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https://www.readbyqxmd.com/read/29651779/out-of-pocket-costs-and-health-insurance-take-up-rates
#1
Vasilios D Kosteas, Francesco Renna
BACKGROUND: Over the first ten years of this century, the share of the US population covered by employer-sponsored health insurance plans experienced a significant decline. A decrease in the take-up rate accounts for about a quarter of this decline. Usually, the increasing share of the premium that is paid by workers is used to explain the decline in the take-up rate. However, in recent years the increase in copayments, deductible and coinsurance rate has far outpaced the increase in worker contribution...
April 12, 2018: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/29601424/an-acuity-tool-for-heart-failure-case-management-quantifying-workload-service-utilization-and-disease-severity
#2
Matthew D Kilgore
PURPOSE: The cardiology service line director at a health maintenance organization (HMO) in Washington State required a valid, reliable, and practical means for measuring workloads and other productivity factors for six heart failure (HF) registered nurse case managers located across three geographical regions. The Kilgore Heart Failure Case Management (KHFCM) Acuity Tool was systematically designed, developed, and validated to measure workload as a dependent function of the number of heart failure case management (HFCM) services rendered and the duration of times spent on various care duties...
May 2018: Professional Case Management
https://www.readbyqxmd.com/read/29582950/-hadassah-medical-organization-a-pioneer-in-population-health
#3
REVIEW
Ronit Calderon-Margalit, Hagai Levine, Avi Israeli, Ora Paltiel
Population health is a term encompassing "the health outcomes of a group of individuals, including the distribution of such outcomes within the group." Only recently have hospitals viewed themselves as focal points for promoting health in a community, involving themselves with population health. Hadassah Medical Organization (HMO), however, has been in the business of population health since its founding. Its early programs, promoting and delivering nutritional support, maternal-child health and other services to the Yishuv's inhabitants, showed that the HMO defined its community broadly...
March 2018: Harefuah
https://www.readbyqxmd.com/read/29553277/overuse-and-insurance-plan-type-in-a-privately-insured-population
#4
Meredith B Rosenthal, Carrie H Colla, Nancy E Morden, Thomas D Sequist, Alexander J Mainor, Zhonghe Li, Kevin H Nguyen
OBJECTIVES: A substantial portion of healthcare spending is wasted on services that do not directly improve patient health and that cause harm in some cases. Features of health insurance coverage, including enrollment in high-deductible health plans (HDHPs) or health maintenance organizations (HMOs), may provide financial and nonfinancial mechanisms to potentially reduce overuse of low-value healthcare services. STUDY DESIGN: Using 2009 to 2013 administrative data from 3 large commercial insurers, we examined patient characteristics and health insurance plan types associated with overuse of 6 healthcare services identified by the Choosing Wisely campaign...
March 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29551328/pneumococcal-vaccine-coverage-in-adults-aged-19-64-years-newly-diagnosed-with-chronic-conditions-in-the-u-s
#5
Tanaz Petigara, Dongmu Zhang
INTRODUCTION: This study examined pneumococcal vaccine coverage in adults aged 19-64 years newly diagnosed with diabetes, chronic heart, lung, or liver disease. These conditions are indicated for pneumococcal vaccination by the Advisory Committee on Immunization Practices. METHODS: A retrospective cohort analysis was conducted in 2016 using the Truven Health MarketScan® database. The study population was adults aged 19-64 years with at least one new chronic condition during 2009-2013 and continuous health plan enrolment for 2 years before and 1 year after the initial diagnosis...
March 15, 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29541207/novel-exostosin-2-mutation-identified-in-a-chinese-family-with-hereditary-multiple-osteochondroma
#6
Weiwei Ruan, Li Cao, Zhonghua Chen, Mingxiang Kong, Qing Bi
Hereditary multiple osteochondroma (HMO) is an autosomal dominant genetic disorder characterized by multiple outgrowing bony tumors capped by cartilage, generally affecting the metaphyses. The disease is known as hereditary multiple exostoses, familial exostosis, multiple cartilaginous exostoses or hereditary malformation of cartilage. The prevalence of HMO in Europe and the Unites States is ~1:100,000, although it has not been reported in China. The disease is often accompanied by pain, asymmetry and skeletal malformations, including forearm and leg bending deformities, limb length discrepancies, and knee internal and external rotation abnormalities...
April 2018: Oncology Letters
https://www.readbyqxmd.com/read/29500268/-bifidobacterium-breve-ucc2003-employs-multiple-transcriptional-regulators-to-control-metabolism-of-particular-human-milk-oligosaccharides
#7
Kieran James, Mary O'Connell Motherway, Christophe Penno, Rebecca Louise O'Brien, Douwe van Sinderen
Bifidobacterial carbohydrate metabolism has been studied in considerable detail for a variety of both plant and human-derived glycans, particularly involving the bifidobacterial prototype Bifidobacterium breve UCC2003. We recently elucidated the metabolic pathways by which the <u>h</u>uman <u>m</u>ilk <u>o</u>ligosaccharide (HMO) constituents lacto-N-tetraose (LNT), lacto-N-neotetraose (LNnT) and lacto-N-biose (LNB) are utilized by B. breve UCC2003. However, to date no work has been carried out on the regulatory mechanisms that control expression of the genetic loci involved in these HMO metabolic pathways...
March 2, 2018: Applied and Environmental Microbiology
https://www.readbyqxmd.com/read/29480975/insurance-access-in-adults-with-congenital-heart-disease-in-the-affordable-care-act-era
#8
Chien-Jung Lin, Eric Novak, Michael W Rich, Joseph J Billadello
BACKGROUND: Adults with congenital heart disease (ACHD) have traditionally been viewed as an underinsured population. Whether this is true in the Affordable Care Act era is unknown. We determined insurance patterns in ACHD patients compared to the non-ACHD cardiology population in a contemporary cohort. METHODS: All cardiology outpatient visits between July 2016 and February 2017 to a large referral center in the United States were reviewed. The primary payer was categorized as health maintenance organization (HMO), preferred provider organization (PPO), Medicare, Medicaid, self-pay, or other...
February 26, 2018: Congenital Heart Disease
https://www.readbyqxmd.com/read/29409907/national-imaging-trends-after-percutaneous-nephrolithotomy
#9
Jessica C Dai, Justin S Ahn, Sarah K Holt, Philip C May, Mathew D Sorensen, Jonathan D Harper
PURPOSE: Follow up imaging after percutaneous nephrolithotomy (PCNL) serves to detect post-operative complications, residual fragments, and silent hydronephrosis. However, the timing and optimal imaging modality remain poorly defined. Herein, we describe imaging utilization patterns after PCNL. MATERIALS AND METHODS: Within the MarketScan® database, we identified patients 17-64 years old who underwent PCNL between 2007-2014. Imaging modalities were identified by CPT, ICD-9, and ICD-10 codes and tracked for 1 year following PCNL, including computed tomography (CT), renal ultrasound (US), abdominal x-ray (KUB), and intravenous pyelogram (IVP)...
January 31, 2018: Journal of Urology
https://www.readbyqxmd.com/read/29400645/expanding-canadian-medicare-to-include-a-national-pharmaceutical-benefit-while-controlling-expenditures-possible-lessons-from-israel
#10
Bruce Rosen
In Canada, there is an ongoing debate about whether to expand Medicare to include a national pharmaceutical benefit on a universal basis. The potential health benefits are understood to be significant, but there are ongoing concerns about affordability. In Israel, the National Health Insurance benefits package includes a comprehensive pharmaceutical benefit. Nonetheless, per capita pharmaceutical spending is well below that of Canada and the Organization for Economic Co-operation and Development average. This paper highlights seven strategies that Israel has employed to constrain pharmaceutical spending: (1) prioritizing new technologies, subject to a global budget constraint; (2) using regulations and market power to secure fair and reasonable prices; (3) establishing an efficient pharmaceutical distribution system; (4) promoting effective prescribing behavior; (5) avoiding artificial inflation of consumer demand; (6) striking an appropriate balance between respect for IP rights, access and cost containment; and (7) developing a shared societal understanding about the value and limits of pharmaceutical spending...
February 5, 2018: Health Economics, Policy, and Law
https://www.readbyqxmd.com/read/29400410/discussion-group-networks-in-occupational-medicine-a-tool-for-continuing-education-to-promote-the-integration-of-workers-with-disabilities
#11
Lilah Rinsky-Halivni, Yehuda Lerman
BACKGROUND: Despite their legal rights, individuals with disabilities face numerous obstacles to integration in the workplace which can result in their discharge from the labor force. Currently occupational physicians have few resources to help decide whether to integrate disabled workers in pre-placement, or in cases of return-to-work. METHODS: A network of 13 discussion groups comprised of the occupational physicians of each regional clinic of a large Health Maintenance Organization (HMO) in Israel was created to deal with disability management dilemmas...
February 5, 2018: American Journal of Industrial Medicine
https://www.readbyqxmd.com/read/29377120/human-milk-oligosaccharides-attenuate-antigen-antibody-complex-induced-chemokine-release-from-human-intestinal-epithelial-cell-lines
#12
Sehrish Zehra, Ibrahim Khambati, Megan Vierhout, M Firoz Mian, Rachael Buck, Paul Forsythe
There has been increased interest in the use of dietary ingredients, including prebiotics such as human-milk oligosaccharides (HMOs), as therapeutic strategies for food allergy. Understanding the mechanisms underlying the beneficial effects of HMOs is important to realizing their therapeutic potential. Here we demonstrate that the HMO, 6'-sialyllactose (6'SL) inhibited chemokine (IL-8 and CCL20) release from T-84 and HT-29 cells stimulated with antigen-antibody complex, TNFα or PGE2 ; an effect that was PPARγ dependent and associated with decreased activity of the transcription factors AP-1 and NFκB...
February 2018: Journal of Food Science
https://www.readbyqxmd.com/read/29372119/cominigut-a-small-volume-in-vitro-colon-model-for-the-screening-of-gut-microbial-fermentation-processes
#13
Maria Wiese, Bekzod Khakimov, Sebastian Nielsen, Helena Sørensen, Frans van den Berg, Dennis Sandris Nielsen
Driven by the growing recognition of the influence of the gut microbiota (GM) on human health and disease, there is a rapidly increasing interest in understanding how dietary components, pharmaceuticals and pre- and probiotics influence GM. In vitro colon models represent an attractive tool for this purpose. With the dual objective of facilitating the investigation of rare and expensive compounds, as well as an increased throughput, we have developed a prototype in vitro parallel gut microbial fermentation screening tool with a working volume of only 5 ml consisting of five parallel reactor units that can be expanded with multiples of five to increase throughput...
2018: PeerJ
https://www.readbyqxmd.com/read/29336526/human-milk-oligosaccharides-as-promising-antivirals
#14
REVIEW
Vasily Morozov, Grant Hansman, Franz-Georg Hanisch, Horst Schroten, Clemens Kunz
Human milk oligosaccharides (HMOs) are diverse unconjugated carbohydrates that are highly abundant in human breast milk. These glycans are investigated in the context of exhibiting multiple functions in infant growth and development. They seem to provide protection against infectious diseases, including a number of poorly manageable viral infections. Although the potential mechanism of the HMO antiviral protection is rather broad, much of the current experimental work has focused on studying of HMO antiadhesive properties...
March 2018: Molecular Nutrition & Food Research
https://www.readbyqxmd.com/read/29334815/impact-of-medication-adherence-on-risk-of-ischemic-stroke-major-bleeding-and-deep-vein-thrombosis-in-atrial-fibrillation-patients-using-novel-oral-anticoagulants
#15
Chinmay G Deshpande, Stephen Kogut, Robert Laforge, Cynthia Willey
OBJECTIVES: Our study examined the impact of adherence to novel oral anticoagulants [NOACs - dabigatran and rivaroxaban] on ischemic-stroke (IS), major-bleeding (MB), deep-vein-thrombosis and pulmonary-embolism (DVTPE) risk in a large, nationwide, propensity-matched sample. METHODS: A retrospective cohort study utilized data from a US commercial managed-care database (2010-2012). Adult patients with ≥1 diagnosis of atrial fibrillation/flutter (ICD-9 427.31/32), >1 prescription of NOACs and CHA2 DS2 -VASc score ≥1 were included...
February 15, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29333864/non-digestible-carbohydrates-in-infant-formula-as-substitution-for-human-milk-oligosaccharide-functions-effects-on-microbiota-and-gut-maturation
#16
Renate Akkerman, Marijke M Faas, Paul de Vos
Human milk (HM) is the golden standard for nutrition of newborn infants. Human milk oligosaccharides (HMOs) are abundantly present in HM and exert multiple beneficial functions, such as support of colonization of the gut microbiota, reduction of pathogenic infections and support of immune development. HMO-composition is during lactation continuously adapted by the mother to accommodate the needs of the neonate. Unfortunately, for many valid reasons not all neonates can be fed with HM and are either totally or partly fed with cow-milk derived infant formulas, which do not contain HMOs...
January 15, 2018: Critical Reviews in Food Science and Nutrition
https://www.readbyqxmd.com/read/29329571/environmental-exposures-and-fetal-growth-the-haifa-pregnancy-cohort-study
#17
Rachel Golan, Itai Kloog, Ronit Almog, Anat Gesser-Edelsburg, Maya Negev, Maya Jolles, Varda Shalev, Vered H Eisenberg, Gideon Koren, Wiessam Abu Ahmad, Hagai Levine
BACKGROUND: The developing fetus is susceptible to environmental insults. Studying the effects of environmental exposures on fetal growth is essential for understanding the causal pathway between prenatal exposures and pregnancy outcomes. Here we describe the Haifa Pregnancy Cohort Study (HPCS) and discuss challenges and opportunities in applying "big data" paradigm. METHODS: Maccabi Healthcare Services (MHS), is the second largest Israeli health maintenance organization (HMO) providing care services to two million beneficiaries...
January 12, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29310579/gene-trait-matching-across-the-bifidobacterium-longum-pan-genome-reveals-considerable-diversity-in-carbohydrate-catabolism-among-human-infant-strains
#18
Silvia Arboleya, Francesca Bottacini, Mary O'Connell-Motherway, C Anthony Ryan, R Paul Ross, Douwe van Sinderen, Catherine Stanton
BACKGROUND: Bifidobacterium longum is a common member of the human gut microbiota and is frequently present at high numbers in the gut microbiota of humans throughout life, thus indicative of a close symbiotic host-microbe relationship. Different mechanisms may be responsible for the high competitiveness of this taxon in its human host to allow stable establishment in the complex and dynamic intestinal microbiota environment. The objective of this study was to assess the genetic and metabolic diversity in a set of 20 B...
January 8, 2018: BMC Genomics
https://www.readbyqxmd.com/read/29282087/do-beneficiaries-views-matter-in-healthcare-purchasing-decisions-experiences-from-the-nigerian-tax-funded-health-system-and-the-formal-sector-social-health-insurance-program-of-the-national-health-insurance-scheme
#19
Ogochukwu Ibe, Ayako Honda, Enyi Etiaba, Nkoli Ezumah, Kara Hanson, Obinna Onwujekwe
BACKGROUND: Purchasing is a health financing function that involves the transfer of pooled resources to providers on behalf of a covered population. Little attention has been paid to the extent to which the views of that population  are reflected in purchasing decisions. This article explores how purchasers in two financing mechanisms: the Formal Sector Social Health Insurance Programme (FSSHIP) operating under the Nigerian National Health Insurance Scheme (NHIS), and the tax-funded health system perform their roles in light of their responsibilities to the populations...
December 28, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/29239412/screening-natural-libraries-of-human-milk-oligosaccharides-against-lectins-using-car-esi-ms
#20
Amr El-Hawiet, Yajie Chen, Km Shams-Ud-Doha, Elena N Kitova, Pavel I Kitov, Lars Bode, Naim Hage, Franco H Falcone, John S Klassen
Human milk oligosaccharides (HMOs) afford many health benefits to breast-fed infants, such as protection against infection and regulation of the immune system, through the formation of non-covalent interactions with protein receptors. However, the molecular details of these interactions are poorly understood. Here, we describe the application of catch-and-release electrospray ionization mass spectrometry (CaR-ESI-MS) for screening natural libraries of HMOs against lectins. The HMOs in the libraries were first identified based on molecular weights (MWs), ion mobility separation arrival times (IMS-ATs) and collision-induced dissociation (CID) fingerprints of their deprotonated anions...
January 15, 2018: Analyst
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