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https://www.readbyqxmd.com/read/28214902/impact-of-renal-disease-on-patients-with-hepatitis-c-a-retrospective-analysis-of-disease-burden-clinical-outcomes-and-health-care-utilization-and-cost
#1
Craig A Solid, Senaka A Peter, Tanya Natwick, Haifeng Guo, Allan J Collins, Jean Marie Arduino
BACKGROUND/AIMS: Few studies explore the magnitude of the disease burden and health care utilization imposed by renal disease among patients with hepatitis C virus (HCV). We aimed to describe the characteristics, outcomes, and health care utilization and costs of patients with HCV with and without renal impairment. METHODS: This retrospective analysis used 2 administrative claims databases: the US commercially insured population in Truven Health MarketScan® data (aged 20-64 years), and the US Medicare fee-for-service population in the Medicare 20% sample (aged ≥65 years)...
February 18, 2017: Nephron
https://www.readbyqxmd.com/read/28214235/effects-of-postacute-settings-on-readmission-rates-and-reasons-for%C3%A2-readmission-following-total-knee-arthroplasty
#2
Rodney Laine Welsh, James E Graham, Amol M Karmarkar, Natalie E Leland, Jacques G Baillargeon, Dana L Wild, Kenneth J Ottenbacher
OBJECTIVES: Examine the effects of postacute discharge setting on unplanned hospital readmissions following total knee arthroplasty (TKA) in older adults. DESIGN: Secondary analyses of 100% Medicare (inpatient) claims files. SETTING: Acute hospitals across the United States. PARTICIPANTS: Medicare fee-for-service beneficiaries ≥66 years of age who were discharged from an acute hospital following TKA in 2009-2011 (n = 608,031)...
February 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28208030/intensive-care-unit-admission-and-survival-among-older-patients-with-chronic-obstructive-pulmonary-disease-heart-failure-or-myocardial-infarction
#3
Thomas S Valley, Michael W Sjoding, Andrew M Ryan, Theodore J Iwashyna, Colin R Cooke
RATIONALE: Admission to an intensive care unit (ICU) may be beneficial to pneumonia patients with uncertain ICU needs; however, evidence regarding the association between ICU admission and mortality for other common conditions is largely unknown. OBJECTIVES: To estimate the relationship between ICU admission and outcomes for hospitalized patients with exacerbation of chronic obstructive pulmonary disease (COPD), exacerbation of heart failure (HF), or acute myocardial infarction (AMI)...
February 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28207744/utilization-of-smoking-cessation-medication-benefits-among-medicaid-fee-for-service-enrollees-1999-2008
#4
Jennifer Kahende, Ann Malarcher, Lucinda England, Lei Zhang, Paul Mowery, Xin Xu, Varadan Sevilimedu, Italia Rolle
OBJECTIVE: To assess state coverage and utilization of Medicaid smoking cessation medication benefits among fee-for-service enrollees who smoked cigarettes. METHODS: We used the linked National Health Interview Survey (survey years 1995, 1997-2005) and the Medicaid Analytic eXtract files (1999-2008) to assess utilization of smoking cessation medication benefits among 5,982 cigarette smokers aged 18-64 years enrolled in Medicaid fee-for-service whose state Medicaid insurance covered at least one cessation medication...
2017: PloS One
https://www.readbyqxmd.com/read/28205279/cancelled-procedures-in-the-english-nhs-evidence-from-the-2010-tariff-reform
#5
Graham Cookson, Simon Jones, Ioannis Laliotis
This paper explores the role of incentives in the English National Health Service. Until financial year 2009/2010, elective procedures that were cancelled after admission received a fixed reimbursement associated with a specific healthcare resource group code. We investigate whether this induced trusts to admit and then cancel, rather than cancel before admission and/or to cancel low fee over high fee work. As the tariff was ended in April 2010, we conduct an interrupted time series analysis to examine if their behaviour was affected after the tariff removal...
February 16, 2017: Health Economics
https://www.readbyqxmd.com/read/28197663/-in-patient-early-rehabilitation
#6
Claus-W Wallesch, Sindy Lautenschläger
It is difficult to develop the financing and hospital provision of interventions for early rehabilitation within the diagnosis-related group (DRG) system. In addition to a range of partially rehabilitative complex interventions, the system recognizes three main forms of early rehabilitative interventions: geriatric, neurological/neurosurgical, and interdisciplinary and others. In this article, the appropriate definitions and cost-effectiveness of these procedures are analyzed and compared. The early rehabilitative interventions are characterized by constant cooperation in the therapeutic team, especially neurological early rehabilitation through the incorporation of nursing as a therapeutic profession...
February 14, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/28196460/prescribing-of-clozapine-and-antipsychotic-polypharmacy-for-schizophrenia-in-a-large-medicaid-program
#7
Yan Tang, Marcela Horvitz-Lennon, Walid F Gellad, Judith R Lave, Chung-Chou H Chang, Sharon-Lise Normand, Julie M Donohue
OBJECTIVE: Underuse of clozapine and overuse of antipsychotic polypharmacy are both indicators of poor quality of care. This study examined variation in prescribing clozapine and antipsychotic polypharmacy across providers, as well as factors associated with these practices. METHODS: Using 2010-2012 Pennsylvania Medicaid data, prescribers were identified if they wrote antipsychotic prescriptions for ten or more nonelderly adult patients with schizophrenia annually...
February 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28195645/exploring-the-views-of-relatives-of-frail-elderly-patients-about-participating-in-a-geriatric-dentistry-program
#8
Diego Machado Ardenghi, Chris Wyatt
Elderly residents of long-term care facilities (LTC) have difficulty accessing dental services. Aiming to improve access for this population, the Geriatric Dental Program (GDP) was established by UBC Faculty of Dentistry in 2002. Within the GDP, elderly people receive fee-for-service dental care. The objective of this research was to explore whether accessing these services had an impact on the lives of the patients' relatives. Data was collected through semi-structured, face-to-face, audio-recorded interviews with family members of 12 GDP patients...
February 14, 2017: Special Care in Dentistry
https://www.readbyqxmd.com/read/28192556/changes-in-postacute-care-in-the-medicare-shared-savings-program
#9
J Michael McWilliams, Lauren G Gilstrap, David G Stevenson, Michael E Chernew, Haiden A Huskamp, David C Grabowski
Importance: Postacute care is thought to be a major source of wasteful spending. The extent to which accountable care organizations (ACOs) can limit postacute care spending has implications for the importance and design of other payment models that include postacute care. Objective: To assess changes in postacute care spending and use of postacute care associated with provider participation as ACOs in the Medicare Shared Savings Program (MSSP) and the pathways by which they occurred...
February 13, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28192148/something-new-in-the-air-paying-for-community-based-environmental-approaches-to-asthma-prevention-and-control-work-group-report-of-the-practice-diagnostics-and-therapeutics-committee-of-the-american-academy-of-allergy-asthma-immunology
#10
Megan M Tschudy, Joshua Sharfstein, Elizabeth Matsui, Charles S Barnes, Stacey Chacker, Rosa Codina, John R Cohn, Megan Sandel, H James Wedner
Despite the recommendation in national asthma guidelines to target indoor environmental exposures, most insurers generally have not covered the outreach, education, environmental assessments, or durable goods integral to home environmental interventions. Emerging payment approaches, however, offer new potential for coverage of home-based environmental intervention costs. These opportunities are becoming available as public and private insurers shift reimbursement to reward better health outcomes and their key characteristic is a focus on the value rather than the volume of services...
February 10, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28184060/do-high-tuition-fees-make-a-difference-characteristics-of-applicants-to-uk-medical-and-dental-schools-before-and-after-the-introduction-of-high-tuition-fees-in-2012
#11
J E Gallagher, A Calvert, V Niven, L Cabot
Aim To compare trends in the volume, socio-demography and academic experience of UK applicants and entrants to medicine and dentistry in the UK with university in general, before and after the major increase in university fees in England in 2012.Methods Descriptive trend analyses of University and College Admissions Services (UCAS) data for focused (preferred subject was medicine or dentistry) and accepted applicants, 2010-14, compared with university in general in relation to socio-demography (age, sex, ethnicity, POLAR 2, region) and academic experience (school type)...
February 10, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28178979/managed-care-and-inpatient-mortality-in-adults-effect-of-primary-payer
#12
Anika L Hines, Susan O Raetzman, Marguerite L Barrett, Ernest Moy, Roxanne M Andrews
BACKGROUND: Because managed care is increasingly prevalent in health care finance and delivery, it is important to ascertain its effects on health care quality relative to that of fee-for-service plans. Some stakeholders are concerned that basing gatekeeping, provider selection, and utilization management on cost may lower quality of care. To date, research on this topic has been inconclusive, largely because of variation in research methods and covariates. Patient age has been the only consistently evaluated outcome predictor...
February 8, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28177102/-central-purchasing-bodies-and-spending-review-in-health-sector
#13
Luigi Spampinato
The aim of this paper is to analyze the new model of centralization of purchases in Italy after the approval of the 2016 Stability Law, with particular reference to the health sector. In fact, the spending review process in Italy in the health sector has had a strong evolution with the 2016 Stability Law, which has introduced the obligation for the institutions of the National Health Service to obtain supplies, exclusively, from aggregators subjects, for certain product categories of the health sector. The legislature, over the years, was mainly characterized by measures to reduce the spending limits for purchases of goods and services or by resetting the fees, including the provision of an obligation for the renegotiation of health goods and services contracts, in order to ensure the effective implementation of the expenditure rationalization by aggregation of goods and services...
January 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28169978/analysis-of-patient-visits-and-collections-after-opening-a-satellite-pediatric-emergency-department
#14
Katherine M Nichols, Kerry Caperell, Keith Cross, Scott Duncan, Ben Foster, Gil Liu, Hank Pritchard, Gary Southard, Ben Shinabery, Brad Sutton, In K Kim
OBJECTIVE: Satellite pediatric emergency departments (PEDs) have emerged as a strategy to increase patient capacity. We sought to determine the impact on patient visits, physician fee collections, and value of emergency department (ED) time at the primary PED after opening a nearby satellite PED. We also illustrate the spatial distribution of patient demographics and overlapping catchment areas for the primary and satellite PEDs using geographical information system. METHODS: A structured, financial retrospective review was conducted...
February 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28167723/longer-periods-of-hospice-service-associated-with-lower-end-of-life-spending-in-regions-with-high-expenditures
#15
Shiyi Wang, Sylvia H Hsu, Siwan Huang, Pamela R Soulos, Cary P Gross
Hospice use is expected to decrease end-of-life expenditures, yet evidence for its financial impact remains inconclusive. One potential explanation is that the use of hospice may produce differential cost-savings effects by region because of geographic variation in end-of-life spending patterns. We examined 103,745 elderly Medicare fee-for-service beneficiaries in the Surveillance, Epidemiology, and End Results Program Medicare database who died from cancer in 2004-11. We created quintiles by the adjusted mean end-of-life expenditures per hospital referral region (HRR), and we examined HRR-level variation in the association between length of hospice service and expenditures across quintiles...
February 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28167722/projected-coding-intensity-in-medicare-advantage-could-increase-medicare-spending-by-200%C3%A2-billion-over-ten-years
#16
Richard Kronick
Over the past decade, the average risk score for Medicare Advantage (MA) enrollees has risen steadily relative to that for fee-for-service Medicare beneficiaries, by approximately 1.5 percent per year. The Centers for Medicare and Medicaid Services (CMS) uses patient demographic and diagnostic information to calculate a risk score for each beneficiary, and these risk scores are used to determine payment to MA plans. The increase in relative MA risk scores is largely the result of successful efforts by MA plans to identify additional diagnoses, also known as coding intensity, and not of changes in enrollees' true health...
February 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28167228/comparison-of-conflict-of-interest-among-published-hernia-researchers-self-reported-to-the-centers-of-medicare-and-medicaid-services-open-payments-database
#17
Oscar A Olavarria, Julie L Holihan, Deepa Cherla, Cristina A Perez, Lillian S Kao, Tien C Ko, Mike K Liang
INTRODUCTION: Many healthcare providers have financial interests and relationships with healthcare companies. In order to maintain transparency, investigators are expected to disclose their conflicts of interest (COI). Recently, the Centers of Medicare and Medicaid Services (CMS) developed an open payment database of COI reported by industry. We hypothesize there is discordance between industry-reported and physician self-reported COI among ventral hernia publications. METHODS: PubMed was searched for ventral hernia studies accepted for publication between June 2013 and October 2015 and published by authors from the United States...
February 3, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28166546/the-relationship-of-obesity-to-hospice-use-and-expenditures-a-cohort-study
#18
John A Harris, Elena Byhoff, Chithra R Perumalswami, Kenneth M Langa, Alexi A Wright, Jennifer J Griggs
Background: Obesity complicates medical, nursing, and informal care in severe illness, but its effect on hospice use and Medicare expenditures is unknown. Objective: To describe the associations between body mass index (BMI) and hospice use and Medicare expenditures in the last 6 months of life. Design: Retrospective cohort. Setting: The HRS (Health and Retirement Study). Participants: 5677 community-dwelling Medicare fee-for-service beneficiaries who died between 1998 and 2012...
February 7, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28161340/evaluating-the-impact-of-strabismus-surgery-on-the-association-of-musculoskeletal-injuries-fractures-and-falls-with-disorders-of-binocular-vision-in-medicare-beneficiaries
#19
Stacy L Pineles, Michael X Repka, Fei Yu, Flora Lum, Anne L Coleman
Disorders of binocular vision that are increasingly prevalent among aged, fee-for-service Medicare beneficiaries are associated with fractures, falls, and musculoskeletal injuries. We evaluate whether strabismus surgery influences the association of injuries in elderly patients with disorders of binocular vision in a 5% random sample of Medicare fee-for-service claims data from 2010 to 2013. There were 22,237 Medicare beneficiaries with a claim that included a diagnosis of a disorder of binocular vision. Of these, the majority had strabismus (49...
February 1, 2017: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/28160900/evidence-based-practice-in-the-surgical-treatment-of-thumb-carpometacarpal-joint-arthritis
#20
Frank Yuan, Oluseyi Aliu, Kevin C Chung, Elham Mahmoudi
PURPOSE: Thumb carpometacarpal (CMC) arthritis contributes considerably to functional disability in the aging adult United States (US) population. Owing to the increasing growth in this segment of our population, its burden on health care resources will increase in the future. Variations exist in the degree of complexity and cost among different surgical treatments. We examined the national trends of the surgical treatment of thumb CMC arthritis and hypothesized that current practice patterns are not supported by evidence favoring the simpler trapeziectomy-only procedure...
February 2017: Journal of Hand Surgery
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