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https://www.readbyqxmd.com/read/27920303/the-dental-medical-divide
#1
Elizabeth A Mertz
The importance of oral health for overall well-being cannot be overstated. Yet the US dental delivery system struggles to address effectively the two most common oral diseases (caries and periodontal disease), which are among the most prevalent of all chronic diseases and are largely preventable. This article describes the evolution of contemporary US dental care policy and practice, highlighting the challenges resulting from the dental system's separation from the rest of health care, and explores the implications of this divide for the future of oral health policy and system reform...
December 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27919238/an-equity-analysis-of-utilization-of-health-services-in-afghanistan-using-a-national-household-survey
#2
Christine Kim, Khwaja Mir Ahad Saeed, Ahmad Shah Salehi, Wu Zeng
BACKGROUND: Afghanistan has made great strides in the coverage of health services across the country but coverage of key indicators remains low nationally and whether the poorest households are accessing these services is not well understood. METHODS: We analyzed the Afghanistan Mortality Survey 2010 on utilization of inpatient and outpatient care, institutional delivery and antenatal care by wealth quintiles. Concentration indexes (CIs) were generated to measure the inequality of using the four services...
December 5, 2016: BMC Public Health
https://www.readbyqxmd.com/read/27918401/establishing-a-viable-workforce-pipeline-of-primary-care-nurse-practitioners-benefits-of-a-health-system-and-academic-partnership
#3
Billie Madler, Mary Helland
Maldistribution and shortages of primary care providers, changing reimbursement structures, movement from inpatient to community-based models of care, an aging population, and health care reform lead to increased numbers of patients seeking care. All of these phenomena have a part in creating a health care landscape that requires industry leaders enlist innovative strategies to meet the health care needs of their communities. Delivery of high-quality, efficient care by qualified providers is essential for the success of any health care system...
January 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/27914968/segmenting-high-cost-medicare-patients-into-potentially-actionable-cohorts
#4
Karen E Joynt, Jose F Figueroa, Nancy Beaulieu, Robert C Wild, E John Orav, Ashish K Jha
BACKGROUND: Providers are assuming growing responsibility for healthcare spending, and prior studies have shown that spending is concentrated in a small proportion of patients. Using simple methods to segment these patients into clinically meaningful subgroups may be a useful and accessible strategy for targeting interventions to control costs. METHODS: Using Medicare fee-for-service claims from 2011 (baseline year, used to determine comorbidities and subgroups) and 2012 (spending year), we used basic demographics and comorbidities to group beneficiaries into 6 cohorts, defined by expert opinion and consultation: under-65 disabled/ESRD, frail elderly, major complex chronic, minor complex chronic, simple chronic, and relatively healthy...
November 30, 2016: Healthcare
https://www.readbyqxmd.com/read/27911935/the-impact-of-healthcare-insurance-on-the-utilisation-of-facility-based-delivery-for-childbirth-in-the-philippines
#5
Hebe N Gouda, Andrew Hodge, Raoul Bermejo, Willibald Zeck, Eliana Jimenez-Soto
OBJECTIVES: In recent years, the government of the Philippines embarked upon an ambitious Universal Health Care program, underpinned by the rapid scale-up of subsidized insurance coverage for poor and vulnerable populations. With a view of reducing the stubbornly high maternal mortality rates in the country, the program has a strong focus on maternal health services and is supported by a national policy of universal facility-based delivery (FBD). In this study, we examine the impact that recent reforms expanding health insurance coverage have had on FBD...
2016: PloS One
https://www.readbyqxmd.com/read/27906761/surgical-education-and-health-care-reform-defining-the-role-and-value-of-trainees-in-an-evolving-medical-landscape
#6
Oluwadamilola M Fayanju, Reena Aggarwal, Rebeccah B Baucom, Cristina R Ferrone, David Massaro, Kyla P Terhune
OBJECTIVE: Health care reform and surgical education are often separated functionally. However, especially in surgery, where resident trainees often spend twice as much time in residency and fellowship than in undergraduate medical education, one must consider their contributions to health care. SUMMARY BACKGROUND DATA: In this short commentary, we briefly review the status of health care in the United States as well as some of the recent and current changes in graduate medical education that pertain to surgical trainees...
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27905941/financing-strategies-to-improve-essential-public-health-equalization-and-its-effects-in-china
#7
Li Yang, Li Sun, Liankui Wen, Huyang Zhang, Chenyang Li, Kara Hanson, Hai Fang
BACKGROUND: In 2009, China launched a health reform to promote the equalization of national essential public health services package (NEPHSP). The present study aimed to describe the financing strategies and mechanisms to improve access to public health for all, identify the strengths and weaknesses of the different approaches, and showed evidence on equity improvement among different regions. METHODS: We reviewed the relevant literatures and identified 208 articles after screening and quality assessment and conducted six key informants' interviews...
December 1, 2016: International Journal for Equity in Health
https://www.readbyqxmd.com/read/27896623/effect-of-the-new-maternity-insurance-scheme-on-medical-expenditures-for-caesarean-delivery-in-wuxi-china-a-retrospective-pre-post-reform-case-study
#8
Chun Chen, Zhihong Cheng, Ping Jiang, Mei Sun, Qi Zhang, Jun Lv
Aiming to control rising medical expenditures and help improve China's healthcare systems, this study examined whether a cap-based medical insurance scheme with shared financial interest between the insurance and healthcare providers is effective in containing hospitals' C-section medical expenditures. We used 6547 caesarean delivery case records from a teaching tertiary-level general public hospital located in Wuxi, China (2004-2013), and used the Chow test to investigate the possibility of significant variation in mean medical expenditures for caesarean deliveries pre- and post-reform...
November 28, 2016: Frontiers of Medicine
https://www.readbyqxmd.com/read/27890982/towards-a-better-health-care-delivery-system-the-tamil-nadu-model
#9
R Parthasarathi, S P Sinha
The Tamil Nadu model of public health is renowned for its success in providing quality health services at an affordable cost especially to the rural people. Tamil Nadu is the only state with a distinctive public health cadre in the district level and also the first state to enact a Public Health Act in 1939. Tamil Nadu has gained significant ground in the various aspects of health in the last few decades largely because of the significant reforms in its health sector which dates back to 1980s which saw rigorous expansion of rural health infrastructure in the state besides deployment of thousands of multipurpose health workers as village health nurses in rural areas...
October 2016: Indian Journal of Community Medicine
https://www.readbyqxmd.com/read/27888945/radiology-as-the-point-of-cancer-patient-and-care%C3%A2-team-engagement-applying-the-4r-model-at%C3%A2-a-patient-s-breast-cancer-care-initiation
#10
Christine B Weldon, Sarah M Friedewald, Swati A Kulkarni, Melissa A Simon, Ruth C Carlos, Jonathan B Strauss, Mikele M Bunce, Art Small, Julia R Trosman
Radiologists aspire to improve patient experience and engagement, as part of the Triple Aim of health reform. Patient engagement requires active partnerships among health providers and patients, and rigorous teamwork provides a mechanism for this. Patient and care team engagement are crucial at the time of cancer diagnosis and care initiation but are complicated by the necessity to orchestrate many interdependent consultations and care events in a short time. Radiology often serves as the patient entry point into the cancer care system, especially for breast cancer...
December 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/27873383/building-leadership-capacity-in-advanced-nurse-practitioners-the-role-of-organisational-management
#11
Naomi Elliott
AIM: To highlight the organisation-level management's role in building leadership capacity in advanced nurse practitioners and the need for appropriate supports to increase their becoming leaders. BACKGROUND: Little is published about the role of organisation-level management in building leadership capacity and in developing the next generation of nurse leaders. In times of economic constraint, organisations need to focus their efforts on targeted leadership initiatives...
November 21, 2016: Journal of Nursing Management
https://www.readbyqxmd.com/read/27869655/a-shared-decision-making-approach-to-telemedicine-engaging-rural-patients-in-glycemic-management
#12
Michelle L Griffith, Linda Siminerio, Tammie Payne, Jodi Krall
Telemedicine can connect specialist health care providers with patients in remote and underserved areas. It is especially relevant in diabetes care, where a proliferation of treatment options has added further complexity to the care of an already complex, highly prevalent disease. Recent developments in health reform encourage delivery systems to use team-based models and engage patients in shared decision-making (SDM), where patients and providers together make health care decisions that are tailored to the specific characteristics and values of the patient...
November 17, 2016: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/27852345/psychiatric-rehabilitation-in-latin-america-challenges-and-opportunities
#13
J M Uribe-Restrepo, M L Escobar, L Cubillos
Comprehensive psychiatric rehabilitation programs in Latin America have been designed across several countries in the region without yet achieving full implementation. Facing an increasing burden of disease due to mental disorders, including alcohol and substance use disorders, the region has responded unevenly to the challenge. Moreover, low priority for mental health in national policies and insufficient funding for mental health services are common barriers for the much-needed mental health services reforms...
November 17, 2016: Epidemiology and Psychiatric Sciences
https://www.readbyqxmd.com/read/27851858/existing-and-emerging-payment-and-delivery-reforms-in-cardiology
#14
Steven A Farmer, Margaret L Darling, Meaghan George, Paul N Casale, Eileen Hagan, Mark B McClellan
Importance: Recent health care reforms aim to increase patient access, reduce costs, and improve health care quality as payers turn to payment reform for greater value. Cardiologists need to understand emerging payment models to succeed in the evolving payment landscape. We review existing payment and delivery reforms that affect cardiologists, present 4 emerging examples, and consider their implications for clinical practice. Observations: Public and commercial payers have recently implemented payment reforms and new models are evolving...
November 16, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27851856/leading-on-payment-and-delivery-reform-in-cardiology
#15
Karen E Joynt, Thomas M Maddox
No abstract text is available yet for this article.
November 16, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27849351/the-role-of-internal-medicine-subspecialists-in-patient-care-management
#16
Jonathan L Vandergrift, Bradley M Gray, James D Reschovsky, Eric S Holmboe, Rebecca D Lipner
OBJECTIVES: To understand the clinical roles in which internal medicine (IM) subspecialists engage, especially those involving ongoing patient management. STUDY DESIGN: Measures of physician clinical roles were based on survey responses collected from 8020 mid-career IM subspecialists who registered for the American Board of Internal Medicine maintenance of certification program (86% registration/response rate) between 2009 and 2013. METHODS: Each subspecialist reported their percentage of clinical time in 5 clinical roles: primary, principal, longitudinal consultative, medical consultative, and procedural care...
November 1, 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27849349/health-systems-tackling-social-determinants-of-health-promises-pitfalls-and-opportunities-of-current-policies
#17
Krisda H Chaiyachati, David T Grande, Jaya Aysola
Although improving the quality and delivery of clinical care is a critical mission for health systems, they are increasingly being tasked with improving the overall health of patients. This new directive is reflected in the growing number of health sector efforts in population health-a concept intertwined with social forces that impact patient care and health outcomes: the social determinants of health. Three policies that have the potential to help health systems intervene on social determinants of health are: 1) the Internal Revenue Service-mandated Community Health Needs Assessment for nonprofit hospitals, 2) value-based payment reform, and 3) CMS' Accountable Health Communities program...
November 1, 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27836506/evaluating-community-health-centers-adoption-of-a-new-global-capitation-payment-echange-study-protocol
#18
H Angier, J P O'Malley, M Marino, K J McConnell, E Cottrell, R L Jacob, S Likumahuwa-Ackman, J Heintzman, N Huguet, S R Bailey, J E DeVoe
Primary care patient-centered medical homes (PCMHs) are an effective healthcare delivery model. Evidence regarding the most effective payment models for increased coordination efforts is sparse. This protocol paper describes the evaluation of an Alternative Payment Methodology (APM) implemented in a subset of Oregon community health centers (CHCs), using a prospective matched observational design. The APM is a primary care payment reform intervention that changed Oregon's Medicaid payment for several CHCs from fee-for-service reimbursement to a per-member-per-month capitated payment...
November 9, 2016: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/27832778/inequality-in-the-use-of-maternal-and-child-health-services-in-the-philippines-do-pro-poor-health-policies-result-in-more-equitable-use-of-services
#19
Karlo Paolo P Paredes
BACKGROUND: The Philippines failed to achieve its Millennium Development Goal (MDG) commitment to reduce maternal deaths by three quarters. This, together with the recently launched Sustainable Development Goals (SDGs), reinforces the need for the country to keep up in improving reach of maternal and child health (MCH) services. Inequitable use of health services is a risk factor for the differences in health outcomes across socio-economic groups. This study aims to explore the extent of inequities in the use of MCH services in the Philippines after pro-poor national health policy reforms...
November 10, 2016: International Journal for Equity in Health
https://www.readbyqxmd.com/read/27830055/can-delivery-systems-use-cost-effectiveness-analysis-to-reduce-healthcare-costs-and-improve-value
#20
REVIEW
Lucy A Savitz, Samuel T Savitz
Understanding costs and ensuring that we demonstrate value in healthcare is a foundational presumption as we transform the way we deliver and pay for healthcare in the U.S. With a focus on population health and payment reforms underway, there is increased pressure to examine cost-effectiveness in healthcare delivery. Cost-effectiveness analysis (CEA) is a type of economic analysis comparing the costs and effects (i.e. health outcomes) of two or more treatment options. The result is expressed as a ratio where the denominator is the gain in health from a measure (e...
2016: F1000Research
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