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Gail S Kerr, Christopher Swearingen, Ted R Mikuls, Yusuf Yazici
BACKGROUND: In the United States, there is racial/ethnic disparity in the care of rheumatoid arthritis (RA), yet there are limited data regarding the impact of varied health care systems on treatment outcomes. OBJECTIVE: The aim fo this study was to compare the frequencies of use of disease-modifying antirheumatic drugs and biologic agents in racial minorities with RA in a single-payer and variable-access health systems. METHODS: Rheumatoid arthritis disease status was examined in the Ethnic Minority Rheumatoid Arthritis Consortium (EMRAC) and Veterans Affairs Rheumatoid Arthritis Registry (VARA); frequencies of prednisone and disease-modifying antirheumatic drugs and biologic agent use at enrollment were documented...
January 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Christopher J D Wallis, Colin Lundeen, Nicole Golda, Hilary Brotherhood, Peter Pommerville, Lesley Carr
INTRODUCTION: We sought to understand the contemporary pharmacologic management of overactive bladder (OAB) in a single-payer system. We examined temporal trends in the use of anticholinergic medications and assessed whether the likelihood of patients changing their anticholinergic therapy was predicted by their current therapy. METHODS: We conducted a retrospective, population-based analysis of prescription records from the PharmaNet database in BC, Canada. We identified patients treated with one or more anticholinergic prescriptions between 2001 and 2009...
August 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Kyle Fluegge
The incorporation of genetics into health services research has largely floundered, despite the rapidly accelerating availability of, and access to, such data. This is expected given the ethical questions involved. However, using these new resources robustly to examine population choices when it comes to health insurer selection, coverage therein and especially the subsequent use of health services is a necessary step forward, especially given the increasing prevalence of multimorbidity. Such a novel advancement in health services research may eventually propel public and private insurers to redesign their infrastructure to more accurately reflect the behavioural inclinations of their beneficiary populations...
November 2, 2016: Journal of Health Services Research & Policy
D J Kagedan, M E Dixon, R S Raju, Q Li, M Elmi, E Shin, N Liu, A El-Sedfy, L Paszat, A Kiss, C C Earle, N Mittmann, N G Coburn
BACKGROUND: In the present study, we aimed to describe, at the population level, patterns of adjuvant treatment use after curative-intent resection for pancreatic adenocarcinoma (pcc) and to identify independent predictors of adjuvant treatment use. METHODS: In this observational cohort study, patients undergoing pcc resection in the province of Ontario (population 13 million) during 2005-2010 were identified using the provincial cancer registry and were linked to administrative databases that include all treatments received and outcomes experienced in the province...
October 2016: Current Oncology
Michael McCarthy
No abstract text is available yet for this article.
October 28, 2016: BMJ: British Medical Journal
Cheryl R Laratta, Willis H Tsai, James Wick, Sachin R Pendharkar, Kerri A Johannson, Paul E Ronksley
Obstructive sleep apnea (OSA) is a common condition associated with significant morbidity and health-care utilization. We determined the validity of an algorithm derived from administrative data for identifying OSA using the respiratory disturbance index (RDI) as the reference standard. We conducted a retrospective cohort study of adults in Alberta, Canada referred for facility and community-based sleep diagnostic testing between July 2005 and August 2007. Validity indices were estimated for several case definitions of OSA derived from outpatient physician billing claims and hospital discharge codes...
October 20, 2016: Journal of Sleep Research
Gwyn Bevan
Marchildon highlights the lack of evidence on policies of regionalization in Canada: with regionalization being in favour in the 2000s followed by disillusion and the abolition of regions by some provincial governments. This paper looks at evidence from the UK's single-payer system of the impacts of regions on the performance of the delivery of healthcare. In England, regions were an important part of the hierarchical structure of the National Health Service (NHS) from its beginning, in 1948, to the introduction of provider competition, in the 1990s...
2016: HealthcarePapers
Linda C Lee, Armando J Lorenzo, Rakan Odeh, Michelle Falkiner, Dawn-Ann Lebarron, Jeffrey Traubici, Erika Mann, Paul R Bowlin, Martin A Koyle
PURPOSE: Voiding cystourethrogram involves radiation exposure and is invasive. Several guidelines, including the 2011 AAP (American Academy of Pediatrics) guidelines, no longer recommend routine voiding cystourethrogram after the initial urinary tract infection in children. The recent trend in voiding cystourethrogram use remains largely unknown. We examined practice patterns of voiding cystourethrogram use and explored the impact of these guidelines in a single payer system in the past 8 years...
September 2, 2016: Journal of Urology
Thomas P Weil
Numerous papers have been written comparing the Canadian and US healthcare systems, and a number of health policy experts have recommended that the Americans implement their single-payer system to save 12-20% of its healthcare expenditures. This paper is different in that it assumes that neither country will undertake a significant philosophic or structural change in their healthcare system, but there are lessons to be learned that are inherent in one that could be a major breakthrough for the other. Following the model in Canada and in Western Europe, the USA could implement universal health insurance so that the 32...
July 2016: International Journal of Health Planning and Management
Alexander Marius van den Heever
In 2011, the South African government published a Green Paper outlining proposals for a single-payer National Health Insurance arrangement as a means to achieve universal health coverage (UHC), followed by a White Paper in 2015. This follows over two decades of health reform proposals and reforms aimed at deepening UHC. The most recent reform departure aims to address pooling and purchasing weaknesses in the health system by internalising both functions within a single scheme. This contrasts with the post-apartheid period from 1994 to 2008 where pooling weaknesses were to be addressed using pooling schemes, in the form of government subsidies and risk-equalisation arrangements, external to the public and private purchasers...
December 2016: Health Policy
Saied Samiedaluie, Sandra Peterson, Rollin Brant, Janusz Kaczorowski, Wendy V Norman
BACKGROUND: The British Columbia (BC) Ministry of Health collects abortion procedure data in the Medical Services Plan (MSP) physician billings database and in the hospital information Discharge Abstracts Database (DAD). Our study seeks to validate abortion procedure coding in these databases. METHODS: Two randomized controlled trials enrolled a cohort of 1031 women undergoing abortion. The researcher collected database includes both enrollment and follow up chart review data...
July 12, 2016: BMC Health Services Research
Gilbert G Berdine
No abstract text is available yet for this article.
July 2016: Chest
Adam W Gaffney, Philip A Verhoef, Jesse B Hall
No abstract text is available yet for this article.
July 2016: Chest
Daniel J Kagedan, Liza Abraham, Nik Goyert, Qing Li, Lawrence F Paszat, Alexander Kiss, Craig C Earle, Nicole Mittmann, Natalie G Coburn
BACKGROUND: The single-payer universal health care system in Ontario, Canada creates a setting with reduced socioeconomic barriers to treatment. Herein, the authors sought to elucidate the influence of sociodemographic marginalization on receipt of pancreatectomy, overall survival (OS), and receipt of adjuvant treatment among patients diagnosed with pancreatic cancer at the population level using an observational cohort study design. METHODS: Patients diagnosed with pancreatic cancer in Ontario between January 2005 and January 2010 were identified using the provincial cancer registry and linked to administrative databases...
July 8, 2016: Cancer
Huang-Tz Ou, Yen-Ting Chen, Ya-Ming Liu, Jin-Shang Wu
OBJECTIVE: To assess the cost-effectiveness of metformin-based dual therapies associated with cardiovascular disease (CVD) risk in a Chinese population with type 2 diabetes. METHODS: We utilized Taiwan's National Health Insurance Research Database (NHIRD) 1997-2011, which is derived from the claims of National Health Insurance, a mandatory-enrollment single-payer system that covers over 99% of Taiwan's population. Four metformin-based dual therapy cohorts were used, namely a reference group of metformin plus sulfonylureas (Metformin-SU) and metformin plus acarbose, metformin plus thiazolidinediones (Metformin-TZD), and metformin plus glinides (Metformin-glinides)...
June 2016: Diabetes Research and Clinical Practice
Abiodun Mafolasire, Xiaopan Yao, Cayce Nawaf, Alfredo Suarez-Sarmiento, Wong-Ho Chow, Wei Zhao, Douglas Corley, Jonathan N Hofmann, Mark Purdue, Adebowale J Adeniran, Brian Shuch
Significant racial disparities in survival for renal cell carcinoma (RCC) exist between white and black patients. Differences in access to care and comorbidities are possible contributors. To investigate if racial disparities persist when controlling for access to care, we analyzed data from a single-payer healthcare system. As part of a case-control study within the Kaiser Permanente Northern California system, pathologic and clinical records were obtained for RCC cases (2152 white, 293 black) diagnosed from 1998 to 2008...
August 2016: Cancer Medicine
Paul C Langley
In common with a number of other single payer health systems, Ireland, through the Health Information and Quality Authority, has established guidelines for formulary submissions by pharmaceutical manufacturers. In the last few months, however, there have been a number of questions raised as to whether or not guidelines for economic evaluations in such submissions are consistent with the standards of normal science. Do they require those making the submission to put their claims in the form of testable hypotheses that can support falsification and replication? The purpose of this review is to consider whether the 2014 guidelines meet these standards...
May 16, 2016: Current Medical Research and Opinion
S Tauro
The pharmacological therapy of non-promyelocytic acute myeloid leukemia (AML) has remained unchanged for over 40 years with an anthracycline-cytarabine combination forming the backbone of induction treatments. Nevertheless, the survival of younger patients has increased due to improved management of the toxicity of therapies including stem cell transplantation. Older patients and those with infirmity that precludes treatment-intensification have, however, not benefited from improvements in supportive care and continue to experience poor outcomes...
2016: Blood Cancer Journal
Ronald L Malzer
No abstract text is available yet for this article.
May 2016: Family Medicine
Adam Gaffney, Steffie Woolhandler, Marcia Angell, David U Himmelstein
No abstract text is available yet for this article.
June 2016: American Journal of Public Health
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