Read by QxMD icon Read

Health Care Reform

Arinze Nkemdirim Okere
With the current legalization of medical marijuana and the possibility of recreational use being permitted in some states, the health care benefits associated with the use of marijuana is questionable. States that are on the path of legalizing marijuana, should recognize that as there are perceived positive benefits, there are also many evidence-based negative health consequences which may result in negative economic and societal consequences. As more data on health outcomes regarding the use of marijuana continue to emerge, policies directed toward legalizing marijuana, whether medical or recreational, should consider protecting the society from both harm and societal cost...
March 1, 2018: Annals of Pharmacotherapy
Cuirong Zhao, Chao Wang, Chengwu Shen, Qian Wang
China has undertaken waves of healthcare reforms to keep pace with its rapid economic growth. By 2011, universal health insurance coverage was successfully achieved through the creation of a basic social medical insurance system. Growing economic power, extensive government subsidies, and strategies for program implementation are critical to that achievement. However, the breadth and depth of coverage varies considerably across insurance schemes and localities. The disjointed insurance scheme led to inequality in coverage, accessibility, and affordability of medical services, lopsided allocation of health resources, and increasing medical expenditures, and these remain crucial challenges for healthcare insurance coverage...
2018: Drug Discoveries & Therapeutics
Yongjian Xu, Jie Ma, Na Wu, Xiaojing Fan, Tao Zhang, Zhongliang Zhou, Jianmin Gao, Jianping Ren, Gang Chen
INTRODUCTION: In 2009, China officially launched the New Health Care Reform (NHCR). One important purpose of the reform was to reduce financial burden of health care through health insurance expansion and health care provider regulations. This study aimed to provide evidence on the effect of the NHCR reform on catastrophic health expenditure (CHE) by comparing the occurrence and inequality of CHE among households with chronic diseases patients before and after the reform. METHODS: This study used the subset of data from the 2008 and 2013 National Health Services Survey conducted in Shaanxi Province...
2018: PloS One
Emily M Ko, Laura J Havrilesky, Ronald D Alvarez, Oliver Zivanovic, Leslie R Boyd, Elizabeth L Jewell, Patrick F Timmins, Randall S Gibb, Anuja Jhingran, David E Cohn, Sean C Dowdy, Matthew A Powell, Eva Chalas, Yongmei Huang, Jill Rathbun, Jason D Wright
Health care in the United States is in the midst of a significant transformation from a "fee for service" to a "fee for value" based model. The Medicare Access and CHIP Reauthorization Act of 2015 has only accelerated this transition. Anticipating these reforms, the Society of Gynecologic Oncology developed the Future of Physician Payment Reform Task Force (PPRTF) in 2015 to develop strategies to ensure fair value based reimbursement policies for gynecologic cancer care. The PPRTF elected as a first task to develop an Alternative Payment Model for thesurgical management of low risk endometrial cancer...
March 12, 2018: Gynecologic Oncology
Stephanie M Topp, Chanda Mwamba, Anjali Sharma, Njekwa Mukamba, Laura K Beres, Elvin Geng, Charles B Holmes, Izukanji Sikazwe
BACKGROUND: Failure to keep people living with HIV engaged in life-long care and treatment has serious implications for individual and population-level health. Nested within a four-province study of HIV care and treatment outcomes, we explored the dynamic role of social and service-related factors influencing retention in HIV care in Zambia. METHODS: From a stratified random sample of 31 facilities, eight clinics were selected, one urban and one rural from each province...
2018: PloS One
Carl D Stevens
The sudden, dramatic collapse of the seven-year struggle in Congress to repeal and replace the Affordable Care Act holds important lessons for all would-be reformers, including those advocating fundamental changes in medical education. In this Invited Commentary, the author draws parallels between reform initiatives in health policy and those in medical education, highlighting that, in both settings, stakeholders rarely support "repeal" in the absence of a superior replacement, even when they view the status quo as deeply flawed...
March 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Vineet M Arora
With the advent of electronic medical records (EMRs) fueling the rise of big data, the use of predictive analytics, machine learning, and artificial intelligence are touted as transformational tools to improve clinical care. While major investments are being made in using big data to transform health care delivery, little effort has been directed toward exploiting big data to improve graduate medical education (GME). Because our current system relies on faculty observations of competence, it is not unreasonable to ask whether big data in the form of clinical EMRs and other novel data sources can answer questions of importance in GME such as when is a resident ready for independent practice...
March 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Lisa B VanWagner, Fasiha Kanwal
With the passage of the Affordable Care Act (ACA) followed by the physician payment reform, there is an urgent need to better understand the complex relationships between structure (including incentives), processes, and outcomes of health care and, based on this understanding, identify interventions that can ensure delivery of high value care to patients with liver disease. As hepatologists, how do we systematically address these issues and ensure that we provide high-value care to our patients? These factors combine in the burgeoning field of health services research...
March 14, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Irene Papanicolas, Liana R Woskie, Ashish K Jha
Importance: Health care spending in the United States is a major concern and is higher than in other high-income countries, but there is little evidence that efforts to reform US health care delivery have had a meaningful influence on controlling health care spending and costs. Objective: To compare potential drivers of spending, such as structural capacity and utilization, in the United States with those of 10 of the highest-income countries (United Kingdom, Canada, Germany, Australia, Japan, Sweden, France, the Netherlands, Switzerland, and Denmark) to gain insight into what the United States can learn from these nations...
March 13, 2018: JAMA: the Journal of the American Medical Association
J Hiquet, E Christin, F Tovagliaro, J Fougas, O Dubourg, C Chevalier, F Abel, M Ebouat, M-E Ploquin, M Malo, S Gromb-Monnoyeur
BACKGROUND: The Forensic medicine reform in 2011 enabled the development of forensic units specialized in multidisciplinary care of victims of criminal offences. Thanks to an annual budgetary allocation, the Ministry of Justice handles the financing of judicial acts, while the health care facilities assume the medical, psychological and social aspects. The objective of this study was to determine the direct costs of medical care provided to rape victims (such as defined in the article 222-23 of the Penal Code) in order to see how its funding could be reconsidered to prevent any additional cost that could be caused by non-sufficient medical, psychological and social care...
March 9, 2018: Revue D'épidémiologie et de Santé Publique
Carol Atmore
This viewpoint outlines a brief history of primary care health reforms over the last 25 years, and how this history has influenced the business of caring. It also suggests where we should next look to improve the provision of equitable patient-centred care in the current climate of fiscal constraint, while meeting the challenges of an ageing population and increasing multimorbidity.
September 2017: Journal of Primary Health Care
Muktesh Daund, Sushma Sonavane, Amresh Shrivastava, Avinash Desousa, Sanjay Kumawat
Mental hospitals are an integral part of mental health services in India. It is an interesting story how mental hospitals have responded to the challenges of contemporary period they were built in. It is beyond doubt that it is a progressive journey along with advances in mental health both in India and internationally. As in other countries, mental hospitals in India have responded to the social challenges, disparities, and poor resources of workforce and fiscal investment. Historically, there have been changes and three major reforms are needed, namely attempt to facilitate discharge and placing patients back into the family, introducing teaching and research in mental hospitals, and accountability to civil rights as per the requirements of the National Human Rights Commission...
February 2018: Indian Journal of Psychiatry
Kenneth Munge, Stephen Mulupi, Edwine W Barasa, Jane Chuma
BACKGROUND: Purchasing refers to the process by which pooled funds are paid to providers in order to deliver a set of health care interventions. Very little is known about purchasing arrangements in low- and middle-income countries (LMICs), and certainly not in Kenya. This study aimed to critically analyse purchasing arrangements in Kenya, using the National Hospital Insurance Fund (NHIF) as a case study. METHODS: We applied a principal-agent relationship framework, which identifies three pairs of principal-agent relationships (government-purchaser, purchaser-provider, and citizen-purchaser) and specific actions required within them to achieve strategic purchasing...
July 18, 2017: International Journal of Health Policy and Management
Franco Mascayano, Cristián Montenegro
In this article we describe what is known as the recovery approach to mental health, considering the possibilities and potentialities that this model offers to Latin America. We propose that its adoption would enhance the modernization of systems and policies on mental health in the region. Although improvements in these areas are well recognized and documented, the participation of users and the development of services according to their needs and interests constitutes an important gap. We brie?y describe the historical roots of the recovery model and the evidence that supports it, emphasizing how the model has transformed mental health care in different regions of the globe...
November 2017: Vertex: Revista Argentina de Psiquiatriá
Stephen Duckett
BACKGROUND: Payment models for palliative care vary across nations, with few adopting contemporary payments designs that apply to other parts of the health system. AIM: To propose optimal payment arrangements for palliative care. APPROACH: Review of relevant literature on funding mechanisms in health care generally and palliative care in particular. RESULTS: Payment models for palliative care should move toward activity-based funding using an agreed classification, be uncapped funding with performance monitoring, and make explicit use of performance metrics and reporting...
March 7, 2018: BMC Palliative Care
Mansour Naseriasl, Ali Janati, Abolgasem Amini, Davoud Adham
Because of insufficient communication between primary health care providers and specialists, which leads to inefficiencies and ineffectiveness in rural population health outcomes, to implement a well-functioning referral system is one of the most important tasks for some countries. Using purposive and snowballing sampling methods, we included health experts, policy-makers, family physicians, clinical specialists, and experts from health insurance organizations in this study according to pre-determined criteria...
March 5, 2018: Cadernos de Saúde Pública
Lilit Karapetyan, Om Dawani, Heather S Laird-Fick
The immigrant population in the United States has grown over the past years. Undocumented immigrants account for 14.6% of the uninsured population in the United States. Decisions about end-of-life treatment are often difficult to reach in the best of situations. We present a 43-year-old undocumented Mexican female immigrant with metastatic sarcomatoid squamous cell cervical cancer and discuss the barriers that she faced during her treatment. Limited English proficiency, living below the poverty line, low level of education, and lack access to Medicare, Medicaid, or other insurance coverage under the Affordable Care Act are major causes of decreased health-care access and service utilization by the immigrant population...
January 1, 2018: Journal of Palliative Care
Manjula Kurella Tamura, Ann M O'Hare, Eugene Lin, Laura M Holdsworth, Elizabeth Malcolm, Alvin H Moss
The dominant health delivery model for advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) in the United States, which focuses on provision of dialysis, is ill-equipped to address many of the needs of seriously ill patients. Although palliative care may address some of these gaps in care, its integration into advanced CKD care has been suboptimal due to several health system barriers. These barriers include uneven access to specialty palliative care services, underdeveloped models of care for seriously ill patients with advanced CKD, and misaligned policy incentives...
March 3, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Eva Frazer, Roger A Mitchell, LaQuandra S Nesbitt, Mallory Williams, Edith P Mitchell, Richard Allen Williams, Doris Browne
While much progress has occurred since the civil rights act of 1964, minorities have continued to suffer disparate and discriminatory access to economic opportunities, education, housing, health care and criminal justice. The latest challenge faced by the physicians and public health providers who serve the African American community is the detrimental, and seemingly insurmountable, causes and effects of violence in impoverished communities of color. According to statistics from the Centers for Disease Control (CDC), the number one killer of black males ages 10-35 is homicide, indicating a higher rate of violence than any other group...
February 2018: Journal of the National Medical Association
Leslie Sheu, Catherine Burke, Dylan Masters, Patricia S O'Sullivan
Phenomenon: Preclerkship medical education has undergone extensive reform, and the clerkship years are growing targets for curricular innovation. As institutions implement new preclerkship curricula to better prepare medical students to practice medicine in the context of modern healthcare systems, the perspective of clerkship leaders regarding clerkship student roles and potential for change will facilitate redefining these roles so that preclerkship educational innovations can continue into clerkships. APPROACH: In this qualitative exploratory study, authors conducted semistructured interviews with clerkship and site directors for eight core clerkships from April to May 2016...
March 6, 2018: Teaching and Learning in Medicine
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"