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https://www.readbyqxmd.com/read/29734968/impacts-of-the-type-of-social-health-insurance-on-health-service-utilisation-and-expenditures-implications-for-a-unified-system-in-china
#1
Si Ying Tan, Xun Wu, Wei Yang
While moving towards unified social health insurance (SHI) is often a politically popular policy reform in countries where rapid expansion in health insurance coverage has given rise to the segmentation of SHI systems as different SHI schemes were rolled out to serve different populations, the potential impacts of reform on service utilisation and health costs have not been systematically studied. Using data from the Chinese Health and Retirement Longitudinal Study (CHARLS), we compared the mean costs incurred for both inpatient and outpatient care under different health insurance schemes, and the impact of different SHI schemes on treatment utilisation and health care costs using a two-part model...
May 8, 2018: Health Economics, Policy, and Law
https://www.readbyqxmd.com/read/29708214/achieving-high-value-care-for-all-and-the-perverse-incentives-of-340b-price-agreements
#2
Melanie D Whittington, Jonathan D Campbell, R Brett McQueen
Section 340B of the Public Health Service Act requires drug manufacturers to enter into price agreements with the Department of Health and Human Services. These agreements result in variation in the price paid to acquire a drug by sector, which complicates the price used in cost-effectiveness analyses. We describe the transactions and sectors in a 340B agreement using a multiple sclerosis drug. Cost-effectiveness estimates were calculated for the drug using drug prices from the manufacturer and payer perspective...
April 2018: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/29694275/a-regressive-formula-of-perversity-wertham-and-the-women-of-comics
#3
Carol L Tilley
This essay serves as a close reading of psychiatrist Fredric Wertham's 1950s descriptions and critiques of female comics characters. I draw on archival sources as well as relevant texts in the study of gender and sexuality. Additionally, I integrate ideas from two of his close associates, folklorist Gershon Legman and psychiatrist Hilde Mosse, whose contributions to Seduction of the Innocent are woven-often invisibly-throughout that text. The character of Wonder Woman serves as a touchstone, but other provocative female figures that Wertham found objectionable in mid-twentieth-century comics accompany her...
April 25, 2018: Journal of Lesbian Studies
https://www.readbyqxmd.com/read/29675960/translating-value-based-health-care-an-experiment-into-healthcare-governance-and-dialogical-accountability
#4
Morten Bonde, Claus Bossen, Peter Danholt
This article analyses an experiment into healthcare governance in Denmark inspired by principles of value-based health care and intended to re-orient the focus of healthcare governance from 'productivity' to 'value for the patient'. The region in charge of the experiment exempted nine hospital departments from activity-based financing and accountability based on diagnosis-related groups, which allegedly incentivised hospitals in 'perverse' and counterproductive ways. Instead, the departments were to develop new indicators from their local practices to support and account for quality and value for the patient...
April 19, 2018: Sociology of Health & Illness
https://www.readbyqxmd.com/read/29621459/perverse-effects-how-insufficient-guidance-to-ipfs-can-undermine-both-research-and-health-outcomes-of-clinical-trials
#5
John W Frye
No abstract text is available yet for this article.
April 2018: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/29565758/the-disorder-specific-psychological-impairment-in-complex-ptsd-a-flawed-working-model-for-restoration-of-trust
#6
Andreas Laddis
This article methodically gathers concepts and findings from related disciplines to propose that there is a fundamental, disorder-specific psychological impairment, which defines Complex Posttraumatic Stress Disorder (PTSD) as etiologically different from simple PTSD. This impairment is a flawed working model for restoration of trust when one partner fears betrayal. This working model is legacy of childhood relationships with manipulative caretakers who kept the child powerless to test the trustworthiness of their reasons to break promises and to fail the child's expectations...
March 22, 2018: Journal of Trauma & Dissociation
https://www.readbyqxmd.com/read/29564163/performance-based-financing-in-low-income-and-middle-income-countries-isn-t-it-time-for-a-rethink
#7
REVIEW
Elisabeth Paul, Lucien Albert, Badibanga N'Sambuka Bisala, Oriane Bodson, Emmanuel Bonnet, Paul Bossyns, Sandro Colombo, Vincent De Brouwere, Alexandre Dumont, Dieudonné Sèdjro Eclou, Karel Gyselinck, Fatoumata Hane, Bruno Marchal, Remo Meloni, Mathieu Noirhomme, Jean-Pierre Noterman, Gorik Ooms, Oumar Mallé Samb, Freddie Ssengooba, Laurence Touré, Anne-Marie Turcotte-Tremblay, Sara Van Belle, Philippe Vinard, Valéry Ridde
This paper questions the view that performance-based financing (PBF) in the health sector is an effective, efficient and equitable approach to improving the performance of health systems in low-income and middle-income countries (LMICs). PBF was conceived as an open approach adapted to specific country needs, having the potential to foster system-wide reforms. However, as with many strategies and tools, there is a gap between what was planned and what is actually implemented. This paper argues that PBF as it is currently implemented in many contexts does not satisfy the promises...
2018: BMJ Global Health
https://www.readbyqxmd.com/read/29556080/prevent-perverse-outcomes-from-global-protected-area-policy
#8
Megan D Barnes, Louise Glew, Carina Wyborn, Ian D Craigie
No abstract text is available yet for this article.
March 19, 2018: Nature Ecology & Evolution
https://www.readbyqxmd.com/read/29542757/controllable-rotational-inversion-in-nanostructures-with-dual-chirality
#9
Lu Dai, Ka-Di Zhu, Wenzhong Shen, Xiaojiang Huang, Li Zhang, Alain Goriely
Chiral structures play an important role in natural sciences due to their great variety and potential applications. A perversion connecting two helices with opposite chirality creates a dual-chirality helical structure. In this paper, we develop a novel model to explore quantitatively the mechanical behavior of normal, binormal and transversely isotropic helical structures with dual chirality and apply these ideas to known nanostructures. It is found that both direction and amplitude of rotation can be finely controlled by designing the cross-sectional shape...
March 15, 2018: Nanoscale
https://www.readbyqxmd.com/read/29511741/evaluating-healthcare-priority-setting-at-the-meso-level-a-thematic-review-of-empirical-literature
#10
Dennis Waithaka, Benjamin Tsofa, Edwine Barasa
Background : Decentralization of health systems has made sub-national/regional healthcare systems the backbone of healthcare delivery. These regions are tasked with the difficult responsibility of determining healthcare priorities and resource allocation amidst scarce resources. We aimed to review empirical literature that evaluated priority setting practice at the meso level of health systems. Methods : We systematically searched PubMed, ScienceDirect and Google scholar databases and supplemented these with manual searching for relevant studies, based on the reference list of selected papers...
2018: Wellcome Open Research
https://www.readbyqxmd.com/read/29473220/cost-shifting-and-other-perverse-incentives-in-biodiversity-offsetting-in-india
#11
Divya Narain, Martine Maron
Biodiversity offsetting aims to compensate for development-induced biodiversity loss through commensurate conservation gains and is gaining traction among governments and businesses. However, cost shifting (i.e., diversion of offset funds to other conservation programs) and other perverse incentives can undermine the effectiveness of biodiversity offsetting. Additionality-the requirement that biodiversity offsets result in conservation outcomes that would not have been achieved otherwise-is fundamental to biodiversity offsetting...
February 23, 2018: Conservation Biology: the Journal of the Society for Conservation Biology
https://www.readbyqxmd.com/read/29459365/making-soft-intelligence-hard-a-multi-site-qualitative-study-of-challenges-relating-to-voice-about-safety-concerns
#12
Graham P Martin, Emma-Louise Aveling, Anne Campbell, Carolyn Tarrant, Peter J Pronovost, Imogen Mitchell, Christian Dankers, David Bates, Mary Dixon-Woods
BACKGROUND: Healthcare organisations often fail to harvest and make use of the 'soft intelligence' about safety and quality concerns held by their own personnel. We aimed to examine the role of formal channels in encouraging or inhibiting employee voice about concerns. METHODS: Qualitative study involving personnel from three academic hospitals in two countries. Interviews were conducted with 165 participants from a wide range of occupational and professional backgrounds, including senior leaders and those from the sharp end of care...
February 19, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29458428/a-review-of-promoting-access-to-medicines-in-china-problems-and-recommendations
#13
Jing Sun, Cecile Jia Hu, Mark Stuntz, Hans Hogerzeil, Yuanli Liu
BACKGROUND: Despite recent reforms, distorting funding mechanisms and over-prescribing still maintain severe financial barriers to medicines access in China. Complicated and interrelated problems in the pharmaceutical sector require a common framework to be resolved as fragmented solutions do not work. We present a preliminary assessment of the impact of the national healthcare reforms on access to medicines, and propose policy recommendations for promoting universal access to medicines in China...
February 20, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29427159/can-anticancer-chemotherapy-promote-the-progression-of-brain-metastases
#14
Aymeric Amelot, Louis-Marie Terrier, Bertrand Mathon, Ann-Rose Cook, Jean-Jacques Mazeron, Charles-Ambroise Valery, Philippe Cornu, Marc Leveque, Alexandre Carpentier
Brain metastases natural history from one primary tumor type might be accelerated or favored by using certain systemic chemotherapy. A great deal was described in mice and suggested in human with antiangiogenic drugs, but little is known about the metastatic progression generated by the perverse effect of anticancer drugs. A total of 413 patients who underwent treatment for brain metastasis (2013-2016) were included. The identification of all previous anticancer drugs received by patients from primary tumor diagnosis to brain metastases diagnosis was collated...
February 9, 2018: Medical Oncology
https://www.readbyqxmd.com/read/29410855/modelling-science-trustworthiness-under-publish-or-perish-pressure
#15
David Robert Grimes, Chris T Bauch, John P A Ioannidis
Scientific publication is immensely important to the scientific endeavour. There is, however, concern that rewarding scientists chiefly on publication creates a perverse incentive, allowing careless and fraudulent conduct to thrive, compounded by the predisposition of top-tier journals towards novel, positive findings rather than investigations confirming null hypothesis. This potentially compounds a reproducibility crisis in several fields, and risks undermining science and public trust in scientific findings...
January 2018: Royal Society Open Science
https://www.readbyqxmd.com/read/29382387/hospital-costs-associated-with-psychiatric-comorbidities-a-retrospective-study
#16
Jan Wolff, Thomas Heister, Claus Normann, Klaus Kaier
BACKGROUND: Psychiatric comorbidities are relevant for the diagnostic and therapeutic regimes in somatic hospital care. The main aim of this study was to analyse the association between psychiatric comorbidities and hospital costs per inpatient episode. A further aim was to discuss and address the methodological challenges in the estimation of these outcomes based on retrospective data. METHODS: The study included 338,162 inpatient episodes consecutively discharged between 2011 and 2014 at a German university hospital...
January 30, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29314473/the-extent-and-predictability-of-the-biodiversity-carbon-correlation
#17
LETTER
Moreno Di Marco, James E M Watson, David J Currie, Hugh P Possingham, Oscar Venter
Protecting biomass carbon stocks to mitigate climate change has direct implications for biodiversity conservation. Yet, evidence that a positive association exists between carbon density and species richness is contrasting. Here, we test how this association varies (1) across spatial extents and (2) as a function of how strongly carbon and species richness depend on environmental variables. We found the correlation weakens when moving from larger extents, e.g. realms, to narrower extents, e.g. ecoregions. For ecoregions, a positive correlation emerges when both species richness and carbon density vary as functions of the same environmental variables (climate, soil, elevation)...
March 2018: Ecology Letters
https://www.readbyqxmd.com/read/29302610/what-theory-for-whom-and-in-which-context-reflections-on-the-application-of-theory-in-the-development-and-evaluation-of-complex-population-health-interventions
#18
Graham F Moore, Rhiannon E Evans
Recent years have seen a growing emphasis on the value of building and testing middle range theory throughout the development and evaluation of complex population health interventions. We agree that a coherent theoretical basis for intervention development, and use of evaluation to test key causal assumptions and build theory, are crucial. However, in this editorial, we argue that such recommendations have often been operationalised in somewhat simplistic terms with potentially perverse consequences, and that an uncritical assumption that an intervention explicitly based on theory is inherently superior carries significant risks...
December 2017: SSM—Population Health
https://www.readbyqxmd.com/read/29127849/quasi-experimental-evidence-on-tobacco-tax-regressivity
#19
Steven F Koch
Tobacco taxes are known to reduce tobacco consumption and to be regressive, such that tobacco control policy may have the perverse effect of further harming the poor. However, if tobacco consumption falls faster amongst the poor than the rich, tobacco control policy can actually be progressive. We take advantage of persistent and committed tobacco control activities in South Africa to examine the household tobacco expenditure burden. For the analysis, we make use of two South African Income and Expenditure Surveys (2005/06 and 2010/11) that span a series of such tax increases and have been matched across the years, yielding 7806 matched pairs of tobacco consuming households and 4909 matched pairs of cigarette consuming households...
January 2018: Social Science & Medicine
https://www.readbyqxmd.com/read/29113611/the-added-value-of-integrate-hta-guidance-in-the-work-processes-of-health-technology-assessment-agencies
#20
Gert Jan van der Wilt, Wietske Kievit, Wija Oortwijn
A central idea underlying the INTEGRATE-HTA project is that many of the interventions that are being used in health care are quite complex. By this, we mean that the relation between the delivery of the intervention on the one hand, and the onset of (desired and undesired) changes may be less straightforward than hoped for. There may be all sorts of reasons for this, varying from a lack of resources, lack of skills, perverse incentives, organizational problems, etc. Not identifying such factors and their potential impact may seriously compromise the policy relevance of a health technology assessment (HTA) (1)...
January 2017: International Journal of Technology Assessment in Health Care
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