented. It has been defined as "the health outcomes of a group of individuals, including the distribution of such outcomes within the group." This includes health outcomes and patterns of health determinants, and policies and interventions that link these two. Moving from a fee-for-service payment system to a quality- or value-based system, this model places on the clinician more responsibility for the costs of health care and its reimbursements...
2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28806793/holding-providers-accountable-for-health-care-outcomes
#17
David W Baker, Mark R Chassin
Federal public reporting and payment programs have increasingly emphasized the measurement of outcomes (such as readmission, health care-associated infections, and mortality). Yet, the criteria for assessing whether outcome measures are accurate and valid enough to use for public reporting, payment, and accreditation are not well-defined. An outcome measure should be used only if the outcome can be influenced substantially by providers (that is, a strong process-outcome link exists) and statistical adjustment can be made for differences in patient populations across providers so that differences in outcomes are truly attributable to differences in the care provided...
September 19, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28804904/early-impact-on-outpatients-of-mandatory-adoption-of-the-diagnosis-related-group-based-reimbursement-system-in-korea-on-use-of-outpatient-care-differences-in-medical-utilization-and-presurgery-examination
#18
Seung Ju Kim, Kyu-Tae Han, Woorim Kim, Sun Jung Kim, Eun-Cheol Park
OBJECTIVE: To explore the impact of mandatory adoption of diagnosis-related groups (DRGs) on the use of outpatient care in Korea. DATA SOURCES: National Health Claim data from 2,022 hospitals and 1,029,101 admission cases during 2011-2014: tonsillectomy/adenoidectomy, inguinal/femoral hernia operation, and hemorrhoidectomy. STUDY DESIGN: Outcome variables included probability of outpatient visit, number of outpatient visits, and outpatient medical expenditures within 30 days...
August 14, 2017: Health Services Research
https://www.readbyqxmd.com/read/28799198/does-paying-service-providers-by-results-improve-recovery-outcomes-for-drug-misusers-in-treatment-in-england
#19
Andrew Jones, Matthias Pierce, Matt Sutton, Thomas Mason, Tim Millar
AIM: To compare drug recovery outcomes in commissioning areas included in a 'payment by results' scheme with all other areas. DESIGN: Observational and data linkage study of the National Drug Treatment Monitoring System, Office for National Statistics mortality database, and Police National Computer criminal records, for two years before and after introduction of the scheme. Pre-post controlled comparison compared outcomes in participating versus non-participating areas following adjustment for drug use, functioning and drug treatment status...
August 10, 2017: Addiction
https://www.readbyqxmd.com/read/28783203/cumulative-occupational-mechanical-exposures-during-working-life-and-risk-of-sickness-absence-and-disability-pension-prospective-cohort-study
#20
Emil Sundstrup, Åse Marie Hansen, Erik Lykke Mortensen, Otto Melchior Poulsen, Thomas Clausen, Reiner Rugulies, Anne Møller, Lars L Andersen
Objectives The aim of this study was to determine the prospective association of cumulative mechanical exposure during working life with health-related labor market outcomes. Methods This prospective cohort study combines data from 5076 older workers (age 49-63 years) from the Copenhagen Aging and Midlife Biobank with a job exposure matrix and a national register containing information on social transfer payment. By coding individual job histories from the Danish version of ISCO-codes (International Standard Classification of Occupations), we calculated cumulative occupational mechanical exposures from a JEM for ton-years (lifting 1000 kg each day in one year), lifting-years (lifting loads weighing ≥20 kg >10 times each day in one year), kneeling-years (kneeling for one hour each day in one year) and vibration-years (whole-body vibration for one hour each day in one year)...
August 7, 2017: Scandinavian Journal of Work, Environment & Health
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