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Health Care Reform

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https://www.readbyqxmd.com/read/28225697/who-should-ration
#1
Philip M Rosoff
A principal component of physician decision making is judging what interventions are clinically appropriate. Due to the inexorable and steady increase of health care costs in the US, physicians are constantly being urged to exercise judicious financial stewardship with due regard for the financial implications of what they prescribe. When applied on a case-by-case basis, this otherwise reasonable approach can lead to either inadvertent or overt and arbitrary restriction of interventions for some patients rather than others on the basis of clinically irrelevant characteristics such as ethnicity, gender, age, or skin color...
February 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28225545/enhancing-political-will-for-universal-health-coverage-in-nigeria
#2
Bolaji S Aregbeshola
Universal health coverage aims to increase equity in access to quality health care services and to reduce financial risk due to health care costs. It is a key component of international health agenda and has been a subject of worldwide debate. Despite differing views on its scope and pathways to reach it, there is a global consensus that all countries should work toward universal health coverage. The goal remains distant for many African countries, including Nigeria. This is mostly due to lack of political will and commitment among political actors and policymakers...
January 2017: MEDICC Review
https://www.readbyqxmd.com/read/28224675/substance-use-treatment-provider-behavior-and-healthcare-reform-evidence-from-massachusetts
#3
Johanna Catherine Maclean, Brendan Saloner
We examine the impact of the 2006 Massachusetts healthcare reform on substance use disorder (SUD) treatment facilities' provision of care. We test the impact of the reform on treatment quantity and access. We couple data on the near universe of specialty SUD treatment providers in the USA with a synthetic control method approach. We find little evidence that the reform lead to changes in treatment quantity or access. Reform effects were similar among for-profit and non-profit facilities. In an extension, we show that the reform altered the setting in which treatment is received, the number of offered services, and the number of programs for special populations...
February 21, 2017: Health Economics
https://www.readbyqxmd.com/read/28224441/does-medicaid-insurance-confer-adequate-access-to-adult-orthopaedic-care-in-the-era-of-the-patient-protection-and-affordable-care-act
#4
Joseph T Labrum, Taylor Paziuk, Theresa C Rihn, Alan S Hilibrand, Alexander R Vaccaro, Mitchell G Maltenfort, Jeffrey A Rihn
BACKGROUND: A current appraisal of access to orthopaedic care for the adult patient receiving Medicaid is important, since Medicaid expansion was written into law by the Patient Protection and Affordable Care Act (PPACA). QUESTIONS/PURPOSES: (1) Do orthopaedic practices provide varying access to orthopaedic care for simulated patients with Medicaid insurance versus private insurance in a blinded survey? (2) What are the surveyed state-by-state Medicaid acceptance rates for adult orthopaedic practices in the current era of Medicaid expansion set forth by the PPACA? (3) Do surveyed rates of access to orthopaedic care in the adult patient population vary across practice setting (private vs academic) or vary with different Medicaid physician reimbursement rates? (4) Are there differences in the surveyed Medicaid acceptance rates for adult orthopaedic practices in states that have expanded Medicaid coverage versus states that have foregone expansion? METHODS: Simulated Patient Survey: We performed a telephone survey study of orthopaedic offices in four states with Medicaid expansion...
February 21, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28224422/satisfaction-of-village-doctors-with-the-township-and-village-health-services-integration-policy-in-the-western-minority-inhabited-areas-of-china
#5
Da Feng, Liang Zhang, Yuan-Xi Xiang, Dong-Lan Zhang, Ruo-Xi Wang, Shang-Feng Tang, Hang Fu, Bo-Yang Li
Township and Village Health Services Integration Management (TVHSIM) is an essential form of China's two-tiered health service integration plan at the township and village level. Its main purpose, also one of the target goals in China's new healthcare reform, is to gradually integrate rural health services and appropriately allocate rural health resources. This study aims to assess the village doctors' satisfaction with the TVHSIM and provide scientific base to further improve TVHSIM. A cross-sectional study was carried out in which 162 village doctors from Qinghai, Inner Mongolia and Xinjiang in western China were interviewed...
February 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/28219377/the-effect-of-increasing-the-coinsurance-rate-on-outpatient-utilization-of-healthcare-services-in-south-korea
#6
Hyo Jung Lee, Sung-In Jang, Eun-Cheol Park
BACKGROUND: The Korean healthcare system is composed of costly and inefficient structures that fail to adequately divide the functions and roles of medical care organizations. To resolve this matter, the government reformed the cost-sharing policy in November of 2011 for the management of outpatients visiting general or tertiary hospitals with comparatively mild diseases. The purpose of the present study was to examine the impact of increasing the coinsurance rate of prescription drug costs for 52 mild diseases at general or tertiary hospitals on outpatient healthcare service utilization...
February 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28217602/health-worker-posting-and-transfer-at-primary-level-in-tamil-nadu-governance-of-a-complex-health-system-function
#7
Surekha Garimella, Kabir Sheikh
BACKGROUND: Posting and transfer (PT) of health personnel - placing the right health workers in the right place at the right time - is a core function of any large-scale health service. In the context of government health services, this may be seen as a simple process of bureaucratic governance and implementation of the rule of law. However the literature from India and comparable low and middle-income country health systems suggests that in reality PT is a contested domain, driven by varied expressions of private and public interest throughout the chain of implementation...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28216767/mental-health-and-the-law-an-overview-and-need-to-develop-and-strengthen-the-discipline-of-forensic-psychiatry-in-india
#8
REVIEW
Pratima Murthy, B C Malathesh, C Naveen Kumar, Suresh Bada Math
Human rights and mental health care of vulnerable population need supportive legislations and policies. Both "hard" and "soft" laws relevant to mental health care have been devised internationally and locally. Amendments in laws and the formulation of new laws are often required and have been seen to occur in the area of mental health care in India. So far, reform in mental health care has largely been reactive, but newer legislations and policies carry the hope of proactive reform. The lack of trained human resources is one of the biggest problems in effective mental health care delivery in India...
December 2016: Indian Journal of Psychiatry
https://www.readbyqxmd.com/read/28216765/mental-health-mental-illness-and-human-rights-in-india-and-elsewhere-what-are-we-aiming-for
#9
REVIEW
Brendan D Kelly
The Mental Health Care Bill 2013 was introduced to the Rajya Sabha (India's upper house of parliament) in August 2013 and following 134 official amendments, passed in August 2016. Properly implemented, mental health legislation such as this plays a key role in protecting the rights of the mentally ill, ensuring access to care, and promoting social justice for the mentally ill, their families and carers. In this context, the 2006 United Nations' Convention on the Rights of Persons with Disabilities (CRPD) presents a real opportunity to improve the position of people with disabilities and those disabled by long-term mental illness...
December 2016: Indian Journal of Psychiatry
https://www.readbyqxmd.com/read/28213659/profiles-of-mental-health-care-professionals-based-on-work-role-performance
#10
Marie-Pierre Markon, Jean-Marie Bamvita, François Chiocchio, Marie-Josée Fleury
The worldwide burden of mental disorders is considerable, and on the rise, putting pressure on health care systems. Current reforms aim to improve the efficiency of mental health care systems by increasing service integration in communities and strengthening primary mental health care. In this context, mental health care professionals (MHPs) are increasingly required to work on interdisciplinary teams in a variety of settings. Little is known, however, about the profiles of MHPs in relation to their perceived work role performance...
February 18, 2017: Psychiatric Quarterly
https://www.readbyqxmd.com/read/28212967/decision-making-on-medical-innovations-in-a-changing-health-care-environment-insights-from-accountable-care-organizations-and-payers-on-personalized-medicine-and-other-technologies
#11
Julia R Trosman, Christine B Weldon, Michael P Douglas, Patricia A Deverka, John B Watkins, Kathryn A Phillips
BACKGROUND: New payment and care organization approaches, such as those of accountable care organizations (ACOs), are reshaping accountability and shifting risk, as well as decision making, from payers to providers, within the Triple Aim context of health reform. The Triple Aim calls for improving experience of care, improving health of populations, and reducing health care costs. OBJECTIVES: To understand how the transition to the ACO model impacts decision making on adoption and use of innovative technologies in the era of accelerating scientific advancement of personalized medicine and other innovations...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28212653/coordination-between-primary-and-secondary-care-the-role-of-electronic-messages-and-economic-incentives
#12
Antonella La Rocca, Thomas Hoholm
BACKGROUND: In Norway, a government reform has recently been introduced to enhance coordination between primary and secondary care. This paper examines the effects of two newly introduced measures to improve the coordination: an ICT-based communication tool/standard and an economic incentive scheme. METHOD: This qualitative study is based primarily on 27 open-ended interviews. We interviewed nine employees at a hospital (the focal actor), 17 employees from seven different municipalities, and a representative of a Regional Health Authority...
February 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28212638/commissioning-for-health-improvement-following-the-2012-health-and-social-care-reforms-in-england-what-has-changed
#13
E W Gadsby, S Peckham, A Coleman, D Bramwell, N Perkins, L M Jenkins
BACKGROUND: The wide-ranging program of reforms brought about by the Health and Social Care Act (2012) in England fundamentally changed the operation of the public health system, moving responsibility for the commissioning and delivery of services from the National Health Service to locally elected councils and a new national public health agency. This paper explores the ways in which the reforms have altered public health commissioning. METHODS: We conducted multi-methods research over 33 months, incorporating national surveys of Directors of Public Health and local council elected members at two time-points, and in-depth case studies in five purposively selected geographical areas...
February 17, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28212201/health-sector-reform-emotional-exhaustion-and-nursing-burnout-a-retrospective-panel-study-in-iran
#14
Ahmad Kalateh Sadati, Farnaz Rahnavard, Seyed Taghi Heydari, Soroor Hemmati, Najmeh Ebrahimzadeh, Kamran Bagheri Lankarani
BACKGROUND: Nursing burnout is affected by various factors, including work overload. Since the inauguration of the Health Sector Evolution Plan (HSEP) in Iran in 2014, government hospitals have been required to provide health services to the public at all levels. This decision, however, has increased the volume of patients admitted to government hospitals. Because nurses are on the front line of health services, they are faced with a greater load of care provision. PURPOSE: This study aimed to evaluate nursing burnout before and after HSEP in Iran, with an emphasis on the differences between government and private hospitals...
February 16, 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/28211994/building-the-coverage-continuum-the-role-of-state-medicaid-directors-and-insurance-commissioners
#15
Joel Ario, Deborah Bachrach
Issue: The Affordable Care Act has expanded coverage to 20 million newly insured individuals, split between state Medicaid programs and commercially insured marketplaces, with limited integration between the two. The seamless continuum of coverage envisioned by the law is central to achieving the full potential of the Affordable Care Act, but it remains an elusive promise. Goals: To examine the historical and cultural differences between state Medicaid agencies and insurance departments that contribute to this lack of coordination...
2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28203120/international-lessons-in-new-methods-for-grading-and-integrating-cost-effectiveness-evidence-into-clinical-practice-guidelines
#16
REVIEW
Kathryn M Antioch, Michael F Drummond, Louis W Niessen, Hindrik Vondeling
Economic evidence is influential in health technology assessment world-wide. Clinical Practice Guidelines (CPG) can enable economists to include economic information on health care provision. Application of economic evidence in CPGs, and its integration into clinical practice and national decision making is hampered by objections from professions, paucity of economic evidence or lack of policy commitment. The use of state-of-art economic methodologies will improve this. Economic evidence can be graded by 'checklists' to establish the best evidence for decision making given methodological rigor...
2017: Cost Effectiveness and Resource Allocation: C/E
https://www.readbyqxmd.com/read/28199277/funding-accountable-care-in-oregon-financial-models-in-two-coordinated-care-organizations
#17
Lauren Broffman, Kristin Brown, Bruce K Bayley, Lucy Savitz, Jill Rissi
Oregon's coordinated care organizations (CCOs) are an integral part of a massive statewide reform that brings accountable care to Medicaid. CCOs are regional collaboratives among health plans, providers, county public health, and communitybased organizations that administer a single global budget covering physical, mental, and dental healthcare for low-income Oregonians. CCOs have been given freedom within the global budget to implement reforms that might capture efficiencies in cost and quality. For this study-fielded between 2012 and 2015-we traced the path of the global budget through the interior structures of two of Oregon's most promising CCOs...
July 2016: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28197664/-rehabilitation-in-undergraduate-education-and-advanced-professional-training-of-the-participating-professional-groups
#18
Wilfried Mau, Jürgen Bengel, Klaus Pfeifer
In the German health care system, multiprofessional and coordinated rehabilitation care provides support for successful disease management. Against a background of the conditions and strong dynamics of the provision, this article gives an overview of some of the pertinent developments in rehabilitation-related undergraduate education and advanced professional training of physicians, psychologists, and exercise therapy professions in Germany. Frequently, there are few provisions and great variation between different locations...
February 14, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/28196518/a-comparison-of-how-behavioral-health-organizations-utilize-training-to-prepare-for-health-care-reform
#19
Victoria Stanhope, Mimi Choy-Brown, Stacey Barrenger, Jennifer Manuel, Micaela Mercado, Mary McKay, Steven C Marcus
BACKGROUND: Under the Affordable Care Act, States have obtained Medicaid waivers to overhaul their behavioral health service systems to improve quality and reduce costs. Critical to implementation of broad service delivery reforms has been the preparation of organizations responsible for service delivery. This study focused on one large-scale initiative to overhaul its service system with the goal of improving service quality and reducing costs. The study examined the participation of behavioral health organizations in technical assistance efforts and the extent to which organizational factors related to their participation...
February 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28192712/personal-and-political-histories-in-the-designing-of-health-reform-policy-in-bolivia
#20
Alissa Bernstein
While health policies are a major focus in disciplines such as public health and public policy, there is a dearth of work on the histories, social contexts, and personalities behind the development of these policies. This article takes an anthropological approach to the study of a health policy's origins, based on ethnographic research conducted in Bolivia between 2010 and 2012. Bolivia began a process of health care reform in 2006, following the election of Evo Morales Ayma, the country's first indigenous president, and leader of the Movement Toward Socialism (Movimiento al Socialism)...
January 21, 2017: Social Science & Medicine
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