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Cost sharing in healthcare

John M Collins, Ofer Reizes, Michael K Dempsey
Academic investigators are generating a plethora of insights and technologies that have the potential to significantly improve patient care. However, to address the imperative to improve the quality, cost and access to care with ever more constrained funding, the efficiency and the consistency with which they are translated into cost effective products and/or services need to improve. Healthcare commercialization programs (HCPs) are described and proposed as an option that institutions can add to their portfolio to improve translational research...
2016: IEEE Journal of Translational Engineering in Health and Medicine
Rajeev Gupta, Raghuvir Singh Khedar, Raja Babu Panwar
Hypertension is the most important cause of global burden of disease. It is highly prevalent in India and other low and lower-middle income countries. Prevalence of uncontrolled hypertension varies from 70-90% and is significantly greater in rural vs urban locations. Guidelines based treatment strategy has improved blood pressure (BP) control in high income countries but no context-specific guidelines exist in low and lower-middle income countries such as India. There are numerous barriers to proper BP control in these countries and include political apathy, bureaucratic inertia, weak health systems, overburdened healthcare providers and unempowered patients...
September 2016: Journal of the Association of Physicians of India
Rajeev Gupta
High BP is the most important cause of mortality and disease burden globally as well as in South Asian region. Global Burden of Diseases Study has reported that in year 2013 high systolic BP globally led to 10.8 million deaths and 208.1 million DALYs and in South Asian countries led to 2.1 million deaths (19.4%) and 49.9 million DALYs (24.0%). Global Burden of Chronic Disease Risk Factors study has reported from years 1980 to 2008 that while mean BP declined in high income countries, it increased in South Asian countries...
September 2016: Journal of Hypertension
Jaeyong Shin, Young Choi, Sang Gyu Lee, Tae Hyun Kim, Eun-Cheol Park
Unnecessary use of high-quality resources in general hospitals hinders treatment of patients with urgent and complicated conditions. Thus, the Korean Government has sought to reduce general hospital visiting of patients with 52 mild diseases, including hypertension. The higher cost sharing for medical expenses and medications from general hospitals were enacted in 2009 and 2011, respectively.We determined whether these regulations were effective through evaluating changing trends in first-visited healthcare organizations and defined the first visiting healthcare organization level (primary clinics, hospital, and general hospital) as an outcome measure...
October 2016: Medicine (Baltimore)
Peng-Jun Lu, Alissa O'Halloran, Walter W Williams, Rafael Harpaz
INTRODUCTION: Shingles (herpes zoster) causes substantial morbidity, especially among older adults. The shingles vaccine has been recommended for people aged ≥60 years since 2006. This study assessed recent shingles vaccination at national and state levels among adults aged ≥60 years. METHODS: The 2014 Behavioral Risk Factor Surveillance System data were analyzed in 2015 to assess shingles vaccination coverage among adults aged ≥60 years at national and state levels...
October 5, 2016: American Journal of Preventive Medicine
Bethany Lanese
Purpose The purpose of this paper is to test and measure the outcome of a community hospital in implementing the Affordable Care Act (ACA) through a co-management arrangement. RQ1: do the benefits of a co-management arrangement outweigh the costs? RQ2: does physician alignment aid in the effective implementation of the ACA directives set for hospitals? Design/methodology/approach A case study of a 350-bed non-profit community hospital co-management company. The quantitative data are eight quarters of quality metrics prior and eight quarters post establishment of the co-management company...
September 19, 2016: Journal of Health Organization and Management
Michael Jones, Julie Gassaway
OBJECTIVE: Peer support is an important adjunct to clinical care for people with disabilities, and may help address barriers to community reintegration. Peers offer positive role models and the benefit of learning from shared experiences of living with disability. Despite potential benefits, peer support is not consistently integrated in the rehabilitation process. This presentation describes three interventions recommended by patients, and directed by peer mentors, to promote successful community transition after rehabilitation for traumatic spinal cord injury (SCI)...
September 2016: Annals of Physical and Rehabilitation Medicine
Hans-Joerg Fugel, Mark Nuijten, Maarten Postma
RATIONALE: Stratified Medicine (SM) is becoming a natural result of advances in biomedical science and a promising path for the innovation-based biopharmaceutical industry to create new investment opportunities. While the use of biomarkers to improve R&D efficiency and productivity is very much acknowledged by industry, much work remains to be done to understand the drivers and conditions that favour using a stratified approach to create economically viable products and to justify the investment in SM interventions as a stratification option...
December 25, 2016: New Biotechnology
Yossef Lomnicky, Daniel Kurnik, Ronen Loebstein, Itzhak Katzir, Janet Vesterman-Landes, Nava Siegelmann-Danieli
BACKGROUND: Modern drug therapy accounts for a major share of health expenditure and challenges public provider resources. The objective of our study was to compare drug expenditure trends for ten major drug classes over 16 years at Maccabi Healthcare Services (MHS), the 2(nd) largest healthcare organization in Israel. METHODS: A retrospective analysis of drug expenditure per HMO beneficiary between the years 1998-2014. Trends in annual mean drug expenditures per MHS member were compared among 10 major drug classes...
2016: Israel Journal of Health Policy Research
Hamid Pourasghari, Mehdi Jafari, Mohammad Bakhtiari, Iman Keliddar, Afifeh Irani, Mahnaz Afshari
INTRODUCTION: Today, the provision of healthcare should be efficient and equitable to achieve the health system's goals. The aim of this study was to survey equality in healthcare expenditures and its effects on income redistribution. METHODS: This study was a descriptive-analysis, cross-sectional study that was conducted with data obtained from the Statistical Center of Iran (SCI) during 2006 and 2011. The source population and study population were the urban and rural residents of Iran and their households' income and expenditures on health...
July 2016: Electronic Physician
Geoffrey Omuse, Kristien Nel Van Zyl, Kim Hoek, Shima Abdulgader, Samuel Kariuki, Andrew Whitelaw, Gunturu Revathi
BACKGROUND: Staphylococcus aureus (S. aureus) has established itself over the years as a major cause of morbidity and mortality both within the community and in healthcare settings. Methicillin resistant S. aureus (MRSA) in particular has been a major cause of nosocomial infections resulting in significant increase in healthcare costs. In Africa, the MRSA prevalence has been shown to vary across different countries. In order to better understand the epidemiology of MRSA in a setting, it is important to define its population structure using molecular tools as different clones have been found to predominate in certain geographical locations...
2016: Annals of Clinical Microbiology and Antimicrobials
Rajeev Gupta
High BP is the most important cause of mortality and disease burden globally as well as in South Asian region. Global Burden of Diseases Study has reported that in year 2013 high systolic BP globally led to 10.8 million deaths and 208.1 million DALYs and in South Asian countries led to 2.1 million deaths (19.4%) and 49.9 million DALYs (24.0%). Global Burden of Chronic Disease Risk Factors study has reported from years 1980 to 2008 that while mean BP declined in high income countries, it increased in South Asian countries...
September 2016: Journal of Hypertension
Gavin Giovannoni, Helmut Butzkueven, Suhayl Dhib-Jalbut, Jeremy Hobart, Gisela Kobelt, George Pepper, Maria Pia Sormani, Christoph Thalheim, Anthony Traboulsee, Timothy Vollmer
INTRODUCTION: We present international consensus recommendations for improving diagnosis, management and treatment access in multiple sclerosis (MS). Our vision is that these will be used widely among those committed to creating a better future for people with MS and their families. METHODS: Structured discussions and literature searches conducted in 2015 examined the personal and economic impact of MS, current practice in diagnosis, treatment and management, definitions of disease activity and barriers to accessing disease-modifying therapies (DMTs)...
September 2016: Multiple Sclerosis and related Disorders
Mila Petrova, Julia Riley, Julian Abel, Stephen Barclay
BACKGROUND: Electronic Palliative Care Coordination Systems (EPaCCS) are England's pre-eminent initiative in enabling advance care planning and improved communication and coordination at the end of life. EPaCCS have been under development for 8 years after being proposed, as Locality Registers, in the 2008 End of Life Care Strategy for England. EPaCCS are electronic registers or tools and processes for sharing data which aim to enable access to information about dying patients. Striking outcomes have been reported around EPaCCS, such as 77...
September 16, 2016: BMJ Supportive & Palliative Care
Katarzyna Kolasa, Marta Kowalczyk
BACKGROUND: There are positive and negative consequences of the implementation of out of pocket (OOP) payments as a source of the healthcare financing. On the one hand, OOP burden increases awareness of treatment costs and limits unnecessary use of healthcare services. On the other hand, it may prevent the sick from accessing needed care. Consequently there are several aspects that ought to be taken into consideration while defining the optimal structure of OOP payments. The objective of this study was twofold...
2016: BMC Public Health
Kebede Beyene, Trudi Aspden, Janie Sheridan
BACKGROUND: Prescription medicine sharing has been defined as the lending of medicines (giving prescription medicines to someone else) or borrowing of medicines (being given and using a medicine prescribed for another person). This qualitative study explored the views of patients, to elicit information regarding factors influencing medicine sharing behaviours, their experiences of the consequences of prescription medicine sharing, and their risk assessment strategies when deciding to share...
2016: Journal of Pharmaceutical Policy and Practice
Hayden B Bosworth, Stephen P Fortmann, Jennifer Kuntz, Leah L Zullig, Phil Mendys, Monika Safford, Shobha Phansalkar, Tracy Wang, Maureen H Rumptz
Medication non-adherence is a significant clinical challenge that adversely affects psychosocial factors, costs, and outcomes that are shared by patients, family members, providers, healthcare systems, payers, and society. Patient-centered care (i.e., involving patients and their families in planning their health care) is increasingly emphasized as a promising approach for improving medication adherence, but clinician education around what this might look like in a busy primary care environment is lacking. We use a case study to demonstrate key skills such as motivational interviewing, counseling, and shared decision-making for clinicians interested in providing patient-centered care in efforts to improve medication adherence...
September 6, 2016: Journal of General Internal Medicine
Christopher T Chen, D Clay Ackerly, Gary Gottlieb
Accountable care organizations (ACOs) have shown promise in reducing healthcare spending growth, but have proven to be financially unsustainable for many healthcare organizations. Even ACOs with shared savings have experienced overall losses because the shared savings bonuses have not covered the costs of delivering population health. As physicians and former ACO leaders, we believe in the concept of accountable care, but ACOs need to evolve if they are to have a viable future. We propose the novel possibility of allowing ACOs to bill fee-for-service for their population health interventions, a concept we call population health billing...
September 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Dana Lustbader, Mitchell Mudra, Carole Romano, Ed Lukoski, Andy Chang, James Mittelberger, Terry Scherr, David Cooper
BACKGROUND: People with advanced illness usually want their healthcare where they live-at home-not in the hospital. Innovative models of palliative care that better meet the needs of seriously ill people at lower cost should be explored. OBJECTIVES: We evaluated the impact of a home-based palliative care (HBPC) program implemented within an Accountable Care Organization (ACO) on cost and resource utilization. METHODS: This was a retrospective analysis to quantify cost savings associated with a HBPC program in a Medicare Shared Savings Program ACO where total cost of care is available...
August 30, 2016: Journal of Palliative Medicine
Leonard Fromer
Anaphylaxis is a life-threatening condition, with at-risk individuals remaining at chronic high risk of recurrence. Anaphylaxis is frequently underrecognized and undertreated by healthcare providers. The first-line pharmacologic intervention for anaphylaxis is epinephrine, and guidelines uniformly agree that its prompt administration is vital to prevent progression, improve patient outcomes, and reduce hospitalizations and fatalities. Importantly, healthcare costs potentially associated with failure to provide epinephrine (hospitalizations and emergency department visits) generally exceed those of its provision...
August 20, 2016: American Journal of Medicine
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