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https://www.readbyqxmd.com/read/28339426/evolution-of-us-health-care-reform
#1
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
Major health policy creation or changes, including governmental and private policies affecting health care delivery are based on health care reform(s). Health care reform has been a global issue over the years and the United States has seen proposals for multiple reforms over the years. A successful, health care proposal in the United States with involvement of the federal government was the short-lived establishment of the first system of national medical care in the South. In the 20th century, the United States was influenced by progressivism leading to the initiation of efforts to achieve universal coverage, supported by a Republican presidential candidate, Theodore Roosevelt...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28327143/the-imperative-for-systems-thinking-to-promote-access-to-medicines-efficient-delivery-and-cost-effectiveness-when-implementing-health-financing-reforms-a-qualitative-study
#2
Tom Achoki, Abaleng Lesego
BACKGROUND: Health systems across Africa are faced with a multitude of competing priorities amidst pressing resource constraints. Expansion of health insurance coverage offers promise in the quest for sustainable healthcare financing for many of the health systems in the region. However, the broader policy implications of expanding health insurance coverage have not been fully investigated and contextualized to many African health systems. METHODS: We interviewed 37 key informants drawn from public, private and civil society organizations involved in health service delivery in Botswana...
March 21, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28321291/re-thinking-barriers-to-organizational-change-in-public-hospitals
#3
Nigel Edwards, Richard B Saltman
Public hospitals are well known to be difficult to reform. This paper provides a comprehensive six-part analytic framework that can help policymakers and managers better shape their organizational and institutional behavior. The paper first describes three separate structural characteristics which, together, inhibit effective problem description and policy design for public hospitals. These three structural constraints are i) the dysfunctional characteristics found in most organizations, ii) the particular dysfunctions of professional health sector organizations, and iii) the additional dysfunctional dimensions of politically managed organizations...
2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28316039/public-health-data-in-action-an-analysis-of-using-louisiana-vital-statistics-for-quality-improvement-and-payment-reform
#4
Valery A Danilack, Rebekah E Gee, Danielle P Berthelot, Rebecca Gurvich, Janet H Muri
Introduction In 2012, the Louisiana (LA) Department of Health and Hospitals revised the LA birth certificate to include medical reasons for births before 39 completed weeks' gestation. We compared the completeness and validity of these data with hospital discharge records. Methods For births occurring 4/1/2012-9/30/2012 at Woman's Hospital of Baton Rouge, we linked maternal delivery and newborn birth data collected through the National Perinatal Information Center with LA birth certificates. Among early term births (37-38 completed weeks' gestation), we quantified the reasons for early delivery listed on the birth certificate and compared them with ICD-9-CM codes from Woman's discharge data...
March 18, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28302597/mhealth-interventions-for-health-system-strengthening-in-china-a-systematic-review
#5
Maoyi Tian, Jing Zhang, Rong Luo, Shi Chen, Djordje Petrovic, Julie Redfern, Dong Roman Xu, Anushka Patel
BACKGROUND: With rapidly expanding infrastructure in China, mobile technology has been deemed to have the potential to revolutionize health care delivery. There is particular promise for mobile health (mHealth) to positively influence health system reform and confront the new challenges of chronic diseases. OBJECTIVE: The aim of this study was to systematically review existing mHealth initiatives in China, characterize them, and examine the extent to which mHealth contributes toward the health system strengthening in China...
March 16, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28300976/primary-health-care-reform-in-the-cities-of-lisbon-and-rio-de-janeiro-context-strategies-results-learning-and-challenges
#6
Daniel Soranz, Luís Augusto Coelho Pisco
On the 30th anniversary of Alma-Ata, the World Health Organization published in 2008 the "Primary Health Care Now More Than Ever" Report, calling on all governments to reflect on the need to reflect on four sets of reforms. These included: (i) universal coverage reforms; (ii) service delivery reforms; (iii) public policies reforms that would ensure healthier communities; and (iv) leadership reforms. In this context, in the period 2005-2016, the cities of Rio de Janeiro and Lisbon developed a profound primary healthcare reform, and did so by sharing many of the solutions based on the best internationally recognized organizational practices...
March 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28298226/addressing-the-double-burden-of-diabetes-and-tuberculosis-lessons-from-kyrgyzstan
#7
Jolene Skordis-Worrall, Jeff Round, Matthias Arnold, Aida Abdraimova, Baktygul Akkazieva, David Beran
BACKGROUND: The incidence of diabetes and tuberculosis co-morbidity is rising, yet little work has been done to understand potential implications for health systems, healthcare providers and individuals. Kyrgyzstan is a priority country for tuberculosis control and has a 5% prevalence of diabetes in adults, with many health system challenges for both conditions. METHODS: Patient exit interviews collected data on demographic and socio-economic characteristics, health spending and care seeking for people with diabetes, tuberculosis and both diabetes and tuberculosis...
March 15, 2017: Globalization and Health
https://www.readbyqxmd.com/read/28293670/evaluation-of-the-current-status-of-rehabilitation-physical-medicine-and-naturopathy-education-10-years-after-the-reform-of-the-medical-licensure-act-a-nationwide-survey-of-german-medical-universities
#8
Beate Stock-Schröer, Roman Huber, Stefanie Joos, Petra Klose
Introduction: After the reform of the German Medical Licensure Act of 2003, Rehabilitation, Naturopathy and Physical Medicine were integrated into one discipline to be taught in Medical University. The aim of this survey is to determine the outcome of this change by evaluating the current status of education of these three disciplines based on the experience and satisfaction reported by lecturers responsible for teaching these subjects to medical students. Methods: A questionnaire-based survey. A paper version of the questionnaire for each discipline was posted to each Medical University in Germany...
2017: GMS Journal for Medical Education
https://www.readbyqxmd.com/read/28264956/primary-health-care-that-works-the-costa-rican-experience
#9
Madeline Pesec, Hannah L Ratcliffe, Ami Karlage, Lisa R Hirschhorn, Atul Gawande, Asaf Bitton
Long considered a paragon among low- and middle-income countries in its provision of primary health care, Costa Rica reformed its primary health care system in 1994 using a model that, despite its success, has been generally understudied: basic integrated health care teams. This case study provides a detailed description of Costa Rica's innovative implementation of four critical service delivery reforms and explains how those reforms supported the provision of the four essential functions of primary health care: first-contact access, coordination, continuity, and comprehensiveness...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28264953/impact-of-health-care-delivery-system-innovations-on-total-cost-of-care
#10
Kevin W Smith, Anupa Bir, Nikki L B Freeman, Benjamin C Koethe, Julia Cohen, Timothy J Day
Using delivery system innovations to advance health care reform continues to be of widespread interest. However, it is difficult to generalize about the success of specific types of innovations, since they have been examined in only a few studies. To gain a broader perspective, we analyzed the results of forty-three ambulatory care programs funded by the first round of the Center for Medicare and Medicaid Innovation's Health Care Innovations Awards. The innovations' impacts on total cost of care were estimated by independent evaluators using multivariable difference-in-differences models...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28264948/early-impact-of-carefirst-s-patient-centered-medical-home-with-strong-financial-incentives
#11
Christopher C Afendulis, Laura A Hatfield, Bruce E Landon, Jonathan Gruber, Mary Beth Landrum, Robert E Mechanic, Darren E Zinner, Michael E Chernew
In 2011 CareFirst BlueCross BlueShield, a large mid-Atlantic health insurance plan, implemented a payment and delivery system reform program. The model, called the Total Care and Cost Improvement Program, includes enhanced payments for primary care, significant financial incentives for primary care physicians to control spending, and care coordination tools to support progress toward the goal of higher-quality and lower-cost patient care. We conducted a mixed-methods evaluation of the initiative's first three years...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28264947/texas-medicaid-payment-reform-fewer-early-elective-deliveries-and-increased-gestational-age-and-birthweight
#12
Heather M Dahlen, J Mac McCullough, Angela R Fertig, Bryan E Dowd, William J Riley
Infants born at full term have better health outcomes. However, one in ten babies in the United States are born via a medically unnecessary early elective delivery: induction of labor, a cesarean section, or both before thirty-nine weeks gestation. In 2011 the Texas Medicaid program sought to reduce the rate of early elective deliveries by denying payment to providers for the procedure. We examined the impact of this policy on clinical care practice and perinatal outcomes by comparing the changes in Texas relative to comparison states...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28264946/oregon-s-medicaid-reform-and-transition-to-global-budgets-were-associated-with-reductions-in-expenditures
#13
K John McConnell, Stephanie Renfro, Richard C Lindrooth, Deborah J Cohen, Neal T Wallace, Michael E Chernew
In 2012 Oregon initiated an ambitious delivery system reform, moving the majority of its Medicaid enrollees into sixteen coordinated care organizations, a type of Medicaid accountable care organization. Using claims data, we assessed measures of access, appropriateness of care, utilization, and expenditures for five service areas (evaluation and management, imaging, procedures, tests, and inpatient facility care), comparing Oregon to the neighboring state of Washington. Overall, the transformation into coordinated care organizations was associated with a 7 percent relative reduction in expenditures across the sum of these services, attributable primarily to reductions in inpatient utilization...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28263939/association-between-physician-teamwork-and-health-system-outcomes-after-coronary-artery-bypass-grafting
#14
John M Hollingsworth, Russell J Funk, Spencer A Garrison, Jason Owen-Smith, Samuel A Kaufman, Francis D Pagani, Brahmajee K Nallamothu
BACKGROUND: Patients undergoing coronary artery bypass grafting (CABG) must often see multiple providers dispersed across many care locations. To test whether teamwork (assessed with the bipartite clustering coefficient) among these physicians is a determinant of surgical outcomes, we examined national Medicare data from patients undergoing CABG. METHODS AND RESULTS: Among Medicare beneficiaries who underwent CABG between 2008 and 2011, we mapped relationships between all physicians who treated them during their surgical episodes, including both surgeons and nonsurgeons...
November 2016: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28255928/a-systematic-review-of-randomized-controlled-trials-to-assess-outcomes-of-genetic-counseling
#15
REVIEW
Barbara A Athens, Samantha L Caldwell, Kendall L Umstead, Philip D Connors, Ethan Brenna, Barbara B Biesecker
With the advancements in precision medicine and health care reform, it is critical that genetic counseling practice respond to emerging evidence to maximize client benefit. The objective of this review was to synthesize evidence on outcomes from randomized controlled trials (RCTs) of genetic counseling to inform clinical practice. Seven databases were searched in conducting this review. Studies were selected for inclusion if they were: (a) RCTs published from 1990 to 2015, and (b) assessed a direct outcome of genetic counseling...
March 2, 2017: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/28253876/inequality-in-the-distribution-of-health-resources-and-health-services-in-china-hospitals-versus-primary-care-institutions
#16
Tao Zhang, Yongjian Xu, Jianping Ren, Liqi Sun, Chaojie Liu
BACKGROUND: Equity is one of the major goals of China's recent health system reform. This study aimed to evaluate the equality of the distribution of health resources and health services between hospitals and primary care institutions. METHODS: Data of this study were drawn from the China Health Statistical Year Books. We calculated Gini coefficients based on population size and geographic size, respectively, for the indicators: number of institutions, number of health workers and number of beds; and the concentration index (CI) for the indicators: per capita outpatient visits and annual hospitalization rates...
March 3, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28248847/effect-of-pregnancy-and-delivery-on-cytokine-expression-in-a-mouse-model-of-pelvic-organ-prolapse
#17
Bruna M Couri, Andrew T Lenis, Ali Borazjani, Brian M Balog, Mei Kuang, Robert S Butler, Marc S Penn, Margot S Damaser
OBJECTIVES: The aim of this study was to determine the effect of pregnancy and delivery mode on cytokine expression in the pelvic organs and serum of lysyl oxidase like-1 knockout (LOXL1 KO) mice, which develop pelvic organ prolapse after delivery. METHODS: Bladder, urethra, vagina, rectum, and blood were harvested from female LOXL1 KO mice during pregnancy, after vaginal or cesarean delivery, and from sham cesarean and unmanipulated controls. Pelvic organs and blood were also harvested from pregnant and vaginally delivered wild-type (WT) mice and from unmanipulated female virgin WT controls...
February 28, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28243870/disruptive-models-in-primary-care-caring-for-high-needs-high-cost-populations
#18
Michael Hochman, Steven M Asch
Starfield and colleagues have suggested four overarching attributes of good primary care: "first-contact access for each need; long-term person- (not disease) focused care; comprehensive care for most health needs; and coordinated care when it must be sought elsewhere." As this series on reinventing primary care highlights, there is a compelling need for new care delivery models that would advance these objectives. This need is particularly urgent for high-needs, high-cost (HNHC) populations. By definition, HNHC patients require extensive attention and consume a disproportionate share of resources, and as a result they strain traditional office-based primary care practices...
February 27, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28242193/reforming-management-of-behavior-symptoms-and-psychiatric-conditions-in-long-term-care-facilities-a-different-perspective
#19
Steven A Levenson, Abhilash K Desai
Despite much attention including national initiatives, concerns remain about the approaches to managing behavior symptoms and psychiatric conditions across all settings, including in long-term care settings such as nursing homes and assisted living facilities. One key reason why problems persist is because most efforts to "reform" and "correct" the situation have failed to explore or address root causes and instead have promoted inadequate piecemeal "solutions." Further improvement requires jumping off the bandwagon and rethinking the entire issue, including recognizing and applying key concepts of clinical reasoning and the care delivery process to every situation...
February 24, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28219429/engaging-with-complexity-to-improve-the-health-of-indigenous-people-a-call-for-the-use-of-systems-thinking-to-tackle-health-inequity
#20
EDITORIAL
Alison Hernández, Ana Lorena Ruano, Bruno Marchal, Miguel San Sebastián, Walter Flores
The 400 million indigenous people worldwide represent a wealth of linguistic and cultural diversity, as well as traditional knowledge and sustainable practices that are invaluable resources for human development. However, indigenous people remain on the margins of society in high, middle and low-income countries, and they bear a disproportionate burden of poverty, disease, and mortality compared to the general population. These inequalities have persisted, and in some countries have even worsened, despite the overall improvements in health indicators in relation to the 15-year push to meet the Millennium Development Goals...
February 21, 2017: International Journal for Equity in Health
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