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https://www.readbyqxmd.com/read/28210351/cross-continuum-tool-is-associated-with-reduced-utilization-and-cost-for-frequent-high-need-users
#1
Lauran Hardin, Adam Kilian, Leslie Muller, Kevin Callison, Michael Olgren
INTRODUCTION: High-need, high-cost (HNHC) patients can over-use acute care services, a pattern of behavior associated with many poor outcomes that disproportionately contributes to increased U.S. healthcare cost. Our objective was to reduce healthcare cost and improve outcomes by optimizing the system of care. We targeted HNHC patients and identified root causes of frequent healthcare utilization. We developed a cross-continuum intervention process and a succinct tool called a Complex Care Map (CCM)© that addresses fragmentation in the system and links providers to a comprehensive individualized analysis of the patient story and causes for frequent access to health services...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28197665/-use-of-the-icf-in-medical-rehabilitation-in-germany-claims-and-reality
#2
Tobias-Raphael Wenzel, Matthias Morfeld
BACKGROUND: The International Classification of Functioning, Disability and Health (ICF) is being used in the medical rehabilitation practice in different ways. The World Health Organization (WHO) and many other stakeholders have formulated claims and expectations for its use. OBJECTIVES: A comparative presentation of the claims of various stakeholders for the use of the ICF with examples in current practice. MATERIALS AND METHODS: Database searches (PubMed, REHADAT, and Google Scholar) were conducted for studies concerning claims and the current use of the ICF in practice...
February 14, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/28195811/determinants-of-patient-centered-financial-stress-in-patients-with-locally-advanced-head-and-neck-cancer
#3
Jonas A de Souza, Sunny Kung, Jeremy O'Connor, Bonnie J Yap
PURPOSE: To prospectively estimate patient-centered financial stress and its relationship with health care utilization in patients with head and neck cancer. This was a survey-based, longitudinal, prospective study of treatment-naïve patients with stage III, IVa, or IVb locally advanced head and neck cancer at a single-institution tertiary care hospital from May 2013 to November 2014. With 121 patients approached, 73 (60%) agreed to participate. METHODS: Self-reported data were collected on demographics, income, wealth, cost-coping strategies, out-of-pocket costs, supportive medication compliance, and perceived social isolation...
February 14, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28192635/risk-factors-for-hospitalization-of-children-with-congenital-adrenal-hyperplasia
#4
Ming Yang, Perrin C White
BACKGROUND AND OBJECTIVES: Patients with congenital adrenal hyperplasia (CAH) owing to 21-hydroxylase deficiency are prone to potentially life-threatening adrenal crises. We tried to identify risk factors for post-diagnosis hospitalization for children with the salt wasting form of CAH. METHODS: We reviewed medical records of all children who presented to Children's Medical Center Dallas from 1999 to 2013 with congenital adrenal hyperplasia (ICD-9 code 255.2). RESULTS: 522 unique patients were coded for ICD-9 code of 255...
February 13, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28183411/funding-of-graduate-medical-education-in-a-market-based-healthcare-system
#5
Barbara L Schuster
The graduate medical education (GME) process in the United States is considered the most respected model for high-quality education of graduate physicians in the world. With substantial funding through government and private insurers and through structured educational accreditation standards, the American Board of Medical Specialists-certified physicians are recognized for their expertise in delivering high-quality medical care. However, under fiscal constraints and changing social expectations, questions are continually posed about the process of funding and whether the "physician outcomes" are sufficient to continue with the investment...
February 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28181864/employment-support-for-the-transition-to-retirement
#6
David C Stapleton, Jody Schimmel Hyde
As workers near retirement, many experience a medical event that limits the ability to work. Public programs provide health insurance and income support for these individuals, but that support is often not adequate to protect against poverty following the onset of a new health condition. Moreover, these policies generally are not designed to encourage continuing work rather than premature retirement. In this article, we propose a new type of program-Employment Support for the Transition to Retirement-designed to encourage older workers with health limitations to remain in the workforce, reducing their reliance on federal disability and early retirement benefits...
January 2017: Research on Aging
https://www.readbyqxmd.com/read/28181100/the-effects-of-public-health-insurance-expansion-on-private-health-insurance-in-urban-china
#7
Xiaohui Hou, Jing Zhang
The public social health insurance coverage has rapidly increased in China in the last decade. The rapid market development and high economic growth also present an immense opportunity for the private insurance market. This paper uses the China Health and Nutrition Survey panel data and the difference-in-difference method to identify the causal effects of public health insurance expansion on private health insurance development in the case of expansion of the China Urban Residential Basic Medical Insurance (URBMI) program...
February 8, 2017: Int J Health Econ Manag
https://www.readbyqxmd.com/read/28170304/hiv-pre-exposure-prophylaxis-and-postexposure-prophylaxis-in-japan-context-of-use-and-directions-for-future-research-and-action
#8
Anthony S DiStefano, Makiko Takeda
Biomedical HIV prevention strategies are playing an increasingly prominent role in addressing HIV epidemics globally, but little is known about their use in Japan, where persistent HIV disparities and a recently stable, but not declining, national epidemic indicate the need for evolving approaches. We conducted an ethnographic study to determine the context of pre-exposure prophylaxis (PrEP) and postexposure prophylaxis (PEP) use and to identify directions for future research and action in Japan. We used data from observational fieldwork in the Kansai region and Tokyo Metropolitan Area (n = 178 persons observed), qualitative interviews (n = 32), documents and web-based data sources (n = 321), and email correspondences (n = 9) in the period 2013-2016...
February 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28153752/income-financial-barriers-to-health-care-and-public-health-expenditure-a-multilevel-analysis-of-28-countries
#9
Tae Jun Kim, Nico Vonneilich, Daniel Lüdecke, Olaf von dem Knesebeck
International studies have repeatedly shown that people with lower income are more likely to experience difficulties to access medical services. Less is known on why these relations vary across countries. This study investigates whether the association between income and financial barriers to health care is influenced by national public health expenditures (PHE, in % of total health expenditure). Data from the International Social Survey Programme (2011) was used (28 countries, 23,669 respondents). Financial barriers were assessed by the individual experience of forgone care due to financial reasons...
January 24, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28152999/a-participatory-supportive-return-to-work-program-for-workers-without-an-employment-contract-sick-listed-due-to-a-common-mental-disorder-an-economic-evaluation-alongside-a-randomized-controlled-trial
#10
Lieke Lammerts, Johanna M van Dongen, Frederieke G Schaafsma, Willem van Mechelen, Johannes R Anema
BACKGROUND: Mental disorders are associated with high costs for productivity loss, sickness absence and unemployment. A participatory supportive return to work (RTW) program was developed in order to improve RTW among workers without an employment contract, sick-listed due to a common mental disorder. The program contained a participatory approach, integrated care and direct placement in a competitive job. The aim of this study was to evaluate the cost-effectiveness and cost-utility of this new program, compared to usual care...
February 2, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28118837/physical-and-mental-health-functioning-after-all-cause-and-diagnosis-specific-sickness-absence-a-register-linkage-follow-up-study-among-ageing-employees
#11
Minna Mänty, Tea Lallukka, Jouni Lahti, Olli Pietiläinen, Mikko Laaksonen, Eero Lahelma, Ossi Rahkonen
BACKGROUND: Sickness absence has been shown to be a risk marker for severe future health outcomes, such as disability retirement and premature death. However, it is poorly understood how all-cause and diagnosis-specific sickness absence is reflected in subsequent physical and mental health functioning over time. The aim of this study was to examine the association of all-cause and diagnosis-specific sickness absence with subsequent changes in physical and mental health functioning among ageing municipal employees...
January 25, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28109188/impoverishing-effects-of-catastrophic-health-expenditures-in-malawi
#12
Martina Mchenga, Gowokani Chijere Chirwa, Levison S Chiwaula
BACKGROUND: Out of pocket (OOP) health spending can potentially expose households to risk of incurring large medical bills, and this may impact on their welfare. This work investigates the effect of catastrophic OOP on the incidence and depth of poverty in Malawi. METHODS: The paper is based on data that was collected from 12,271 households that were interviewed during the third Malawi integrated household survey (IHS-3). The paper considered a household to have incurred a catastrophic health expenditure if the share of health expenditure in the household's non-food expenditure was greater than a given threshold ranging between 10 and 40%...
January 21, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28078660/racial-ethnic-disparities-in-diabetes-quality-of-care-the-role-of-healthcare-access-and-socioeconomic-status
#13
Juan R Canedo, Stephania T Miller, David Schlundt, Mary K Fadden, Maureen Sanderson
INTRODUCTION: Blacks, Hispanics, and Asians are disproportionately affected by diabetes. We assessed the state of racial/ethnic disparities in diabetes quality of care in the USA. METHODS: We analyzed cross-sectional data of adults diagnosed with Type 2 diabetes in the nationally representative 2013 Medical Expenditure Panel Survey. Differences in adherence to five diabetes quality of care recommendations (HbA1c twice yearly, yearly foot exam, dilated eye exam, blood cholesterol test, and flu vaccination) were examined by race/ethnicity while controlling for three social determinants of health (health insurance status, poverty, and education) and other demographic variables...
January 11, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28068793/utilization-of-preventive-dental-services-before-and-after-health-insurance-covered-dental-scaling-in-korea
#14
Young-Eun Jang, Chun-Bae Kim, Nam-Hee Kim
Health insurance reduces the economic burden of diseases and enhances access to medical services. This study compared, among social classes, the utilization of preventive dental service before and after health insurance covered dental scaling. We analyzed time-series secondary data for 3  175  584 participants from 253 survey areas nationwide in the Community Health Survey (2009-2014) in Korea. The weighted proportion of participants who underwent dental scaling was defined as the scaling rate. Data regarding demographic and socioeconomic characteristics were collected...
January 1, 2017: Asia-Pacific Journal of Public Health
https://www.readbyqxmd.com/read/28064169/potentially-inappropriate-medication-prescribing-is-associated-with-socioeconomic-factors-a-spatial-analysis-in-the-french-nord-pas-de-calais-region
#15
Jean-Baptiste Beuscart, Michael Genin, Corrine Dupont, David Verloop, Alain Duhamel, Marguerite-Marie Defebvre, François Puisieux
BACKGROUND: potentially inappropriate medication (PIM) prescribing is common in older people and leads to adverse events and hospital admissions. OBJECTIVE: to determine whether prevalence of PIM prescribing varies according to healthcare supply and socioeconomic status. METHODS: all prescriptions dispensed at community pharmacies for patients aged 75 and older between 1 January  and 31 March 2012 were retrieved from French Health Insurance Information System of the Nord-Pas-de-Calais Region for patients affiliated to the Social Security scheme...
January 6, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28063614/analysis-of-emergency-department-length-of-stay-for-mental-health-patients-at-ten-massachusetts-emergency-departments
#16
Mark D Pearlmutter, Kristin H Dwyer, Laura G Burke, Niels Rathlev, Louise Maranda, Greg Volturo
STUDY OBJECTIVE: Prolonged boarding times in the emergency department (ED) disproportionately affect mental health patients, resulting in patient and provider dissatisfaction and increased patient morbidity and mortality. Our objective is to quantify the burden of mental health boarding and to elucidate the effect of insurance together with demographic, social, and comorbid factors on length of stay. METHODS: We conducted a cross-sectional observational study of 871 consecutive patients requiring an ED mental health evaluation at one of 10 unaffiliated Massachusetts hospitals...
December 30, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28062815/content-and-outcomes-of-social-work-consultation-for-patients-with-diabetes-in-primary-care
#17
Andrew J Rabovsky, Michael B Rothberg, Susannah L Rose, Andrei Brateanu, Lei Kou, Anita D Misra-Hebert
PURPOSE: Social workers are positioned to address social determinants of health (SDHs), but their specific roles in outpatient primary care practice have not been well described. We aimed to describe needs of patients with diabetes addressed during social work (SW) consultations and their impact on disease control. METHODS: This study was a retrospective review of electronic medical records of 977 patients with diabetes with a SW consultation at 3 primary care internal medicine sites in 2014...
January 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28028505/the-effects-of-social-medical-insurance-participation-on-migrant-workers-in-china-estimation-based-on-the-propensity-score-matching-approach
#18
Shenghua Xie, Junling Xu
No abstract text is available yet for this article.
November 2016: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/27995269/-new-legal-regulations-for-palliative-care-with-implications-for-politics-and-practice
#19
Heiner Melching
In December 2015 two different laws were adopted. Both are of importance for palliative care. One of the laws criminalizes commercial, "business-like" assisted suicide (§ 217 German Criminal Code), the other one aims to improve hospice and palliative care in Germany. Through the latter far-reaching changes in Social Code Books V and XI, as well as of the Hospital Finance Act have been made. This new Act to Improve Hospice and Palliative Care (HPG) focuses, amongst others, on: (a) Better funding of hospice services, by raising the minimum grant for patients in inpatient hospices paid per day by the health insurance funds by about 28...
January 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/27995225/oral-health-status-and-oral-health-care-model-in-china
#20
Jian Liu, Shan Shan Zhang, Shu Guo Zheng, Tao Xu, Yan Si
OBJECTIVE: To review the current oral health status and oral health care models in China in an effort to provide recommendations for the future implementation of these models. METHODS: A systematic literature review was conducted. The Medline, EMBASE, CNKI and Wanfang databases were searched for English and Chinese articles reporting relevant data from 1949 to the present. Data from three national oral health epidemiology surveys, Chinese government reports and national statistics yearbooks from 2011 to 2015 were also included...
2016: Chinese Journal of Dental Research
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