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https://www.readbyqxmd.com/read/28931125/patients-with-mental-problems-the-most-defenseless-travellers
#1
Peter Felkai, Tamas Kurimay
Background: Severe mental illness occurring abroad is a difficult situation for patients, their families, and for the local medical community. Patients with mental problem are doublely stigmatized due to their mental illness and because they are foreigners in an unfamiliar country. The appropriate treatment is often delayed, while patients are often dealt with in a manner that violates their human rights. Moreover, repatriation - which is vital in this case - is often delayed due to the lack of international protocols for the transportation and treatment of mentally ill travelers...
September 1, 2017: Journal of Travel Medicine
https://www.readbyqxmd.com/read/28930892/costs-and-trends-in-utilization-of-low-value-services-among-older-adults-with-commercial-insurance-or-medicare-advantage
#2
Elizabeth A Carter, Pamela E Morin, Keith D Lind
BACKGROUND: Overutilization of low-value services (unnecessary or minimally beneficial tests or procedures) has been cited as a large contributor to the high costs of health care in the United States. OBJECTIVES: To analyze trends in utilization of low-value services from 2009 to 2014 among commercial and Medicare Advantage (MA) enrollees 50 and older. RESEARCH DESIGN: A retrospective analysis of deidentified claims obtained from the OptumLab Data Warehouse...
September 19, 2017: Medical Care
https://www.readbyqxmd.com/read/28930820/gatekeeping-and-the-utilization-of-community-health-services-in-shenzhen-china-a-cross-sectional-study
#3
Wenzhen Li, Yong Gan, Xiaoxin Dong, Yanfeng Zhou, Shiyi Cao, Naomiem Kkandawire, Yingjie Cong, Huilian Sun, Zuxun Lu
To assess the effects of the gatekeeper policy implemented in Shenzhen, China, in conjunction with a labor health insurance program, on channeling patients toward community health centers (CHCs).Eight thousand patients who visited 8 CHCs in Shenzhen were surveyed between May 1, 2013 and July 28, 2013. Half of the patients were subject to gatekeeper policy and the other half of them were not. Structured questionnaire was used to collect patients' choices of initial medical institution, use of CHCs and their satisfaction with health care...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28930707/re-evaluating-the-ethics-of-uterine-transplantation
#4
Danish Zaidi
In February 2016, the Cleveland Clinic initiated the first attempt at cadaveric uterine transplantation (UTx) in the United States. The transplantation was ultimately unsuccessful, but it opened doors for further research on both live and cadaveric UTx. While initial strides toward successful transplantation have been made, questions persist on the ethics of UTx: whether the uterus is a vital organ, whether we should prioritize live or cadaveric options, and how the procedure should be covered by health insurance...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28930514/weight-and-metabolic-outcomes-12-years-after-gastric-bypass
#5
Ted D Adams, Lance E Davidson, Sheldon E Litwin, Jaewhan Kim, Ronette L Kolotkin, M Nazeem Nanjee, Jonathan M Gutierrez, Sara J Frogley, Anna R Ibele, Eliot A Brinton, Paul N Hopkins, Rodrick McKinlay, Steven C Simper, Steven C Hunt
BACKGROUND: Few long-term or controlled studies of bariatric surgery have been conducted to date. We report the 12-year follow-up results of an observational, prospective study of Roux-en-Y gastric bypass that was conducted in the United States. METHODS: A total of 1156 patients with severe obesity comprised three groups: 418 patients who sought and underwent Roux-en-Y gastric bypass (surgery group), 417 patients who sought but did not undergo surgery (primarily for insurance reasons) (nonsurgery group 1), and 321 patients who did not seek surgery (nonsurgery group 2)...
September 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28930231/a-population-based-cohort-study-on-the-ability-of-acupuncture-to-reduce-post-stroke-depression
#6
Shuo-Ping Tseng, Yu-Ching Hsu, Ching-Ju Chiu, Shang-Te Wu
Objective: Post-stroke depression (PSD) is common and has a negative impact on recovery. Although many stroke patients in Taiwan have used acupuncture as a supplementary treatment for reducing stroke comorbidities, little research has been done on the use of acupuncture to prevent PSD. Accordingly, our goal is to investigate whether using acupuncture after a stroke can reduce the risk of PSD. Method: This population-based cohort study examined medical claims data from a random sample of 1 million insured people registered in Taiwan...
March 15, 2017: Medicines (Basel, Switzerland)
https://www.readbyqxmd.com/read/28929731/stabilizing-individual-health-insurance-markets-with-subsidized-reinsurance
#7
Scott E Harrington
Subsidized reinsurance represents a potentially important tool to help stabilize individual health insurance markets. This brief describes alternative forms of subsidized reinsurance and the mechanisms by which they spread risk and reduce premiums. It summarizes specific state initiatives and Congressional proposals that include subsidized reinsurance. It compares approaches to each other and to more direct subsidies of individual market enrollment. For a given amount of funding, a particular program’s efficacy will depend on how it affects insurers' risk and the risk margins built into premiums, incentives for selecting or avoiding risks, incentives for coordinating and managing care, and the costs and complexity of administration...
September 2017: LDI Issue Brief
https://www.readbyqxmd.com/read/28929700/extending-the-children%C3%A2-s-health-insurance-program-high-stakes-for-families-and-states
#8
Sara Rosenbaum, Rachel Gunsalus, Sara Rothenberg, Sara Schmucker
Issue: Congress must decide whether to extend federal funding authority for the Children’s Health Insurance Program (CHIP), which ends September 30, 2017. CHIP operates much like Medicaid, providing federal matching payments for state program expenses, although CHIP’s funding rate is higher than the federal rate paid for traditional Medicaid and was further enhanced under the Affordable Care Act. States can use their CHIP funds to expand Medicaid, operate separate CHIP programs, or combine the two approaches...
September 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28929641/patients-choice-between-public-and-private-hospital-emergency-departments-a-cross-sectional-survey
#9
Jun He, Xiang-Yu Hou, Ghasem Sam Toloo, Gerry FitzGerald
OBJECTIVE: The aim of this study was to understand what factors influence patients' choice between public and private hospital ED and the relative weight of those factors among adult patients with private health insurance in Australia. METHODS: A survey of 280 patients was conducted in four public and private hospitals' EDs in Brisbane between May and August 2015. The survey included information about respondent's demographics, nature of illness, decision-making, attitudes and choice...
September 19, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28929269/behavioral-health-integration-in-health-care-settings-lessons-learned-from-a-pediatric-hospital-primary-care-system
#10
Leandra Godoy, Melissa Long, Donna Marschall, Stacy Hodgkinson, Brooke Bokor, Hope Rhodes, Howard Crumpton, Mark Weissman, Lee Beers
Behavioral health integration within primary care has been evolving, but literature traditionally focuses on smaller scale efforts. We detail how behavioral health has been integrated across a large, urban pediatric hospital system's six primary care clinics (serving over 35,000 children annually and insured predominately through Medicaid) and discuss strategies for success in sustaining and expanding efforts to achieve effective integration of behavioral health into primary care. In a time span of 3 years, the clinics have implemented routine, universal behavioral health screening at well child visits, participated in a 15-month behavioral health screening quality improvement learning collaborative, and integrated the work of psychologists and psychiatrists...
September 19, 2017: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/28929251/risk-reduction-of-long-term-major-adverse-cardiovascular-events-after-endoscopic-thoracic-sympathectomy-in-palmar-hyperhidrosis
#11
Chun-An Cheng, Chun-Gu Cheng, Hsin Chu, Hung-Che Lin, Chi-Hsiang Chung, Hung-Wen Chiu, Wu-Chien Chien
PURPOSE: Palmar hyperhidrosis (PH) is excessive sweating of the palms resulting from sympathetic overactivity, and patients who undergo endoscopic thoracic sympathectomy (ETS) show reduced cardiac demand after 1 year and improved cerebral perfusion within 2-4 weeks. However, the long-term risks of major adverse cardiovascular events (MACE) following ETS remain unclear. METHODS: We searched the Longitudinal National Health Insurance Database in Taiwan and identified PH patients (International Classification of Disease, Ninth Revision, Clinical Modification diagnostic code 708...
September 19, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/28929232/-prevalence-comorbidity-and-interdisciplinary-treatment-of-rheumatoid-arthritis-insurance-data-on-outpatient-and-inpatient-care-in-baden-w%C3%A3-rttemberg
#12
A Strahl, O Schneider, J Frankenhauser-Mannuß, S Knapstein, C Hermann, B Lembeck, H-M Lorenz, W Rüther, J Flechtenmacher
BACKGROUND: Rheumatoid arthritis (RA) has an increased number of comorbidities compared with the general population. OBJECTIVE: Study aim was to collect epidemiological data on prevalence, incidence and comorbidities of RA as well as utilization of outpatient and inpatient care services. MATERIAL AND METHODS: In an age and gender-adjusted case control study, a total of 3.4 million patients insured by the AOK Baden-Württemberg were analysed with respect to visits to physicians, prevalence, incidence and comorbidities of RA...
September 19, 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/28929230/defensive-medicine-among-neurosurgeons-in-the-netherlands-a-national-survey
#13
Sandra C Yan, Alexander F C Hulsbergen, Ivo S Muskens, Marjel van Dam, William B Gormley, Marike L D Broekman, Timothy R Smith
OBJECTIVE: In defensive medicine, practice is motivated by legal rather than medical reasons. Previous studies have analyzed the correlation between perceived medico-legal risk and defensive behavior among neurosurgeons in the United States, Canada, and South Africa, but not yet in Europe. The aim of this study is to explore perceived liability burdens and self-reported defensive behaviors among neurosurgeons in the Netherlands and compare their practices with their non-European counterparts...
September 20, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28929037/risk-of-death-from-prostate-cancer-with-and-without-definitive-local-therapy-when-gleason-pattern-5-is-present-a-surveillance-epidemiology-and-end-results-analysis
#14
Jonathan Frandsen, Andrew Orton, Dennis Shrieve, Jonathan Tward
Purpose The purpose is to evaluate the patterns of care and comparative effectiveness for cause-specific and overall survival of definitive local treatments versus conservatively managed men with a primary or secondary Gleason pattern of 5. Methods and materials Patients diagnosed from 2004 to 2012 with a primary or secondary Gleason pattern of 5 N0M0 prostate cancer were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier and Cox regression analyses were used to estimate the survival...
July 10, 2017: Curēus
https://www.readbyqxmd.com/read/28928887/association-between-periodontal-disease-and-prostate-cancer-results-of-a-12-year-longitudinal-cohort-study-in-south-korea
#15
Jae-Hong Lee, Helen Hye-In Kweon, Jung-Kyu Choi, Young-Taek Kim, Seong-Ho Choi
The incidence of prostate cancer (PC) accompanying periodontal disease (PD) is anticipated to increase due to population aging. The aim of this study was to determine the association between PD and PC using data in the National Health Insurance Service-Health Examinee Cohort (NHIS-HEC). A random stratified sample of 187,934 South Koreans was collected from the NHIS database from 2002 to 2013. We assessed the relationship between PD and PC while adjusting for potential confounding factors (sex, age, household income, insurance status, residence area, hypertension, diabetes mellitus, cerebral infarction, angina pectoris, myocardial infarction, smoking status, alcohol intake, and regular exercise)...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28928665/nationwide-case-control-study-examining-the-association-between-tamoxifen-use-and-alzheimer-s-disease-in-aged-women-with-breast-cancer-in-taiwan
#16
Kuan-Fu Liao, Cheng-Li Lin, Shih-Wei Lai
Background and Objectives: Little is known about the association between tamoxifen use and Alzheimer's disease in women with breast cancer. The study aimed to explore the association between tamoxifen use and Alzheimer's disease in aged women with breast cancer in Taiwan. Methods: We conducted a retrospective nationwide case-control study using the database of the Taiwan National Health Insurance Program. Totally, 173 female subjects with breast cancer aged ≥ 65 years with newly diagnosed Alzheimer's disease from 2000 to 2011 were identified as the cases...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28928331/outcomes-according-to-body-mass-index-following-laparoscopic-surgery-in-patients-with-colorectal-cancer
#17
Han Deok Kwak, Jae Kyun Ju, Dong Woo Kang, Se-Jin Baek, Jung Myun Kwak, Jin Kim, Seon-Hahn Kim
PURPOSE: Body mass index (BMI) may not be appropriate for different populations. Therefore, the World Health Organization (WHO) suggested 25 kg/m2 as a measure of obesity for Asian populations. The purpose of this report was to compare the oncologic outcomes of laparoscopic colorectal resection with BMI classified from the WHO Asia-Pacific perspective. PATIENTS AND METHODS: All patients underwent laparoscopic colorectal resection from September 2006 to March 2015 at a tertiary referral hospital...
September 20, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28928321/opening-gambit-strategic-options-to-initiate-the-tobacco-endgame
#18
Pranay Lal, Rana J Singh, Ashish Kumar Pandey
Endgame strategies to rapidly hasten the decline of tobacco are already well within reach; a few plausible policy options are outlined herein for policy practitioners, tobacco control advocates, and public health specialists. The implementation of these measures which already exist within the gamut of existing legislation requires the galvanization of political will. The options we essay include liquidating existing public investments in tobacco, holding tobacco companies accountable within the jurisdictions of their operations, fixing liability for injury and the imposition of realistic costs on insurance providers...
September 2017: Indian Journal of Public Health
https://www.readbyqxmd.com/read/28928288/association-between-insurance-and-transfer-of-injured-children-from-emergency-departments
#19
Yunru Huang, Jamie L Kissee, Parul Dayal, Nancy Ewen Wang, Ilana S Sigal, James P Marcin
OBJECTIVES: To determine if injured children presenting to nondesignated trauma centers are more or less likely to be transferred relative to being admitted based on insurance status. METHODS: We conducted a cross-sectional study by using the Healthcare Cost and Utilization Project Nationwide Emergency Department Sample. Pediatric trauma patients receiving care in emergency departments (EDs) at nontrauma centers who were either admitted locally or transferred to another hospital were included...
September 19, 2017: Pediatrics
https://www.readbyqxmd.com/read/28928197/impact-of-oral-self-care-on-incident-functional-disability-in-elderly-japanese-the-ohsaki-cohort-2006-study
#20
Shino Bando, Yasutake Tomata, Jun Aida, Kemmyo Sugiyama, Yumi Sugawara, Ichiro Tsuji
OBJECTIVES: To assess whether oral self-care (tooth brushing, regular dental visits and use of dentures) affects incident functional disability in elderly individuals with tooth loss. DESIGN: A 5.7-year prospective cohort study. SETTING: Ohsaki City, Japan. PARTICIPANTS: 12 370 community-dwelling individuals aged 65 years and older. PRIMARY OUTCOME MEASURES: Incident functional disability (new long-term care insurance certification)...
September 18, 2017: BMJ Open
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