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https://www.readbyqxmd.com/read/28214574/minimally-invasive-versus-open-approach-for-cystectomy-trends-in-the-utilization-and-demographic-or-clinical-predictors-using-the-national-cancer-database-ncdb
#1
Andrew G Bachman, Alexander A Parker, Marshall D Shaw, Brian W Cross, Kelly L Stratton, Michael S Cookson, Sanjay G Patel
OBJECTIVES: To examine temporal national trends of operative approach for cystectomy and identify demographic or clinical predictive factors that influence choice of approach. METHODS: We performed a retrospective cohort study of patients who underwent cystectomy for bladder cancer between 2010 and 2013 using the National Cancer Database (NCDB). Approach was stratified by open vs. minimally invasive (robotic or laparoscopic). Univariate Pearson chi-square and multivariate logistic regression analysis was used to assess relationships between demographic and hospital factors and the receipt of minimally invasive or open surgical approach...
February 15, 2017: Urology
https://www.readbyqxmd.com/read/28214250/colorectal-cancer-screening-adherence-in-selected-disabilities-over-10-years
#2
Chelsea B Deroche, Suzanne W McDermott, Joshua R Mann, James W Hardin
INTRODUCTION: Colorectal cancer (CRC) is the second leading cause of cancer mortality in the U.S.; however, if the population aged 50 years or older received routine screening, approximately 60% of these deaths could be eliminated. This study investigates whether adults, aged 50-75 years, with one of three disabilities (blind/low vision [BLV], intellectual disability [ID], spinal cord injury [SCI]) receive CRC screening at rates equivalent to adults without the three disabilities, by accounting for combinations of recommended CRC screenings during a 10-year period (colonoscopy, sigmoidoscopy, fecal occult blood test)...
February 14, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28213393/the-racial-divide-in-state-medicaid-expansions
#3
Colleen M Grogan, Sunggeun Ethan Park
This study considers five important questions related to the role of race in state-level public support for the Medicaid expansion: (1) whether public support for the Medicaid expansion varies across the American states; (2) whether public support is positively related to state adoption; (3) whether this support is racialized; (4) whether, if racialized, there is evidence of more state responsiveness to white support than to nonwhite (black and/or Latino) support; and (5) does the size of the nonwhite population matter more when white support is relatively low? Our findings suggest that while public support for the Medicaid expansion is high at the state level, especially in comparison to public support for the ACA, there are important variations across the states...
February 17, 2017: Journal of Health Politics, Policy and Law
https://www.readbyqxmd.com/read/28212899/outcome-disparities-by-insurance-type-for-patients-with-acute-myeloblastic-leukemia
#4
Dianne Pulte, Felipe A Castro, Hermann Brenner, Lina Jansen
Survival for patients with acute myeloblastic leukemia (AML) has increased during the past two decades. However, socioeconomic disparities may affect survival for some patient populations. We examine survival by insurance type for patients with AML. Using data from the Surveillance, Epidemiology, and End Results database we estimated survival according to insurance status (no insurance, Medicaid, and other insurance) for patients diagnosed with AML in the United States in 2007-2013. One, 3-, and 5-year survival was lower for patients with no insurance and Medicaid than for patients with other insurance...
February 3, 2017: Leukemia Research
https://www.readbyqxmd.com/read/28211994/building-the-coverage-continuum-the-role-of-state-medicaid-directors-and-insurance-commissioners
#5
Joel Ario, Deborah Bachrach
Issue: The Affordable Care Act has expanded coverage to 20 million newly insured individuals, split between state Medicaid programs and commercially insured marketplaces, with limited integration between the two. The seamless continuum of coverage envisioned by the law is central to achieving the full potential of the Affordable Care Act, but it remains an elusive promise. Goals: To examine the historical and cultural differences between state Medicaid agencies and insurance departments that contribute to this lack of coordination...
2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28211567/isolation-precautions-use-for-multidrug-resistant-organism-infection-in-nursing-homes
#6
Catherine C Cohen, Andrew Dick, Patricia W Stone
OBJECTIVES: To examine factors associated with isolation precaution use in nursing home (NH) residents with multidrug-resistant organism (MDRO) infection. DESIGN: Retrospective, cross-sectional analysis. SETTING: Nursing homes with Centers for Medicare and Medicaid Services' certification from October 2010 to December 2013. PARTICIPANTS: Elderly, long-stay NH residents with positive MDRO infection assessments. MEASUREMENTS: Data were obtained from the Minimum Data Set (MDS) 3...
February 17, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28210537/multilevel-predictors-of-colorectal-cancer-testing-modality-among-publicly-and-privately-insured-people-turning-50
#7
Stephanie B Wheeler, Tzy-Mey Kuo, Anne Marie Meyer, Christa E Martens, Kristen M Hassmiller Lich, Florence K L Tangka, Lisa C Richardson, Ingrid J Hall, Judith Lee Smith, Maria E Mayorga, Paul Brown, Trisha M Crutchfield, Michael P Pignone
Understanding multilevel predictors of colorectal cancer (CRC) screening test modality can help inform screening program design and implementation. We used North Carolina Medicare, Medicaid, and private, commercially available, health plan insurance claims data from 2003 to 2008 to ascertain CRC test modality among people who received CRC screening around their 50th birthday, when guidelines recommend that screening should commence for normal risk individuals. We ascertained receipt of colonoscopy, fecal occult blood test (FOBT) and fecal immunochemical test (FIT) from billing codes...
June 2017: Preventive Medicine Reports
https://www.readbyqxmd.com/read/28209637/the-impact-of-payer-source-on-trauma-outcomes-in-a-pediatric-population
#8
Felecia A Lee, Ashley M Hervey, Arash Sattarin, Aaron Deeds, Gina M Berg, Kimberly Molik
OBJECTIVES: Determine if there were differences in conclusions drawn regarding disparities in trauma outcomes based on literature-derived payer source definitions in a pediatric population. PATIENTS AND METHODS: Retrospective registry review of admitted pediatric trauma patients (≤17 years of age) at a level II pediatric trauma facility. Eligible patients were categorized into 3 payer source definitions: definition 1: commercially insured, Medicaid, uninsured; definition 2: insured, uninsured; definition 3: commercially insured, underinsured...
February 16, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28209490/surgical-site-infection-in-gynecologic-surgery-pathophysiology-and-prevention
#9
REVIEW
Holly L Steiner, Eric A Strand
Surgical site infections (SSIs) represent a well-known cause of patient morbidity as well as added healthcare costs. In gynecologic surgery, particularly hysterectomy, SSIs are often the result of a number of risk factors that may or may not be modifiable. As both the Centers for Medicaid and Medicare Services and the Joint Commission on the Accreditation of Healthcare Organizations have identified SSIs as a patient safety priority, gynecologic surgeons continue to seek out the most effective interventions for SSI prevention...
February 13, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28209168/the-impact-of-preterm-birth-37%C3%A2-weeks-on-parents-and-families-a-cross-sectional-study-in-the-2%C3%A2-years-after-discharge-from-the-neonatal-intensive-care-unit
#10
Ashwini Lakshmanan, Meghana Agni, Tracy Lieu, Eric Fleegler, Michele Kipke, Philippe S Friedlich, Marie C McCormick, Mandy B Belfort
BACKGROUND: Little is known about the quality of life of parents and families of preterm infants after discharge from the neonatal intensive care unit (NICU). Our aims were (1) to describe the impact of preterm birth on parents and families and (2) and to identify potentially modifiable determinants of parent and family impact. METHODS: We surveyed 196 parents of preterm infants <24 months corrected age in 3 specialty clinics (82% response rate). Primary outcomes were: (1) the Impact on Family Scale total score; and (2) the Infant Toddler Quality of Life parent emotion and (3) time limitations scores...
February 16, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28208610/non-emergency-medical-transportation-needs-of-middle-aged-and-older-adults-a-rural-urban-comparison-in-delaware-usa
#11
Matthew Lee Smith, Thomas R Prohaska, Kara E MacLeod, Marcia G Ory, Amy R Eisenstein, David R Ragland, Cheryl Irmiter, Samuel D Towne, William A Satariano
Background: Older adults in rural areas have unique transportation barriers to accessing medical care, which include a lack of mass transit options and considerable distances to health-related services. This study contrasts non-emergency medical transportation (NEMT) service utilization patterns and associated costs for Medicaid middle-aged and older adults in rural versus urban areas. Methods: Data were analyzed from 39,194 NEMT users of LogistiCare-brokered services in Delaware residing in rural (68.3%) and urban (30...
February 10, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28207744/utilization-of-smoking-cessation-medication-benefits-among-medicaid-fee-for-service-enrollees-1999-2008
#12
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/28207344/the-future-of-the-affordable-care-act-and-insurance-coverage
#13
Sherry Glied, Adlan Jackson
We describe the patterns of coverage gains associated with the Affordable Care Act (ACA) expansions and use these patterns to assess the potential impact of alternative repeal or repeal and replace strategies because Congress and the president are weighing options to repeal or replace the ACA. We find that specific provisions of the ACA, including the Medicaid expansion and the structure of premium subsidies, have been associated with large and robust gains in insurance coverage. We evaluate the impact of retaining dependent coverage and high-risk pool provisions and show, on the basis of the ACA experience, that these provisions would have little effect on coverage...
February 16, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28207336/local-television-news-coverage-of-the-affordable-care-act-emphasizing-politics-over-consumer-information
#14
Sarah E Gollust, Laura M Baum, Jeff Niederdeppe, Colleen L Barry, Erika Franklin Fowler
OBJECTIVES: To examine the public health and policy-relevant messages conveyed through local television news during the first stage of Affordable Care Act (ACA) implementation, when about 10 million Americans gained insurance. METHODS: We conducted a content analysis of 1569 ACA-related local evening television news stories, obtained from sampling local news aired between October 1, 2013, and April 19, 2014. Coders systematically collected data using a coding instrument tracking major messages and information sources cited in the news...
February 16, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28202501/national-health-expenditure-projections-2016-25-price-increases-aging-push-sector-to-20%C3%A2-percent-of-economy
#15
Sean P Keehan, Devin A Stone, John A Poisal, Gigi A Cuckler, Andrea M Sisko, Sheila D Smith, Andrew J Madison, Christian J Wolfe, Joseph M Lizonitz
Under current law, national health expenditures are projected to grow at an average annual rate of 5.6 percent for 2016-25 and represent 19.9 percent of gross domestic product by 2025. For 2016, national health expenditure growth is anticipated to have slowed 1.1 percentage points to 4.8 percent, as a result of slower Medicaid and prescription drug spending growth. For the rest of the projection period, faster projected growth in medical prices is partly offset by slower projected growth in the use and intensity of medical goods and services, relative to that observed in 2014-16 associated with the Affordable Care Act coverage expansions...
February 15, 2017: Health Affairs
https://www.readbyqxmd.com/read/28201949/evaluating-efficacy-of-current-lung-cancer-screening-guidelines
#16
Barbara Nemesure, April Plank, Lisa Reagan, Denise Albano, Michael Reiter, Thomas V Bilfinger
Objective Current lung cancer screening criteria based primarily on outcomes from the National Lung Screening Trial may not adequately capture all subgroups of the population at risk. We aimed to evaluate the efficacy of lung cancer screening criteria recommended by the United States Preventive Services Task Force, Centers for Medicare and Medicaid Services, and the National Comprehensive Cancer Network in identifying known cases of lung cancer. Methods An investigation of the Stony Brook Cancer Center Lung Cancer Evaluation Center's database identified 1207 eligible, biopsy-proven lung cancer cases diagnosed between January 1996 and March 2016...
January 1, 2017: Journal of Medical Screening
https://www.readbyqxmd.com/read/28199277/funding-accountable-care-in-oregon-financial-models-in-two-coordinated-care-organizations
#17
Lauren Broffman, Kristin Brown, Bruce K Bayley, Lucy Savitz, Jill Rissi
Oregon's coordinated care organizations (CCOs) are an integral part of a massive statewide reform that brings accountable care to Medicaid. CCOs are regional collaboratives among health plans, providers, county public health, and communitybased organizations that administer a single global budget covering physical, mental, and dental healthcare for low-income Oregonians. CCOs have been given freedom within the global budget to implement reforms that might capture efficiencies in cost and quality. For this study-fielded between 2012 and 2015-we traced the path of the global budget through the interior structures of two of Oregon's most promising CCOs...
July 2016: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28199137/patient-and-hospital-characteristics-associated-with-inter-hospital-transfer-for-adults-with-ventilator-dependent-respiratory-failure
#18
Nandita R Nadig, Andrew J Goodwin, Annie N Simpson, Kit N Simpson, Jeremy Richards, Dee W Ford
RATIONALE: Patients with ventilator-dependent respiratory failure have improved outcomes at centers with greater expertise, yet most patients are not treated in such facilities. Efforts to align care for respiratory failure and hospital capability would necessarily require inter-hospital transfer. OBJECTIVES: To characterize the prevalence and patient and hospital factors associated with inter-hospital transfer of adults residing in Florida with ventilator-dependent respiratory failure...
February 15, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28196518/a-comparison-of-how-behavioral-health-organizations-utilize-training-to-prepare-for-health-care-reform
#19
Victoria Stanhope, Mimi Choy-Brown, Stacey Barrenger, Jennifer Manuel, Micaela Mercado, Mary McKay, Steven C Marcus
BACKGROUND: Under the Affordable Care Act, States have obtained Medicaid waivers to overhaul their behavioral health service systems to improve quality and reduce costs. Critical to implementation of broad service delivery reforms has been the preparation of organizations responsible for service delivery. This study focused on one large-scale initiative to overhaul its service system with the goal of improving service quality and reducing costs. The study examined the participation of behavioral health organizations in technical assistance efforts and the extent to which organizational factors related to their participation...
February 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28196460/prescribing-of-clozapine-and-antipsychotic-polypharmacy-for-schizophrenia-in-a-large-medicaid-program
#20
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
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