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social medical insurance

André Strahl, Christian Gerlich, Georg W Alpers, Katja Ehrmann, Jörg Gehrke, Annette Müller-Garnn, Heiner Vogel
BACKGROUND: The German quality assurance programme for evaluating work capacity is based on peer review that evaluates the quality of medical experts' reports. Low reliability is thought to be due to systematic differences among peers. For this purpose, we developed a curriculum for a standardized peer-training (SPT). This study investigates, whether the SPT increases the inter-rater reliability of social medical physicians participating in a cross-institutional peer review. METHODS: Forty physicians from 16 regional German Pension Insurances were subjected to SPT...
June 13, 2018: BMC Medical Education
Andres Pichon-Riviere, Natalie Soto, Federico Augustovski, Laura Sampietro-Colom
OBJECTIVES: Latin American countries are taking important steps to expand and strengthen universal health coverage, and health technology assessment (HTA) has an increasingly prominent role in this process. Participation of all relevant stakeholders has become a priority in this effort. Key issues in this area were discussed during the 2017 Latin American Health Technology Assessment International (HTAi) Policy Forum. METHODS: The Forum included forty-one participants from Latin American HTA agencies; public, social security, and private insurance sectors; and the pharmaceutical and medical device industry...
June 11, 2018: International Journal of Technology Assessment in Health Care
Md Saiful Islam, Md Mahmudul Hasan, Xiaoyi Wang, Hayley D Germack, Md Noor-E-Alam
The growing healthcare industry is generating a large volume of useful data on patient demographics, treatment plans, payment, and insurance coverage—attracting the attention of clinicians and scientists alike. In recent years, a number of peer-reviewed articles have addressed different dimensions of data mining application in healthcare. However, the lack of a comprehensive and systematic narrative motivated us to construct a literature review on this topic. In this paper, we present a review of the literature on healthcare analytics using data mining and big data...
May 23, 2018: Healthcare (Basel, Switzerland)
Takamasa Komiyama, Takashi Ohi, Yoshitada Miyoshi, Takahisa Murakami, Akito Tsuboi, Yasutake Tomata, Ichiro Tsuji, Makoto Watanabe, Yoshinori Hattori
PURPOSE: The purpose of this study was to examine whether the status of dentition is associated with incident functional disability in elderly people. METHODS: This prospective cohort study targeted community-dwelling Japanese adults of age ≥70 years (n=838). Participants were classified into the following four groups in accordance with Miyachi's Triangular Classification, which represents the status of dentition on the basis of numbers of remaining teeth and occlusal supports: Zone A, ≥10 occlusal supports; Zone B, 5-9 occlusal supports; Zone D, ≤4 occlusal supports and ≥11 remaining teeth and Zone C, ≤10 remaining teeth...
June 4, 2018: Journal of Prosthodontic Research
Nobuo Kawazoe, Xiumin Zhang, Chifa Chiang, Hongjian Liu, Jinghua Li, Yoshihisa Hirakawa, Atsuko Aoyama
Objective: The burden of noncommunicable diseases (NCDs) is increasing in China, together with economic development and social changes. The prevalence of risk factors for NCDs, such as overweight/obesity, hypertension, diabetes, and dyslipidemia, is reported to be high even among poor residents of rural areas. We aimed to investigate the prevalence of hypertension among elderly adults in rural Northeast China and the proportion with controlled hypertension among those on antihypertensive medication (hypertension control rate)...
May 2018: Journal of Rural Medicine: JRM
Kirsi Karvala, Jukka Uitti, Saara Taponen, Ritva Luukkonen, Lauri Lehtimäki
OBJECTIVE: To study the association between perceptions of various triggers of asthma and employment status. METHODS: A questionnaire was administered to all those adults living in the city of Tampere, Finland, who were entitled to special reimbursement for asthma medication by the Social Insurance Institution (n = 2613). The response rate was 79%. The study population (n = 1657) consisted of individuals who worked full-time (n = 967), were unemployed (n = 197), had all-cause work disability (n = 334), or were retired due to old age (n = 159)...
June 2018: Respiratory Medicine
Nahed O ElHassan, Shasha Bai, Neal Gibson, Greg Holland, James M Robbins, Jeffrey R Kaiser
BACKGROUND: The relative influence of prematurity vs. maternal social factors (socioeconomic status and education level) on academic performance has rarely been examined. OBJECTIVE: To examine the impact of prematurity and maternal social factors on academic performance from 3rd through 8th grade. METHODS: We conducted a retrospective cohort study of infants born in 1998 at the University of Arkansas for Medical Sciences. The study sample included 58 extremely low gestational age newborns (ELGANs, 23‒<28 weeks), 171 preterm (≥28‒<34 weeks), 228 late preterm (≥34‒<37 weeks), and 967 term ((≥37‒<42 weeks) infants...
2018: PloS One
Winifred L Boal, Jia Li, Aaron Sussell
Lack of health insurance has been associated with poorer health status and with difficulties accessing preventive health services and obtaining medical care, especially for chronic diseases (1-3). Among workers, the prevalence of chronic conditions, risk behaviors, and having health insurance has been shown to vary by occupation (4,5). CDC used data from the 2013 and 2014 Behavioral Risk Factor Surveillance System (BRFSS) to estimate the prevalence of having no health care coverage (e.g., health insurance, prepaid plans such as health maintenance organizations, government plans such as Medicare, or Indian Health Service) by occupation...
June 1, 2018: MMWR. Morbidity and Mortality Weekly Report
Dan Shetler, Donald S Shepard
Medical respite (MR) programs provide medical care, social services, and a safe place to recuperate for people experiencing homelessness after hospital discharge. We examined the financial impact of MR on hospitals and insurers in states with varying Medicaid coverage. Urban case-study hospitals were selected from a state with Medicaid expansion under the Affordable Care Act (Connecticut) and without expansion (Florida). We calculated costs and savings from MR to hospitals and payers from the hospitals' financial data...
2018: Journal of Health Care for the Poor and Underserved
Martin Wohlgemuth, Julia Heinrich
BACKGROUND: This article describes the introduction of the law to combat corruption in the healthcare system. OBJECTIVE: The effects of the introduced penal regulations on the delivery of medical services is critically scrutinized and the associated procedures as well as indications for the course of action are presented. RESULTS: Knowledge of the relevant regulations and types of procedure is decisive for the penal, social legislative and professional conduct risk minimization...
May 24, 2018: Der Urologe. Ausg. A
Pegah Misagh, Afsaneh Vazin, Soha Namazi
This study was aimed at finding the occurrence rate of prescription errors in the outpatients› prescriptions written by faculty and non-faculty physicians practicing in Shiraz, Iran. In this cross-sectional study 2000 outpatient prescriptions were randomly collected from pharmacies affiliated with Shiraz University of Medical Sciences (SUMS) and social security insurance in Shiraz, Iran. Patient information including age, weight, diagnosis and chief complain were recorded. Physicians 'characteristics were extracted from prescriptions...
2018: Iranian Journal of Pharmaceutical Research: IJPR
Julia Christiane Beck-Ripp, Holger Dressel
AIM OF THE STUDY: There is an ongoing discussion on the increasing number of children with mental and developmental disorders, with some even needing long-term care according to the German Social Code XI. This study was performed to identify the main diagnoses justifying such care in children and to analyse their prevalence over time. METHODS: The diagnoses justifying long-term care were evaluated using care assessments of Bavarian children and adolescents between 2009 to 2014 by the medical service of statutory health insurance...
May 22, 2018: Das Gesundheitswesen
Daniel Gero, Bors Hulesch, Marco Bueter
PURPOSE OF REVIEW: Cumulating evidence is available to demonstrate the efficacy of bariatric surgery (BS) in achieving weight loss and optimizing comorbidities. However, currently, only a minority of eligible patients approaches bariatric centers. The underuse of BS can no longer be explained by the lack of evidence supporting its beneficial outcomes along with its favorable safety-profile, rather, by the supporting infrastructure, insurance coverage, and mindset of society, including potential patients and allied healthcare professionals...
May 21, 2018: Current Atherosclerosis Reports
Shalginbay A Baimagambetov, Serik S Balgazarov, Zhanatay K Ramazanov, Yelena A Belan, Ruslan S Abilov, Alexey A Dolgov, Amangol S Balgazarov
PURPOSE: The purpose of the paper is shaping of ideas about possible ways of decreasing complications of the analyzed types of operations and identification of opportunities of the impact on the socio-economic environment among the Afro-American population of USA. The paper demonstrates that the issue of coxofemoral prosthesis is not only a purely medical but also a social problem. In particular, availability of timely aid, as well as insurance in the form of surgery, refer to relevance of the range of problems...
June 2018: Journal of the National Medical Association
Wolfgang Seger
Medicine is at risk of sliding into a sole repair service for the malfunction of organs. But the patients' hope and confidence towards doctors practicing this repair work go far beyond that: after acute medical treatment many patients suffer from chronic impairments due to the natural course of the disease or as a result of medical interventions. Despite resulting handicaps, patients aim at participating in family and social life, retaining a workplace and receiving support to remain a valued member of the family and the community...
March 2018: Electronic Physician
Joelle Abramowitz
This article considers the extent to which Affordable Care Act state Medicaid expansions alleviated the burden of out-of-pocket costs associated with obtaining health insurance and medical care using data from the 2011 to 2016 Current Population Survey Annual Social and Economic Supplement. Using a difference-in-differences framework, the analysis examines effects of the Medicaid expansions on out-of-pocket expenditures for health insurance premiums and medical care, comparing expenditures across expansion and nonexpansion states before and after the expansions were implemented, performing separate analyses for individuals with family income at various eligibility cutoff levels in the first and second years of expansion implementation...
May 1, 2018: Medical Care Research and Review: MCRR
Si Ying Tan, Xun Wu, Wei Yang
While moving towards unified social health insurance (SHI) is often a politically popular policy reform in countries where rapid expansion in health insurance coverage has given rise to the segmentation of SHI systems as different SHI schemes were rolled out to serve different populations, the potential impacts of reform on service utilisation and health costs have not been systematically studied. Using data from the Chinese Health and Retirement Longitudinal Study (CHARLS), we compared the mean costs incurred for both inpatient and outpatient care under different health insurance schemes, and the impact of different SHI schemes on treatment utilisation and health care costs using a two-part model...
May 8, 2018: Health Economics, Policy, and Law
Hanna Klingshirn, Rene Mittrach, Kathrin Braitmayer, Ralf Strobl, Andreas Bender, Eva Grill, Martin Müller
BACKGROUND: A multitude of different rehabilitation interventions and other specific health care services are offered for individuals with disorders of consciousness in long-term care settings. To investigate the association of those services and patient-relevant outcomes, a specific instrument to document the utilization of those services is needed. The purpose of this study was to develop such a questionnaire administered to caregivers in epidemiological studies or patient registries in Germany...
May 4, 2018: BMC Health Services Research
Gabriel Perreault, Adam Goodman, Sebastian Larion, Ahana Sen, Kirsten Quiles, Michael Poles, Renee Williams
Background: This study was performed to compare patient-reported tolerability and its barriers in single- vs. split-dose 4-L polyethylene glycol (PEG) bowel preparation for colonoscopy in a large multiethnic, safety-net patient population. Methods: A cross-sectional, dual-center study using a multi-language survey was used to collect patient-reported demographic, medical, socioeconomic, and tolerability data from patients undergoing outpatient colonoscopy. Univariate and multivariate analyses were used to identify demographic and clinical factors significantly associated with patient-reported bowel preparation tolerability...
May 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Rao Chen, Ning-Xiu Li, Xiang Liu
BACKGROUND: The equity of medical services utilization for elderly individuals enrolled in different basic social medical insurance systems holds significant meaning for social harmony against a background of demographic aging and a growing wealth gap in China. This study is to explore the equity of the three medical insurance systems in southwest China with the aim of providing recommendations for relevant policy. METHODS: A total of 9600 elderly people insured through basic social medical insurance were selected and interviewed with a questionnaire...
May 2, 2018: International Journal for Equity in Health
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