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https://www.readbyqxmd.com/read/28526776/gps-demand-full-reimbursement-of-crippling-indemnity-fees
#1
Gareth Iacobucci
No abstract text is available yet for this article.
May 19, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28526721/health-care-resource-utilization-and-associated-costs-among-metastatic-cutaneous-melanoma-patients-treated-with-ipilimumab-intuition-study
#2
Grant A McArthur, Peter Mohr, Paolo Antonio Ascierto, Ana Arance, Ana Banos Hernaez, Peter Kaskel, Michael Weichenthal, Reshma Shinde, Kendall Stevinson
BACKGROUND: There are limited real-world data on health care resource utilization (HCRU) among advanced melanoma patients. The objective of this study was to describe HCRU and health care costs associated with the management of advanced melanoma patients receiving ipilimumab. METHODS: This retrospective multinational, observational study included advanced melanoma patients from Australia, Germany, Italy, and Spain who had received at least 1 dose of ipilimumab. Data extracted from medical charts included inpatient admissions, outpatient visits, surgical procedures, laboratory investigations, radiation therapy, imaging studies, and concomitant medications...
May 19, 2017: Oncologist
https://www.readbyqxmd.com/read/28526379/the-polish-intestinal-failure-centres-consensus-on-the-use-of-teduglutide-for-the-treatment-of-short-bowel-syndrome
#3
Stanisław Klek, Marek Kunecki, Jacek Sobocki, Konrad Matysiak, Katarzyna Karwowska, Krystyna Urbanowicz
OBJECTIVE: Teduglutide is an active, glucagon-like peptide (GLP)-2 analog with proven clinical efficacy regarding intestinal adaptation in patients with short bowel syndrome (SBS). There are two factors that preclude its reimbursement, and thereby, its availability: its cost (reaching ∼$300,000/y)-which significantly exceeds the cost of home parenteral nutrition (HPN) in most countries-and the lack of clear guidelines. The aim of this study was to create evidence-based working criteria for the use of teduglutide that could be used in clinical settings...
June 2017: Nutrition
https://www.readbyqxmd.com/read/28524730/recent-advances-in-genetic-testing-for-familial-hypercholesterolemia
#4
Michael A Iacocca, Robert A Hegele
Familial hypercholesterolemia (FH) is a common genetic cause of premature coronary heart disease that is widely underdiagnosed and undertreated. To improve the identification of FH and initiate timely and appropriate treatment strategies, genetic testing is becoming increasingly offered worldwide as a central part of diagnosis. Areas covered: Recent advances have been propelled by an improved understanding of the genetic determinants of FH together with substantially reduced costs of appropriate screening strategies...
May 19, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28524248/how-should-hospital-reimbursement-be-refined-to-support-concentration-of-complex-care-services
#5
Chris Bojke, Katja Grašič, Andrew Street
The English National Health Service is promoting concentration of the treatment of patients with relatively rare and complex conditions into a limited number of specialist centres. If these patients are more costly to treat, the prospective payment system based on Healthcare Resource Groups (HRGs) may need refinement because these centres will be financially disadvantaged. To assess the funding implications of this concentration policy, we estimate the cost differentials associated with caring for patients that receive complex care and examine the extent to which complex care services are concentrated across hospitals and HRGs...
May 19, 2017: Health Economics
https://www.readbyqxmd.com/read/28522031/-the-french-medecine-pricing-committee-and-the-medicine-economic-policy-rules-and-competences
#6
D Giorgi
The French medicine pricing committee (CEPS), a governmental and inter-institutional body exercises essential competences for the regulation of the economy of the reimbursable drugs in France. It provides a good example of administered price regulation. It also supervises the proper use of products (control of promotion, conventional control of sales volumes). Finally, it regulates the annual envelope of drug expenditures by means of discounts paid by pharmaceutical companies. The article presents the legal criteria and the doctrine of price setting used in France...
May 15, 2017: Annales Pharmaceutiques Françaises
https://www.readbyqxmd.com/read/28520749/access-and-response-to-direct-antiviral-agents-daa-in-hiv-hcv-co-infected-patients-in-italy-data-from-the-icona-cohort
#7
Antonella d'Arminio Monforte, Alessandro Cozzi-Lepri, Francesca Ceccherini-Silberstein, Andrea De Luca, Sergio Lo Caputo, Antonella Castagna, Cristina Mussini, Antonella Cingolani, Alessandro Tavelli, Milensu Shanyinde, Andrea Gori, Enrico Girardi, Massimo Andreoni, Andrea Antinori, Massimo Puoti
BACKGROUND: Real-life data on access and response to direct antiviral agents (DAA) in HIV-HCV coinfected individuals are lacking. METHODS: HCV viremic, HIV-positive patients from Icona and Hepaicona cohorts naïve to DAA by January 2013 were included. Access and predictors of starting DAA were evaluated. Switches of antiretroviral drugs at starting DAA were described. We calculated sustained virological response (SVR12) in those reaching 12 weeks after end-of-treatment (EOT), and defined treatment failure (TF) as discontinuation of DAA before EOT or non-SVR12...
2017: PloS One
https://www.readbyqxmd.com/read/28520605/reducing-postsurgical-wound-complications-a-critical-review
#8
Barbara Delmore, Joshua Mitchell Cohen, Daniel O'Neill, Andy Chu, Vinh Pham, Ernest Chiu
GENERAL PURPOSE: To provide information on risk factors for surgical site infections (SSIs) and actions to mitigate that risk. TARGET AUDIENCE: This continuing education activity is intended for surgeons, surgical teams, physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to:1...
June 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28520602/medical-nutrition-therapy-obesity-behavioral-therapy-and-smoking-cessation-counseling-reimbursement-q-a-s
#9
Kathleen D Schaum
No abstract text is available yet for this article.
June 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28516332/prevalence-and-mortality-of-patients-with-multiple-sclerosis-in-france-in-2012-a-study-based-on-french-health-insurance-data
#10
Stéphanie Foulon, Géric Maura, Marie Dalichampt, François Alla, Marc Debouverie, Thibault Moreau, Alain Weill
Data on the prevalence of multiple sclerosis (MS) in France are scarce. National and regional updated estimates are needed to better plan health policies. In this nationwide study, we provided estimates of the prevalence of MS in France in 2012 and mortality rate in 2013. MS cases were identified in the French national health insurance database (SNIIRAM-PMSI) using reimbursement data for disease-modifying treatment, long-term disease status for MS, disability pension for MS, and hospitalisation for MS (MS ICD-10 code: G35)...
May 17, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28516194/-current-legal-and-jurisdictional-questions-from-the-perspective-of-the-german-federal-association-for-geriatrics-practical-report
#11
REVIEW
Dirk van den Heuvel, Carsten Klein
The article discusses the questions of the arbitration bodies according to § 111b SGB V (Volume V of the Social Insurance Code) in the individual federal states from the perspective of geriatric rehabilitation hospitals. The content of the agreement of reimbursement between a rehabilitation hospital and health insurance will be targeted as well as the question whether the entire content of the agreements of reimbursement can be negotiated at the arbitration body. In addition, the authors describe the consequences of the jurisprudence of the Federal Social Court on § 301 I...
May 17, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28513993/patient-report-outcome-measures-in-orthopaedics
#12
REVIEW
Joel J Gagnier
Patient reported outcome measures (PROMs) are key tools when performing clinical research and PROM data are increasingly used to inform clinical decision-making, patient-centered care, health policy and more recently, reimbursement decisions. PROMs must possess particular properties before they are used. Thus purpose of this paper is to give an overview of PROMs, their definition, how their evidence can be assessed, how they should be reported in clinical research, how to choose PROMs, the types of PROMs available in orthopaedics, where these measures can be found, PROMs in orthopaedic clinical practice and what are some key next steps in this field...
May 17, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28511946/national-incidence-of-patient-safety-indicators-in-the-total-hip-arthroplasty-population
#13
Joseph E Tanenbaum, Derrick M Knapik, Glenn D Wera, Steven J Fitzgerald
BACKGROUND: The Centers for Medicare & Medicaid Services use the incidence of patient safety indicators (PSIs) to determine health care value and hospital reimbursement. The national incidence of PSI has not been quantified in the total hip arthroplasty (THA) population, and it is unknown if patient insurance status is associated with PSI incidence after THA. METHODS: All patients in the Nationwide Inpatient Sample (NIS) who underwent THA in 2013 were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification codes...
April 12, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28511830/personality-disorders-and-the-difficult-dermatology-patient-maximizing-patient-satisfaction
#14
Mio Nakamura, John Koo
Personality disorders (PDs) are stable and enduring patterns of thought, feeling, and behavior that deviate from one's cultural norms and cause impairment in functionality. Patients with PDs are commonly encountered in the dermatologic setting and can be perceived by providers as "difficult." Given that PDs are chronic, rigid, and frustrating to deal with, it is important to be skillful in the approach to such patients, especially in the era of the value-based reimbursement system, in which patient satisfaction is crucial for reimbursement...
May 2017: Clinics in Dermatology
https://www.readbyqxmd.com/read/28510514/door-is-open-for-hras-to-make-a-comeback
#15
Jan Greene
For four years, businesses that wanted to reimburse employees for their health insurance premiums rather than buying their coverage for them were told that that was no longer allowed under the ACA. But the health reimbursement arrangement (HRA) is back, brought back to life by provisions tucked into last year's 21st Century Cure Act.
March 2017: Managed Care
https://www.readbyqxmd.com/read/28509620/the-role-of-social-workers-in-addressing-nonmedical-needs-in-primary-health-care
#16
Jeannine M Rowe, Victoria M Rizzo, Matthew R Vail, Suk-Young Kang, Robyn Golden
Nonmedical needs are intricately linked to health. Unaddressed nonmedical needs often result in poorer health and increased healthcare costs. Although social workers are well positioned to address nonmedical needs, their role in healthcare environments to address nonmedical needs is limited. The limited role relates to a lack of reimbursement streams, which stems from poor articulation about their unique contributions. An analysis of a case study in which a social worker using AIMS, a protocolized care coordination model, was undertaken to highlight specific activities performed by social workers...
May 16, 2017: Social Work in Health Care
https://www.readbyqxmd.com/read/28508022/impact-of-health-literacy-on-senior-citizen-engagement-in-health-care-it-usage
#17
Alice M Noblin, Ashley Rutherford
Objective: Patient engagement in health care information technology (IT) is required for government reimbursement programs. This research surveyed one older adult group to determine their willingness to use health information from a variety of sources. Health literacy was also measured using the Newest Vital Sign (NVS) and eHealth Literacy Scale (eHEALS) tools. Method: Regression models determined engagement in health care IT usage and impact of literacy levels based on survey data collected from the group...
January 2017: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/28508011/mandated-health-insurance-and-provider-reimbursement-via-private-insurance-evidence-from-the-massachusetts-health-reform
#18
Andrew Friedson, Allison Marier
In 2006, Massachusetts passed a reform that required individuals to purchase health insurance and provided subsidized health insurance to low-income individuals. The US Patient Protection and Affordable Care Act (ACA) was modeled after this reform, making Massachusetts an ideal place to look at potential outcomes from the ACA. Postreform, the proportion of the health-insured population in Massachusetts greatly increased, which potentially changed physician reimbursement for procedures as usage of care, particularly preventative care for children increased...
January 2017: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/28507206/real-world-data-on-prognostic-factors-for-overall-survival-in-egfr-mutation-positive-advanced-non-small-cell-lung-cancer-patients-treated-with-first-line-gefitinib
#19
Zong-Han Yao, Wei-Yu Liao, Chao-Chi Ho, Kuan-Yu Chen, Jin-Yuan Shih, Jin-Shing Chen, Zhong-Zhe Lin, Chia-Chi Lin, James Chih-Hsin Yang, Chong-Jen Yu
BACKGROUND: This study aimed to identify independent prognostic factors for overall survival (OS) of patients with advanced non-small cell lung cancer (NSCLC) harboring an activating epidermal growth factor receptor (EGFR) mutation and receiving gefitinib as first-line treatment in real-world practice. MATERIALS AND METHODS: We enrolled 226 patients from June 2011 to May 2013. During this period, gefitinib was the only EGFR-tyrosine kinase inhibitor reimbursed by the Bureau of National Health Insurance of Taiwan...
May 15, 2017: Oncologist
https://www.readbyqxmd.com/read/28506979/impact-of-ezetimibe-on-the-rate-of-cardiovascular-related-hospitalizations-and-associated-costs-among-patients-with-a-recent-acute-coronary-syndrome-results-from-the-improve-it-trial-improved-reduction-of-outcomes-vytorin-efficacy-international-trial
#20
Yashashwi Pokharel, Khaja Chinnakondepalli, Katherine Vilain, Kaijun Wang, Daniel B Mark, Glenn Davies, Michael A Blazing, Robert P Giugliano, Eugene Braunwald, Christopher P Cannon, David J Cohen, Elizabeth A Magnuson
BACKGROUND: Ezetimibe, when added to simvastatin therapy, reduces cardiovascular events after recent acute coronary syndrome. However, the impact of ezetimibe on cardiovascular-related hospitalizations and associated costs is unknown. METHODS AND RESULTS: We used patient-level data from the IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial) to examine the impact of simvastatin-ezetimibe versus simvastatin-placebo on cardiovascular-related hospitalizations and related costs (excluding drug costs) over 7 years follow-up...
May 2017: Circulation. Cardiovascular Quality and Outcomes
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