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https://www.readbyqxmd.com/read/28532470/health-care-professionals-attitudes-towards-evidence-based-medicine-in-the-workers-compensation-setting-a-cohort-study
#1
Nieke A Elbers, Robin Chase, Ashley Craig, Lyn Guy, Ian A Harris, James W Middleton, Michael K Nicholas, Trudy Rebbeck, John Walsh, Simon Willcock, Keri Lockwood, Ian D Cameron
BACKGROUND: Problems may arise during the approval process of treatment after a compensable work injury, which include excess paperwork, delays in approving services, disputes, and allegations of over-servicing. This is perceived as undesirable for injured people, health care professionals and claims managers, and costly to the health care system, compensation system, workplaces and society. Introducing an Evidence Based Medicine (EBM) decision tool in the workers' compensation system could provide a partial solution, by reducing uncertainty about effective treatment...
May 22, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28530851/chondral-injuries-and-irreparable-meniscal-tears-among-adolescents-with-anterior-cruciate-ligament-or-meniscal-tears-are-more-common-in-patients-with-public-insurance
#2
Ariel A Williams, Nickolas S Mancini, Matthew J Solomito, Carl W Nissen, Matthew D Milewski
BACKGROUND: Access to health care services is a critical component of health care reform and may differ among patients with different types of insurance. Hypothesis/Purpose: The purpose was to compare adolescents with private and public insurance undergoing surgery for anterior cruciate ligament (ACL) and/or meniscal tears. We hypothesized that patients with public insurance would have a delayed presentation from the time of injury and therefore would have a higher incidence of chondral injuries and irreparable meniscal tears and lower preoperative International Knee Documentation Committee (IKDC) scores than patients with private insurance...
May 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28526230/shared-decision-making-in-taiwan
#3
Hsun-Hsiang Liao, Huey-Wen Liang, Hou-Chaung Chen, Ching-I Chang, Pa-Chun Wang, Chung-Liang Shih
The paper aims to introduce the current status of shared decision making (SDM) in Taiwan under its mixed health care system and single-payer health insurance system. With experiences in promoting both evidence based medicine and patient safety, the Joint Commission of Taiwan has implemented a nationwide SDM program under the aegis of the Ministry of Health and Welfare since 2016, incorporating multiple approaches such as developing patient decision aids (PDAs), executing the Medical Decision Aids Campaign, establishing a SDM platform, and integrating SDM in clinical practice...
May 17, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28523128/comparison-of-medicines-management-strategies-in-insurance-schemes-in-middle-income-countries-four-case-studies
#4
Warren A Kaplan, Paul G Ashigbie, Mohamad I Brooks, Veronika J Wirtz
BACKGROUND: Many middle-income countries are scaling up health insurance schemes to provide financial protection and access to affordable medicines to poor and uninsured populations. Although there is a wealth of evidence on how high income countries with mature insurance schemes manage cost-effective use of medicines, there is limited evidence on the strategies used in middle-income countries. This paper compares the medicines management strategies that four insurance schemes in middle-income countries use to improve access and cost-effective use of medicines among beneficiaries...
2017: Journal of Pharmaceutical Policy and Practice
https://www.readbyqxmd.com/read/28506414/unintentional-recurrent-laryngeal-nerve-injuries-following-thyroidectomy-is-it-the-surgeon-who-pays-the-bill
#5
REVIEW
C Gambardella, A Polistena, A Sanguinetti, R Patrone, S Napolitano, D Esposito, D Testa, V Marotta, A Faggiano, P G Calò, N Avenia, G Conzo
BACKGROUND: Thyroidectomy is one of the most common intervention in general surgery and, after the turn of the century, its rate has sharply increased, along with a worldwide increased incidence of differentiated thyroid cancers. Therefore, injuries of the recurrent laryngeal nerve have become one of the most frequent cause of surgical malpractice claims, mostly following surgery for benign pathology. MAIN BODY: Even if the incidence of definitive paralysis is generally lower than 3%, during the last 20 years in Italy, the number of claims for damages has sharply raised...
May 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28505161/effect-on-healthcare-utilization-and-costs-of-spinal-manual-therapy-for-acute-low-back-pain-in-routine-care-a-propensity-score-matched-cohort-study
#6
Jochen Walker, Ulf Kai Mertens, Carsten Oliver Schmidt, Jean-François Chenot
Spinal manual therapy (SMT) is a popular treatment option for low back pain (LBP). The aim of our analysis was to evaluate the effects of manual therapy delivered by general practitioners and ambulatory orthopedic surgeons in routine care on follow up consultations, sick leave, health service utilization and costs for acute LBP compared to matched patients not receiving manual therapy. This is a propensity score matched cohort study based on health claims data. We identified a total of 113.652 adult patients with acute LBP and no coded red flags of whom 21...
2017: PloS One
https://www.readbyqxmd.com/read/28499829/characteristics-of-traditional-chinese-medicine-usage-in-children-with-precocious-puberty-a-nationwide-population-based-study
#7
Yi-Chun Lin, Tung-Ti Chang, Husan-Ju Chen, Chung-Hsing Wang, Mao-Feng Sun, Hung-Rong Yen
ETHNOPHARMACOLOGICAL RELEVANCE: Precocious puberty (PP) occurs in children with the early onset of pubertal development leading to physical and psychological problems. Current medical treatment is expensive and has its side effects. However, little is known about the utilization of traditional Chinese medicine (TCM) among patients with PP. To characterize the application of TCM among these patients, we conducted a nationwide population-based study. MATERIALS AND METHODS: We used the Taiwanese National Health Insurance Research Database (NHIRD), to perform a nationwide population-based study...
May 9, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28497319/trends-in-and-relation-between-hip-fracture-incidence-and-osteoporosis-medication-utilization-and-prices-in-estonia-in-2004-2015
#8
Ott Laius, Heti Pisarev, Katre Maasalu, Sulev Kõks, Aare Märtson
Osteoporosis medicines reduce osteoporotic fractures. There is a very strong negative correlation between the consumption of medicines and the price of an average daily dose indicating that affordability is a key factor that could increase consumption of antiosteoporotic medicines and, through that, reduce fractures. PURPOSE: Osteoporosis is a major cause of morbidity and mortality in the modern world. Our study aims to describe the trends in incidence of hip fractures in relation to drug utilization patterns and the average price of antiosteoporotic medicines in Estonia...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28496002/risk-of-cancer-in-patients-with-heart-failure-who-use-digoxin-a-10-year-follow-up-study-and-cell-based-verification
#9
Min-Huey Chung, Yi-Wen Wang, Yung-Lung Chang, Shih-Ming Huang, Wei-Shiang Lin
Heart failure (HF) is the leading cause of death in the world and digoxin remains one of the oldest therapies for HF. However, its safety and efficacy have been controversial since its initial use and there is uncertainty about its long-term efficacy and safety. Recently, the repositioning of cardiac glycosides is to function in anti-tumor activity via multiple working pathways. It is interesting to compare the potential effects of digoxin in clinical patients and cell lines. First, we analyze patient information retrieved from the National Health Insurance Research database of Taiwan between January 1, 2000 and December 31, 2000...
April 25, 2017: Oncotarget
https://www.readbyqxmd.com/read/28494776/aggregated-n-of-1-trials-for-unlicensed-medicines-for-small-populations-an-assessment-of-a-trial-with-ephedrine-for-myasthenia-gravis
#10
Stephanie S Weinreich, Charlotte Vrinten, Marja R Kuijpers, Alexander F Lipka, Kirsten J M Schimmel, Erik W van Zwet, Christine Gispen-de Wied, Yechiel A Hekster, Jan J G M Verschuuren, Martina C Cornel
BACKGROUND: Inexpensive medicines with a long history of use may currently be prescribed off-label for rare indications. Reimbursement is at the discretion of health insurance companies, and may be unpredictable. The example addressed was ephedrine as add-on treatment for myasthenia gravis. Stakeholders from academia, a patient organization, the Dutch National Health Care Institute (NHCI) and Dutch Medicines Evaluation Board (MEB) advised on the trial design. The NHCI and MEB agreed to provide scientific advice on the suitability of the evidence generated by the trial, for regulatory decisions...
May 12, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28492008/physician-industry-collaboration-organizational-considerations-for-the-future-of-innovation-and-growth-in-dermatology
#11
EDITORIAL
Wendy E Roberts, Neil S Sadick, Wilma F Bergfeld, Amy S Paller, Valerie D Callender, Lynn A Drake
The U.S. medical environment continues to evolve with issues from Privacy to EMR, Insurance regulations, Physician Access and Healthcare Reform, and MACRA (Medicare Access and CHIP Reauthorization Act) on the discussion table. Not since the advent of Medicare and Medicaid in the mid 1960's, have we seen such widespread changes in the medical healthcare environment (Centers for Medicare and Medicaid Services). Physicians, industry, patients and consumers are affected by the changes. These four groups have historically worked as separate entities, but are now key stakeholders in the future of dermatology...
June 2016: International Journal of Women's Dermatology
https://www.readbyqxmd.com/read/28486159/trends-of-thromboprophylaxis-and-complications-after-major-lower-limb-orthopaedic-surgeries-in-korea-national-health-insurance-claim-data
#12
Sunyoung Kim, Hongyup Ahn, Soon-Ae Shin, Jong-Heon Park, Chang Won Won
BACKGROUND: In Western countries, prophylaxis for venous thromboembolism (VTE) following major lower limb orthopaedic surgeries is recommended. However, that has not been the case in Asian countries, where the reported incidence of postoperative VTE has been low. The present study examined trends in VTE prophylaxis prescriptions and related complications following major lower limb orthopaedic surgeries in South Korea. DESIGN/PARTICIPANTS: Using claim data from the National Health Insurance Corporation, 263,664 patients aged 65years or older who underwent major orthopaedic surgeries (total hip arthroplasty [THA], total knee arthroplasty [TKA], or hip fracture surgery [HFS]) between 2008 and 2012 were included...
April 26, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28484823/-prolonged-weaning-during-early-neurological-and-neurosurgical-rehabilitation-s2k-guideline-published-by-the-weaning-committee-of-the-german-neurorehabilitation-society-dgnr
#13
REVIEW
J D Rollnik, J Adolphsen, J Bauer, M Bertram, J Brocke, C Dohmen, E Donauer, M Hartwich, M D Heidler, V Huge, S Klarmann, S Lorenzl, M Lück, M Mertl-Rötzer, T Mokrusch, D A Nowak, T Platz, L Riechmann, F Schlachetzki, A von Helden, C W Wallesch, D Zergiebel, M Pohl
Prolonged weaning of patients with neurological or neurosurgery disorders is associated with specific characteristics, which are taken into account by the German Society for Neurorehabilitation (DGNR) in its own guideline. The current S2k guideline of the German Society for Pneumology and Respiratory Medicine is referred to explicitly with regard to definitions (e.g., weaning and weaning failure), weaning categories, pathophysiology of weaning failure, and general weaning strategies. In early neurological and neurosurgery rehabilitation, patients with central of respiratory regulation disturbances (e...
May 8, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28477291/the-effect-of-complementary-private-health-insurance-on-the-use-of-health-care-services
#14
Astrid Kiil, Jacob Nielsen Arendt
This study estimates the effect of complementary private health insurance (PHI) on the use of health care. The empirical analysis focuses on an institutional setting in which empirical findings are still limited; namely on PHI covering co-payment for treatments that are only partly financed by a universal health care system. The analysis is based on Danish data recently collected specifically for this purpose, which makes identification strategies assuming selection on observables only, and on both observables and unobservables also, both plausible and possible...
March 2017: International Journal of Health Economics and Management
https://www.readbyqxmd.com/read/28473307/the-rsvp-project-factors-related-to-disengagement-from-human-immunodeficiency-virus-care-among-persons-in-san-francisco
#15
Susan Scheer, Miao-Jung Chen, Maree Kay Parisi, Maya Yoshida-Cervantes, Erin Antunez, Viva Delgado, Nicholas J Moss, Kate Buchacz
BACKGROUND: In the United States, an estimated two-thirds of persons with human immunodeficiency virus (HIV) infection do not achieve viral suppression, including those who have never engaged in HIV care and others who do not stay engaged in care. Persons with an unsuppressed HIV viral load might experience poor clinical outcomes and transmit HIV. OBJECTIVE: The goal of the Re-engaging Surveillance-identified Viremic Persons (RSVP) project in San Francisco, CA, was to use routine HIV surveillance databases to identify, contact, interview, and reengage in HIV care persons who appeared to be out of care because their last HIV viral load was unsuppressed...
May 4, 2017: JMIR Public Health and Surveillance
https://www.readbyqxmd.com/read/28466798/-physicians-assessments-of-work-capacity-in-patients-with-shc-comparison-between-five-european-countries
#16
S L Merkus, K H N Weerdesteijn, F G Schaafsma, S Maeland, M Jourdain, J P Canévet, C Rat, J R Anema, E L Werner
OBJECTIVE: Comparing assessments of incapacity to work in patients with subjective health complaints (SHC) by physicians from 5 different European countries. DESIGN: Cross-sectional study. METHOD: General practitioners from Norway (n=56), Sweden (n=29), Denmark (n=41), France (n=46) and occupational and insurance physicians from the Netherlands (n=93) watched and assessed incapacity to work in nine video vignettes of patients with SHC. We subsequently analysed differences between assessments (whether or not there was incapacity to work) by country, with Norway as a reference, as well as differences between general practitioners from the four countries and occupational and insurance physicians using a generalised linear mixed model...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28461353/the-medicare-access-and-chip-reauthorization-act-and-the-corporate-transformation-of-american-medicine
#17
Lawrence P Casalino
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) may accelerate the movement of physicians into corporate employment by hospitals and, to a lesser extent, by health insurers and other corporations. This article briefly summarizes the demographics of US physician practice, the potential advantages and disadvantages of physician employment by large corporations, and the evidence to date on the performance of large versus small physician practices and hospital-employed versus independent physicians...
May 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28445217/why-health-insurance-matters-and-why-research-evidence-should-too
#18
Benjamin D Sommers
In the current debate over the future of the Affordable Care Act (ACA), research evidence on the impact of the law and the effects of health insurance coverage in general is critical. Studies of health insurance expansion over the past decade have demonstrated that coverage expansions can produce significant reductions in mortality-particularly among minorities, those living in poorer areas, and those with chronic conditions potentially treatable with timely medical care. More recent studies of the ACA in particular demonstrate that the law has produced historically large reductions in the uninsured rate, with resulting improvements in access to care, perceived quality of care, and self-reported health...
April 25, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28442900/identification-of-subtypes-in-subjects-with-mild-to-moderate-airflow-limitation-and-its-clinical-and-socioeconomic-implications
#19
Jin Hwa Lee, Chin Kook Rhee, Kyungjoo Kim, Jee-Ae Kim, Sang Hyun Kim, Kwang Ha Yoo, Woo Jin Kim, Yong Bum Park, Hye Yun Park, Ki-Suck Jung
PURPOSE: The purpose of this study was to identify subtypes in patients with mild-to-moderate airflow limitation and to appreciate their clinical and socioeconomic implications. METHODS: Subjects who were aged ≥20 years and had forced expiratory volume in 1 second (FEV1) ≥60% predicted and FEV1/forced vital capacity <0.7 were selected from the fourth Korea National Health and Nutrition Examination Survey (KNHANES) in 2007-2012. The data were merged to the National Health Insurance reimbursement database during the same period...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28435485/impact-of-health-policy-changes-on-emergency-medicine-in-maryland-stratified-by-socioeconomic-status
#20
Laura Pimentel, David Anderson, Bruce Golden, Edward Wasil, Fermin Barrueto, Jon M Hirshon
INTRODUCTION: On January 1, 2014, the financing and delivery of healthcare in the state of Maryland (MD) profoundly changed. The insurance provisions of the Patient Protection and Affordable Care Act (ACA) began implementation and a major revision of MD's Medicare waiver ushered in a Global Budget Revenue (GBR) structure for hospital reimbursement. Our objective was to analyze the impact of these policy changes on emergency department (ED) utilization, hospitalization practices, insurance profiles, and professional revenue...
April 2017: Western Journal of Emergency Medicine
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