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https://www.readbyqxmd.com/read/28339427/a-critical-analysis-of-obamacare-affordable-care-or-insurance-for-many-and-coverage-for-few
#1
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
The Affordable Care Act (ACA), of 2010, or Obamacare, was the most monumental change in US health care policy since the passage of Medicaid and Medicare in 1965. Since its enactment, numerous claims have been made on both sides of the aisle regarding the ACA's success or failure; these views often colored by political persuasion. The ACA had 3 primary goals: increasing the number of the insured, improving the quality of care, and reducing the costs of health care. One point often lost in the discussion is the distinction between affordability and access...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28325130/antiretroviral-adherence-perspectives-of-pregnant-and-postpartum-women-in-guyana
#2
Deborah Vitalis, Zelee Hill
The Caribbean region has the second highest HIV prevalence after Sub-Saharan Africa. Guyana's adult HIV prevalence is 1.9% among pregnant women, with women accounting for an estimated 58% of all persons living with HIV. However, there are few studies on ART adherence in the Caribbean, none from Guyana, and none focusing on adherence in pregnancy and the postpartum period. The objective of this study was to explore the perspectives of HIV-infected pregnant and postpartum women and healthcare providers in Guyana about barriers and facilitators to ART adherence...
March 2017: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/28323472/the-affordable-care-act-insurance-coverage-and-health-care-utilization-of-previously-incarcerated-young-men-2008-2015
#3
Tyler N A Winkelman, HwaJung Choi, Matthew M Davis
OBJECTIVES: To estimate health insurance and health care utilization patterns among previously incarcerated men following implementation of the Affordable Care Act's (ACA's) Medicaid expansion and Marketplace plans in 2014. METHODS: We performed serial cross-sectional analyses using data from the National Survey of Family Growth between 2008 and 2015. Our sample included men aged 18 to 44 years with (n = 3476) and without (n = 8702) a history of incarceration...
March 21, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28323317/the-health-insurance-gap-after-implementation-of-the-affordable-care-act-in-texas
#4
Gordon Gong, Cassandra C Huey, Coleman Johnson, Debra Curti, Billy U Philips
Households with incomes between 18% and 99% of the federal poverty level (FPL) are ineligible for Medicaid or enrollment in the health insurance exchange marketplace in Texas, resulting in the health insurance gap. We sought to determine the number of non-elderly adult Texans (NEATs) aged between 18 and 64 years in the insurance gap in rural vs urban areas in East Texas, West Texas, and South Texas. Data were obtained from the US Census Bureau website. In 2014, there were 1,101,000 NEATs in the insurance gap, accounting for 24...
March 1, 2017: Texas Medicine
https://www.readbyqxmd.com/read/28291598/identifying-radiology-s-place-in-the-expanding-landscape-of-episode-payment%C3%A2-models
#5
Andrew B Rosenkrantz, Joshua A Hirsch, Bibb Allen, H Benjamin Harvey, Gregory N Nicola
The current fee-for-service system for health care reimbursement in the United Stated is argued to encourage fragmented care delivery and a lack of accountability that predisposes to insufficient focus on quality as well as unnecessary or duplicative resource utilization. Episode payment models (EPMs) seek to improve coordination by linking payments for all services related to a patient's condition or procedure, thereby improving quality and efficiency of care. The CMS Innovation Center has implemented a broadening array of EPMs...
March 10, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28288522/job-satisfaction-of-people-with-intellectual-disabilities-the-role-of-basic-psychological-need-fulfillment-and-workplace-participation
#6
Alma Akkerman, Sabina Kef, Herman P Meininger
PURPOSE: Knowledge on what contributes to job satisfaction of people with intellectual disabilities is limited. Using self-determination theory, we investigated whether fulfillment of basic psychological needs (i.e., autonomy, relatedness, competence) affected job satisfaction, and explored associations between workplace participation, need fulfillment and job satisfaction. METHOD: A total of 117 persons with intellectual disabilities, recruited from a Dutch care organization, were interviewed on need fulfillment at work and job satisfaction...
March 13, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28281245/medicare-modernization-and-diffusion-of-endoscopy-in-ffs-medicare
#7
Lee R Mobley, Pedro Amaral, Tzy-Mey Kuo, Mei Zhou, Srimoyee Bose
OBJECTIVE: To examine how FFS Medicare utilization of endoscopy procedures for colorectal cancer (CRC) screening changed after implementation of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) in 2006, which provided subsidized drug coverage and expanded the geographic availability of Medicare managed care plans across the US. DATA SOURCES/STUDY SETTING: Using secondary data from 100% FFS Medicare enrollees, we analyzed endoscopy utilization during two intervals, 2001-2005 and 2006-2009...
December 2017: Health Economics Review
https://www.readbyqxmd.com/read/28277044/how-the-probability-of-presentation-to-a-primary-care-clinician-correlates-with-cancer-survival-rates-a-european-survey-using-vignettes
#8
Michael Harris, Peter Frey, Magdalena Esteva, Svjetlana Gašparović Babić, Mercè Marzo-Castillejo, Davorina Petek, Marija Petek Ster, Hans Thulesius
OBJECTIVE: European cancer survival rates vary widely. System factors, including whether or not primary care physicians (PCPs) are gatekeepers, may account for some of these differences. This study explores where patients who may have cancer are likely to present for medical care in different European countries, and how probability of presentation to a primary care clinician correlates with cancer survival rates. DESIGN: Seventy-eight PCPs in a range of European countries assessed four vignettes representing patients who might have cancer, and consensus groups agreed how likely those patients were to present to different clinicians in their own countries...
March 6, 2017: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/28274601/producing-a-worthy-illness-personal-crowdfunding-amidst-financial-crisis
#9
Lauren S Berliner, Nora J Kenworthy
For Americans experiencing illnesses and disabilities, crowdfunding has become a popular strategy for addressing the extraordinary costs of health care. The political, social, and health consequences of austerity--along with fallout from the 2008 financial collapse and the shortcomings of the Affordable Care Act (ACA)--are made evident in websites like GoFundMe. Here, patients and caregivers create campaigns to solicit donations for medical care, hoping that they will spread widely through social networks. As competition increases among campaigns, patients and their loved ones are obliged to produce compelling and sophisticated appeals...
February 8, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28258904/a-simplified-approach-to-encephalitis-and-its-mimics-key-clinical-decision-points-in-the-setting-of-specific-imaging-abnormalities
#10
Colin D McKnight, Aine M Kelly, Myria Petrou, Anna E Nidecker, Matthew T Lorincz, Duaa K Altaee, Stephen S Gebarski, Bradley Foerster
RATIONALE AND OBJECTIVES: Infectious encephalitis is a relatively common cause of morbidity and mortality. Treatment of infectious encephalitis with antiviral medication can be highly effective when administered promptly. Clinical mimics of encephalitis arise from a broad range of pathologic processes, including toxic, metabolic, neoplastic, autoimmune, and cardiovascular etiologies. These mimics need to be rapidly differentiated from infectious encephalitis to appropriately manage the correct etiology; however, the many overlapping signs of these various entities present a challenge to accurate diagnosis...
February 28, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28257613/indigenous-clients-intersecting-with-mainstream-nursing-a-reflection
#11
Scott Trueman
CONTEXT: Mental health care for Australian Aboriginal and Torres Strait Islander people living in rural and remote locations is delivered primarily by nurses. Culturally safe therapeutic interventions can promote understanding and improve care. Reflective knowledge thinking, writing and practice can support nurses to practice cultural safety. ISSUES: Two instances of mental health care for Australian Aboriginal and Torres Strait Islander clients are described in this reflective piece of writing...
January 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/28254577/intolerance-of-uncertainty-social-anxiety-and-generalized-anxiety-differences-by-diagnosis-and-symptoms
#12
Alyssa Counsell, Melissa Furtado, Christina Iorio, Leena Anand, Alexandra Canzonieri, Alexa Fine, Kathryn Fotinos, Irvin Epstein, Martin A Katzman
Research suggests that Intolerance of Uncertainty (IU) is related to the severity of suffering in Generalized Anxiety Disorder (GAD). However, its role in Social Anxiety Disorder (SAD) has not been extensively studied. This study examines IU in a clinical sample of 248 individuals referred to a tertiary care clinic. Few individuals had a diagnosis of pure SAD or pure GAD, but we examined differences of IU scores by diagnostic category. We further examined the relationships between IU scores, social anxiety scores, and worry through a structural equation model...
February 20, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28247870/teledermatology-in-the-inpatient-setting
#13
Rechelle Tull, Karolyn A Wanat
Teledermatology (TD) is a health care delivery modality that uses telecommunication technology to provide dermatologic care. It has grown to be a reliable and diagnostically accurate means of producing quality care while increasing access and reducing wait times in the outpatient setting. In the inpatient setting, TD may be an effective method to improve access to dermatologic care by remotely triaging, assisting, or providing dermatologic consultative services. For inpatient dermatology, there is the potential for TD to increase access to care in the community setting where dermatologists have full outpatient schedules...
March 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28237897/exploring-the-associations-between-intimate-partner-violence-victimization-during-pregnancy-and-delayed-entry-into-prenatal-care-evidence-from-a-population-based-study-in-bangladesh
#14
Md Jahirul Islam, Lisa Broidy, Kathleen Baird, Paul Mazerolle
OBJECTIVE: Intimate partner violence (IPV) during pregnancy can have serious health consequences for mothers and newborns. The aim of the study is to explore: 1) the influence of experiencing IPV during pregnancy on delayed entry into prenatal care; and 2) whether women's decision-making autonomy and the support for traditional gender roles act to mediate or moderate the relationship between IPV and delayed entry into prenatal care. DESIGN: cross-sectional survey...
February 7, 2017: Midwifery
https://www.readbyqxmd.com/read/28236986/-inclusion-criteria-and-rating-scales-for-rcts-in-psychiatry-the-future-of-qualitative-studies
#15
D Pringuey, R Pommier, F Pringuey-Criou, S Boyer, C Massoubre, E Fakra, M Adida, R Belzeaux, T Bottai, J-M Azorin
An inventory on the two critical dimensions that structure the Randomized Controlled Trial in Psychiatry, namely the definition of inclusion criteria for eligible patients for testing and the choice of psychometric methods of pathology assessment and its evolution during the experiment, considers the importance of increasingly numerous and precise international recommendations. Taking into account the formal constraints of industrial, questioning the cultural differences of the methodological approach of the tests, meeting the requirements of feasibility and ever increasing security, frequent cumbersome procedure often contrasts with the modest nature of the results...
December 2016: L'Encéphale
https://www.readbyqxmd.com/read/28230452/prescription-drug-utilization-and-reimbursement-increased-following-state-medicaid-expansion-in-2014
#16
Nirosha Mahendraratnam, Stacie B Dusetzina, Joel F Farley
BACKGROUND: The Affordable Care Act (ACA) expanded health care and medication insurance coverage through Medicaid expansion in select states. Expansion has the potential to increase the availability of health services to patients, including prescription medications. However, limited studies have examined how expansion affected prescription drug utilization and reimbursement. OBJECTIVE: To compare prescription drug utilization (number of prescriptions filled) and reimbursement trends between states that did and did not expand Medicaid coverage in 2014, while accounting for known effects of expansion on Medicaid enrollment...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28210082/multitarget-stool-dna-tests-increases-colorectal-cancer-screening-among-previously-noncompliant-medicare-patients
#17
Mark Prince, Lynn Lester, Rupal Chiniwala, Barry Berger
AIM: To determine the uptake of noninvasive multitarget stool DNA (mt-sDNA) in a cohort of colorectal cancer (CRC) screening non-compliant average-risk Medicare patients. METHODS: This cross sectional primary care office-based study examined mt-sDNA uptake in routine clinical practice among 393 colorectal cancer screening non-compliant Medicare patients ages 50-85 ordered by 77 physicians in a multispecialty group practice (USMD Physician Services, Dallas, TX) from October, 2014-September, 2015...
January 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28208098/-don-t-think-i-m-going-to-leave-you-over-it-accounts-of-changing-hepatitis-c-status-among-couples-who-inject-drugs
#18
Jake Rance, Carla Treloar, Suzanne Fraser, Joanne Bryant, Tim Rhodes
BACKGROUND: While the health-related benefits of intimate partnership are well documented, little attention has been paid to couples exposed to high levels of social stigma and exclusion. In this project we investigated an important site of stigma for partnerships by collecting accounts of changing hepatitis C (HCV) status ("sero-change") among couples that inject drugs. We explored what these accounts reveal about the meaning of HCV for these couples, and how this understanding contributes to our collective efforts at prevention and care...
April 1, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28201956/hiv-screening-and-the-affordable-care-act
#19
Greg Carter, Christopher Owens, Hsien-Chang Lin
Men continue to bear disproportionate accounts of HIV diagnoses. The Patient Protection and Affordable Care act aims to address health care disparities by recommending preventative services, including HIV screening, expanding community health centers, and increasing the healthcare workforce. This study examined the decision making of physician and primary care health providers to provide HIV screenings. A quasi-experimental design was used to estimate the effects of the Affordable Care Act on provider-initiated HIV screening...
March 2017: American Journal of Men's Health
https://www.readbyqxmd.com/read/28201932/turkish-adult-children-as-caregivers-of-parents-with-alzheimer-s-disease-perceptions-and-caregiving-experiences
#20
Yagmur Ar, A Nuray Karanci
There is substantial evidence suggesting that Western and non-Western caregivers of patients with Alzheimer's disease have different caregiving experiences depending on the cultural values they adopt. Although family-centered constructs such as familism and filial piety have taken some attention, there is still a paucity of research on how cultural values and norms shape caregiving appraisals, coping strategies, and formal service use specifically in Eastern-oriented contexts. The aim of this study was to investigate Turkish adult children caregivers' perceptions of Alzheimer's disease and caregiving experience...
January 1, 2017: Dementia
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