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Cost sharing in healthcare

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https://www.readbyqxmd.com/read/28333302/outcomes-of-multisite-antimicrobial-stewardship-programme-implementation-with-a-shared-clinical-decision-support-system
#1
Stuart E Bond, Adriana J Chubaty, Suman Adhikari, Spiros Miyakis, Craig S Boutlis, Wilfred W Yeo, Marijka J Batterham, Cara Dickson, Brendan J McMullan, Mona Mostaghim, Samantha Li-Yan Hui, Kate R Clezy, Pamela Konecny
Background: Studies evaluating antimicrobial stewardship programmes (ASPs) supported by computerized clinical decision support systems (CDSSs) have predominantly been conducted in single site metropolitan hospitals. Objectives: To examine outcomes of multisite ASP implementation supported by a centrally deployed CDSS. Methods: An interrupted time series study was conducted across five hospitals in New South Wales, Australia, from 2010 to 2014...
March 14, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28319584/episode-of-care-characteristics-and-costs-for-hip-and-knee-replacement-surgery-in-hospitals-belonging-to-the-high-value-health-care-collaborative-compared-with-similar-hospitals-in-the-same-health-care-markets
#2
William B Weeks, William J Schoellkopf, David J Ballard, Gary S Kaplan, Brent James, James N Weinstein
BACKGROUND: To inform consumers and restrain health care cost growth, efforts to promote transparency and to reimburse for care episodes are accelerating in the United States. OBJECTIVE: To compare characteristics and costs of 30-day episode of care for hip and knee replacement occurring in High Value Healthcare Collaborative (HVHC)-member hospitals to those occurring in like non-HVHC-member hospitals in the same 15 health care markets before interventions by HVHC members to improve health care value for those interventions...
March 17, 2017: Medical Care
https://www.readbyqxmd.com/read/28314467/association-between-copayment-medication-adherence-and-outcomes-in-the-management-of-patients-with-diabetes-and-heart-failure
#3
REVIEW
George Gourzoulidis, Georgia Kourlaba, Panagiotis Stafylas, Gregory Giamouzis, John Parissis, Nikolaos Maniadakis
OBJECTIVE: To determine the association between copayment, medication adherence and outcomes in patients with Heart failure (HF) and Diabetes Mellitus (DM). METHODS: PubMed, Scopus and Cochrane databases were searched using combinations of four sets of key words for: drug cost sharing; resource use, health and economic outcomes; medication adherence; and chronic disease. RESULTS: Thirty eight studies were included in the review. Concerning the direct effect of copayment changes on outcomes, the scarcity and diversity of data, does not allow us to reach a clear conclusion, although there is some evidence indicating that higher copayments may result in poorer health and economic outcomes...
February 28, 2017: Health Policy
https://www.readbyqxmd.com/read/28300421/the-state-of-cloud-based-biospecimen-and-biobank-data-management-tools
#4
Shonali Paul, Aditi Gade, Sumani Mallipeddi
Biobanks are critical for collecting and managing high-quality biospecimens from donors with appropriate clinical annotation. The high-quality human biospecimens and associated data are required to better understand disease processes. Therefore, biobanks have become an important and essential resource for healthcare research and drug discovery. However, collecting and managing huge volumes of data (biospecimens and associated clinical data) necessitate that biobanks use appropriate data management solutions that can keep pace with the ever-changing requirements of research...
March 16, 2017: Biopreservation and Biobanking
https://www.readbyqxmd.com/read/28298241/five-shared-decision-making-tools-in-5%C3%A2-months-use-of-rapid-reviews-to-develop-decision-boxes-for-seniors-living-with-dementia-and-their-caregivers
#5
Moulikatou Adouni Lawani, Béatriz Valéra, Émilie Fortier-Brochu, France Légaré, Pierre-Hugues Carmichael, Luc Côté, Philippe Voyer, Edeltraut Kröger, Holly Witteman, Charo Rodriguez, Anik M C Giguere
BACKGROUND: Decision support tools build upon comprehensive and timely syntheses of literature. Rapid reviews may allow supporting their development by omitting certain components of traditional systematic reviews. We thus aimed to describe a rapid review approach underlying the development of decision support tools, i.e., five decision boxes (DB) for shared decision-making between seniors living with dementia, their caregivers, and healthcare providers. METHOD: We included studies based on PICO questions (Participant, Intervention, Comparison, Outcome) describing each of the five specific decision...
March 15, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28290933/leveraging-the-partnership-for-patients-initiative-to-improve-patient-safety-and-quality-within-the-military-health-system
#6
Heidi B King, Kimberly Kesling, Carmen Birk, Theodore Walker, Heather Taylor, Michael Datena, Brittany Burgess, Lyndsay Bower
INTRODUCTION: Partnership for Patients (PfP) was a national initiative sponsored by the Department of Health and Human Services, Centers for Medicare and Medicaid Services, to reduce preventable hospital acquired conditions (HACs) by 40% and readmissions (within 30 days) by 20%, by the end of 2013 (as compared to the baseline of CY2010). Along with partners across the nation, the Assistant Secretary of Defense for Health Affairs, Dr. Jonathan Woodson, pledged to support PfP in June 2011...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28285693/high-risk-community-and-primary-care-providers-knowledge-about-and-barriers-to-low-dose-computed-topography-lung-cancer-screening
#7
Vani N Simmons, Jhanelle E Gray, Matthew B Schabath, Lauren E Wilson, Gwendolyn P Quinn
INTRODUCTION: Until recently, there has not been a valid and reliable screening test for lung cancer. As compared to chest X-ray, low-dose computed tomography (LDCT) lung cancer screening has demonstrated greater sensitivity resulting in lung cancer diagnosis at an earlier stage, thereby reducing lung cancer mortality among high-risk individuals by 20%. In the current study, we sought to examine knowledge and attitudes about LDCT screening for lung cancer among an ethnically and racially diverse sample of high risk (HR) community members and primary care providers (PCP)...
April 2017: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
https://www.readbyqxmd.com/read/28282257/human-microbiome-and-learning-healthcare-systems-integrating-research-and-precision-medicine-for-inflammatory-bowel-disease
#8
Kim H Chuong, David R Mack, Alain Stintzi, Kieran C O'Doherty
Healthcare institutions face widespread challenges of delivering high-quality and cost-effective care, while keeping up with rapid advances in biomedical knowledge and technologies. Moreover, there is increased emphasis on developing personalized or precision medicine targeted to individuals or groups of patients who share a certain biomarker signature. Learning healthcare systems (LHS) have been proposed for integration of research and clinical practice to fill major knowledge gaps, improve care, reduce healthcare costs, and provide precision care...
March 10, 2017: Omics: a Journal of Integrative Biology
https://www.readbyqxmd.com/read/28272599/health-information-exchange-in-us-hospitals-the-current-landscape-and-a-path-to-improved-information-sharing
#9
REVIEW
A Jay Holmgren, Julia Adler-Milstein
Electronic health information exchange (HIE) was a foundational goal of the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act, but 7 years later we are far from a nationally interoperable health system. Connected electronic health records have the potential to enable fast access to a wealth of clinical data and can deliver a solution to the highly fragmented US healthcare system. In this review, we present a history and background of HIE, including its potential to deliver significant cost savings to the healthcare system...
March 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28260406/reducing-preventable-harm-observations-on-minimizing-bloodstream-infections
#10
Peter J Pronovost, Sally J Weaver, Sean M Berenholtz, Lisa H Lubomski, Lisa L Maragakis, Jill A Marsteller, Julius Cuong Pham, Melinda D Sawyer, David A Thompson, Kristina Weeks, Michael A Rosen
Purpose The purpose of this paper is to provide a practical framework that health care organizations could use to decrease preventable healthcare-acquired harms. Design/methodology/approach An existing theory of how hospitals succeeded in reducing rates of central line-associated bloodstream infections was refined, drawing from the literature and experiences in facilitating improvement efforts in thousands of hospitals in and outside the USA. Findings The following common interventions were implemented by hospitals able to reduce and sustain low infection rates...
March 20, 2017: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/28255897/bdmard-dose-reduction-in-rheumatoid-arthritis-a-narrative-review-with-systematic-literature-search
#11
REVIEW
Lise M Verhoef, Lieke Tweehuysen, Marlies E Hulscher, Bruno Fautrel, Alfons A den Broeder
INTRODUCTION: Although bDMARDs are effective in the treatment of RA, they are associated with dose-dependent side effects, patient burden, and high costs. Recently, many studies have investigated the possibility of discontinuing or tapering bDMARDs when patients have reached their treatment goal. The aim of this review is to provide a narrative overview of the existing evidence on bDMARD dose reduction and to provide answers to specific dose-reduction-related questions that are of interest to clinicians...
March 2, 2017: Rheumatology and Therapy
https://www.readbyqxmd.com/read/28247543/improving-diabetes-care-for-people-with-intellectual-disabilities-a-qualitative-study-exploring-the-perceptions-and-experiences-of-professionals-in-diabetes-and-intellectual-disability-services
#12
M Brown, L Taggart, T Karatzias, M Truesdale, R Walley, R Northway, S Macrae, M Carey, M Davies
BACKGROUND: Globally, diabetes is increasing with concerns about the impact on outcomes, including premature death and the costs associated with managing the condition. Research indicates that adults with intellectual disabilities (ID) are two to three times more likely to develop diabetes; however, there has been limited focus on diabetes service utilisation in this population. The aim of this study is to explore the perceptions and experiences of diabetes and ID practitioners. METHODS: A series of 1:1 semi-structured interviews were undertaken in one Scottish health service area...
February 28, 2017: Journal of Intellectual Disability Research: JIDR
https://www.readbyqxmd.com/read/28239296/cost-effectiveness-of-a-nurse-led-intervention-to-optimise-implementation-of-guideline-concordant-continence-care-study-protocol-of-the-cocon-study
#13
Aaltje P D Jansen, Maaike E Muntinga, Judith E Bosmans, Bary Berghmans, Janny Dekker, Jacqueline Hugtenburgh, Giel Nijpels, Paul van Houten, Miranda G H Laurant, Huub C H van der Vaart
BACKGROUND: Guidelines on urinary incontinence recommend that absorbent products are only used as a coping strategy pending definitive treatment, as an adjunct to ongoing therapy, or for long-term management after all treatment options have been explored. However, these criteria are rarely met and a significant share of long-term product users could still benefit from therapeutic interventions recommended in guidelines for urinary incontinence. Better implementation of these guidelines can potentially result in both health benefits for women and long-term cost savings for society...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28236697/budget-impact-of-perampanel-as-adjunctive-treatment-of-uncontrolled-partial-onset-and-primary-generalized-tonic-clonic-seizures-in-the-united-states
#14
Gabriel Tremblay, Victoria Barghout, Vardhaman Patel, Wan Tsong, Zhixiao Wang
PURPOSE: To evaluate the budget impact (BI) of adopting perampanel for adjunctive treatment of partial-onset seizures (POS), with or without secondarily generalized seizures, and the adjunctive treatment of primary generalized tonic-clonic seizures (PGTCS) in patients 12years or older in the United States. METHODS: A BI model was developed to estimate the potential BI of adopting adjunctive perampanel from a US payer (direct costs only) and societal (direct and indirect costs) perspective over a 5-year period...
February 17, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28222905/implementation-of-the-2013-amended-patients-rights-act-in-norway-clinical-priority-guidelines-and-access-to-specialised-health-care
#15
Kjell Arne Johansson, Elizabeth Nygaard, Berit Herlofsen, Frode Lindemark
In 2013, the Norwegian Patient Rights' Act was amended in order to simplify the priority setting process for specialized elective health care and to improve access to care. As a result of the amendment, priority for treatment is now determined by only two criteria: 1) clinical effectiveness; and 2) cost-effectiveness of the intervention. There are 33 clinical priority-setting guidelines organised by medical specialty, which help hospitals evaluate whether individual patients have a right to access care. Following the amendment of the Patient Rights' Act, these guidelines had to be revised in order to assure coherence with the new legislation...
February 20, 2017: Health Policy
https://www.readbyqxmd.com/read/28220485/epidemiology-of-basal-cell-carcinoma-scholarly-review
#16
REVIEW
J A C Verkouteren, K H R Ramdas, M Wakkee, T Nijsten
Basal cell carcinoma (BCC) is the most common cancer in white-skinned individuals with increasing incidence rates worldwide. Patients with BCC place a large burden on healthcare systems, because of the high incidence and the increased risk of synchronous and metachronous BCCs and other ultraviolet radiation (UVR) related skin cancers (i.e. field cancerization). As a result, the disability-adjusted life years and healthcare costs have risen significantly in recent decades. BCC is a complex disease, in which the interplay between UVR, phenotype (UVR-sensitive) and genotype (somatic mutations and germline mutations/polymorphisms) fulfils a key role in the aetiopathogenesis...
February 20, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28219377/the-effect-of-increasing-the-coinsurance-rate-on-outpatient-utilization-of-healthcare-services-in-south-korea
#17
Hyo Jung Lee, Sung-In Jang, Eun-Cheol Park
BACKGROUND: The Korean healthcare system is composed of costly and inefficient structures that fail to adequately divide the functions and roles of medical care organizations. To resolve this matter, the government reformed the cost-sharing policy in November of 2011 for the management of outpatients visiting general or tertiary hospitals with comparatively mild diseases. The purpose of the present study was to examine the impact of increasing the coinsurance rate of prescription drug costs for 52 mild diseases at general or tertiary hospitals on outpatient healthcare service utilization...
February 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28216118/systematic-review-of-patient-education-practices-in-weight-loss-surgery
#18
Karen D Groller
BACKGROUND: Education plays a key role in adherence to lifestyle modifications after weight loss surgery (WLS). Education given before and after surgery may decrease weight recidivism rates and improve outcomes. OBJECTIVE: The purpose of this systematic review was to analyze educational practices in bariatric centers. METHODS: The Cumulative Index to Nursing and Allied Health and PubMed databases were searched in May 2016 for English-language, peer-reviewed studies about WLS patient education practices from 1999 to 2016...
January 11, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28212159/liver-allocation-and-distribution-time-for-a-change
#19
Ranjit Deshpande, Ryutaro Hirose, David Mulligan
PURPOSE OF REVIEW: Liver allograft allocation has been a topic of hot debate for over a decade. New redistricting changes have been proposed by the Liver and Intestinal Transplant Committee to the existing United Network for Organ Sharing (UNOS) liver allocation policy. The basis of this new proposal is similar to the old one with an aim to distribute organs in a fair, efficient and equitable fashion. In this review, we plan to look in depth at the redistribution proposals thus far, their merits and how they may help patients who do not have adequate access to livers...
February 15, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28210864/pharmacy-benefit-management-companies-do-they-create-value-in-the-us-healthcare-system
#20
Alan Lyles
Pharmacy benefit management companies (PBMs) perform functions in the US market-based healthcare system that may be performed by public agencies or quasi-public institutions in other nations. By aggregating lives covered under their many individual contracts with payers, PBMs have formidable negotiating power. They influence pharmaceutical insurance coverage, design the terms of coverage in a plan's drug benefit, and create competition among providers for inclusion in a plan's network. PBMs have, through intermediation, the potential to secure lower drug prices and to improve rational prescribing...
February 16, 2017: PharmacoEconomics
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