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Cost sharing in healthcare

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https://www.readbyqxmd.com/read/28808952/effect-of-reducing-cost-sharing-for-outpatient-care-on-children-s-inpatient-services-in-japan
#1
Hirotaka Kato, Rei Goto
BACKGROUND: Assessing the impact of cost sharing on healthcare utilization is a critical issue in health economics and health policy. It may affect the utilization of different services, but is yet to be well understood. OBJECTIVE: This paper investigates the effects of reducing cost sharing for outpatient services on hospital admissions by exploring a subsidy policy for children's outpatient services in Japan. METHODS: Data were extracted from the Japanese Diagnosis Procedure Combination database for 2012 and 2013...
August 15, 2017: Health Economics Review
https://www.readbyqxmd.com/read/28805448/stakeholders-views-on-data-sharing-in-multicenter-studies
#2
Kathleen M Mazor, Allison Richards, Mia Gallagher, David E Arterburn, Marsha A Raebel, W Benjamin Nowell, Jeffrey R Curtis, Andrea R Paolino, Sengwee Toh
AIM: To understand stakeholders' views on data sharing in multicenter comparative effectiveness research studies and the value of privacy-protecting methods. MATERIALS & METHODS: Semistructured interviews with five US stakeholder groups. RESULTS: We completed 11 interviews, involving patients (n = 15), researchers (n = 10), Institutional Review Board and regulatory staff (n = 3), multicenter research governance experts (n = 2) and healthcare system leaders (n = 4)...
August 14, 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/28796625/collaborative-ehealth-meets-security-privacy-enhancing-patient-profile-management
#3
Rosa Sanchez-Guerrero, Florina Almenarez, Daniel Diaz-Sanchez, Patricia Arias, Andres Marin
Collaborative healthcare environments offer potential benefits, including enhancing the healthcare quality delivered to patients and reducing costs. As a direct consequence, sharing of Electronic Health Records (EHRs) among healthcare providers has experienced a noteworthy growth in the last years, since it enables physicians to remotely monitor patients' health and enables individuals to manage their own health data more easily. However, these scenarios face significant challenges regarding security and privacy of the extremely sensitive information contained in EHRs...
August 7, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28776113/the-impact-of-copayments-on-mental-healthcare-utilization-a-natural-experiment
#4
Timo R Lambregts, René C J A van Vliet
Empirical evidence suggests that people are fairly sensitive to cost sharing arrangements in ambulatory mental healthcare. However, pure cost sharing effects are typically hard to measure due to the presence of adverse selection effects. In this paper, we examine the impact of cost sharing on mental healthcare utilization in the context of mandatory health insurance where adverse selection is absent. Using a large proprietary dataset of a Dutch private health insurer, we examine to what extent a new copayment scheme for adult mental healthcare changed healthcare utilization...
August 3, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28763462/sativex-in-resistant-multiple-sclerosis-spasticity-discontinuation-study-in-a-large-population-of-italian-patients-sa-fe-study
#5
Silvia Messina, Claudio Solaro, Isabella Righini, Roberto Bergamaschi, Simona Bonavita, Roberto Bruno Bossio, Vincenzo Brescia Morra, Gianfranco Costantino, Paola Cavalla, Diego Centonze, Giancarlo Comi, Salvatore Cottone, Maura Chiara Danni, Ada Francia, Alberto Gajofatto, Claudio Gasperini, Mauro Zaffaroni, Loredana Petrucci, Elisabetta Signoriello, Giorgia Teresa Maniscalco, Gabriella Spinicci, Manuela Matta, Massimiliano Mirabella, Graziella Pedà, Letizia Castelli, Marco Rovaris, Edoardo Sessa, Daniele Spitaleri, Damiano Paolicelli, Alfredo Granata, Mario Zappia, Francesco Patti
BACKGROUND: The approval of Sativex for the management of multiple sclerosis (MS) spasticity opened a new opportunity to many patients. In Italy, the healthcare payer can be fully reimbursed by the involved pharma company with the cost of treatment for patients not responding after a 4 week (28 days) trial period (Payment by Results, PbR), and 50% reimbursed with the cost of 6 weeks (42 days) treatment for other patients discontinuing (Cost Sharing, CS). The aim of our study was to describe the Sativex discontinuation profile from a large population of spasticity treated Italian MS patients...
2017: PloS One
https://www.readbyqxmd.com/read/28753038/physician-experiences-with-high-value-care-in-internal-medicine-residency-mixed-methods-study-of-2003-2013-residency-graduates
#6
Kira L Ryskina, Eric S Holmboe, Judy A Shea, Esther Kim, Judith A Long
Phenomenon: High healthcare costs and relatively poor health outcomes in the United States have led to calls to improve the teaching of high value care (defined as care that balances potential benefits of interventions with their harms including costs) to physicians-in-training. Numerous interventions to increase high value care in graduate medical education were implemented at the national and local levels over the past decade. However, there has been little evaluation of their impact on physician experiences during training and perceived preparedness for practice...
July 28, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/28738986/pilot-testing-fall-tips-tailoring-interventions-for-patient-safety-a-patient-centered-fall-prevention-toolkit
#7
Patricia C Dykes, Megan Duckworth, Stephanie Cunningham, Sasha Dubois, Melissa Driscoll, Zinnia Feliciano, Michael Ferrazzi, Farah E Fevrin, Stephanie Lyons, Mary Ellen Lindros, Allison Monahan, Matthew M Paley, Saby Jean-Pierre, Maureen Scanlan
BACKGROUND: Patient falls during an acute hospitalization cause injury, reduced mobility, and increased costs. The laminated paper Fall TIPS Toolkit (Fall TIPS) provides clinical decision support at the bedside by linking each patient's fall risk assessment with evidence-based interventions. Strategies were needed to integrate this evidence into clinical practice. METHODS: The Institute for Healthcare Improvement's Framework for Spread is the conceptual model for pilot implementation of Fall TIPS at Brigham and Women's Hospital (BWH; Boston) and Montefiore Medical Center (MMC; Bronx, New York)...
August 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28730508/quality-improvement-initiatives-in-inflammatory-bowel-disease
#8
REVIEW
Sameer K Berry, Corey A Siegel, Gil Y Melmed
PURPOSE OF REVIEW: This article serves as an overview of several quality improvement initiatives in inflammatory bowel disease (IBD). RECENT FINDINGS: IBD is associated with significant variation in care, suggesting poor quality of care. There have been several efforts to improve the quality of care for patients with IBD. Quality improvement (QI) initiatives in IBD are intended to be patient-centric, improve outcomes for individuals and populations, and reduce costs-all consistent with "the triple aim" put forth by the Institute for Healthcare Improvement (IHI)...
August 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28727801/proponent-or-collaborative-physician-perspectives-and-approaches-to-disease-modifying-therapies-in-sickle-cell-disease
#9
Nitya Bakshi, Cynthia B Sinha, Diana Ross, Kirshma Khemani, George Loewenstein, Lakshmanan Krishnamurti
Sickle cell disease (SCD) is an inherited blood disorder that primarily affects African-American and other ethnic minority populations. There are three available disease-modifying therapies for sickle cell disease: hydroxyurea (HU), bone marrow transplantation (BMT), and chronic blood transfusion (CBT). Since these treatments vary in their therapeutic intent, efficacy in preventing progression of the disease, short and long-term adverse effects, costs and patient burden, the decision-making process regarding these therapies is complicated for both the patient and healthcare provider...
2017: PloS One
https://www.readbyqxmd.com/read/28705157/ward-social-workers-views-of-what-facilitates-or-hinders-collaboration-with-specialist-palliative-care-team-social-workers-a-grounded-theory
#10
Janice Firn, Nancy Preston, Catherine Walshe
BACKGROUND: Inpatient, generalist social workers in discharge planning roles work alongside specialist palliative care social workers to care for patients, often resulting in two social workers being concurrently involved in the same patient's care. Previous studies identifying components of effective collaboration, which impacts patient outcomes, care efficiency, professional job satisfaction, and healthcare costs, were conducted with nurses and physicians but not social workers. This study explores ward social workers' perceptions of what facilitates or hinders collaboration with palliative care social workers...
July 14, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28701193/do-elections-matter-for-private-sector-healthcare-management-in-brazil-an-analysis-of-municipal-health-policy
#11
Alecia J McGregor, Carlos Eduardo Siqueira, Alan M Zaslavsky, Robert J Blendon
BACKGROUND: This study analyzed several political determinants of increased private-sector management in Brazilian health care. In Brazil, the poor depend almost exclusively on the public Unified Health System (the SUS), which remains severely underfunded. Given the overhead costs associated with privately contracted health services, increased private management is one driver of higher expenditures in the system. Although left parties campaign most vocally in support of greater public control of the SUS, the extent to which their stated positions translate into health care policy remains untested...
July 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28696797/cancer-costs-and-outcomes-in-the-finnish-population-2004-2014
#12
Paulus Torkki, Riikka-Leena Leskelä, Miika Linna, Suvi Mäklin, Jukka-Pekka Mecklin, Petri Bono, Vesa Kataja, Sakari Karjalainen
INTRODUCTION: The cost of cancer and outcomes of cancer care has been much debated, since cancer represents 3-6% of total healthcare costs. The objective of this study was to analyse the development of the costs and outcomes in Finland between 2004 and 2014. MATERIAL AND METHODS: The national cost, episodes and outcomes data were obtained from the national register databases. Two hospitals were used to validate the costs of care. The outcome measures included relative survival rate, mortality, sick leave days per patient and number of new disability pensions...
July 11, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28692016/time-well-spent-patient-industry-and-occupation-data-collection-in-emergency-departments
#13
Jennifer A Taylor, Shannon A Widman, Samantha J James, Judith Green-McKenzie, Cydney McGuire, Erica J Harris
OBJECTIVE: No comprehensive national system tracking work-related diseases and injuries exists in the United States. Industry and occupation (I/O) are the missing data elements that would make existing healthcare data useful for occupational health. The authors previously petitioned the National Uniform Billing Committee (NUBC) to adopt I/O standards for states to consider during their healthcare data rulemaking processes. METHODS: The NUBC asked for a pilot study to ascertain the potential burden...
August 2017: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28681277/availability-and-pricing-new-medicines-in-ireland-reflections-and-reform
#14
Paul K Gorecki
This paper argues that the current method of determining the availability and pricing of new medicines for public reimbursement in Ireland likely results in too large a share of public healthcare expenditure allocated to medicines. Resources are misallocated. Welfare is lowered. In contrast to some other areas of public healthcare, patients exercise 'voice' rather than 'exit' concerning the public provision of high-cost new medicines. Setting publicly agreed cost-effectiveness thresholds, with clear predictable criteria for when the cost-effectiveness thresholds can be exceeded, would contribute to the creation of a more appropriate new medicine decision-making framework...
July 5, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28655683/integration-of-prevention-of-mother-to-child-hiv-transmission-into-maternal-health-services-in-senegal
#15
C Cisse
The objective of this study was to assess the level of integration of prevention of mother-to-child HIV transmission (PMTCT) in facilities providing services for maternal, newborn, and child health (MNCH) and reproductive health (RH) in Senegal. The survey, conducted from August through November, 2014, comprised five parts : a literature review to assess the place of this integration in the health policies, standards, and protocols in effect in Senegal; an analysis by direct observation of attitudes and practices of 25 healthcare providers at 5 randomly-selected obstetrics and gynecology departments representative of different levels of the health pyramid; a questionnaire evaluating knowledge and attitudes of 10 providers about the integration of PMTCT services into MNCH/RH facilities; interviews to collect the opinions of 70 clients, including 16 HIV-positive, about the quality of PMTCT services they received; and a questionnaire evaluating knowledge and opinions of 14 policy-makers/managers of health programs focusing on mothers and children about this integration...
June 1, 2017: Médecine et Santé Tropicales
https://www.readbyqxmd.com/read/28636444/a-highly-infectious-disease-care-network-in-the-us-healthcare-system
#16
Aurora B Le, Paul D Biddinger, Philip W Smith, Jocelyn J Herstein, Deborah A Levy, Shawn G Gibbs, John J Lowe
During the 2014-15 Ebola outbreak in West Africa, the United States responded by stratifying hospitals into 1 of 3 Centers for Disease Control and Prevention (CDC)-designated categories-based on the hospital's ability to identify, isolate, assess, and provide care to patients with suspected or confirmed Ebola virus disease (EVD)-in an attempt to position the US healthcare system to safely isolate and care for potential patients. Now, with the Ebola epidemic quelled, it is crucial that we act on the lessons learned from the EVD response to broaden our national perspective on infectious disease mitigation and management, build on our newly enhanced healthcare capabilities to respond to infectious disease threats, develop a more cost-effective and sustainable model of infectious disease prevention, and continue to foster training so that the nation is not in a vulnerable position once more...
May 2017: Health Security
https://www.readbyqxmd.com/read/28620302/adoption-of-biosimilar-infliximab-for-rheumatoid-arthritis-ankylosing-spondylitis-and-inflammatory-bowel-diseases-in-the-eu5-a-budget-impact-analysis-using-a-delphi-panel
#17
Tim A Kanters, Jelena Stevanovic, Isabelle Huys, Arnold G Vulto, Steven Simoens
Introduction: Introducing biosimilar infliximab for the treatment in rheumatology (rheumatoid arthritis and ankylosing spondylitis) and inflammatory bowel disease (Crohn's disease and ulcerative colitis) may reduce treatment costs associated with biologics. This study aimed to investigate the budget impact of adopting biosimilar infliximab in five European countries, considering that the budget impact includes the adoption of biosimilar infliximab and the availability of biologic alternatives such as vedolizumab, biosimilar etanercept, biosimilar rituximab, and other relevant factors...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28619038/the-experiences-of-women-with-maternal-near-miss-and-their-perception-of-quality-of-care-in-kelantan-malaysia-a-qualitative-study
#18
Mohd Noor Norhayati, Nik Hussain Nik Hazlina, Ab Razak Asrenee, Zaharah Sulaiman
BACKGROUND: Maternal mortality has been the main way of ascertaining the outcome of maternal and obstetric care. However, maternal morbidities occur more frequently than maternal deaths; therefore, maternal near miss was suggested as a more useful indicator for the evaluation and improvement of maternal health services. Our study aimed to explore the experiences of women with maternal near miss and their perception of the quality of care in Kelantan, Malaysia. METHODS: A qualitative phenomenological approach with in-depth interview method was conducted in two tertiary hospitals in Kelantan, Malaysia...
June 15, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28616208/patient-survey-of-current-water-intake-practices-in-autosomal-dominant-polycystic-kidney-disease-the-sips-survey
#19
Ragada El-Damanawi, Tess Harris, Richard N Sandford, Fiona E Karet Frankl, Thomas F Hiemstra
Background: Autosomal dominant polycystic kidney disease (ADPKD) affects 12.5 million worldwide. Vasopressin drives cysts growth and in animal models can be suppressed through high water intake. A randomized controlled trial of 'high' versus 'standard' water intake in ADPKD is essential to determine if this intervention is beneficial. We conducted an ADPKD patient survey to gain an understanding of current fluid intake practices and the design challenges of a randomized water intake trial. Methods: In collaboration with the PKD Charity, we developed and distributed an online survey to ADPKD patients over age 16 years and not on renal replacement therapy...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28604507/visits-to-registered-nurses-an-opportunity-to-increase-contraceptive-access-in-california
#20
Emese C Parker, Kevin Kong, Leslie A Watts, Eleanor B Schwarz, Philip D Darney, Heike Thiel de Bocanegra
BACKGROUND: In 2013, California passed Assembly Bill (A.B.) 2348, approving registered nurses (RNs) to dispense patient self-administered hormonal contraceptives and administer injections of hormonal contraceptives. The Family Planning, Access, Care and Treatment (Family PACT) program, which came into effect in 1997 to expand low-income, uninsured California resident access to contraceptives at no cost, is one program in which qualified RNs can dispense and administer contraceptives. AIMS: The aims of this study were to (a) describe utilization of RN visits within California's Family PACT program and (b) evaluate the impact of RN visits on client birth control acquisition during the first 18 months after implementation of A...
July 2017: Nursing Research
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