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https://www.readbyqxmd.com/read/28922297/quality-of-care-in-the-united-states-territories-1999-2012
#1
Sudhakar V Nuti, Yun Wang, Frederick A Masoudi, Marcella Nunez-Smith, Sharon-Lise T Normand, Karthik Murugiah, Orlando Rodríguez-Vilá, Joseph S Ross, Harlan M Krumholz
BACKGROUND: Millions of Americans live in the US territories, but health outcomes and payments among Medicare beneficiaries in these territories are not well characterized. METHODS: Among Fee-for-Service Medicare beneficiaries aged 65 years and older hospitalized between 1999 and 2012 for acute myocardial infarction (AMI), heart failure (HF), and pneumonia, we compared hospitalization rates, patient outcomes, and inpatient payments in the territories and states...
September 15, 2017: Medical Care
https://www.readbyqxmd.com/read/28916289/breast-cancer-screening-utilization-among-women-from-muslim-majority-countries-in-ontario-canada
#2
Mandana Vahabi, Aisha Lofters, Eliane Kim, Josephine Pui-Hing Wong, Lisa Ellison, Erin Graves, Richard H Glazier
Breast cancer screening disparities continue to prevail with immigrant women being at the forefront of the under screened population. There is a paucity of knowledge about the role of religious affiliation or cultural orientation on immigrant women's cancer screening uptake. This study examined differences in uptake of breast cancer screening among women from Muslim and non- Muslim majority countries in Ontario, Canada. A cohort of 1,851,834 screening-eligible women living in Ontario during April 1, 2013 to March 31, 2015 was created using linked health and social administrative databases...
September 12, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28916017/payment-for-integrated-care-challenges-and-opportunities
#3
REVIEW
Katherine Hobbs Knutson
A multidisciplinary team approach to care and robust care coordination services are primary components of almost all integrated care delivery systems. Given that these services have limited reimbursement in fee-for-service payment arrangements, integrating care in a fee-for-service environment is almost impossible. Capitated payment models hold promise for supporting integrated behavioral and physical health services. There are multiple national examples of integrated care delivery systems supported by capitated payment arrangements...
October 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28914278/magnitude-of-potentially-inappropriate-thrombophilia-testing-in-the-inpatient-hospital-setting
#4
Eric Mou, Henry Kwang, Jason Hom, Lisa Shieh, Andre Kumar, Ilana Richman, Caroline Berube
Laboratory costs of thrombophilia testing exceed an estimated $650 million (in US dollars) annually. Quantifying the prevalence and financial impact of potentially inappropriate testing in the inpatient hospital setting represents an integral component of the effort to reduce healthcare expenditures. We conducted a retrospective analysis of our electronic medical record to evaluate 2 years' worth of inpatient thrombophilia testing measured against preformulated appropriateness criteria. Cost data were obtained from the Centers for Medicare and Medicaid Services 2016 Clinical Laboratory Fee Schedule...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28906314/quality-of-care-in-the-united-states-territories-1999-2012
#5
Sudhakar V Nuti, Yun Wang, Frederick A Masoudi, Marcella Nunez-Smith, Sharon-Lise T Normand, Karthik Murugiah, Orlando Rodríguez-Vilá, Joseph S Ross, Harlan M Krumholz
BACKGROUND: Millions of Americans live in the US territories, but health outcomes and payments among Medicare beneficiaries in these territories are not well characterized. METHODS: Among Fee-for-Service Medicare beneficiaries aged 65 years and older hospitalized between 1999 and 2012 for acute myocardial infarction (AMI), heart failure (HF), and pneumonia, we compared hospitalization rates, patient outcomes, and inpatient payments in the territories and states...
October 2017: Medical Care
https://www.readbyqxmd.com/read/28906313/two-innovative-cancer-care-programs-have-potential-to-reduce-utilization-and-spending
#6
Erin M Colligan, Erin Ewald, Nancy L Keating, Shriram Parashuram, Michelle Spafford, Sarah Ruiz, Adil Moiduddin
BACKGROUND: Cancer patients often present to the emergency department (ED) and hospital for symptom management, but many of these visits are avoidable and costly. OBJECTIVE: We assessed the impact of 2 Health Care Innovation Awards that used an oncology medical home model [Community Oncology Medical Home (COME HOME)] or patient navigation model [Patient Care Connect Program (PCCP)] on utilization and spending. METHODS: Participants in COME HOME and PCCP models were matched to similar comparators using propensity scores...
October 2017: Medical Care
https://www.readbyqxmd.com/read/28905669/correction-notice
#7
(no author information available yet)
Agee, M. D., & Gates, Z. (2014). The Impact of an Insurance Administration-Free Primary Care Office on Hospital Admissions: A Community-Level Comparison With Traditional Fee-for-Service Family Practice Groups. Journal of Primary Care & Community Health, 5, 202-207. doi: 10.1177/2150131914522123 The following Conflict of Interest statement was originally omitted and will be added to the article: Author Zane Gates's affiliation, UPMC Altoona, is the parent organization of Partnering for Health Services. Additionally, author Zane Gates has an ownership interest in the Empower(3) Center for Health, a direct-pay primary care clinic using a subscription coverage model, that additionally provides insurance counseling and prescription programs...
September 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28901243/an-exploration-into-municipal-waste-charges-for-environmental-management-at-local-level-the-case-of-spain
#8
Ignasi Puig-Ventosa, Sergio Sastre Sanz
Municipal waste charges have been widely acknowledged as a crucial tool for waste management at the local level. This is because they contribute to financing the costly provision of waste collection and treatment services and they can be designed to provide an economic stimulus to encourage citizens and local businesses to improve separate collection and recycling. This work presents a methodology to evaluate a sample of 125 municipal waste charges in Spain for the year 2015, covering 33.91% of the Spanish population...
September 1, 2017: Waste Management & Research
https://www.readbyqxmd.com/read/28895820/bob-kocher-believes-with-missionary-zeal-that-venture-capital-can-start-to-cure-what-ails-american-health-care
#9
Timothy Kelley
This upbeat doctor-policymaker-entrepreneur sees opportunity where others see a federal policy train wreck these days. For instance, he's pleased that both political parties seem to endorse a shift from fee-for-service to value-based care. However, continuing uncertainty about the individual market may chill new investment in that area for a while.
August 2017: Managed Care
https://www.readbyqxmd.com/read/28893323/out-of-pocket-expenditure-for-seeking-health-care-for-sick-children-younger-than-5%C3%A2-years-of-age-in-bangladesh-findings-from-cross-sectional-surveys-2009-and-2012
#10
Tazeen Tahsina, Nazia Binte Ali, D M Emdadul Hoque, Tanvir M Huda, Shumona Sharmin Salam, Mohammad Mehedi Hasan, Md Altaf Hossain, Ziaul Matin, Lianne Kuppen, Sarah P Garnett, Shams El Arifeen
BACKGROUND: Bangladesh has committed to universal health coverage, and options to decrease household out-of-pocket expenditure (OPE) are being explored. Understanding the determinants of OPE is an essential step. This study aimed to estimate and identify determinants of OPE in seeking health care for sick under-five children. METHODS: Cross-sectional data was collected by structured questionnaire in 2009 (n = 7362) and 2012 (n = 6896) from mothers of the under-five children...
September 11, 2017: Journal of Health, Population, and Nutrition
https://www.readbyqxmd.com/read/28891549/effects-of-health-care-services-and-commodities-cost-on-the-patients-at-the-primary-health-facilities-in-zaria-metropolis-north-western-nigeria
#11
O Adegboyega, K Abioye
INTRODUCTION: The payment for health-care services is a major problem for many poor patients in developing nations. The aim of the study was to examine the cost of services and commodities and how these affect the patients who utilizes the primary health-care centers in Zaria, North western Nigeria. METHODOLOGY: A descriptive cross-sectional survey of six primary health-care facilities in Zaria metropolis, namely Baban dodo, Tudun Wada, Magajiya PHCs from Zaria local government areas (LGA) and Samaru, Kwata, and Dogarawa PHCs from Sabon Gari LGA, was carried out...
August 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28891235/financial-arrangements-for-health-systems-in-low-income-countries-an-overview-of-systematic-reviews
#12
REVIEW
Charles S Wiysonge, Elizabeth Paulsen, Simon Lewin, Agustín Ciapponi, Cristian A Herrera, Newton Opiyo, Tomas Pantoja, Gabriel Rada, Andrew D Oxman
BACKGROUND: One target of the Sustainable Development Goals is to achieve "universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all". A fundamental concern of governments in striving for this goal is how to finance such a health system. This concern is very relevant for low-income countries. OBJECTIVES: To provide an overview of the evidence from up-to-date systematic reviews about the effects of financial arrangements for health systems in low-income countries...
September 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28890891/collaborative-approaches-and-policy-opportunities-for-accelerated-progress-toward-effective-disease-prevention-care-and-control-using-the-case-of-poverty-diseases-to-explore-universal-access-to-affordable-health-care
#13
Samia Laokri
BACKGROUND: There is a massive global momentum to progress toward the sustainable development and universal health coverage goals. However, effective policies to health-care coverage can only emerge through high-quality services delivered to empowered care users by means of strong local health systems and a translational standpoint. Health policies aimed at removing user fees for a defined health-care package may fail at reaching desired results if not applied with system thinking. METHOD: Secondary data analysis of two country-based cost-of-illness studies was performed to gain knowledge in informed decision-making toward enhanced access to care in the context of resource-constraint settings...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28890798/american-football-and-other-sports-injuries-may-cause-migraine-persistent-pain-decades-later-and-can-be-treated-successfully-with-electrical-twitch-obtaining-intramuscular-stimulation-etoims
#14
J Chu, S McNally, F Bruyninckx, D Neuhauser
INTRODUCTION: Autonomous twitch elicitation at myofascial trigger points from spondylotic radiculopathies-induced denervation supersensitivity can provide favourable pain relief using electrical twitch-obtaining intramuscular stimulation (ETOIMS). AIM: To provide objective evidence that ETOIMS is safe and efficacious in migraine and persistent pain management due to decades-old injuries to head and spine from paediatric American football. METHODS AND MATERIALS: An 83-year-old mildly hypertensive patient with 25-year history of refractory migraine and persistent pain self-selected to regularly receive fee-for-service ETOIMS 2/week over 20 months...
April 2017: BMJ Innovations
https://www.readbyqxmd.com/read/28886338/hospitalizations-for-ambulatory-care-sensitive-conditions-and-unplanned-readmissions-among-medicare-beneficiaries-with-alzheimer-s-disease
#15
Pei-Jung Lin, Yue Zhong, Howard M Fillit, Joshua T Cohen, Peter J Neumann
INTRODUCTION: Medicare beneficiaries with Alzheimer's disease and related dementias (ADRDs) may have more potentially avoidable hospitalizations and readmissions than people without dementia. These hospitalizations may be indicative of access barriers, problems in continuity of care, inefficient resource use, and poor patient outcomes. METHODS: We examined national frequency and costs of ambulatory care sensitive condition hospitalizations and unplanned, all-cause, and condition-specific 30-day readmissions in >2...
September 5, 2017: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
https://www.readbyqxmd.com/read/28885288/early-effects-of-medicare-s-bundled-payment-for-care-improvement-bpci-program-for-lumbar-fusion
#16
Brook I Martin, Jon D Lurie, Farrokh R Farrokhi, Kevin J McGuire, Sohail K Mirza
STUDY DESIGN: Retrospective analysis of Medicare claims linked to hospital participation in the Center for Medicare and Medicaid Innovation's episode-based Bundled Payment for Care Improvement (BPCI) program for lumbar fusion. OBJECTIVES: To describe the early effects of BPCI participation for lumbar fusion on 90-day reimbursement, procedure volume, reoperation, and readmission. SUMMARY OF BACKGROUND DATA: Initiated on January 1st, 2013, BPCI's voluntary bundle payment program provides a predetermined payment for services related to a Diagnosis Related Group-defined "triggering event" over a defined time period...
September 6, 2017: Spine
https://www.readbyqxmd.com/read/28877170/overtreatment-in-the-united-states
#17
Heather Lyu, Tim Xu, Daniel Brotman, Brandan Mayer-Blackwell, Michol Cooper, Michael Daniel, Elizabeth C Wick, Vikas Saini, Shannon Brownlee, Martin A Makary
BACKGROUND: Overtreatment is a cause of preventable harm and waste in health care. Little is known about clinician perspectives on the problem. In this study, physicians were surveyed on the prevalence, causes, and implications of overtreatment. METHODS: 2,106 physicians from an online community composed of doctors from the American Medical Association (AMA) masterfile participated in a survey. The survey inquired about the extent of overutilization, as well as causes, solutions, and implications for health care...
2017: PloS One
https://www.readbyqxmd.com/read/28875573/people-with-intellectual-disabilities-at-the-end-of-their-lives-the-case-for-specialist-care
#18
Rachel Forrester-Jones, Jennifer K Beecham, Magali Barnoux, David Oliver, Elyse Couch, Claire Bates
BACKGROUND: People with intellectual disabilities have a shorter life expectancy, but healthcare improvements mean that they are beginning to live longer, with associated health difficulties. This means that there is an urgent need to focus research on ageing as well as end-of-life care. This study aimed to explore a specialist intellectual disability service for older people who are dying and how it related to their quality of life and to costs associated with care provided. METHOD: Data were collected for nine residents and 15 staff members of the specialist service...
September 5, 2017: Journal of Applied Research in Intellectual Disabilities: JARID
https://www.readbyqxmd.com/read/28874487/high-levels-of-capitation-payments-needed-to-shift-primary-care-toward-proactive-team-and-nonvisit-care
#19
Sanjay Basu, Russell S Phillips, Zirui Song, Asaf Bitton, Bruce E Landon
Capitated payments in the form of fixed monthly payments to cover all of the costs associated with delivering primary care could encourage primary care practices to transform the way they deliver care. Using a microsimulation model incorporating data from 969 US practices, we sought to understand whether shifting to team- and non-visit-based care is financially sustainable for practices under traditional fee-for-service, capitated payment, or a mix of the two. Practice revenues and costs were computed for fee-for-service payments and a range of capitated payments, before and after the substitution of team- and non-visit-based services for low-complexity in-person physician visits...
September 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28873324/proportion-and-patterns-of-hospice-discharges-in-medicare-advantage-compared-to-medicare-fee-for-service
#20
Joan M Teno, Thomas J Christian, Pedro Gozalo, Michael Plotzke
BACKGROUND: When Medicare Advantage (MA) patients elect hospice, all covered services are reimbursed under the Medicare fee-for-service (FFS) program. This financial arrangement may incentivize MA plans to refer persons to hospice near end of life when costs of care typically rise. OBJECTIVE: To characterize hospice discharge patterns for MA versus FFS patients and examine whether patterns differ by MA concentration across hospital referral regions (HRRs). DESIGN AND MEASUREMENT: The rate and pattern of live discharges and length of stay (LOS) between FFS and MA patients were examined...
September 5, 2017: Journal of Palliative Medicine
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