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direct pay practice

Radek Wojcik, Julia Lowin, David Vilardell, Silvia Maeso, Leonardo Ruiz, John Lear, Colin Morton
OBJECTIVE: The objective of this analysis was to estimate the relative cost-effectiveness of Actikerall * (5-FU-SA) versus cryotherapy in a secondary care setting in the UK, for lesion-directed treatment in patients with actinic keratoses (AK) of the face and scalp. METHODS: The model was a simple decision tree, with a 6-month time horizon. The perspective was that of the UK National Health Service (NHS). Modelled treatment effects included reported per-patient histological clearance and recurrence rates...
October 7, 2016: Journal of Medical Economics
Martin Tickle, Ciaran O'Neill, Michael Donaldson, Stephen Birch, Solveig Noble, Seamus Killough, Lynn Murphy, Margaret Greer, Julie Brodison, Rejina Verghis, Helen V Worthington
BACKGROUND: Dental caries is the most common disease of childhood. The NHS guidelines promote preventative care in dental practices, particularly for young children. However, the cost-effectiveness of this policy has not been established. OBJECTIVE: To measure the effects and costs of a composite fluoride intervention designed to prevent caries in young children attending dental services. DESIGN: The study was a two-arm, parallel-group, randomised controlled trial, with an allocation ratio of 1 : 1...
September 2016: Health Technology Assessment: HTA
Qiushi Chen, Turgay Ayer, Jagpreet Chhatwal
BACKGROUND: Sequential decision problems are frequently encountered in medical decision making, which are commonly solved using Markov decision processes (MDPs). Modeling guidelines recommend conducting sensitivity analyses in decision-analytic models to assess the robustness of the model results against the uncertainty in model parameters. However, standard methods of conducting sensitivity analyses cannot be directly applied to sequential decision problems because this would require evaluating all possible decision sequences, typically in the order of trillions, which is not practically feasible...
September 28, 2016: Medical Decision Making: An International Journal of the Society for Medical Decision Making
Christiane Kugler, Selda Akca, Ina Einhorn, Anne Rebafka, Cynthia L Russell
BACKGROUND Numerically, nurses represent the largest healthcare profession, thus setting norms for the quality and safety of direct patient care. Evidence of a global shortage of nurses in all clinical practice settings across different healthcare systems and countries has been documented. The aims of the present study were: (1) to assess work environments in a sample of German transplant nurses, and (2) to compare their statements with a US-based sample. MATERIAL AND METHODS In a cross-sectional study, 181 transplant nurses from 16 German transplant centers provided information on their work environments...
2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Reginald Middlebrooks, Heather Carter-Templeton, Angela R Mund
UNLABELLED: HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo...
September 1, 2016: Journal of Continuing Education in Nursing
Kathie A Wong, Luke Hodgson, George Garas, George Malietzis, Sheraz Markar, Christopher Rao, Ludwig K von Segesser, Thanos Athanasiou
Surgeons, as the consumers, must engage in commercial activity regarding medical devices since it directly has impacts on surgical practice and patient outcomes. Unique features defy traditional economic convention in this specific market partly because consumers do not usually pay directly. Greater involvement with commercial activity means better post-market surveillance of medical devices which leads to improved patient safety. The medical device industry has exhibited astonishing levels of growth and profitability reaching $398 billion on a global scale with new product development focusing on unmet clinical need...
August 11, 2016: Interactive Cardiovascular and Thoracic Surgery
S S Hu
The cardiovascular surgery in China has achieved great progress both on scale and technology though development over the past thirty years. However, the technical predominance of cardiovascular surgery in therapies for some diseases has been weakened, along with developments of new drugs and interventional technology. Besides, the change of doctor-patient relationship result from internet medical information service and less attraction of cardiovascular surgery discipline to talents bring certain challenge to the development of cardiovascular surgery...
August 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
L Franco-Trigo, L N Hossain, D Durks, D Fam, S C Inglis, S I Benrimoj, D Sabater-Hernández
BACKGROUND: Participatory approaches involving stakeholders across the health care system can help enhance the development, implementation and evaluation of health services. These approaches may be particularly useful in planning community pharmacy services and so overcome challenges in their implementation into practice. Conducting a stakeholder analysis is a key first step since it allows relevant stakeholders to be identified, as well as providing planners a better understanding of the complexity of the health care system...
June 30, 2016: Research in Social & Administrative Pharmacy: RSAP
Mark L Wahlqvist
Effective clinical nutrition practice depends on a sound knowledge of biomedical, societal and environmental science and the skills to diagnose, prevent and manage the health problems related to food patterns, energy equilibrium (mostly to do with physical activity) and nutrient metabolism. Its delivery needs to be accessible, equitable, affordable and sustainable. Ordinarily, this will require both local and widely distributed health services. In North-East (NE) Asia, these requisites are being met to an ever increasing extent...
2016: Asia Pacific Journal of Clinical Nutrition
Edward Gibson, Najida Begum, Federico Martinón-Torres, Marco Aurélio Safadi, Alfred Sackeyfio, Judith Hackett, Sankarasubramanian Rajaram
BACKGROUND: Influenza poses a significant burden on healthcare systems and society, with under-recognition in the paediatric population. Existing vaccination policies (largely) target the elderly and other risk groups where complications may arise. OBJECTIVE: The goal of this study was to evaluate the cost-effectiveness of annual paediatric vaccination (in 2-17-year-olds) with live attenuated influenza vaccination (LAIV), as well as the protective effect on the wider population in England and Wales (base)...
2016: Journal of Market Access & Health Policy
Emmanuel Olushola Shobowale, Benjamin Adegunle, Ken Onyedibe
BACKGROUND: Hand hygiene has been described as the cornerstone and starting point in all infection control programs, with the hands of healthcare staff being the drivers and promoters of infection in critically ill patients. The objectives of this study were to access healthcare workers compliance with the World Health Organization (WHO) prescribed five moments of hand hygiene as it relates to patient care and to determine the various strata of healthcare workers who are in default of such prescribed practices...
May 2016: Nigerian Medical Journal: Journal of the Nigeria Medical Association
Nicole Seyring, Marie Dollhofer, Jakob Weißenbacher, Ioannis Bakas, David McKinnon
The Waste Framework Directive obliged European Union Member States to set up separate collection systems to promote high quality recycling for at least paper, metal, plastic and glass by 2015. As implementation of the requirement varies across European Union Member States, the European Commission contracted BiPRO GmbH/Copenhagen Resource Institute to assess the separate collection schemes in the 28 European Union Member States, focusing on capital cities and on metal, plastic, glass (with packaging as the main source), paper/cardboard and bio-waste...
September 2016: Waste Management & Research
Alexander Morgan Capron, Francis L Delmonico, Beatriz Dominguez-Gil, Dominique Elizabeth Martin, Gabriel M Danovitch, Jeremy Chapman
Governmental and private programs that pay next of kin who give permission for the removal of their deceased relative's organs for transplantation exist in a number of countries. Such payments, which may be given to the relatives or paid directly for funeral expenses or hospital bills unrelated to being a donor, aim to increase the rate of donation. The Declaration of Istanbul Custodian Group-in alignment with the World Health Organization Guiding Principles and the Council of Europe Convention Against Trafficking in Human Organs-has adopted a new policy statement opposing such practices...
September 2016: Transplantation
J Gregory Fitz
The ∼90% probability of curing individual patients with hepatitis C virus (HCV)using direct-acting antivirals represents one of the most dramatic medical success stories of the modern era, and the journey from viral discovery to treatment occurred over just ∼25 years. The realities of the global burden of disease (2-3% of the world's population is infected), limited access to care and cost of treatment mean that HCV will continue to be a major problem for the next 25 years. But what if HCV (and hepatitis B) could be eradicated? Since liver transplantation and HCV management have been the mainstays of academic hepatology practice, where do we go from here? Unfortunately, we are in an era where the incidence and prevalence of liver diseases around the globe is increasing, and death from complications of cirrhosis is now among the top 10 causes in most countries; so hepatologists are expected to play a major role in the future...
2016: Digestive Diseases
Shannon Stock, Katie Rubino, Sook-Bin Woo, Arthur Margolis, Irena Thomas, Ali Aboalela, thomas Ali, Nathaniel Treister
For many oral medicine conditions, the use of compounded topical therapies that are locally absorbed and act directly at the affected site can provide greater efficacy compared with systemically delivered medications while minimizing systemic side effects. The objective of this study was to characterize the utilization and costs associated with the use of compounded medications in an academic, hospital-based oral medicine practice. This was a retrospective analysis of outpatients treated at the Center for Oral Disease at Brigham and Women's Hospital (Boston, Massachusetts) during the five-year period from November 2006 through November 2011...
March 2016: International Journal of Pharmaceutical Compounding
James V Freeman, David W Hutton, Geoffrey D Barnes, Ruo P Zhu, Douglas K Owens, Alan M Garber, Alan S Go, Mark A Hlatky, Paul A Heidenreich, Paul J Wang, Amin Al-Ahmad, Mintu P Turakhia
BACKGROUND: Randomized trials of left atrial appendage (LAA) closure with the Watchman device have shown varying results, and its cost effectiveness compared with anticoagulation has not been evaluated using all available contemporary trial data. METHODS AND RESULTS: We used a Markov decision model to estimate lifetime quality-adjusted survival, costs, and cost effectiveness of LAA closure with Watchman, compared directly with warfarin and indirectly with dabigatran, using data from the long-term (mean 3...
June 2016: Circulation. Arrhythmia and Electrophysiology
Nancy J Egerton
The high cost of cancer therapies continues to lead to questions of affordability for the healthcare system and to patients. Ensuring patient access to oral cancer drugs presents a unique set of challenges due to the significant cost of these novel agents, healthcare/payer policies, and established distribution practices. The National Community Oncology Dispensing Association, Inc (NCODA) is a grassroots, nonprofit organization established by pharmacists who are directly involved at the community practice level in assisting patients with the acquisition of their oral cancer drugs...
March 2016: American Journal of Managed Care
Jacopo Giuliani, Andrea Bonetti
OBJECTIVE: The aim of this study was to estimate the pharmacologic costs for the management of skin toxicity in patients treated with epidermal growth factor receptor (EGFR) inhibitors in our institution in order to value the direct medical economic impact in daily clinical practice. PATIENTS AND METHODS: We retrospectively analyzed all consecutive patients treated with EGFR inhibitors (cetuximab, panitunumab, and erlotinib) at our institution from January 2008 to December 2014...
May 5, 2016: Clinical Lung Cancer
L R S Moreira, E X F Filho
Hemicelluloses are a vast group of complex, non-cellulosic heteropolysaccharides that are classified according to the principal monosaccharides present in its structure. Xylan is the most abundant hemicellulose found in lignocellulosic biomass. In the current trend of a more effective utilization of lignocellulosic biomass and developments of environmentally friendly industrial processes, increasing research activities have been directed to a practical application of the xylan component of plants and plant residues as biopolymer resources...
June 2016: Applied Microbiology and Biotechnology
Vincent T Janmaat, Marco J Bruno, Suzanne Polinder, Sylvie Lorenzen, Florian Lordick, Maikel P Peppelenbosch, Manon C W Spaander
BACKGROUND: Costly biologicals in palliative oncology are emerging at a rapid pace. For example, in patients with advanced esophageal squamous cell carcinoma addition of cetuximab to a palliative chemotherapy regimen appears to improve survival. However, it simultaneously results in higher costs. We aimed to determine the incremental cost-effectiveness ratio of adding cetuximab to first-line chemotherapeutic treatment of patients with advanced esophageal squamous cell carcinoma, based on data from a randomized controlled phase II trial...
2016: PloS One
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