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https://www.readbyqxmd.com/read/28454044/unintended-impacts-of-regulatory-changes-to-british-columbia-methadone-maintenance-program-on-addiction-and-hiv-related-outcomes-an-interrupted-time-series-analysis
#1
M Eugenia Socías, Evan Wood, Ryan McNeil, Thomas Kerr, Huiru Dong, Jean Shoveller, Julio Montaner, M-J Milloy
BACKGROUND: In February 2014, several regulatory reforms were introduced to the methadone maintenance treatment (MMT) program in British Columbia, Canada, including a switch to a ten-times more concentrated methadone formulation and restrictions in pharmacy delivery services. We evaluated possible unintended effects of these changes on illicit drug use patterns and HIV treatment outcomes among HIV-positive opioid users. METHODS: Data was drawn from ACCESS, a prospective community-recruited cohort of HIV-positive people who use illicit drugs in Vancouver, Canada...
April 25, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28448825/health-policy-in-the-concertaci%C3%A3-n-era-1990-2010-reforms-the-chilean-way
#2
María Soledad Martinez-Gutierrez, Cristóbal Cuadrado
The Chilean health system has experienced important transformations in the last decades with a neoliberal turn to privatization of the health insurance and healthcare market since the Pinochet reforms of the 1980s. During 20 years of center-left political coalition governments several reforms were attempted to regulate and reform such markets. This paper analyzes regulatory policies for the private health insurance and health care delivery market, adopted during the 1990-2010 period. A framework of variation in market types developed by Gingrich is adopted as analytical perspective...
April 9, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28438218/malaria-elimination-in-lao-pdr-the-challenges-associated-with-population-mobility
#3
REVIEW
Sengchanh Kounnavong, Deyer Gopinath, Bouasy Hongvanthong, Chanthalone Khamkong, Odai Sichanthongthip
Although the Lao People's Democratic Republic (Lao PDR) is comparatively small landlocked country with patterns of both in- and out-migration, its human migration situation has been poorly studied. This is despite all of the country's 18 provinces sharing both official and unofficial border checkpoints with neighboring countries. Economic reforms in the last decade have seen a gradual increase in the promotion of foreign investment, and main towns and transportation networks have been expanding thus offering new opportunities for livelihoods and economic activities...
April 25, 2017: Infectious Diseases of Poverty
https://www.readbyqxmd.com/read/28420558/maternal-medical-complexity-impact-on-prenatal-health-care-spending-among-women-at-low-risk-for-cesarean-section
#4
Shayna D Cunningham, Carolina Herrera, Ifeyinwa E Udo, Katy B Kozhimannil, Eric Barrette, Urania Magriples, Jeannette R Ickovics
BACKGROUND: Obstetric procedures are among the most expensive health care services, yet relatively little is known about health care spending among pregnant women, particularly the commercially-insured. OBJECTIVE: The objective of this study was to examine the association between maternal medical complexity, as a result of having one or more comorbid conditions, and health care spending during the prenatal period among a national sample of 95,663 commercially-insured women at low risk for cesarean delivery...
April 15, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28402826/the-affordable-care-act-implications-for-health-care-equity
#5
REVIEW
Adam Gaffney, Danny McCormick
Inequalities in medical care are endemic in the USA. The Affordable Care Act (ACA), passed in 2010 and fully implemented in 2014, was intended to expand coverage and bring about a new era of health-care access. In this review, we evaluate the legislation's impact on health-care equity. We consider the law's coverage expansion, insurance market reforms, cost and affordability provisions, and delivery-system reforms. Although the ACA improved coverage and access-particularly for poorer Americans, women, and minorities-its overall impact was modest in comparison with the gaps present before the law's implementation...
April 8, 2017: Lancet
https://www.readbyqxmd.com/read/28381224/informing-primary-care-reform-in-greece-patient-expectations-and-experiences-the-qualicopc-study
#6
Christos Lionis, Sophia Papadakis, Chrysanthi Tatsi, Antonis Bertsias, George Duijker, Prodromos-Bodosakis Mekouris, Wienke Boerma, Willemijn Schäfer
BACKGROUND: Primary health care is the cornerstone of a high quality health care system. Greece has been actively attempting to reform health care services in order to improve heath outcomes and reduce health care spending. Patient-centered approaches to health care delivery have been increasingly acknowledged for their value informing quality improvement activities. This paper reports the quality of primary health care services in Greece as perceived by patients and aspects of health care delivery that are valued by patients...
April 5, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28379852/unmet-supportive-care-needs-of-men-with-locally-advanced-and-metastatic-prostate-cancer-on-hormonal-treatment-a-mixed-methods-study
#7
Catherine Paterson, Sławomir Grzegorz Kata, Ghulam Nandwani, Debi Das Chaudhury, Ghulam Nabi
BACKGROUND: Men affected by prostate cancer who are undergoing hormone therapy can endure a range of symptoms that can adversely affect quality of life. Little research has been conducted to date, to understand the specific unmet supportive care needs of this patient group within the context of current service delivery. OBJECTIVE: The aim of this study was to understand the experiences of unmet supportive care needs of men affected by prostate cancer on hormone therapy in the United Kingdom...
April 4, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28365616/the-new-uk-internal-medicine-curriculum%C3%A2
#8
David Black
Reform of physician education is needed to meet the needs of patients, based on comorbidities, chronic disease management and complexity. The Joint Royal Colleges of Physicians Training Board has developed a new internal medicine curriculum for physician training that aims to not only deliver this expectation, but will simplify competency-based education, smooth the transition to the medical registrar role and hopefully fill some of the current empty funded training posts. However, the change process is complex and requires close working with the General Medical Council and other partners in curriculum delivery...
April 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28363470/time-driven-activity-based-costing-a-dynamic-value-assessment-model-in-pediatric-appendicitis
#9
Yangyang R Yu, Paulette I Abbas, Carolyn M Smith, Kathleen E Carberry, Hui Ren, Binita Patel, Jed G Nuchtern, Monica E Lopez
OBJECTIVES: Healthcare reform policies are emphasizing value-based healthcare delivery. We hypothesize that time-driven activity-based costing (TDABC) can be used to appraise healthcare interventions in pediatric appendicitis. METHODS: Triage-based standing delegation orders, surgical advanced practice providers, and a same-day discharge protocol were implemented to target deficiencies identified in our initial TDABC model. Post-intervention process maps for a hospital episode were created using electronic time stamp data for simple appendicitis cases during February to March 2016...
March 18, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28356772/chinese-health-care-system-and-clinical-epidemiology
#10
REVIEW
Yuelian Sun, Hans Gregersen, Wei Yuan
China has gone through a comprehensive health care insurance reform since 2003 and achieved universal health insurance coverage in 2011. The new health care insurance system provides China with a huge opportunity for the development of health care and medical research when its rich medical resources are fully unfolded. In this study, we review the Chinese health care system and its implication for medical research, especially within clinical epidemiology. First, we briefly review the population register system, the distribution of the urban and rural population in China, and the development of the Chinese health care system after 1949...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28355878/promoting-colorectal-cancer-screening-through-a-new-model-of-delivering-rural-primary-care-in-the-usa-a-qualitative-study
#11
Jungyoon Kim, Lufei Young, Sarbinaz Bekmuratova, Daniel J Schober, Hongmei Wang, Shreya Roy, Soumitra S Bhuyan, Alice Schumaker, Li-Wu Chen
INTRODUCTION: Despite the known benefits of colorectal cancer (CRC) screening, rural areas have consistently reported lower screening rates than their urban counterparts. Alternative healthcare delivery models, such as accountable care organizations (ACOs), have the potential to increase CRC rates through collaboration among healthcare providers with the aim of improving quality and decreasing cost. However, researchers have not sufficiently explored how this innovative model could influence the promotion of cancer screening...
January 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/28351118/how-will-repealing-the-aca-affect-medicaid-impact-on-health-care-coverage-delivery-and-payment
#12
Sara Rosenbaum, Sara Rothenberg, Sara Schmucker, Rachel Gunsalus, J. Zoë Beckerman
ISSUE: The Affordable Care Act enhanced Medicaid's role as a health care purchaser by expanding eligibility and broadening the range of tools and strategies available to states. All states have embraced delivery and payment reform as basic elements of their programs. GOAL: To examine the effects of reducing the size and scope of Medicaid under legislation to repeal the ACA. FINDINGS AND CONCLUSIONS: Were the ACA's Medicaid expansion to be eliminated and were federal Medicaid funding to experience major reductions through block grants or per capita caps, the effects on system transformation would be significant...
March 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28350948/bending-the-cost-curve-establishing-value-in-spine-surgery
#13
Scott L Parker, Silky Chotai, Clinton J Devin, Lindsay Tetreault, Thomas E Mroz, Darrel S Brodke, Michael G Fehlings, Matthew J McGirt
BACKGROUND: As publically promoted by all stakeholders in health care reform, prospective outcomes registry platforms lie at the center of all current evidence-driven value-based models. OBJECTIVE: To demonstrate the variability in outcomes and cost at population level and individual patient level for patients undergoing spine surgery for degenerative diseases. METHODS: Retrospective analysis of prospective longitudinal spine registry data was conducted...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350232/massachusetts-substance-use-disorder-treatment-organizations-perspectives-on-the-affordable-care-act-changes-in-payment-services-and-system-design
#14
Amity E Quinn, Maureen T Stewart, Mary Brolin, Constance Horgan, Nancy E Lane
The Affordable Care Act (ACA) expanded insurance benefits and coverage for substance use disorder (SUD) treatment and encouraged delivery and payment reforms. Massachusetts passed a similar reform in 2006. This study aims to assess Massachusetts SUD treatment organizations' responses to the ACA. Organizational interviews addressing challenges of and responses to the ACA were conducted in person June-December 2014 with 31 leaders at 12 treatment organizations across Massachusetts. Many organizations were affiliated with medical or social services and offered a range of SUD services...
March 28, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28342917/science-of-health-care-delivery-as-a-first-step-to-advance-undergraduate-medical-education-a-multi-institutional-collaboration
#15
Stephanie R Starr, Darcy A Reed, Alison Essary, William Hueston, C Daniel Johnson, Natalie Landman, John Meurer, Bonnie Miller, Greg Ogrinc, Elizabeth M Petty, John Raymond, William Riley, Sherine Gabriel, Cheryl Maurana
Physicians must possess knowledge and skills to address the gaps facing the US health care system. Educators advocate for reform in undergraduate medical education (UME) to align competencies with the Triple Aim. In 2014, five medical schools and one state university began collaborating on these curricular gaps. The authors report a framework for the Science of Health Care Delivery (SHCD) using six domains and highlight curricular examples from each school. They describe three challenges and strategies for success in implementing SHCD curricula...
March 22, 2017: Healthcare
https://www.readbyqxmd.com/read/28339426/evolution-of-us-health-care-reform
#16
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
#17
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
#18
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
#19
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
#20
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
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