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Cost sharing in healthcare

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https://www.readbyqxmd.com/read/29218817/impact-of-a-shared-decision-making-intervention-on-healthcare-utilization-a-secondary-analysis-of-the-chest-pain-choice-multicenter-randomized-trial
#1
Jason T Schaffer, Erik P Hess, Judd E Hollander, Jeffrey A Kline, Carlos A Torres, Deborah B Diercks, Russell Jones, Kelly P Owen, Zachary F Meisel, Michel Demers, Annie Leblanc, Jonathan Inselman, Jeph Herrin, Victor M Montori, Nilay D Shah
BACKGROUND: Patients at low risk for acute coronary syndrome (ACS) are frequently admitted for observation and cardiac testing, resulting in substantial burden and cost to the patient and the healthcare system. OBJECTIVES: The purpose of this investigation was to measure the effect of the Chest Pain Choice decision aid (CPC) on overall healthcare utilization as well as utilization of specific services both during the index emergency department visit and in the subsequent 45 days...
December 8, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29192004/effectiveness-of-a-comprehensive-case-management-service-for-children-with-medical-complexity
#2
Tamara D Simon, Kathryn B Whitlock, Wren Haaland, Davene R Wright, Chuan Zhou, John Neff, Waylon Howard, Brian Cartin, Rita Mangione-Smith
OBJECTIVES: To assess whether children with medical complexity (CMC) exposed to a hospital-based comprehensive case management service (CCMS) experience improved health care quality, improved functional status, reduced hospital-based utilization, and/or reduced overall health care costs. METHODS: Eligible CMC at Seattle Children's Hospital were enrolled in a cluster randomized controlled trial between December 1, 2010, and September 29, 2014. Participating primary care providers (PCPs) were randomly assigned, and CMC either had access to an outpatient hospital-based CCMS or usual care directed by their PCP...
November 30, 2017: Pediatrics
https://www.readbyqxmd.com/read/29191185/compassionate-collaborative-care-an-integrative-review-of-quality-indicators-in-end-of-life-care
#3
Kathryn Pfaff, Adelais Markaki
BACKGROUND: Compassion and collaborative practice are individually associated with high quality healthcare. When combined in a compassionate collaborative care (CCC) practice framework, they are reported to improve health, strengthen care provision, and control health costs. Little is known about how to integrate and measure CCC, yet it is fundamentally applied in palliative and end-of-life care settings. This study aimed to identify quality indicators of CCC by systematically reviewing and synthesizing the current state of the palliative and end-of-life care literature...
December 1, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29190418/interventions-to-change-the-behaviour-of-health-professionals-and-the-organisation-of-care-to-promote-weight-reduction-in-children-and-adults-with-overweight-or-obesity
#4
REVIEW
Gerd Flodgren, Daniela C Gon├žalves-Bradley, Carolyn D Summerbell
BACKGROUND: The prevalence of overweight and obesity is increasing globally, an increase which has major implications for both population health and costs to health services. This is an update of a Cochrane Review. OBJECTIVES: To assess the effects of strategies to change the behaviour of health professionals or the organisation of care compared to standard care, to promote weight reduction in children and adults with overweight or obesity. SEARCH METHODS: We searched the following databases for primary studies up to September 2016: CENTRAL, MEDLINE, Embase, CINAHL, DARE and PsycINFO...
November 30, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29189491/project-echo-a-telementoring-network-model-for-continuing-professional-development
#5
Sanjeev Arora, Summers G Kalishman, Karla A Thornton, Miriam S Komaromy, Joanna G Katzman, Bruce B Struminger, William F Rayburn
INTRODUCTION: A major challenge with current systems of CME is the inability to translate the explosive growth in health care knowledge into daily practice. Project ECHO (Extension for Community Healthcare Outcomes) is a telementoring network designed for continuing professional development (CPD) and improving patient outcomes. The purpose of this article was to describe how the model has complied with recommendations from several authoritative reports about redesigning and enhancing CPD...
November 15, 2017: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/29189476/pursuit-of-value-drives-strategy-to-improve-operations-and-outcomes
#6
Marna P Borgstrom, Ohm M Deshpande, Thomas J Balcezak
The future of American healthcare remains cloudy, with the shifting contours of regulatory and fiscal reform still being shaped. Providers are beset by many challenges that vary but often include state and federal healthcare funding decisions that are antithetical to the interests of patients and aging populations. Regional public health crises and rapidly evolving relationships with third-party payers complicate matters even further.Yale New Haven Health System decided to pursue value as its overriding strategy for navigating the uncertainty in healthcare that is likely to persist for years to come...
January 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/29186782/forging-a-frailty-ready-healthcare-system-to-meet-population-ageing
#7
(no author information available yet)
The beginning of the 21st century has seen health systems worldwide struggling to deliver quality healthcare amidst challenges posed by ageing populations. The increasing prevalence of frailty with older age and accompanying complexities in physical, cognitive, social and psychological dimensions renders the present modus operandi of fragmented, facility-centric, doctor-based, and illness-centered care delivery as clearly unsustainable. In line with the public health framework for action in the World Health Organization's World Health and Ageing Report, meeting these challenges will require a systemic reform of healthcare delivery that is integrated, patient-centric, team-based, and health-centered...
November 24, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29183369/improving-tuberculosis-case-detection-in-underdeveloped-multi-ethnic-regions-with-high-disease-burden-a-case-study-of-integrated-control-program-in-china
#8
Jun Li, Xiao-Qiu Liu, Shi-Wen Jiang, Xue Li, Fei Yu, Yan Wang, Yong Peng, Xiao-Ming Gu, Yan-Ni Sun, Hui Zhang, Li-Xia Wang
BACKGROUND: In the underdeveloped multi-ethnic regions of China, high tuberculosis (TB) burden and regional inequity in access to healthcare service increase the challenge of achieving the End TB goals. Among all the provinces, the highest TB burden is reported in Xinjiang, where ethnic minorities and older people have suffered most. However, current case-finding strategy is inadequate given the complex social determinants and suboptimal case detection rates. Thus, we developed an integrated TB control program to improve case detection and conducted a pilot in Xinjiang from 2014 to 2015...
November 29, 2017: Infectious Diseases of Poverty
https://www.readbyqxmd.com/read/29182354/reframing-the-unaffordability-debate-patient-responsibility-for-physician-care
#9
Katherine Hempstead, Josh Gray, Anna Zink
OBJECTIVES: Public discussion suggests that rising out-of-pocket costs have dramatically reduced the value of insurance and led to patients doing without needed care. Our aim was to ascertain trends in patient responsibility for cost sharing. STUDY DESIGN: We used data from an organization that serves over 78,000 healthcare providers and has access to visit-level data, including the amounts paid by patients. These practices are broadly representative of physicians and patients nationally...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29177105/investigating-molecular-connections-of-non-alcoholic-fatty-liver-disease-with-associated-pathological-conditions-in-west-virginia-for-biomarker-analysis
#10
Dana L Sharma, Hari Vishal Lakhani, Rebecca L Klug, Brian Snoad, Rawan El-Hamdani, Joseph I Shapiro, Komal Sodhi
Non-alcoholic fatty liver disease (NAFLD) is a disease characterized by a steatosis of the liver that may progress to more serious pathological conditions including: nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis. As the prevalence of NAFLD has increased worldwide in recent years, pathophysiology and risk factors associated with disease progression of NAFLD are at the focus of many studies. NAFLD is related to and shares common serum biomarkers with cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM), obesity, and metabolic syndrome (MetS)...
October 2017: Journal of Clinical & Cellular Immunology
https://www.readbyqxmd.com/read/29164650/market-share-and-costs-of-biologic-therapies-for-inflammatory-bowel-disease-in-the-usa
#11
H Yu, D MacIsaac, J J Wong, Z M Sellers, A A Wren, R Bensen, C Kin, K T Park
BACKGROUND: Real-world data quantifying the costs of increasing use of biologics in inflammatory bowel disease (IBD) are unknown. AIM: To determine the outpatient IBD drug utilization trends, relative market share, and costs in the USA during a 9-year period. METHODS: The Truven MarketScan(®) Database was analysed for patients with Crohn's disease (CD) and ulcerative colitis (UC) during 2007-2015. National drug codes were used to identify prescription drugs; Healthcare Common Procedure Coding System J-codes were used to capture biologic out-patient infusions...
November 22, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29161521/lessons-from-the-camden-coalition-of-healthcare-providers-first-medicaid-shared-savings-performance-evaluation
#12
Aaron Truchil, Natasha Dravid, Stephen Singer, Zachary Martinez, Teagan Kuruna, Scott Waulters
Accountable Care Organizations (ACOs) aim to reduce health care costs while improving patient outcomes. Camden Coalition of Healthcare Providers' (Camden Coalition) work already aligned with this aim before receiving state approval to operate a certified Medicaid ACO in New Jersey. Upon its formation, the Camden Coalition ACO partnered with UnitedHealthcare and, through state legislation, Rutgers Center for State Health Policy (CSHP) was established as its external evaluator. In evaluating the Camden Coalition ACO, Rutgers CSHP built on the Medicare Shared Savings model, but modified it based on the understanding that the Medicaid population differs from the Medicare population...
November 21, 2017: Population Health Management
https://www.readbyqxmd.com/read/29155338/financial-toxicity-in-bladder-cancer-patients-reasons-for-delay-in-care-and-effect-on-quality-of-life
#13
Marianne M Casilla-Lennon, Seul Ki Choi, Allison M Deal, Jeannette T Bensen, Gopal Narang, Pauline Filippou, Benjamin McCormick, Raj Pruthi, Eric Wallen, Hung-Jui Tan, Michael Woods, Matthew Nielsen, Angela Smith
PURPOSE: Costly surveillance and treatment of bladder cancer can lead to financial toxicity (FT), a treatment-related financial burden. Our objective was to define the prevalence of FT among bladder cancer patients and identify delays in care and its effect on health-related quality of life (HRQOL). METHODS: We identified bladder cancer patients in the UNC Health Registry/Cancer Survivorship Cohort. FT was defined as agreement with having "to pay more for medical care than you can afford...
November 16, 2017: Journal of Urology
https://www.readbyqxmd.com/read/29149875/prevalence-of-antibiotic-prescription-in-pediatric-outpatients-in-italy-the-role-of-local-health-districts-and-primary-care-physicians-in-determining-variation-a-multilevel-design-for-healthcare-decision-support
#14
Mirko Di Martino, Adele Lallo, Ursula Kirchmayer, Marina Davoli, Danilo Fusco
BACKGROUND: According to scientific literature, antibacterials are prescribed for common pediatric conditions that do not benefit from antibiotic therapy. The link between antibiotic use and bacterial resistance is well known. Antibiotic overprescribing generates high social costs and severe consequences for children. Our objectives were to analyze antibiotic prescription patterns in pediatric outpatients residing in the Lazio region (Italy), to identify physicians' characteristics associated with increased propensity for prescription, to identify the priority axes for action to improve the rational use of antibiotics...
November 17, 2017: BMC Public Health
https://www.readbyqxmd.com/read/29148325/characteristics-of-high-and-low-efficiency-hospitals
#15
Michael Rosko, Herbert S Wong, Ryan Mutter
We compared performance, operating characteristics, and market environments of low- and high-efficiency hospitals in the 37 states that supplied inpatient data to the Healthcare Cost and Utilization Project from 2006 to 2010. Hospital cost-inefficiency estimates using stochastic frontier analysis were generated. Hospitals were then grouped into the 100 most- and 100 least-efficient hospitals for subsequent analysis. Compared with the least efficient hospitals, high-efficiency hospitals tended to have lower average costs, higher labor productivity, and higher profit margins...
January 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29130479/implementing-models-of-geriatric-care-behind-the-scenes
#16
Joshua Chodosh, Michael Weiner
Innovative geriatric clinical programs have proliferated in the 21st century, and many have been highlighted in the Journal of the American Geriatrics Society (JAGS). The Affordable Care Act has supported the accelerated innovation of publicized and unpublicized program development, adaptation, and implementation. Many JAGS articles report work conducted in programs with significant improvements in quality; high satisfaction for patients and providers; and for some, reductions in costs. Despite considerable detail, enabling implementers to attempt to adopt reported programs or adapt them to local environments, much less is typically conveyed about the subtleties of the implementation process that led to a successful outcome...
November 11, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29120010/innovative-transition-interventions-to-better-align-healthcare-needs-in-hospitalised-medical-patients
#17
Alexander Kutz, Fahim Ebrahimi, Tristan Struja, Jeffrey Greenwald, Philipp Schuetz, Beat Mueller
Understanding how best to manage the complex healthcare needs of hospitalised, mostly multimorbid medical patients is an international priority. Healthcare should be effective, safe and provide high quality at a reasonable cost. However, basic logistic and organisational issues of medical ward-based care have received less attention than the medical treatment of specific pathologies. Consequently, we still use old-fashioned care and transition procedures for medical inpatients. This contrasts with dynamic developments in other, non-healthcare industries, where process optimisation is a major part of innovation...
November 9, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29116927/financial-costs-associated-with-monopolies-on-biologic-medicines-in-australia
#18
Deborah Gleeson, Belinda Townsend, Ruth Lopert, Joel Lexchin, Hazel Moir
Objectives The aim of the study was to estimate the potential savings to the Pharmaceutical Benefits Scheme (PBS) and the Repatriation Pharmaceutical Benefits Scheme (RPBS) in 2015-16 if biosimilar versions of selected biologic medicines (biologics) had been available and listed on the PBS.Methods The research involved retrospective analysis of Australian Medicare expenditure data and PBS price data from 2015-16 for biologics, for which biosimilar competition may be available in future, listed on the PBS.Results Australian Government expenditure on biologics on the PBS and RPBS was estimated at A$2...
November 9, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29110264/optimization-of-drug-prescription-and-medication-management-in-older-adults-with-cardiovascular-disease
#19
Nanette K Wenger, Caroline Lloyd Doherty, Jerry H Gurwitz, Glenn A Hirsch, Holly M Holmes, Matthew S Maurer, Michael D Murray
Cardiovascular disease increases incrementally with age and elderly patients concomitantly sustain multimorbidities, with resultant prescription of multiple medications. Despite conforming with disease-specific cardiovascular clinical practice guidelines, this polypharmacy predisposes many elderly individuals with cardiovascular disease to adverse drug events and non-adherence. Patient-centered care requires that the clinician explore with each patient his or her goals of care and that this shared decision-making constitutes the basis for optimization of medication management...
November 6, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29099363/the-effects-of-oral-health-on-systemic-health
#20
Shawn F Kane
The oral cavity is the intersection of medicine and dentistry and the window into the general health of a patient. Hundreds of diseases and medications impact the oral cavity, and pathologic conditions in the mouth have a greater systemic impact than many providers appreciate. It is unclear whether there is true causality or just an association between periodontal disease and certain other systemic conditions, including atherosclerotic vascular disease, pulmonary disease, diabetes, pregnancy-related complications, osteoporosis, and kidney disease...
November 2017: General Dentistry
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