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Healthcare system

Denise D Quigley, Amelia M Haviland, Jacob W Dembosky, David J Klein, Marc N Elliott
OBJECTIVES: To assess whether Medicare patients' reports of denied care, appeals/complaints, and satisfactory resolution were associated with ratings of their health plan or care. STUDY DESIGN: Retrospective analysis of 2010 Medicare Advantage Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data. METHODS: Multivariate linear regression of data from 154,766 respondents (61.1% response rate) tested the association of beneficiary ratings of plan and care with beneficiary reports of denied care, appeals, complaints, and complaint resolution, adjusting for beneficiary demographics...
March 1, 2018: American Journal of Managed Care
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
Jun-Hua Zhang, You-Ping Li, Bo-Li Zhang
The introduction and popularization of evidence-based medicine has opened up a new research field of clinical efficacy evaluation of traditional Chinese medicine(TCM), produced new research ideas and methods, and promoted the progress of clinical research of TCM. After about 20 years assiduous study and earnest practice, the evidence based evaluation method and technique, which conforms to the characteristics of TCM theory and practice, has been developing continuously. Evidence-based Chinese medicine (EBCM) has gradually formed and become an important branch of evidence-based medicine...
January 2018: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
Chul Y Chung, Mark D Alson, Richard Duszak, Andrew J Degnan
Medical coding and billing processes in the United States are complex, cumbersome and poorly understood by radiologists. Despite the direct implications of radiology documentation on reimbursement, trainees and practicing radiologists typically receive limited relevant training. This article summarizes the payer structure including the state-based Children's Health Insurance Programs, discusses the essential processes by which radiologists request and receive reimbursement, details the mechanisms of coding diagnoses using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes and imaging services using Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes, and explores reimbursement and coding-related issues specific to pediatric radiology...
March 19, 2018: Pediatric Radiology
Katherine Smith, Jeffrey P Fleming, Bernard Gros
Heart failure (HF) is one of the most prevalent chronic diseases in the United States (U.S.), with an estimated prevalence of five million patients in the U.S. and an annual healthcare cost of greater than 30 billion dollars. Readmission rates for HF patients are astronomically high, with up to 25% of hospitalized patients with HF requiring readmission within 30 days of discharge. The Hospital Readmissions Reduction Program (HRRP) of the Patient Protection and Affordable Care Act aims to address these concerns by financially penalizing institutions with unacceptably high risk-adjusted 30-day readmission rates for HF patients...
January 15, 2018: Curēus
Sandra Grace, Roger Engel, Ian Jalsion
The Australian chiropractic and osteopathic professions underwent a period of significant transformation between 1960 and 2000. This resulted in an improvement in the views held by the medical profession towards the two professions. However, a recent survey of Australian general practitioners (GPs) reported that a number of GPs still hold negative views towards chiropractors and osteopaths. This paper examines these views from the perspective of critical realism and explores the generative mechanisms that can influence the willingness of health practitioners to collaborate over patient care...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
Yao-Chun Hsu, Terry Cheuk-Fung Yip, Hsiu J Ho, Vincent Wai-Sun Wong, Yen-Tsung Huang, Hashem B El-Serag, Teng-Yu Lee, Ming-Shiang Wu, Jaw-Town Lin, Grace Lai-Hung Wong, Chun-Ying Wu
BACKGROUND & AIMS: The risk of hepatocellular carcinoma (HCC) during antiviral therapy in patients with chronic hepatitis B (CHB) is inadequately predicted by the scores built from untreated patients. We aimed to develop and validate a risk score to predict HCC in CHB patients on entecavir or tenofovir treatment. METHODS: This study analyzed population-wide data from the healthcare databases in Taiwan and Hong Kong to identify CHB patients continuously receiving entecavir or tenofovir...
March 15, 2018: Journal of Hepatology
Meghan N Jeffres, Elizabeth A Hall-Lipsy, S Travis King, John D Cleary
OBJECTIVE: To describe medical negligence and malpractice cases in which a patient with a known penicillin allergy received a beta-lactam and experienced an adverse reaction related to the beta-lactam. DATA SOURCES: Lexis-Nexus, Westlaw, and Google Scholar were searched. STUDY SELECTIONS: Medical negligence and malpractice cases were eligible for inclusion if they met the following criteria: the plaintiff had a known penicillin allergy, received a beta-lactam, and experienced an adverse event...
March 15, 2018: Annals of Allergy, Asthma & Immunology
Jiemin Ma, Rebecca L Siegel, Eric J Jacobs, Ahmedin Jemal
INTRODUCTION: Contemporary state-specific estimates of mortality caused by cigarette smoking are important for tobacco control advocacy and healthcare planning in the U.S., but are currently lacking. METHODS: The population-attributable fraction (i.e., proportion of deaths in the population caused by smoking), number of deaths, and number of years of potential life lost because of active cigarette smoking were estimated for each state based on state-specific smoking prevalence data from the 2014 Behavioral Risk Factor Surveillance System, recently updated relative risks of smoking, and numbers of deaths from smoking-attributable diseases...
March 15, 2018: American Journal of Preventive Medicine
Charlotte Handberg, Sally Thorne, Thomas Maribo
PURPOSE: To analyze and describe health professionals' attitudes and perspectives on the complexities of cancer survivorship and rehabilitation needs assessment in a shared cancer care context. METHOD: The design and methodology for this study was Interpretive Description and the analysis was informed by Symbolic Interactionism as the theoretical framework. Between April and December 2015 an ethnographic fieldwork was carried out by the first author in haematological wards at two Danish hospitals and in two primary care settings conducting cancer survivorship care programs...
April 2018: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
Jill Hall, K Julia Kaal, Junho Lee, Ross Duncan, Nicole Tsao, Mark Harrison
PURPOSE OF THE REVIEW: A number of novel models of care utilizing allied healthcare professionals, including nurses and pharmacists, have emerged as an alternate to rheumatologist specialist care to achieve disease outcomes in patients with inflammatory arthritis. We conducted a review of the literature for studies from the past 5 years that reported on measures of patient satisfaction and/or any health economic outcome in a model of care where the care providers had substantial, but not completely independent, responsibility...
March 17, 2018: Current Rheumatology Reports
H Zatorski, P Mosinska, M Storr, J Fichna
There is an unmet need for effective pharmacological therapies for the treatment of gastroparesis and other upper gastrointestinal (GI) motility disorders, which reduce patients' quality of life and are a burden to the healthcare system. Ghrelin is an endogenous growth hormone secretagogue receptor ligand and has been shown to exert prokinetic effects on GI motility. Nevertheless, considering the short half-life of ghrelin its use in clinical practice is limited. Thus, ghrelin receptor agonists with enhanced pharmacokinetics were developed; they accelerate gastric emptying and improve symptoms of gastroparesis in animal models and humans...
December 2017: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
David Guwatudde, Pilvikki Absetz, Peter Delobelle, Claes-Göran Östenson, Josefien Olmen Van, Helle Molsted Alvesson, Roy William Mayega, Elizabeth Ekirapa Kiracho, Juliet Kiguli, Carl Johan Sundberg, David Sanders, Göran Tomson, Thandi Puoane, Stefan Peterson, Meena Daivadanam
INTRODUCTION: Type 2 diabetes (T2D) is increasingly contributing to the global burden of disease. Health systems in most parts of the world are struggling to diagnose and manage T2D, especially in low-income and middle-income countries, and among disadvantaged populations in high-income countries. The aim of this study is to determine the added benefit of community interventions onto health facility interventions, towards glycaemic control among persons with diabetes, and towards reduction in plasma glucose among persons with prediabetes...
March 17, 2018: BMJ Open
Joel Lexchin, Jillian Clare Kohler, Marc André Gagnon, James Crombie, Paul Thacker, Adrienne Shnier
Corruption in healthcare generally and specifically in the pharmaceutical arena has recently been highlighted in reports by Transparency International. This article focuses on four areas of corruption: legislative/regulatory, financial, ideological/ethical, and communications. The problems identified and the solutions considered focus on structural considerations affecting how pharmaceuticals are discovered, developed, distributed, and ultimately used in clinical settings. These include recourse to user fees in the regulatory sphere, application of intellectual property rights to medical contexts (patents and access to research data), commercial sponsorship of ghost writing and guest authors, linkage/delinkage of the funding of research and overall health objectives to/from drug pricing and sales, transparency of payments to healthcare professionals and institutions, and credible regulatory sanctions...
March 15, 2018: Indian Journal of Medical Ethics
Layla Parast, Q Burkhart, Courtney Gidengil, Eric C Schneider, Rita Mangione-Smith, K Casey Lion, Elizabeth A McGlynn, Adam Carle, Maria T Britto, Marc N Elliott
OBJECTIVES: To validate new caregiver-reported quality measures assessing care coordination services for children with medical complexity (CMC). METHODS: A cross sectional analysis of the associations between 20 newly developed Family Experiences with Coordination of Care (FECC) quality measures and three validation measures among 1209 caregivers who responded to a telephone or mailed survey between August-November 2013 in Minnesota and Washington. Validation measures included an access composite, a provider rating item, and a care coordination outcome measure, all derived from Consumer Assessments of Healthcare Providers and Systems (CAHPS© ) survey items...
March 14, 2018: Academic Pediatrics
Kuo-Chen Huang, Yan-Ren Lin, Yuan-Jhen Syue, Chia-Te Kung, I-Min Chiu, Chao-Jui Li
BACKGROUND: There are fewer female emergency physicians (EPs) than male ones. This study attempted to analyze the differences in clinical practice between female and male EPs in the emergency department (ED). MATERIALS AND METHODS: A retrospective, 1-year cohort study was conducted across 4 EDs in the largest healthcare system in Taiwan. A total of 199,757 adult patients without trauma treated by 76 EPs (9 females and 67 males) were included in the study. The clinical practice of female and male EPs was compared...
March 2018: American Journal of the Medical Sciences
E Rossi, M Di Stefano, M Picchi, M A Panozzo, C Noberasco, L Nurra, S Baccetti
INTRODUCTION:  The healthcare programs of the Region of Tuscany (Italy) have started the process of integration of some types of complementary medicine (CM), including homeopathy, which began in 1996. The Homeopathic Clinic of Lucca was opened in 1998, followed by the Homeopathic Clinic for Women in 2003, and the Clinic for CM and Diet in Oncology in 2013. METHODS:  Observational longitudinal studies conducted on 5,877 patients (3,937 in the general clinic, 1,606 in the women's clinic and 334 in oncology) were consecutively examined from 2003 to 2016...
March 17, 2018: Homeopathy: the Journal of the Faculty of Homeopathy
Camilla Sortsø, Anastasija Komkova, Annelli Sandbæk, Simon J Griffin, Martha Emneus, Torsten Lauritzen, Rebecca K Simmons
AIMS/HYPOTHESIS: Trials have not demonstrated benefits to the population of screening for type 2 diabetes. However, there may be cost savings for those found to have diabetes. We therefore aimed to compare healthcare costs among individuals with incident type 2 diabetes in a screened group with those in an unscreened group. METHODS: In this register-based, non-randomised controlled trial, eligible individuals were men and women aged 40-69 years without known diabetes who were registered with a general practice in Denmark (n = 1,912,392)...
March 16, 2018: Diabetologia
Xiangjun Li, Mingsheng Chen, Zhonghua Wang, Lei Si
OBJECTIVE: In general, published studies analyse healthcare utilisation, rather than foregone care, among different population groups. The assessment of forgone care as an aspect of healthcare system performance is important because it indicates the gap between perceived need and actual utilisation of healthcare services. This study focused on a specific vulnerable group, middle-aged and elderly people with chronic diseases, and evaluated the prevalence of foregone care and associated factors among this population in China...
March 16, 2018: BMJ Open
H Morioka, M Nagao, S Yoshihara, H Ohge, K Kasahara, N Shigemoto, T Kajihara, M Mori, M Iguchi, Y Tomita, S Ichiyama, T Yagi
BACKGROUND: The Japanese government adopted a national action plan on antimicrobial resistance, which aims to reduce drug-resistant pathogens and antimicrobial use. A point-prevalence survey (PPS) is a useful surveillance method to gain information about hospital epidemiology; however, no multi-centre PPS has previously been performed in Japan. AIM: To investigate general information about hospital epidemiology, healthcare-associated infections (HCAIs), and antimicrobial use in multiple Japanese university hospitals...
March 13, 2018: Journal of Hospital Infection
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