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https://www.readbyqxmd.com/read/28886800/temporal-image-comparison-serial-imaging-in-assessing-pigmented-lesions
#1
REVIEW
Rhett J Drugge, Elizabeth D Drugge
The large-scale deployment of low-cost, noninvasive mechanisms of early detection are needed to reduce the melanoma burden. A serial 2-step system could power mass screening efforts serving the uninsured and underinsured as well as the rural and remote US counties where melanoma mortality is doubled for lack of access to dermatologists. Furthermore, serial melanoma screening strategies, serial total body photography and serial digital dermatoscopy imaging may be performed as a telehealth service, and thus would be available in any location that can support activity compliant with the Health Insurance Portability and Accountability Act and has appropriate bandwidth...
October 2017: Dermatologic Clinics
https://www.readbyqxmd.com/read/28881902/frequency-of-endoscopic-surveillance-for-barrett-s-esophagus-is-influenced-by-health-insurance-status-results-from-a-population-based-analysis
#2
A Faqih, K K Broman, L-C Huang, S E Phillips, M D Holzman, R A Pierce, B K Poulose, P S Yachimski
Factors that influence the frequency of surveillance endoscopy for nondysplastic Barrett's esophagus are not well understood. The objective of this study is to assess factors which influence the frequency of endoscopic surveillance for Barrett's esophagus, including health insurance/third-party payer status. Cases of nondysplastic Barrett's esophagus undergoing esophagogastroduodenoscopy with biopsy were identified using longitudinal data from the Healthcare Utilization Project database in 2005-2006 and followed through 2011...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28869210/the-affordable-care-act-s-dependent-care-coverage-expansion-and-behavioral-health-care
#3
Chandler B McClellan
BACKGROUND: In September 2010, the Affordable Care Act (ACA) extended dependent care coverage to individuals under the age of 26, allowing young adults to remain on their parent's private insurance. AIMS OF THE STUDY: This policy offers a natural experiment to examine the impact of expanded insurance coverage on mental health and substance use treatment utilization and payment composition. METHODS: Using National Survey on Drug Use and Health (NSDUH) and Medical Expenditure Panel Survey (MEPS) data between 2005 and 2014, this study employs a difference-in-differences approach with 23-25 year olds as the treatment group and 27-30 year olds as the control group to examine the impact of the expansion on insurance coverage, behavioral health treatment utilization, and treatment payment source...
September 1, 2017: Journal of Mental Health Policy and Economics
https://www.readbyqxmd.com/read/28861676/machete-injuries-to-the-upper-extremity
#4
Chester J Donnally, William Hannay, Derek A Rapp, Nikola Lekic, Seth D Dodds
PURPOSE: We intend to describe and analyze the spectrum of upper extremity injuries that arises from both accidental and intentional machete injuries with a focus on associated complications and comorbidities. This review is the first from a United States institution, and the only from a designated level 1 trauma center. METHODS: A retrospective review of machete related upper extremity injuries admitted to a level 1 trauma center from 2008 to 2016. The following data was collected on admitted patients: demographics, mechanism of injury, surgical management, and complications...
August 31, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28831638/health-insurance-status-and-eligibility-among-patients-who-seek-healthcare-at-a-free-clinic-in-the-affordable-care-act-era
#5
Kristen Sessions, Amal Hassan, Thomas G McLeod, Mark L Wieland
Free clinics provide care to over 1.8 million people in the United States every year and are a valuable safety net for uninsured and underinsured patients. The Affordable Care Act has resulted in millions of newly insured Americans, yet there is continued demand for healthcare at free clinics. In this study, we assessed health insurance status and eligibility among 489 patients who visited a free clinic in 2016. Eighty-seven percent of patients seen were uninsured, 53.1% of whom were eligible for health insurance (Medicaid or subsidized insurance premiums)...
August 22, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28817791/using-practice-facilitation-to-increase-rates-of-colorectal-cancer-screening-in-community-health-centers-north-carolina-2012-2013-feasibility-facilitators-and-barriers
#6
Bryan J Weiner, Catherine L Rohweder, Jennifer E Scott, Randall Teal, Alecia Slade, Allison M Deal, Naima Jihad, Marti Wolf
INTRODUCTION: Practice facilitation involves trained individuals working with practice staff to conduct quality improvement activities and support delivery of evidence-based clinical services. We examined the feasibility of using practice facilitation to assist federally qualified health centers (FQHCs) to increase colorectal cancer screening rates in North Carolina. METHODS: The intervention consisted of 12 months of facilitation in 3 FQHCs. We conducted chart audits to obtain data on changes in documented recommendation for colorectal cancer screening and completed screening...
August 17, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28797422/in-hospital-outcomes-of-percutaneous%C3%A2-coronary-intervention-in%C3%A2-america-s-safety%C3%A2-net-insights-from-the-ncdr-cath-pci-registry
#7
Tushar Acharya, Adam C Salisbury, John A Spertus, Kevin F Kennedy, Amarbir Bhullar, H Kiran K Reddy, Bipin K Joshi, John A Ambrose
OBJECTIVES: This study compared risk-adjusted percutaneous coronary intervention (PCI) outcomes of safety-net hospitals (SNHs) and non-SNHs. BACKGROUND: Although risk adjustment is used to compare hospitals, SNHs treat a disproportionate share of uninsured and underinsured patients, who may have unmeasured risk factors, limited health care access, and poorer outcomes than patients treated at non-SNHs. METHODS: Using the National Cardiovascular Data Registry CathPCI Registry from 2009 to 2015, we analyzed 3,746,961 patients who underwent PCI at 282 SNHs (hospitals where ≥10% of PCI patients were uninsured) and 1,134 non-SNHs...
August 14, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28796862/out-of-pocket-costs-financial-distress-and-underinsurance-in-cancer-care
#8
Fumiko Chino, Jeffrey M Peppercorn, Christel Rushing, Arif H Kamal, Ivy Altomare, Greg Samsa, S Yousuf Zafar
No abstract text is available yet for this article.
August 10, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28708447/coverage-for-gender-affirming-care-making-health-insurance-work-for-transgender-americans
#9
William V Padula, Kellan Baker
Many transgender Americans continue to remain uninsured or are underinsured because of payers' refusal to cover medically necessary, gender-affirming healthcare services-such as hormone therapy, mental health counseling, and reconstructive surgeries. Coverage refusal results in higher costs and poor health outcomes among transgender people who cannot access gender-affirming care. Research into the value of health insurance coverage for gender-affirming care for transgender individuals shows that the health benefits far outweigh the costs of insuring transition procedures...
August 2017: LGBT Health
https://www.readbyqxmd.com/read/28550905/socioeconomic-factors-and-mortality-in-emergency-general-surgery-trends-over-a-20-year-period
#10
Sarah J Armenia, Sri Ram Pentakota, Aziz M Merchant
BACKGROUND: Socioeconomic factors such as race, insurance, and income quartiles have been identified as independent risk factors in emergency general surgery (EGS), but this impact has not been studied over time. We sought to identify trends in disparities in EGS-related operative mortality over a 20-y period. METHODS: The National Inpatient Sample was used to identify patient encounters coded for EGS in 1993, 2003, and 2013. Logistic regression models were used to examine the adjusted relationship between race, primary payer status, and median income quartiles and in-hospital mortality after adjusting for patients' age, gender, Elixhauser comorbidity score, and hospital region, size, and location-cum-teaching status...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28534189/national-trends-in-bariatric-surgery-2012-2015-demographics-procedure-selection-readmissions-and-cost
#11
Scott Kizy, Cyrus Jahansouz, Michael C Downey, Nathanael Hevelone, Sayeed Ikramuddin, Daniel Leslie
BACKGROUND: Bariatric surgery is widely accepted as the best treatment for obesity and type 2 diabetes mellitus (T2DM). The Roux-en-Y gastric bypass (RYGB) and the sleeve gastrectomy (SG) have become the predominant bariatric procedures in the USA over the last several years, although the most recent trends in selection are unknown. OBJECTIVE: The objective of this study is to assess selection trends, readmission rates, and cost of bariatric procedures in the USA from 2012 to 2015...
May 22, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28511946/national-incidence-of-patient-safety-indicators-in-the-total-hip-arthroplasty-population
#12
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...
September 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28346590/implementation-and-evaluation-of-a-large-scale-teleretinal-diabetic-retinopathy-screening-program-in-the-los-angeles-county-department-of-health-services
#13
Lauren P Daskivich, Carolina Vasquez, Carlos Martinez, Chi-Hong Tseng, Carol M Mangione
Importance: Diabetic retinopathy (DR) is the leading cause of blindness in adults of working age in the United States. In the Los Angeles County safety net, a nonvertically integrated system serving underinsured and uninsured patients, the prevalence of DR is approximately 50%, and owing to limited specialty care resources, the average wait times for screening for DR have been 8 months or more. Objective: To determine whether a primary care-based teleretinal DR screening (TDRS) program reduces wait times for screening and improves timeliness of needed care in the Los Angeles County safety net...
May 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28241907/physicians-perceptions-of-volunteer-service-at-safety-net-clinics
#14
Laura Mcgeehan, Michael A Takehara, Ellen Daroszewski
BACKGROUND: Volunteer physicians are crucial for the operation of safety-net clinics, which provide medical care for uninsured and underinsured populations. Thus, identifying ways to maximize the number of physicians volunteering at such clinics is an important goal. OBJECTIVE: To investigate the perceptions, motivations, functions, and barriers associated with physician volunteering in four safety-net clinics in San Bernardino County, Southern California, a location of great medical need with many barriers to care...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28231239/surveillance-for-health-care-access-and-health-services-use-adults-aged-18-64-years-behavioral-risk-factor-surveillance-system-united-states-2014
#15
Catherine A Okoro, Guixiang Zhao, Jared B Fox, Paul I Eke, Kurt J Greenlund, Machell Town
PROBLEM/CONDITION: As a result of the 2010 Patient Protection and Affordable Care Act, millions of U.S. adults attained health insurance coverage. However, millions of adults remain uninsured or underinsured. Compared with adults without barriers to health care, adults who lack health insurance coverage, have coverage gaps, or skip or delay care because of limited personal finances might face increased risk for poor physical and mental health and premature mortality. PERIOD COVERED: 2014...
February 24, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/28209637/the-impact-of-payer-source-on-trauma-outcomes-in-a-pediatric-population
#16
Felecia A Lee, Ashley M Hervey, Arash Sattarin, Aaron Deeds, Gina M Berg, Kimberly Molik
OBJECTIVES: Determine if there were differences in conclusions drawn regarding disparities in trauma outcomes based on literature-derived payer source definitions in a pediatric population. PATIENTS AND METHODS: Retrospective registry review of admitted pediatric trauma patients (≤17 years of age) at a level II pediatric trauma facility. Eligible patients were categorized into 3 payer source definitions: definition 1: commercially insured, Medicaid, uninsured; definition 2: insured, uninsured; definition 3: commercially insured, underinsured...
March 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28166671/the-unintended-consequences-of-the-centers-for-medicare-and-medicaid-services-pay-for-performance-structures-on-safety-net-hospitals-and-the-low-income-medically-vulnerable-population
#17
Elmer B Fos
Safety-net hospitals are hospitals with patient mix that is substantially composed of the uninsured, underinsured, and low-income, medically vulnerable patient populations. They are the hospitals of last resort for poor patients. This article examined the impact of The Centers for Medicare and Medicaid Services pay-for-performance reimbursement policies on the financial viability of safety-net hospitals. Studies showed that these policies, which are based on the principle of reward and punishment, might have unintentionally placed safety-net hospitals on financial disadvantage compared to other hospital organizations...
February 2017: Health Services Management Research
https://www.readbyqxmd.com/read/28109783/the-affordable-care-act-medicaid-expansion-correlated-with-increased-heart-transplant-listings-in-african-americans-but-not-hispanics-or%C3%A2-caucasians
#18
Khadijah Breathett, Larry A Allen, Laura Helmkamp, Kathryn Colborn, Stacie L Daugherty, Prateeti Khazanie, Richard Lindrooth, Pamela N Peterson
OBJECTIVES: The aim of this study was to determine if the Affordable Care Act (ACA) Medicaid Expansion was associated with increased census-adjusted heart transplant listing rates for racial/ethnic minorities. BACKGROUND: Underinsurance limits access to transplants, especially among racial/ethnic minorities. Changes in racial/ethnic listing rates post-ACA Medicaid Expansion are unknown. METHODS: Using the Scientific Registry of Transplant Recipients, we analyzed 5,651 patients from early adopter states (implemented the ACA Medicaid Expansion by January 2014) and 4,769 patients from non-adopter states (no implementation during the study period) from 2012 to 2015...
February 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28077044/reducing-health-disparities-for-women-through-use-of-the-medical-home-model
#19
Patricia Moyle Wright
BACKGROUND: Healthcare services can be difficult to access, particularly for low-income or underinsured women. One way of overcoming the barriers to quality, patient-centered care is through the use of the Medical Home Model (MHM). The MHM is a cost-effective approach to care that improves patient outcomes and improves access. AIM: The purpose of this article is to discuss barriers to healthcare, with an emphasis on reducing healthcare disparities for women. METHOD: Extant, contemporary literature has been reviewed and synthesized to develop this theoretical paper on the benefits of using the MHM to reduce disparities in the provision of healthcare for women...
February 2017: Contemporary Nurse
https://www.readbyqxmd.com/read/28024314/modeling-health-care-spending-growth-of-older-adults
#20
Laura A Hatfield, Melissa M Favreault, Thomas G McGuire, Michael E Chernew
OBJECTIVE: To forecast out-of-pocket health care spending among older adults. Long-term forecasts allow policy makers to explore potential impacts of policy scenarios, but existing microsimulations do not incorporate details of supplemental insurance coverage and income effects on health care spending. DATA SOURCES: Dynamic microsimulation calibrated to survey and administrative data. STUDY DESIGN: We augment Urban Institute's Dynamic Simulation of Income Model (DYNASIM) with modules that incorporate demand responses and economic equilibria, with dynamics driven by exogenous technological change...
December 26, 2016: Health Services Research
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