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https://www.readbyqxmd.com/read/28817299/how-do-medicare-advantage-beneficiary-payments-vary-with-tenure
#1
Paul D Jacobs, Eamon Molloy
OBJECTIVES: To compare how premiums and expected out-of-pocket medical costs (OOPC) vary with the length of time Medicare Advantage (MA) beneficiaries have been enrolled in their plans. STUDY DESIGN: Descriptive and fixed effects regression analyses. METHODS: Using linked administrative enrollment and plan data, we compared the costs of the MA plans that beneficiaries chose with the costs of other plans available to them. We show predicted values adjusted for age, gender, race/ethnicity, disability, individual health risk, presence of mental health diagnoses, health plan quality, relative size of the plan's provider network, and the number of years continuously enrolled in the same plan...
June 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28816522/the-intertwined-relationship-between-patient-education-hospital-waiting-times-and-hospital-utilization
#2
Maike Schulz
Background Hospital waiting times are established instruments to ration healthcare when resources are scarce. However, higher educated patients may be better able to influence access to, and exit from, hospital care when waiting times are long. Methods Based on a representative sample of 11 European countries from the Survey of Health, Ageing and Retirement in Europe (SHARE) collected in 2004/2005, this paper investigates whether the relationship between individual educational background and hospital utilization depends on the prevalent hospital waiting times in a country...
January 1, 2017: Health Services Management Research
https://www.readbyqxmd.com/read/28814373/convenience-quality-and-choice-patient-and-service-provider-perspectives-for-treating-primary-care-complaints-in-urgent-care-settings
#3
David Sturgeon
AIM: To investigate why patients chose to attend two, nurse-led, minor injury units (MIUs) to access primary healthcare services rather than attend their GP practice. BACKGROUND: Since the 1980's, healthcare organisations in the UK and elsewhere have implemented an increasingly consumer-orientated model of healthcare provision. As a result, patients with non-urgent presentations are attending Emergency Departments (EDs) and other urgent care facilities in growing numbers...
August 14, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28812841/university-of-global-health-equity-s-contribution-to-the-reduction-of-education-and-health-services-rationing
#4
EDITORIAL
Agnes Binagwaho
The inadequate supply of health workers and demand-side barriers due to clinical practice that heeds too little attention to cultural context are serious obstacles to achieving universal health coverage and the fulfillment of the human rights to health, especially for the poor and vulnerable living in remote rural areas. A number of strategies have been deployed to increase both the supply of healthcare workers and the demand for healthcare services. However, more can be done to improve service delivery as well as mitigate the geographic inequalities that exist in this field...
May 29, 2017: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/28799226/educational-intervention-on-medication-reviews-aiming-to-reduce-acute-healthcare-consumption-in-elderly-patients-with-potentially-inappropriate-medicines-a-pragmatic-open-label-cluster-randomized-controlled-trial-in-primary-care
#5
K Schmidt-Mende, M Andersen, B Wettermark, J Hasselström
PURPOSE: Potentially inappropriate medicines (PIMs) may cause 10% of unplanned admissions in elderly people. We performed an educational intervention in primary care to reduce acute health care consumption and PIMs through the promotion of medication reviews (MRs) in elderly patients. METHODS: This cluster-randomized controlled trial was conducted in the context of an official campaign promoting rational drug use in elderly people. Sixty-nine primary health care practices with 119,910 patients aged older than or equal to 65 were randomized, with 1 dropout in the intervention group...
August 11, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28795061/a-multi-agent-based-approach-for-prehospital-emergency-management
#6
Reza Safdari, Jaleh Shoshtarian Malak, Niloofar Mohammadzadeh, Azimeh Danesh Shahraki
OBJECTIVE: To demonstrate an architecture to automate the prehospital emergency process to categorize the specialized care according to the situation at the right time for reducing the patient mortality and morbidity. METHODS: Prehospital emergency process were analyzed using existing prehospital management systems, frameworks and the extracted process were modeled using sequence diagram in Rational Rose software. System main agents were identified and modeled via component diagram, considering the main system actors and by logically dividing business functionalities, finally the conceptual architecture for prehospital emergency management was proposed...
July 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28789580/a-potential-benefit-from-infectious-disease-specialist-and-stationary-ward-in-rational-antibiotic-therapy-of-complicated-skin-and-skin-structure-infections
#7
Iiro H Jääskeläinen, Lars Hagberg, Tommy Schyman, Asko Järvinen
BACKGROUND: Management practices of complicated skin and skin structure infections (cSSSI) were compared between two areas with similar healthcare structure and low prevalence of antimicrobial resistance. METHODS: The high affinity to public health-care in the Nordic countries enabled population-based approach used in this retrospective study. The study population (n = 460) consisted of all adult residents from Helsinki (Finland) and Gothenburg (Sweden) treated in hospital due to cSSSI during 2008-2011...
August 8, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28774161/suggestions-on-improvement-of-infectious-disease-law-and-regulations
#8
Mijeong Park
Purpose: The study's perspective is through examining an enactment for the New amendment for legislation, to make proposals for a more rational and concrete basis in the interpretation and application of the Korean legal regime in global infectious disease emergency situations. Methods: The Republic of Korea reported its first laboratory-confirmed case of Middle East Respiratory Syndrome Corona Virus (MERS-CoV) on 20 May 2015. Since the first index case, Korean public health authorities enforced many public health measures that were not authorized in the law...
July 25, 2017: Epidemiology and Health
https://www.readbyqxmd.com/read/28756056/healthcare-costs-related-to-treatment-of-hepatocellular-carcinoma-among-veterans-with-cirrhosis-in-the-united-states
#9
David E Kaplan, Michael K Chapko, Rajni Mehta, Feng Dai, Melissa Skanderson, Ayse Aytaman, Michelle Baytarian, Kathryn D'Addeo, Rena Fox, Kristel Hunt, Christine Pocha, Adriana Valderrama, Tamar H Taddei
BACKGROUND & AIMS: It is important to quantify medical costs associated with hepatocellular carcinoma (HCC), the incidence of which is rapidly increasing incidence in the United States, for development of rational healthcare policies related to liver cancer surveillance and treatment of chronic liver disease. We aimed to comprehensively quantify healthcare costs for HCC among patients with cirrhosis in an integrated health system and develop a model for predicting costs based on clinically relevant variables...
July 26, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28752830/healthcare-associated-infection-good-practices-knowledge-and-the-locus-of-control-in-heatlhcare-professionals
#10
Chiara Taffurelli, Alfonso Sollami, Carmen Camera, Francesca Federa, Annise Grandi, Marcella Marino, Tiziano Marrosu, Leopoldo Sarli
BACKGROUND AND AIM:   The incidence of Healthcare Associated Infections (HAI) is an important indicator of the quality of care. The behaviors associated with the prevention of infections are not only supported by rational knowledge or motivation, but are mediated by social, emotional and often stereotyped behaviors. The awarness of the good practices related to HAI, may be a factor. Other studies, identify how the perception of the problem in healthcare professionals is often influenced by a tendency towards an external Locus of Control: the patient, the family, the other wards, other care settings...
July 18, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28736390/-side-effects-are-central-effects-that-challenge-retention-in-hiv-treatment-programmes-in-six-sub-saharan-african-countries-a-multicountry-qualitative-study
#11
Jenny Renju, Mosa Moshabela, Estelle McLean, William Ddaaki, Morten Skovdal, Fred Odongo, Dominic Bukenya, Joyce Wamoyi, Oliver Bonnington, Janet Seeley, Basia Zaba, Alison Wringe
OBJECTIVES: To explore the bodily and relational experience of taking antiretroviral therapy (ART) and the subsequent effect on retention in HIV care in six sub-Saharan African countries. METHODS: In-depth interviews were conducted with 130 people living with HIV (PLHIV) who had initiated ART, 38 PLHIV who were lost to follow-up and 53 healthcare workers (HCWs) in Kenya, Uganda, Tanzania, Malawi, Zimbabwe and South Africa. PLHIV were purposely selected to include a range of HIV treatment histories...
July 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28730671/many-faces-of-rationality-implications-of-the-great-rationality-debate-for-clinical-decision-making
#12
Benjamin Djulbegovic, Shira Elqayam
Given that more than 30% of healthcare costs are wasted on inappropriate care, suboptimal care is increasingly connected to the quality of medical decisions. It has been argued that personal decisions are the leading cause of death, and 80% of healthcare expenditures result from physicians' decisions. Therefore, improving healthcare necessitates improving medical decisions, ie, making decisions (more) rational. Drawing on writings from The Great Rationality Debate from the fields of philosophy, economics, and psychology, we identify core ingredients of rationality commonly encountered across various theoretical models...
July 20, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28726737/respiratory-tract-infections-and-the-role-of-biologically-active-polysaccharides-in-their-management-and-prevention
#13
REVIEW
Milos Jesenak, Ingrid Urbancikova, Peter Banovcin
Respiratory tract infections (RTIs) are the most common form of infections in every age category. Recurrent respiratory tract infections (RRTIs), a specific form of RTIs, represent a typical and common problem associated with early childhood, causing high indirect and direct costs on the healthcare system. They are usually the consequence of immature immunity in children and high exposure to various respiratory pathogens. Their rational management should aim at excluding other severe chronic diseases associated with increased morbidity (e...
July 20, 2017: Nutrients
https://www.readbyqxmd.com/read/28715605/how-to-select-a-nanosimilar
#14
Alain Astier, Amy Barton Pai, Marco Bissig, Daan J A Crommelin, Beat Flühmann, Jean-Daniel Hecq, Josefien Knoeff, Hans-Peter Lipp, Alberto Morell-Baladrón, Stefan Mühlebach
Nanomedicines in the class of nonbiological complex drugs (NBCDs) are becoming increasingly available. Up to 23 nanomedicines have been approved, and approximately 50 are in clinical development. Meanwhile, the first nanosimilars have entered the market through the generic approval pathway, but clinical differences have been observed. Many healthcare professionals may be unaware of this issue and must be informed of these clinically relevant variances. This article provides a tool for rational decision making for the inclusion of nanomedicines into the hospital formulary, including defined criteria for evaluation of substitutability or interchangeability...
July 17, 2017: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/28694528/balancing-hole-and-electron-conduction-in-ambipolar-split-gate-thin-film-transistors
#15
Hocheon Yoo, Matteo Ghittorelli, Dong-Kyu Lee, Edsger C P Smits, Gerwin H Gelinck, Hyungju Ahn, Han-Koo Lee, Fabrizio Torricelli, Jae-Joon Kim
Complementary organic electronics is a key enabling technology for the development of new applications including smart ubiquitous sensors, wearable electronics, and healthcare devices. High-performance, high-functionality and reliable complementary circuits require n- and p-type thin-film transistors with balanced characteristics. Recent advancements in ambipolar organic transistors in terms of semiconductor and device engineering demonstrate the great potential of this route but, unfortunately, the actual development of ambipolar organic complementary electronics is currently hampered by the uneven electron (n-type) and hole (p-type) conduction in ambipolar organic transistors...
July 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28694036/-priority-setting-and-rationing-of-pharmaceuticals-an-experimental-analysis-of-discussion-processes
#16
Ines Aumann, Svenja Litzkendorf, Kathrin Damm, J Matthias Graf von der Schulenburg
BACKGROUND/OBJECTIVE: In the face of rising expenditure among statutory sickness funds in Germany it is necessary to start a discussion about priority setting in the healthcare system. For a long time this issue was avoided in healthcare debates. As a result, normative directives are still missing, which can lead to priority setting among healthcare providers in daily healthcare practice. A discussion on priority setting can be conducted at three different levels: at the government (macro), the institutional (meso), and the patient (micro) level...
July 7, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28633469/a-framework-illustrating-care-seeking-among-older-adults-in-a-hospital-emergency-department
#17
Barbara J Lutz, Allyson G Hall, Sean B Vanhille, Andrea L Jones, Jessica R Schumacher, Phyllis Hendry, Jeffrey S Harman, Donna L Carden
Background and Objectives: Older adults seeking emergency department (ED) care often have multiple, complex chronic conditions. We sought to understand factors that influence ED care-seeking by older adults and present a theoretical framework illustrating this process. Research Design and Methods: In this grounded theory study, we interviewed 40 older adults with chronic illness within 90 days of an ED visit to explore their decision-making about seeking ED care...
June 17, 2017: Gerontologist
https://www.readbyqxmd.com/read/28632831/-antiseptics-and-disinfectants-aiming-at-rational-use-recommendations-of-the-advisory-committee-on-healthcare-associated-infections-sociedad-chilena-de-infectolog%C3%A3-a
#18
Alexis Diomedi, Eiiana Chacón, Luis Delpiano, Beatrice Hervé, M Irene Jemenao, Myriam Medel, Marcela Quintanilla, Gisela Riedel, Javier Tinoco, Marcela Cifuentes
Proper use of antiseptics and disinfectants, is an essential tool to prevent the spread of infectious agents and to control of healthcare-associated infections (HAI). Given the increasing importance of environmental aspects, as well as several advances and updates in the field of its proper use at local and intemational level, the SOCHINF HAI Advisory Committee considers that it is necessary to develop a guide for the rational use of antiseptics and disinfectants, which it will provide consistent scientific basis with that purpose...
April 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28615355/reducing-unnecessary-imaging-for-patients-with-constipation-in-the-pediatric-emergency-department
#19
Catherine Craun Ferguson, Matthew P Gray, Melissa Diaz, Kevin P Boyd
OBJECTIVES: Constipation is a common diagnosis in the pediatric emergency department (ED). Children diagnosed with constipation may undergo an abdominal radiograph (AXR) as part of their diagnostic workup despite studies that suggest that an AXR in a patient suspected of being constipated is unnecessary and potentially misleading. We aimed to decrease the percentage of low-acuity patients aged between 6 months and 18 years diagnosed with constipation who undergo an AXR in our pediatric ED from 60% to 20% over 12 months...
July 2017: Pediatrics
https://www.readbyqxmd.com/read/28614518/rationalization-and-sensemaking-in-care-management-an-experience-of-change-in-a-hospital-of-the-sus-unified-health-system
#20
Creuza da Silva Azevedo, Marilene de Castilho Sá, Marcela Cunha, Gustavo Correa Matta, Lilian Miranda, Victor Grabois
This study aimed to analyze organizational processes of change in the hospital care management by using qualitative evaluation developed in the case study. The study was developed at the Hospital Fornecedores de Cana de Piracicaba, in São Paulo State, Brazil, in September and October of 2012. There were 25 interviews with members of the senior board of directors of the hospital, managers and health professionals linked to healthcare of adults, in addition to the analysis of managerial documents and observations of some activities...
June 2017: Ciência & Saúde Coletiva
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