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Medical cost

Li F Chen, Hsuan K Chang, Yu C Chen, Jau C Wu, Wen C Huang, Henrich Cheng, Su S Lo
BACKGROUND: This study aimed to investigate the medical expenses and outcomes of central cord syndrome (CCS), comparing patients who received surgical and non-surgical management. METHODS: Using a 14-year nationwide database in Taiwan, this study followed-up all patients of CCS at least 5 years. The incidence rates, medical expenses, permanently disabled spinal cord injury (SCI), and mortality rates were compared for patients who underwent surgery and those who were managed conservatively...
October 19, 2016: Journal of Neurosurgical Sciences
Rajkumar Bharatia, Manoj Chitale, Ganesh Narain Saxena, Raman Ganesh Kumar, Chikkalingaiah, Abhijit Trailokya, Kalpesh Dalvi, Suhas Talele
INTRODUCTION: Hypertension (HTN), being a major risk factor for cardiovascular diseases (CVDs), is an important issue of medical and public health. High blood pressure (BP) is ranked as the third most important risk factor for attributable burden of disease in south Asia (2010). Hypertension (HTN) exerts a substantial public health burden on cardiovascular health status and healthcare systems in India. Uncontrolled hypertension among adults with hypertension is associated with increased mortality...
July 2016: Journal of the Association of Physicians of India
Husam R Kayyali, Anastasia Luniova, Ahmed Abdelmoity
Background. Approximately, one-third of patients with epilepsy are refractory to pharmacological treatment which mandates extensive medical care and imposes significant economic burden on patients and their societies. This study intends to assess the impact of the treatment with ketogenic diet (KD) on reducing seizure-related emergency room visits and hospitalizations in children with refractory epilepsy. Methods. This is a retrospective review of children treated with the KD in one tertiary center. We compared a 12 months' period prior to KD with 12 months after the diet was started in regard to the number of emergency department (ED) visits, hospitalizations, and hospital days as well as their associated charges...
2016: Epilepsy Research and Treatment
Michael Popovich, Brandy Altstadter, Lara Hargraves Popovich, B S Biology
The Health Information Technology for Economic and Clinical Health (HITECH) Act encourages health information exchange between clinical care and public health through Meaningful Use measures. Meaningful Use specifically identifies objectives to support a number of public health programs including immunizations, cancer registries, syndromic surveillance, and disease case reports. The objective is to improve public and population health. Stage 2 of Meaningful Use focused on compliance to sending of information to public health...
2016: Online Journal of Public Health Informatics
Monique Mostert, Anthony Bonavia
BACKGROUND Besides providing anesthesia for surgery, the anesthesiologist's role is to optimize the patient for surgery and for post-surgical recovery. This involves timely identification and treatment of medical comorbidities and abnormal laboratory values that could complicate the patient's perioperative course. There are several potential causes of anion and non-anion gap metabolic acidosis in surgical patients, most of which could profoundly affect a patient's surgical outcome. Thus, the presence of an acute acid-base disturbance requires a thorough workup, the results of which will influence the patient's anesthetic management...
October 18, 2016: American Journal of Case Reports
L Maïmoun, F Paris, O Coste, C Sultan
Participation in recreational physical activity is widely acknowledged to provide significant health benefits. Conversely, intense training imposes several constraints, such as intermittent or chronic metabolic and psychogenic training stressors and maintenance of very low body fat to maximize performance. Adolescent and adult athletic women are therefore at risk of overtraining and/or poor dietary intake, which may have several consequences for endocrine function particularly on hypothalamic-pituitary-gonadal axis...
October 14, 2016: Gynécologie, Obstétrique & Fertilité
Ester Risco, Adelaida Zabalegui, Susana Miguel, Marta Farré, Carme Alvira, Esther Cabrera
OBJECTIVE: To describe the implementation of the Balance of Care model in decision-making regarding the best care for patients with dementia in Spain. METHODS: The Balance of Care model was used, which consists of (1) describing the profile of the typical cases of people with dementia and their caregivers, (2) identifying the most suitable care setting for each of the cases (home-care or long-term care institution), (3) designing specific care plans for each case, and (4) evaluating the cost of the proposed care plans...
October 14, 2016: Gaceta Sanitaria
Peter J Kelly, Gregory W Albers, Anastasios Chatzikonstantinou, Gian Marco De Marchis, Julia Ferrari, Paul George, Mira Katan, Michael Knoflach, Jong S Kim, Linxin Li, Eun-Jae Lee, Jean-Marc Olivot, Francisco Purroy, Nicolas Raposo, Peter M Rothwell, Vijay K Sharma, Bo Song, Georgios Tsivgoulis, Cathal Walsh, Yuming Xu, Aine Merwick
BACKGROUND: Identification of patients at highest risk of early stroke after transient ischaemic attack has been improved with imaging based scores. We aimed to compare the validity and prognostic utility of imaging-based stroke risk scores in patients after transient ischaemic attack. METHODS: We did a pooled analysis of published and unpublished individual-patient data from 16 cohort studies of transient ischaemic attack done in Asia, Europe, and the USA, with early brain and vascular imaging and follow up...
November 2016: Lancet Neurology
Luke Steven Robinson, Mitchell Sarkies, Ted Brown, Lisa O'Brien
BACKGROUND: Injuries sustained to the hand and wrist are common, accounting for 20% of all emergency presentations. The economic burden of these injuries, comprised of direct (medical expenses incurred), indirect (value of lost productivity) and intangible costs, can be extensive and rise sharply with the increase of severity. OBJECTIVE: This paper systematically reviews cost-of-illness studies and health economic evaluations of acute hand and wrist injuries with a particular focus on direct, indirect and intangible costs...
October 1, 2016: Injury
X-F Su, L Sun, B-L Liu, X-J Tao, H-Q Li, F-F Li, L Ye, K-O Lee, J-H Ma, S-L Chen
Aim: Patients with cardiac diseases, especially ischemic heart disease, are known to have a high prevalence of diabetes mellitus (DM). They are at risk of having inadequate glucose control. An intensive diabetes screening and treatment program was developed to identify and treat DM in patients admitted with cardiac diseases. Methods: Adult inpatients of 2 cardiac wards, namely Ward-A and Ward-B, at Nanjing Hospital, Nanjing, China, were studied. Patients were randomly assigned into either ward. In addition to routine examination and treatment, an intensive screening and treatment program to identify and treat patients with DM or impaired glucose regulation (IGR) was only applied in Ward-A patients...
October 17, 2016: Experimental and Clinical Endocrinology & Diabetes
Andréa Marques, Ana M Rodrigues, José Carlos Romeu, Afonso Ruano, Ana Paula Barbosa, Eugénia Simões, Fernanda Águas, Helena Canhão, José Delgado Alves, Raquel Lucas, Jaime Cunha Branco, Jorge Laíns, Mário Mascarenhas, Susete Simões, Viviana Tavares, Oscar Lourenço, José António Pereira da Silva
OBJECTIVE: To establish Portuguese recommendations regarding the indication to perform DXA and to initiate medication aimed at the prevention of fragility fractures. METHODS: A multidisciplinary panel, representing the full spectrum of medical specialties and patient associations devoted to osteoporosis, as well as national experts in this field and in health economics, was gathered to developed recommendations based on available evidence and expert consensus. Recently obtained data on the Portuguese epidemiologic, economic and quality-of-life aspects of fragility fractures were used to support decisions...
October 18, 2016: Acta Reumatológica Portuguesa
Madhumita Sinha, Dan Quan, Fred W McDonald, André Valdez
OBJECTIVE: Scorpion antivenom was recently approved for use in patients with clinically significant scorpion envenomation in the United States; no formal economic analysis on its impact on cost of management has been performed. METHODS: Three different strategies of management of scorpion envenomation with systemic neurotoxic symptoms in children were compared for cost minimization from a societal perspective. In strategy I, patients were managed with supportive care only without antivenom...
October 4, 2016: Pediatric Emergency Care
Emily S Starn, Holly Hampe, Thomas Cline
Health care facility-acquired Clostridium difficile infections (HCFA-CDI) have increased over the last several decades despite facilities developing protocols for prescribing probiotics with antibiotics to prevent HCFA-CDI. The literature does not consistently support this. A retrospective medical record review evaluated the care effectiveness of this practice. Care effectiveness was not found; patients receiving probiotics with antibiotics were twice as likely to develop HCFA-CDI (P = .004). Except with glycopeptides, patients were 1...
October 2016: Quality Management in Health Care
Derenda Lovelace, Diane Hancock, Sabrina S Hughes, Phyllis R Wyche, Claire Jenkins, Cindy Logan
BACKGROUND: In 2011, the Hunter Holmes McGuire Veterans Administration Medical Center (VAMC) in Richmond, VA, had a cumulative readmission rate and emergency department (ED) revisits for discharged Veterans of 1 in 5. In 2012, a transitional care program (TCP) was implemented to improve care coordination and outcomes among Veterans, with an emphasis on geriatric patients with chronic disease. This TCP was created with an interdisciplinary approach using intensive case management interventions, with a goal of reducing Veteran ED and hospital revisits by 30%...
November 2016: Professional Case Management
Derek D Satre, Andrea Altschuler, Sujaya Parthasarathy, Michael J Silverberg, Paul Volberding, Cynthia I Campbell
OBJECTIVES: This study examined implementation of the Affordable Care Act (ACA) in relation to HIV-positive patient enrollment in an integrated health care system; as well as changes in new enrollee characteristics, benefit structure and health care utilization after key ACA provisions went into effect in 2014. METHODS: This mixed-methods study was set in Kaiser Permanente Northern California (KPNC). Qualitative interviews with 29 KPNC leaders explored planning for ACA implementation...
October 3, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Eric W Djimeu, Annette N Brown
BACKGROUND: Seven new impact evaluations of pilot programs for increasing the demand for voluntary medical male circumcision (VMMC) provide evidence of what works and what does not. The study findings suggest that financial compensation designed to relieve the opportunity or transportation costs from undergoing the procedure can increase the uptake of VMMC. There is also evidence that programs using peer influence can be effective, although so far only sports-based programs demonstrate a strong effect...
October 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Jaeyong Shin, Young Choi, Sang Gyu Lee, Tae Hyun Kim, Eun-Cheol Park
Unnecessary use of high-quality resources in general hospitals hinders treatment of patients with urgent and complicated conditions. Thus, the Korean Government has sought to reduce general hospital visiting of patients with 52 mild diseases, including hypertension. The higher cost sharing for medical expenses and medications from general hospitals were enacted in 2009 and 2011, respectively.We determined whether these regulations were effective through evaluating changing trends in first-visited healthcare organizations and defined the first visiting healthcare organization level (primary clinics, hospital, and general hospital) as an outcome measure...
October 2016: Medicine (Baltimore)
Julie A Birt, YingMeei Tan, Neelufar Mozaffarian
OBJECTIVES: To better understand the real-world characteristics and costs of Sjögren's syndrome (SS). METHODS: Analysing the MarketScan Commercial Claims database from Jan. 1, 2006 to Dec. 31, 2011, we identified 10,414 patients ≥18 years old newly diagnosed with SS. Patient characteristics, drugs (commonly used for SS), resource utilisation, and medical costs were evaluated for 12 months pre- and post-diagnosis. RESULTS: Mean age was 55 years; 90% were female...
October 7, 2016: Clinical and Experimental Rheumatology
Drishti Shah, Vamshi Ruthwik Anupindi, Varun Vaidya
Chronic back pain is an extremely common health problem. The largest category for pain therapy costs includes nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids. However, there has been limited evidence outlining their effectiveness in terms of quality of life for the treatment of chronic back pain. The authors performed a comparative pharmacoeconomic analysis of chronic back pain patients using NSAIDs versus those using opioids alone or combination opioid analgesics. This pharmacoeconomic evaluation was conducted using the Medical Expenditure Panel Survey (MEPS)...
October 17, 2016: Journal of Pain & Palliative Care Pharmacotherapy
Xuan Cao, Christian Lau, Yihang Liu, Fanqi Wu, Hui Gui, Qingzhou Liu, Yuqiang Ma, Haochuan Wan, Moh R Amer, Chongwu Zhou
Semiconducting single-wall carbon nanotubes are ideal semiconductors for printed electronics due to their advantageous electrical and mechanical properties, intrinsic printability in solution, and desirable stability in air. However, fully printed, large-area, high-performance, and flexible carbon nanotube active-matrix backplanes are still difficult to realize for future displays and sensing applications. Here, we report fully screen-printed active-matrix electrochromic displays employing carbon nanotube thin-film transistors...
October 17, 2016: ACS Nano
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