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Microsimulation

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https://www.readbyqxmd.com/read/28431415/potential-impact-of-affordable-care-act-related-insurance-expansion-on-trauma-care-reimbursement
#1
John W Scott, Pooja U Neiman, Peter A Najjar, Thomas C Tsai, Kirstin W Scott, Mark G Shrime, David M Cutler, Ali Salim, Adil H Haider
BACKGROUND: Nearly one quarter of trauma patients are uninsured and hospitals recoup less than 20% of inpatient costs for their care. This study examines changes to hospital reimbursement for inpatient trauma care if the full coverage expansion provisions of the Affordable Care Act (ACA) were in effect. METHODS: We abstracted nonelderly adults (ages 18-64 years) admitted for trauma from the Nationwide Inpatient Sample during 2010-the last year before most major ACA coverage expansion policies...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28419541/when-should-active-surveillance-for-prostate-cancer-stop-if-no-progression-is-detected
#2
Tiago M de Carvalho, Eveline A M Heijnsdijk, Harry J de Koning
BACKGROUND: A significant proportion of screen-detected men with prostate cancer may be overdiagnosed. Active Surveillance (AS) has emerged as a way to mitigate this problem, by delaying treatment of men, who are at low-risk until this becomes necessary. However, it is not known after how much time or biopsy rounds should patients stop AS and transition to conservative management (CM), if no progression is detected. METHODS: We used a microsimulation model with natural history of prostate cancer based on ERSPC and SEER data...
April 17, 2017: Prostate
https://www.readbyqxmd.com/read/28408016/a-practical-anova-approach-for-uncertainty-analysis-in-population-based-disease-microsimulation-models
#3
Behnam Sharif, Hubert Wong, Aslam H Anis, Jacek A Kopec
OBJECTIVES: To provide a practical approach for calculating uncertainty intervals and variance components associated with initial-condition and dynamic-equation parameters in computationally expensive population-based disease microsimulation models. METHODS: In the proposed uncertainty analysis approach, we calculated the required computational time and the number of runs given a user-defined error bound on the variance of the grand mean. The equations for optimal sample sizes were derived by minimizing the variance of the grand mean using initial estimates for variance components...
April 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28391272/in-office-application-of-fluoride-gel-or-varnish-cost-effectiveness-and-expected-value-of-perfect-information-analysis
#4
Falk Schwendicke, Michael Stolpe
Application of fluoride gel/varnish (FG/FV) reduces caries increments but generates costs. Avoiding restorative treatments by preventing caries might compensate for these costs. We assessed the cost-effectiveness of dentists applying FG/FV in office and the expected value of perfect information (EVPI). EVPI analyses estimate the economic value of having perfect knowledge, assisting research resource allocation. A mixed public-private-payer perspective in Germany was adopted. A population of 12-year-olds was followed over their lifetime, with caries increments modelled using wide intervals to reflect the uncertainty of caries risk...
April 8, 2017: Caries Research
https://www.readbyqxmd.com/read/28376459/health-benefits-and-cost-effectiveness-of-brief-clinician-tobacco-counseling-for-youth-and-adults
#5
Michael V Maciosek, Amy B LaFrance, Steven P Dehmer, Dana A McGree, Zack Xu, Thomas J Flottemesch, Leif I Solberg
PURPOSE: To help clinicians and care systems determine the priority for tobacco counseling in busy clinic schedules, we assessed the lifetime health and economic value of annually counseling youth to discourage smoking initiation and of annually counseling adults to encourage cessation. METHODS: We conducted a microsimulation analysis to estimate the health impact and cost effectiveness of both types of tobacco counseling in a US birth cohort of 4,000,000. The model used for the analysis was constructed from nationally representative data sets and structured literature reviews...
January 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28376458/health-benefits-and-cost-effectiveness-of-asymptomatic-screening-for-hypertension-and-high-cholesterol-and-aspirin-counseling-for-primary-prevention
#6
Steven P Dehmer, Michael V Maciosek, Amy B LaFrance, Thomas J Flottemesch
PURPOSE: Our aim was to update estimates of the health and economic impact of clinical services recommended for the primary prevention of cardiovascular disease (CVD) for the comparative rankings of the National Commission on Prevention Priorities, and to explore differences in outcomes by sex and race/ethnicity. METHODS: We used a single, integrated, microsimulation model to generate comparable results for 3 services recommended by the US Preventive Services Task Force: aspirin counseling for the primary prevention of CVD and colorectal cancer, screening and treatment for lipid disorders (usually high cholesterol), and screening and treatment for hypertension...
January 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28376457/updated-priorities-among-effective-clinical-preventive-services
#7
Michael V Maciosek, Amy B LaFrance, Steven P Dehmer, Dana A McGree, Thomas J Flottemesch, Zack Xu, Leif I Solberg
PURPOSE: The Patient Protection and Affordable Care Act's provisions for first-dollar coverage of evidence-based preventive services have reduced an important barrier to receipt of preventive care. Safety-net providers, however, still serve a substantial uninsured population, and clinician and patient time remain limited in all primary care settings. As a consequence, decision makers continue to set priorities to help focus their efforts. This report updates estimates of relative health impact and cost-effectiveness for evidence-based preventive services...
January 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28367539/the-potential-cost-effectiveness-of-hiv-vaccines-a-systematic-review
#8
Blythe Adamson, Dobromir Dimitrov, Beth Devine, Ruanne Barnabas
OBJECTIVE: The aim of this paper was to review and compare HIV vaccine cost-effectiveness analyses and describe the effects of uncertainty in model, methodology, and parameterization. METHODS: We systematically searched MEDLINE (1985 through May 2016), EMBASE, the Tufts CEA Registry, and reference lists of articles following Cochrane guidelines and PRISMA reporting. Eligibility criteria included peer-reviewed manuscripts with economic models estimating cost-effectiveness of preventative HIV vaccines...
March 2017: Pharmacoeconom Open
https://www.readbyqxmd.com/read/28343930/cost-effectiveness-of-different-post-retained-restorations
#9
Falk Schwendicke, Michael Stolpe
OBJECTIVES: Dentists can choose between metal and fiber post systems to provide post-retained restorations. The risk of tooth loss and other complications differs between different post systems, as do the initial treatment costs. We aimed to assess the cost-effectiveness of (1) cast metal (MC), (2) preformed metal (MP), (3) glass fiber (GF), and (4) carbon fiber (CF) post-retained restorations. METHODS: A mixed public-private payer's perspective within German healthcare was taken...
March 23, 2017: Journal of Endodontics
https://www.readbyqxmd.com/read/28327833/-burden-of-smoking-related-disease-and-potential-impact-of-cigarette-price-increase-in-peru
#10
Ariel E Bardach, Joaquín E Caporale, Andrea Alcaraz, Federico Augustovski, Leandro Huayanay-Falconí, Cesar Loza-Munarriz, Akram Hernández-Vásquez, Andrés Pichon-Riviere
Objectives: . To calculate the burden of smoking-related disease and evaluate the potential economic and health impact of tax-induced cigarette price increase in Peru. Materials and methods.: A microsimulation model was used to estimate smoking-attributable impact on mortality, quality of life, and costs associated with heart and cerebrovascular disease, chronic obstructive pulmonary disease, pneumonia, lung cancer, and another nine cancers. Three scenarios, involving increased taxes, were evaluated...
October 2016: Revista Peruana de Medicina Experimental y Salud Pública
https://www.readbyqxmd.com/read/28299492/do-healthcare-tax-credits-help-poor-health-individuals-on-low-incomes
#11
Cinzia Di Novi, Anna Marenzi, Dino Rizzi
In several countries, personal income tax permits tax credits for out-of-pocket healthcare expenditure. Tax credits benefit taxpayers at all income levels by reducing their net tax liability and modify the price of out-of-pocket expenditure. To the extent that consumer demand is price elastic, they may influence the amount of eligible healthcare expenditure for which taxpayers may claim a credit. These effects influence, in turn, income distributions and taxpayers' health status and therefore income-related inequality in health...
March 15, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28296927/harms-benefits-and-costs-of-fecal-immunochemical-testing-versus-guaiac-fecal-occult-blood-testing-for-colorectal-cancer-screening
#12
S Lucas Goede, Linda Rabeneck, Marjolein van Ballegooijen, Ann G Zauber, Lawrence F Paszat, Jeffrey S Hoch, Jean H E Yong, Sonja Kroep, Jill Tinmouth, Iris Lansdorp-Vogelaar
BACKGROUND: The ColonCancerCheck screening program for colorectal cancer (CRC) in Ontario, Canada, is considering switching from biennial guaiac fecal occult blood test (gFOBT) screening between age 50-74 years to the more sensitive, but also less specific fecal immunochemical test (FIT). The aim of this study is to estimate whether the additional benefits of FIT screening compared to gFOBT outweigh the additional costs and harms. METHODS: We used microsimulation modeling to estimate quality adjusted life years (QALYs) gained and costs of gFOBT and FIT, compared to no screening, in a cohort of screening participants...
2017: PloS One
https://www.readbyqxmd.com/read/28273181/evaluating-lung-cancer-screening-in-china-implications-for-eligibility-criteria-design-from-a-microsimulation-modeling-approach
#13
Deirdre F Sheehan, Steven D Criss, G Scott Gazelle, Pari V Pandharipande, Chung Yin Kong
More than half of males in China are current smokers and evidence from western countries tells us that an unprecedented number of smoking-attributable deaths will occur as the Chinese population ages. We used the China Lung Cancer Policy Model (LCPM) to simulate effects of computed tomography (CT)-based lung cancer screening in China, comparing the impact of a screening guideline published in 2015 by a Chinese expert group to a version developed for the United States by the U.S. Centers for Medicare & Medicaid Services (CMS)...
2017: PloS One
https://www.readbyqxmd.com/read/28273039/multiple-sclerosis-in-canada-2011-to-2031-results-of-a-microsimulation-modelling-study-of-epidemiological-and-economic-impacts
#14
Nana Amankwah, Ruth Ann Marrie, Christina Bancej, Rochelle Garner, Douglas G Manuel, Ron Wall, Philippe Finès, Julie Bernier, Karen Tu, Kim Reimer
INTRODUCTION: The objective of our study was to present model-based estimates and projections on current and future health and economic impacts of multiple sclerosis (MS) in Canada over a 20-year time horizon (2011-2031). METHODS: Using Statistics Canada's Population Health Microsimulation Model (POHEM) framework, specifically the population-based longitudinal, microsimulation model named POHEM-Neurological, we identified people with MS from health administrative data sources and derived incidence and mortality rate parameters from a British Columbia population-based cohort for future MS incidence and mortality projections...
February 2017: Health Promotion and Chronic Disease Prevention in Canada
https://www.readbyqxmd.com/read/28244405/cost-effectiveness-analysis-of-radiation-therapy-versus-transoral-robotic-surgery-for-oropharyngeal-squamous-cell-carcinoma
#15
Danielle Rodin, Lisa Caulley, Emily Burger, Jane Kim, Stephanie Johnson-Obaseki, David Palma, Alexander V Louie, Aaron Hansen, Brian O'Sullivan
PURPOSE: The objective of this study was to compare the cost-effectiveness of transoral robotic surgery (TORS) versus the standard treatment modality for oropharyngeal squamous cell carcinoma (OPSCC), radiation therapy (RT), in a subset of patients with early-stage OPSCC. METHODS AND MATERIALS: We developed a microsimulation state-transition model associated with RT and TORS for patients with clinically staged T1N0M0 to T2N1M0 OPSCC. Transition probabilities, utilities, and costs for each health state were estimated from recently published data and discounted by 3% annually over a lifetime time horizon...
March 15, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28238953/cost-effectiveness-of-screening-patients-with-gastroesophageal-reflux-disease-for-barrett-s-esophagus-with-a-minimally-invasive-cell-sampling-device
#16
Curtis R Heberle, Amir-Houshang Omidvari, Ayman Ali, Sonja Kroep, Chung Yin Kong, John M Inadomi, Joel H Rubenstein, Angela C Tramontano, Emily C Dowling, William D Hazelton, E Georg Luebeck, Iris Lansdorp-Vogelaar, Chin Hur
BACKGROUND & AIMS: It is important to identify patients with Barrett's esophagus (BE), the precursor to esophageal adenocarcinoma (EAC). Patients with BE are usually identified by endoscopy, which is expensive. The cytosponge, which collects tissue from the esophagus non-invasively, could be a cost-effective tool for screening individuals with gastroesophageal reflux disease (GERD), who are at increased risk for BE. We developed a model to analyze the cost effectiveness of using cytosponge in first-line screening of patients with GERD for BE with endoscopic confirmation, compared to endoscopy screening only, METHODS: We incorporated data from a large clinical trial of cytosponge performance into 2 validated microsimulation models of EAC progression (the esophageal adenocarcinoma model from the Massachusetts General Hospital and the microsimulation screening analysis model from Erasmus University Medical Center)...
February 23, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28224411/personalized-medicine-for-prevention-can-risk-stratified-screening-decrease-colorectal-cancer-mortality-at-an-acceptable-cost
#17
Sujha Subramanian, Georgiy Bobashev, Robert J Morris, Sonja Hoover
PURPOSE: Tailored health care interventions are expected to transform clinical practice. The objective of this study was to develop an innovative model to assess the effectiveness, cost, and harms of risk stratified colorectal cancer screening. METHODS: We updated a previously validated microsimulation model consisting of three interlinked components: risk assessment, natural history, and screening/treatment modules. We used data from representative national surveys and the literature to create a synthetic population that mimics the family history and genetic profile of the US population...
February 21, 2017: Cancer Causes & Control: CCC
https://www.readbyqxmd.com/read/28210776/cost-effectiveness-of-denosumab-versus-oral-alendronate-for-elderly-osteoporotic-women-in-japan
#18
T Mori, C J Crandall, D A Ganz
We constructed a Markov microsimulation model among hypothetical cohorts of community-dwelling elderly osteoporotic Japanese women without prior hip or vertebral fractures over a lifetime horizon. Compared with weekly oral alendronate for 5 years, denosumab every 6 months for 5 years is cost-saving or cost-effective at a conventionally accepted threshold. INTRODUCTION: The objective of the study was to examine the cost-effectiveness of subcutaneous denosumab every 6 months for 5 years compared with weekly oral alendronate for 5 years in Japan...
February 17, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28181868/the-distributional-impact-of-social-security-policy-options
#19
Kenneth A Couch, Gayle L Reznik, Christopher R Tamborini, Howard M Iams
Using microsimulation, we estimate the effects of three policy proposals that would alter Social Security's eligibility rules or benefit structure to reflect changes in women's labor force activity, marital patterns, and differential mortality among the aged. First, we estimate a set of options related to the duration of marriage required to receive divorced spouse and survivor benefits. Second, we estimate the effects of an earnings sharing proposal with survivor benefits, in which benefits are based entirely on earned benefits with spouses sharing their earnings during years of marriage...
January 2017: Research on Aging
https://www.readbyqxmd.com/read/28181866/raising-the-social-security-entitlement-age
#20
Julie Zissimopoulos, Barbara Blaylock, Dana P Goldman, John W Rowe
An aging America presents challenges but also brings social and economic capital. We quantify public revenues from, and public expenditures on, Americans aged 65 and older, the value of their unpaid, productive activities and financial gifts to family. Using microsimulation, we project the value of these activities, and government revenues and expenditures, under different scenarios of change to the Old Age and Survivors Insurance eligibility age through 2050. We find the value of unpaid productive activities and financial gifts are US$721 billion in 2010, while net (of tax revenues) spending on the 65 years and older is US$984 billion...
January 2017: Research on Aging
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