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https://www.readbyqxmd.com/read/28339427/a-critical-analysis-of-obamacare-affordable-care-or-insurance-for-many-and-coverage-for-few
#1
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
The Affordable Care Act (ACA), of 2010, or Obamacare, was the most monumental change in US health care policy since the passage of Medicaid and Medicare in 1965. Since its enactment, numerous claims have been made on both sides of the aisle regarding the ACA's success or failure; these views often colored by political persuasion. The ACA had 3 primary goals: increasing the number of the insured, improving the quality of care, and reducing the costs of health care. One point often lost in the discussion is the distinction between affordability and access...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339426/evolution-of-us-health-care-reform
#2
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
Major health policy creation or changes, including governmental and private policies affecting health care delivery are based on health care reform(s). Health care reform has been a global issue over the years and the United States has seen proposals for multiple reforms over the years. A successful, health care proposal in the United States with involvement of the federal government was the short-lived establishment of the first system of national medical care in the South. In the 20th century, the United States was influenced by progressivism leading to the initiation of efforts to achieve universal coverage, supported by a Republican presidential candidate, Theodore Roosevelt...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28335754/the-structural-and-health-policy-environment-for-delivering-integrated-hiv-and-substance-use-disorder-treatments-in-puerto-rico
#3
Jared A Leff, Diana Hernández, Paul A Teixeira, Pedro C Castellón, Daniel J Feaster, Allan E Rodriguez, Jorge L Santana-Bagur, Sandra Miranda De León, José Vargas Vidot, Lisa R Metsch, Bruce R Schackman
BACKGROUND: HIV prevalence in Puerto Rico is nearly twice that of the mainland United States, a level that was substantially fueled by injection drug use. Puerto Rico has a longstanding history of health provision by the public sector that directly affects how HIV and substance use disorder (SUD) treatment services are provided and funded. As part of pre-implementation research for a randomized trial of a community-level intervention to enhance HIV care access for substance users in San Juan, Puerto Rico, we sought to understand the structural and health policy environment for providing HIV and SUD treatments...
March 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28332943/effects-of-different-models-of-dialysis-care-on-patient-important-outcomes-a-systematic-review-and-meta-analysis
#4
Priya Ramar, Ahmed T Ahmed, Zhen Wang, Sagar S Chawla, Maria Lourdes Gonzalez Suarez, LaTonya J Hickson, Ann Farrell, Amy W Williams, Nilay D Shah, M Hassan Murad, Bjorg Thorsteinsdottir
Ongoing payment reform in dialysis necessitates better patient outcomes and lower costs. Suggested improvements to processes of care for maintenance dialysis patients are abundant; however, their impact on patient-important outcomes is unclear. This systematic review included comparative randomized controlled trials or observational studies with no restriction on language, published from 2000 to 2014, involving at least 5 adult dialysis patients who received a minimum of 6 months of follow-up. The effect size was pooled and stratified by intervention strategy (multidisciplinary care [MDC], home dialysis, alternate dialysis settings, and electronic health record implementation)...
March 23, 2017: Population Health Management
https://www.readbyqxmd.com/read/28332223/change-management-in-an-environment-of-ongoing-primary-health-care-system-reform-a-case-study-of-australian-primary-health-care-services
#5
Sara Javanparast, Janny Maddern, Fran Baum, Toby Freeman, Angela Lawless, Ronald Labonté, David Sanders
INTRODUCTION/BACKGROUND: Globally, health reforms continue to be high on the health policy agenda to respond to the increasing health care costs and managing the emerging complex health conditions. Many countries have emphasised PHC to prevent high cost of hospital care and improve population health and equity. The existing tension in PHC philosophies and complexity of PHC setting make the implementation and management of these changes more difficult. This paper presents an Australian case study of PHC restructuring and how these changes have been managed from the viewpoint of practitioners and middle managers...
March 22, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28329466/healthcare-reform-literacy-among-academic-dermatologists-what-we-know-and-don-t-know-about-the-affordable-care-act
#6
Brian A Raphael, Suephy Chen, Benjamin Stoff
IMPORTANCE: There have been no attempts to determinethe understanding of the Affordable Care Act (ACA)among dermatologists. OBJECTIVE: Assess knowledgeof the ACA among academic dermatologists. DESIGN: A 21-item survey was administered to membersof the Association of Professors of Dermatology(APD). The items assessed knowledge and opinionsof the ACA, and demographics of the participants.Multivariate regressions were conducted todetermine associations between variables...
January 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/28325241/radiation-oncology-in-the-developing-economies-of-central-and-eastern-europe
#7
REVIEW
Natia Esiashvili
Eastern Europe is represented by 22 countries of significant variability in population density and degree of economic development. They have been affected by past geopolitical isolation due to their association with the "Soviet Block." Currently, all Eastern European countries except Slovenia are low- or middle-income level and 10 of them are part of European Union. Health care systems in Central and Eastern Europe have been influenced by the legacy of centralized soviet-era governance; however, most countries, particularly in European Union zone, have gone through health care reforms directed toward modernizing infrastructure and staffing...
April 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28323603/how-medicine-may-save-the-life-of-us-immigration-policy-from-clinical-and-educational-encounters-to-ethical-public-policy
#8
Mark G Kuczewski
Medicine has a conceptual contribution to make to the immigration debate. Our nation has been unable to move forward with meaningful immigration reform because many citizens seem to assume that immigrants are in the United States to access benefits to which they are not entitled. In contrast, when medicine encounters undocumented immigrants in the health care or medical education setting, it is obvious that their contributions to our health care system are denied by exclusionary laws. When the system is amended to be inclusive, immigrants become contributors to the systems that they access...
March 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28321291/re-thinking-barriers-to-organizational-change-in-public-hospitals
#9
Nigel Edwards, Richard B Saltman
Public hospitals are well known to be difficult to reform. This paper provides a comprehensive six-part analytic framework that can help policymakers and managers better shape their organizational and institutional behavior. The paper first describes three separate structural characteristics which, together, inhibit effective problem description and policy design for public hospitals. These three structural constraints are i) the dysfunctional characteristics found in most organizations, ii) the particular dysfunctions of professional health sector organizations, and iii) the additional dysfunctional dimensions of politically managed organizations...
2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28319813/the-clinical-implications-of-legalizing-marijuana-are-physician-and-non-physician-providers-prepared
#10
Elizabeth Brooks, Doris C Gundersen, Erin Flynn, Ashley Brooks-Russell, Sheana Bull
INTRODUCTION: Passage of voter-driven marijuana reform laws signals a shift in public attitudes for marijuana use. For providers, legalization may necessitate practice modifications, particularly regarding patient-provider conversations about use and risk. We examined healthcare providers' knowledge of marijuana laws and health implications, professional practice behaviors, and attitudes about training. MATERIALS AND METHODS: We surveyed 114 Colorado-based providers who care for children, adolescents, pregnant and breastfeeding women using a Venue-Day-Time survey methodology throughout Colorado...
March 10, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28317168/the-health-policy-pendulum-cost-control-vs-activity-growth
#11
Trond Tjerbo, Terje P Hagen
BACKGROUND: Cost containment is a major policy challenge and one of the key drivers of health care reform. In this article, we focus on the role cost control has played as a reform driver in the Norwegian hospital sector between 1980 and 2014. METHODS: We use data on aggregate expenditure as well as on activity changes from year to year. We also use qualitative data for illustrative purposes. RESULTS: We identify 4 phases in the period 1980 to 2014: two where activity increases have dominated the agenda and 2 where cost control has been emphasized...
March 20, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28316557/achieving-prudent-dementia-care-palliare-an-international-policy-and-practice-imperative
#12
Debbie Tolson, Anne Fleming, Elizabeth Hanson, Wilson de Abreu, Manuel Lillo Crespo, Rhoda Macrae, Graham Jackson, Simona Hvalič-Touzery, Iva Holmerová, Pirkko Routasalo
This paper examines the provision of integrated advanced dementia care within seven European countries and critically reviews the potential contribution of the Prudent Healthcare perspective as a starting point for reform. Progressive efforts to innovate, promote quality and integrate care are tempered with the reality of resource constraints. Some policy makers in Europe and North America have turned their attention to the principles of Prudent Healthcare as a potential mechanism to maximise benefits for patients within available resources...
December 31, 2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28302597/mhealth-interventions-for-health-system-strengthening-in-china-a-systematic-review
#13
Maoyi Tian, Jing Zhang, Rong Luo, Shi Chen, Djordje Petrovic, Julie Redfern, Dong Roman Xu, Anushka Patel
BACKGROUND: With rapidly expanding infrastructure in China, mobile technology has been deemed to have the potential to revolutionize health care delivery. There is particular promise for mobile health (mHealth) to positively influence health system reform and confront the new challenges of chronic diseases. OBJECTIVE: The aim of this study was to systematically review existing mHealth initiatives in China, characterize them, and examine the extent to which mHealth contributes toward the health system strengthening in China...
March 16, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28300990/analysis-of-the-attributes-of-primary-health-care-using-the-electronic-medical-records-in-the-city-of-rio-de-janeiro
#14
Daniel Soranz, Luiz Felipe Pinto, Luiz Antonio Bastos Camacho
Epidemiology plays a strategic role at this stage of the policy cycle, contributing to goal setting, resource allocation and use of information systems. In 2009, the Municipal Health Secretariat of Rio de Janeiro initiated a reform of the health care model under the main influence the Primary Health Care concept. This study evaluates the trend of selected pay-for-performance indicators that measure the health care process in the city's PHC. This a study on repeated panels, from the administrative and clinical records of electronic medical records in the period from 2012 to 2016...
March 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28300989/analysis-of-the-performance-of-contractualization-primary-health-care-indicators-in-the-period-2009-2015-in-lisbon-and-tagus-valley
#15
Baltazar Ricardo Monteiro, Fátima Candoso, Magda Reis, Sónia Bastos
Reforms started in 1996 intended that Regional Health Administrations (ARS) should play a relevant role in the process of transforming an integrated model towards a contractual health care model. The essential tool of this transformation would be the Contractualization Agency, established in each ARS. Its role in the new contractualization culture was to negotiate prospective budgets with health care institutions, which included Primary Health Care (PHC). This paper is a longitudinal analysis of the development of a set of nine PHC contractualization indicators in three Health Center Clusters (ACeS) of the Regional Health Administration of Lisbon and Tagus Valley (ARSLVT)...
March 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28300983/preceptorship-in-family-and-community-medicine-challenges-and-achievements-in-a-primary-health-care-in-progress
#16
Mellina Marques Vieira Izecksohn, Jorge Esteves Teixeira, Bruno Pereira Stelet, Adelson Guaraci Jantsch
Strengthening Primary Health Care (PHC) relies directly on training medical specialists in primary care. This text aims to report the Family Medicine training experiences in Rio de Janeiro between 2008 and 2016. It brings to reflection the development of preceptors in medical specialization through an experience report on three Family Medicine medical residency programs, namely, the Municipal Health Secretariat program, the Federal University of Rio de Janeiro program and the National School of Public Health program...
March 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28300982/primary-healthcare-in-portugal-10-years-of-contractualization-of-health-services-in-the-region-of-lisbon
#17
Baltazar Ricardo Monteiro, Ana Maria Silva Azenha Pisco, Fátima Candoso, Sónia Bastos, Magda Reis
Contractualization consists in the development and implementation of a documented agreement whereby one party (payer) provides compensation to the other party (provider) in exchange for a set of health services to a targeted population. We describe, through a case study, the history and the process of implementation of primary health care contractualization (since 1992) in Portugal, emphasizing the consolidation and future challenges of the primary healthcare reform started in 2005. This article resorts to a case study to reflect on the results obtained in the Cluster of Health Centers of the Northern West, Regional Administration of Lisbon and Tagus Valley, between 2009 and 2015, following implementation of contractualization...
March 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28300980/primary-health-care-reform-in-portugal-portuguese-modern-and-innovative
#18
André Rosa Biscaia, Liliana Correia Valente Heleno
The 2005 Portuguese primary health care (CSP) reform was one of the most successful reforms of the country's public services. The most relevant event was the establishment of Family Health Units (USF): voluntary and self-organized multidisciplinary teams that provide customized medical and nursing care to a group of people. Then, the remaining realms of CSP were reorganized with the establishment of Health Center Clusters (ACeS). Clinical governance was implemented aiming at achieving health gains by improving quality and participation and accountability of all...
March 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28300976/primary-health-care-reform-in-the-cities-of-lisbon-and-rio-de-janeiro-context-strategies-results-learning-and-challenges
#19
Daniel Soranz, Luís Augusto Coelho Pisco
On the 30th anniversary of Alma-Ata, the World Health Organization published in 2008 the "Primary Health Care Now More Than Ever" Report, calling on all governments to reflect on the need to reflect on four sets of reforms. These included: (i) universal coverage reforms; (ii) service delivery reforms; (iii) public policies reforms that would ensure healthier communities; and (iv) leadership reforms. In this context, in the period 2005-2016, the cities of Rio de Janeiro and Lisbon developed a profound primary healthcare reform, and did so by sharing many of the solutions based on the best internationally recognized organizational practices...
March 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28299972/older-and-incarcerated-policy-implications-of-aging-prison-populations
#20
Zachary Psick, Jonathan Simon, Rebecca Brown, Cyrus Ahalt
Purpose The purpose of this paper is to explore the policy Implications of aging prison populations. Design/methodology/approach An examination of the worldwide aging trend in prison and its implications for correctional policy, including an examination of population aging in California prisons as a case example of needed reform. Findings Prison populations worldwide are aging at an unprecedented rate, and age-related medical costs have had serious consequences for jurisdictions struggling to respond to the changes...
March 13, 2017: International Journal of Prisoner Health
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