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Pay for value

Armando H Norman, Andrew J Russell, Claudia Merli
The UK's Quality and Outcomes Framework (QOF) is the largest pay-for-performance scheme in the world. This ethnographic study explored how QOF's monetary logic influences the approach to healthcare in UK general practice. From August 2013 to April 2014, we researched two UK general practice surgeries and one general practice training programme. These environments provided the opportunity for studying various spaces such as QOF meetings, consultation rooms, QOF recoding sessions, and the collection of computer-screen images depicting how patients' biomarkers are evaluated and costed through software systems...
October 11, 2016: Social Science & Medicine
A J Sutton, R S Vohra, M Hollyman, P J Marriott, A Buja, D Alderson, S Pasquali, E A Griffiths
BACKGROUND: The optimal timing of cholecystectomy for patients admitted with acute gallbladder pathology is unclear. Some studies have shown that emergency cholecystectomy during the index admission can reduce length of hospital stay with similar rates of conversion to open surgery, complications and mortality compared with a 'delayed' operation following discharge. Others have reported that cholecystectomy during the index acute admission results in higher morbidity, extended length of stay and increased costs...
October 20, 2016: British Journal of Surgery
Andrew Keller, Christian Gericke, Jennifer A Whitty, John Yaxley, Boon Kua, Geoff Coughlin, Troy Gianduzzo
BACKGROUND AND OBJECTIVES: The Göteborg randomised population-based prostate cancer screening trial demonstrated that prostate-specific antigen (PSA)-based screening reduces prostate cancer deaths compared with an age-matched control group. Utilising the prostate cancer detection rates from this study, we investigated the clinical and cost effectiveness of a similar PSA-based screening strategy for an Australian population of men aged 50-69 years. METHODS: A decision model that incorporated Markov processes was developed from a health system perspective...
October 18, 2016: Applied Health Economics and Health Policy
Jonathan Karnon, Ainul Shakirah Shafie, Nneka Orji, Sofoora Kawsar Usman
OBJECTIVE: Zoledronic acid and denosumab were funded by the Australian government for the management of osteoporosis at an equivalent price to alendronate. The price of alendronate has declined by around 65 %, but the price of the other two therapies has remained stable. Using data published since the listing, this paper reports current estimates of the value of denosumab compared to alendronate from an Australian health system perspective. METHODS: A cohort-based state transition model was developed that predicted changes in bone mineral density (BMD), and calibrated fracture probabilities as a function of BMD, age and previous fracture to estimate differences in costs and QALYs gained over a 10-year time horizon...
2016: Cost Effectiveness and Resource Allocation: C/E
Chengxiang Tang, Judy Xu, Meng Zhang
BACKGROUND: Public health care dominated the services provision in China before 1980s. However, the number of private health care providers in China has been increasing since then. The growth of private hospitals escalated after a market-oriented reform was implemented in 2001. Through an experimental approach, this study aims to a better understanding of the dynamic change in preference of health care utilisation among the residents in urban China. METHODS: Based on a discrete choice experiment (DCE) from a random sample of respondents in urban China, the study evaluated preference over health care attributes affecting individuals' choice for the utilisation of hospital health care...
October 18, 2016: BMC Health Services Research
Amanda N Fader, Tim Xu, Brian J Dunkin, Martin A Makary
BACKGROUND: Surgery is one of the highest priced services in health care, and complications from surgery can be serious and costly. Recently, advances in surgical techniques have allowed surgeons to perform many common operations using minimally invasive methods that result in fewer complications. Despite this, the rates of open surgery remain high across multiple surgical disciplines. METHODS: This is an expert commentary and review of the contemporary literature regarding minimally invasive surgery practices nationwide, the benefits of less invasive approaches, and how minimally invasive compared with open procedures are differentially reimbursed in the United States...
October 17, 2016: Surgical Endoscopy
D Wayne Taylor
Canadians need to talk about their healthcare, about who pays for what, when. Lack of money is not the issue; how that money is spent is the issue-what public healthcare is covering and not covering. The same dollar amount can be spent quite differently and more effectively. The 1950s first-dollar, single-payor decision shifted the burden from the individual to government, but a lot has changed since the 1950s. Today Medicare is not universal, comprehensive, reasonably accessible, or portable. With residual constitutional power residing in Ottawa, there is no reason for the fragmentation and inequalities facing Canadians...
October 15, 2016: Healthcare Management Forum
E Zonabend König, J M K Ojango, J Audho, T Mirkena, E Strandberg, A M Okeyo, J Philipsson
Meat production is the most important trait in the breeding objectives of sheep production in East Africa. The aim of this study was to investigate breed differences in live weight, conformation, carcass traits and economic values for meat production among Red Maasai and Dorper sheep and their crosses. In total, 88 ram lambs, which were reared at the ILRI experimental station, Kapiti plains Estate in Central Kenya, were used for the study. The lambs were slaughtered at Kenya Meat Commission (KMC) at about 1 year of age...
October 14, 2016: Tropical Animal Health and Production
Vicki Catherine Cope, Bronwyn Jones, Joyce Hendricks
AIM: To explore residential aged care nurses working in interim, rehabilitation and residential aged care perceptions of resilience. DESIGN: Qualitative Portraiture methodology. Inclusion criteria were that all participants were English speaking; were registered with the Australian Health Practitioners Registration Authority (APHRA) and had more than five years' experience working in an aged care environment. Three participants were interviewed employed within a metropolitan interim, rehabilitation and aged care setting...
October 14, 2016: Contemporary Nurse
Anup D Patel, Robert Moss, Steven W Rust, Jeremy Patterson, Robert Strouse, Satyanarayana Gedela, Jesse Haines, Simon M Lin
INTRODUCTION: Epilepsy is a common neurological condition. Seizure diary reports and patient- or caregiver-reported seizure counts are often inaccurate and underestimated. Many caregivers express stress and anxiety about the patient with epilepsy having seizures when they are not present. Therefore, a need exists for the ability to recognize and/or detect a seizure in the home setting. However, few studies have inquired on detection device features that are important to patients and their caregivers...
October 11, 2016: Epilepsy & Behavior: E&B
(no author information available yet)
BACKGROUND: The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. METHODS: We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015...
October 8, 2016: Lancet
Anirban Basu, Prasun Subedi, Sachin Kamal-Bahl
BACKGROUND: Financing medical breakthroughs or cures is becoming increasingly challenging in the current fiscal environment. OBJECTIVES: In this paper, we develop the precise conditions needed for a financing mechanism, HealthCoin, to work between a private payer and Medicare, to incentivize the former to invest in breakthrough therapies or cures in the US. METHODS: We illustrate the valuation of such a currency for a cure of Type 2 diabetes...
September 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Roberto W Dal Negro, Massimiliano Mazzolini, Paola Turco, Alessandro Zanasi
BACKGROUND: Cough is one of the most common discomforts affecting general population, which can disrupt subjects' quality of life due to its physical, social, and psychological effects. Aim of the study was to investigate the impact of cough and related beliefs of general population. METHODS: A cross-sectional telephone survey was carried out by means of a specific, validated questionnaire on a representative sample of Italian general population. All the interviews were carried out according to the Computer Assisted Telephone Interview (CATI) methodology by expert, professional interviewers...
2016: Multidisciplinary Respiratory Medicine
Elisa Schröder, Hendrik Kajosch, Paul Verbanck, Charles Kornreich, Salvatore Campanella
Event-related potentials (ERPs) bimodal oddball task has disclosed increased sensitivity to show P300 modulations to subclinical symptoms. Even if the utility of such a procedure has still to be confirmed at a clinical level, gathering normative values of this new oddball variant may be of the greatest interest. We specifically addressed the challenge of defining the best location for the recording of P3a and P3b components and selecting the best reference to use by investigating the effect of an offline re-reference procedure on recorded bimodal P3a and P3b...
2016: Frontiers in Psychology
Luis Felipe Casado, Amparo Burgos, Eva González-Haba, Javier Loscertales, Tania Krivasi, Javier Orofino, Carlos Rubio-Terres, Darío Rubio-Rodríguez
OBJECTIVE: To evaluate the cost-effectiveness of obinutuzumab in combination with chlorambucil (GClb) versus rituximab plus chlorambucil (RClb) in the treatment of adults with previously untreated chronic lymphocytic leukemia (CLL) and with comorbidities that make them unsuitable for full-dose fludarabine-based therapy, from the perspective of the Spanish National Health System. METHODS: A Markov model was developed with three mutually exclusive health states: progression-free survival (with or without treatment), progression, and death...
2016: ClinicoEconomics and Outcomes Research: CEOR
Rochelle Steven, James C R Smart, Clare Morrison, J Guy Castley
Conservation of biodiversity, including birds, continues to challenge natural area managers. Stated preference methods (e.g. choice experiments - CE) are increasingly used to provide data for natural ecosystem valuations. Here we use a CE to calculate birders' willingness to pay for different levels of bio-ecological attributes (threatened species, endemic species and diversity) of birding sites, with hypothetical entry fees. The CE was delivered at popular birding and avitourism sites in Australia and the United Kingdom...
October 3, 2016: Conservation Biology: the Journal of the Society for Conservation Biology
Steve King, Iain Fraser, Jesse R O'Hanley
We present findings from a choice experiment investigating improvements in the aquatic environment from mitigation of barriers to fish passage. Implemented at a local and national level, results reveal positive preferences for increased numbers of fish species as well as fish abundance. In addition, we examine if in this case the willingness to pay estimates are suitable for direct transfer between national and local settings. For both samples, we consider the extent to which stated attribute non-attendance impacts estimates of willingness to pay and the potential ability of researchers to transfer values between contexts...
December 1, 2016: Journal of Environmental Management
Daniel A Goldstein, Salomon M Stemmer, Noa Gordon
Cancer drug expenditures have been increasing significantly in countries around the world. A recent paper in the IJHPR provides new knowledge and insights into this global phenomenon by analyzing how it is playing out in an Israeli health plan with over two million members, whose state-of-the-art information systems provide an opportunity to explore these changes in a comprehensive, detailed and reliable manner. There is a wide variation in both the cost-effectiveness and the budget impact of individual drugs...
2016: Israel Journal of Health Policy Research
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
Puttarin Kulchaitanaroaj, John M Brooks, Nathorn Chaiyakunapruk, Amber M Goedken, Elizabeth A Chrischilles, Barry L Carter
OBJECTIVE: To estimate long-term costs and outcomes attributable to a physician-pharmacist collaborative intervention compared with physician management alone for treating essential hypertension. METHODS: A Markov model cohort simulation with a 6-month cycle length to predict acute coronary syndrome, stroke, and heart failure throughout lifetime was performed. A cohort of 399 patients was obtained from two prospective, cluster randomized controlled clinical trials implementing physician-pharmacist collaborative interventions in community-based medical offices in the Midwest, USA...
September 28, 2016: Journal of Hypertension
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