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https://www.readbyqxmd.com/read/28820648/natural-bioactive-food-components-for-improving-enteral-tube-feeding-tolerance-in-adult-patient-populations
#1
Adam J Kuchnia, Beth Conlon, Norman Greenberg
Tube feeding (TF) is the most common form of nutrition support. In recent years, TF administration has increased among patient populations within and outside hospital settings, in part due to greater insurance coverage, reduced use of parenteral nutrition, and improved formularies suitable for sole source nutrition. With increasing life expectancy and improved access to TFs, the number of adults dependent on enteral nutrition is expected to grow. However, enteral TF intolerance (ETFI) is the most common complication of TFs, typically presenting with at least 1 adverse gastrointestinal event, including nausea, diarrhea, and constipation...
August 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28819474/expanding-health-insurance-scheme-in-the-informal-sector-in-nigeria-awareness-as-a-potential-demand-side-tool
#2
David Ayobami Adewole, Saidat Abisola Akanbi, Kayode Omoniyi Osungbade, Segun Bello
INTRODUCTION: The implementation and expansion of a health insurance scheme in the informal sector, particularly in developing countries, is a challenge. With the aid of an innovative Information-Education and Communication model, titled 'Understanding the concept of health insurance: An innovative social marketing tool', an assessment of the awareness and perception of the scheme among market women was carried out. METHODS: This is a cross-sectional descriptive survey, carried out among market women in Ibadan, Nigeria...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28817783/the-association-between-insurance-type-and-cost-related-delay-in-care-a-survey
#3
Sora Al Rowas, Michael B Rothberg, Benjamin Johnson, Joel Miller, Mohanad AlMahmoud, Jennifer Friderici, Sarah L Goff, Tara Lagu
OBJECTIVES: Massachusetts has insurance rates similar to those projected under the Affordable Care Act, but many of the state's patients are insured through private insurance plans with high out-of-pocket costs. We aimed to explore the relationship between insurance type (private vs public) and delays in care due to cost, stratified by income. STUDY DESIGN: Cross-sectional study. METHODS: We conducted a study of English-speaking adults recruited from the waiting rooms of the emergency department or outpatient clinics of a large healthcare system in western Massachusetts...
July 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28817334/community-health-worker-support-for-disadvantaged-patients-with-multiple-chronic-diseases-a-randomized-clinical-trial
#4
Shreya Kangovi, Nandita Mitra, David Grande, Hairong Huo, Robyn A Smith, Judith A Long
OBJECTIVES: To determine whether a community health worker (CHW) intervention improved outcomes in a low-income population with multiple chronic conditions. METHODS: We conducted a single-blind, randomized clinical trial in Philadelphia, Pennsylvania (2013-2014). Participants (n = 302) were high-poverty neighborhood residents, uninsured or publicly insured, and diagnosed with 2 or more chronic diseases (diabetes, obesity, tobacco dependence, hypertension). All patients set a disease-management goal...
August 17, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28817302/comparative-effectiveness-and-costs-of-insulin-pump-therapy-for-diabetes
#5
Ronald T Ackermann, Amisha Wallia, Raymond Kang, Andrew Cooper, Theodore A Prospect, Lewis G Sandy, Deneen Vojta
OBJECTIVES: Continuous subcutaneous insulin infusion (CSII), or "insulin pump" therapy, is an alternative to multiple daily insulin injections (MDII) for management of diabetes. This study evaluates patterns of healthcare utilization, costs, and blood glucose control for patients with diabetes who initiate CSII. STUDY DESIGN: Pre-post with propensity-matched comparison design involving commercially insured US adults (aged 18-64 years) with insulin-requiring diabetes who transitioned from MDII to CSII between July 1, 2009, and June 30, 2012 ("CSII initiators"; n = 2539), or who continued using MDI (n = 2539)...
June 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28816637/the-impact-of-exceeding-tanf-time-limits-on-the-access-to-healthcare-of-low-income-mothers
#6
Kimberly Narain, Susan Ettner
The objective of this article is to estimate the relationship of exceeding Temporary Assistance for Needy Families (TANF) time limits, with health insurance, healthcare, and health outcomes. The authors use Heckman selection models that exploit variability in state time-limit duration and timing of policy implementation as identifying exclusion restrictions to adjust the effect estimates of exceeding time limits for possible correlations between the probability of exceeding time limits and unobservable factors influencing the outcomes...
August 17, 2017: Social Work in Public Health
https://www.readbyqxmd.com/read/28816532/comparing-clinical-outcomes-and-costs-for-different-treatment-intensification-approaches-in-patients-with-type-2-diabetes-uncontrolled-on-basal-insulin-adding-glucagon-like-peptide-1-receptor-agonists-vs-adding-rapid-acting-insulin-or-increasing-basal-insulin
#7
Philip Levin, Tao Fan, Xue Song, Damion Nero, Brian Davis, Bong-Chul Chu
Objective-Not all patients with type 2 diabetes achieve the recommended glycated hemoglobin A1c (A1C) levels after adequate titration of basal insulin (BI). Current intensification approaches include addition of rapid-acting insulin (RAI) or a glucagon-like peptide-1 receptor agonist (GLP-1 RA), but it is not clear which strategy results in better long-term outcomes. Methods-This retrospective analysis of health insurance claims data in the US MarketScan database compared glycemic control and healthcare resource utilization and costs 12 months after adding GLP-1 RA to BI vs adding RAI or increasing BI doses...
August 17, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28816219/primary-or-specialist-medical-care-which-is-more-equitable-a-policy-brief
#8
Prasanta Mahapatra, Sanjeev Upadhyaya, G Surendra
BACKGROUND: Equity in health and equitable access to healthcare has been at the core of health policy in India. The key policy challenge has been how to make that possible? Various health insurance schemes such as the Rashtriya Swasthya Bima Yojana and Arogyasri seek to improve poor people's access to specialist medical care in the public and private sectors. On the other hand, access to primary medical care has been left to the supply side interventions. METHODS: We did a focused review of evidence on equity aspects of primary medical care versus specialist medical care...
March 2017: National Medical Journal of India
https://www.readbyqxmd.com/read/28815608/factors-associated-with-patient-no-show-rates-in-an-academic-otolaryngology-practice
#9
Caitlin E Fiorillo, Allyson L Hughes, Chen I-Chen, Philip M Westgate, Thomas J Gal, Matthew L Bush, Brett T Comer
OBJECTIVES/HYPOTHESIS: Factors affecting access to healthcare is an expanding area of research. This study seeks to identify factors associated with no-show rates in an academic otolaryngology practice to improve clinical efficiency and patient access to care. STUDY DESIGN: Retrospective review. METHODS: A retrospective review of scheduled clinical appointments from February 1, 2015 to January 30, 2016 at a single academic otolaryngology department was performed...
August 16, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28814345/hospital-characteristics-related-to-the-hospital-length-of-stay-among-inpatients-receiving-invasive-cervical-discectomy-due-to-road-traffic-accidents-under-automobile-insurance-in-south-korea
#10
Kyoung Won Shin, Hyo Jung Lee, Chung Mo Nam, Ki Tae Moon, Eun-Cheol Park
BACKGROUND: In South Korea, people injured in road traffic accidents receive compensation for medical costs through their automobile insurance. However, the automobile insurance system appears to manage health care inefficiently. This study aimed to investigate the factors associated with the hospital length of stay (LOS), which was used as an indicator of healthcare utilization, for inpatients covered by automobile insurance and undergoing invasive cervical discectomy. METHODS: Insurance claims data from 158 hospitals were used...
August 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28813219/association-of-reference-pricing-with-drug-selection-and-spending
#11
James C Robinson, Christopher M Whaley, Timothy T Brown
Background In the United States, prices for therapeutically similar drugs vary widely, which has prompted efforts by public and private insurers to steer patients toward the lower-priced options. Under reference pricing, the insurer or employer establishes a maximum contribution it will make toward the price of a drug or procedure, and the patient pays the remainder. Methods We used difference-in-differences multivariable regression methods to analyze changes in prescriptions and pricing for 1302 drugs in 78 therapeutic classes in the United States, before and after implementation of reference pricing by an alliance of private employers...
August 17, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28813166/are-inner-city-children-with-asthma-receiving-specialty-care-as-recommended-in-national-asthma-guidelines
#12
Karen L Warman, Ellen J Silver
OBJECTIVE: To examine whether children with asthma in an urban healthcare network are receiving asthma specialty care, and which factors, if any, are associated with receipt of this care, including: child's racial/ethnic group, age, socio-economic status (SES), insurance, and/or acute care utilization. METHODS: This study is a retrospective cohort study of children ages 7- 17 years old who received primary care in an urban medical center in 2012 and had a primary or secondary ICD9 code for asthma...
August 16, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28812813/do-management-and-leadership-practices-in-the-context-of-decentralisation-influence-performance-of-community-health-fund-evidence-from-iramba-and-iringa-districts-in-tanzania
#13
Chakupewa Joseph, Stephen Oswald Maluka
BACKGROUND: In early 1990s, Tanzania like other African countries, adopted health sector reform (HSR). The most strongly held centralisation system that informed the nature of services provision including health was, thus, disintegrated giving rise to decentralisation system. It was within the realm of HSR process, user fees were introduced in the health sector. Along with user fees, various types of health insurances, including the Community Health Fund (CHF), were introduced. While the country's level of enrolment in the CHF is low, there are marked variations among districts...
September 26, 2016: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/28810129/opioid-prescribing-for-chronic-pain-in-a-community-based-healthcare-system
#14
Robert J Romanelli, Laurence I Ikeda, Braden Lynch, Terri Craig, Joseph C Cappelleri, Trevor Jukes, Denis Y Ishisaka
OBJECTIVES: We sought to evaluate opioid prescribing in an ambulatory setting among patients with noncancer chronic pain (CP). STUDY DESIGN: Cross-sectional analysis. METHODS: We identified patients with at least 2 CP encounters at least 30 days apart in 2012 in the electronic health records of a community-based healthcare delivery system in northern California. We used logistic regression models to assess associations of receiving an opioid prescription with respect to number and type of CP conditions and patient demographics and characteristics...
May 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28809615/does-access-to-private-healthcare-influence-potential-lung-cancer-cure-rates
#15
Thadathilankal-Jess John, Dante Plekker, Elvis M Irusen, Coenie F N Koegelenberg
BACKGROUND: Numerous studies show a link between poor socioeconomic status (SES) and late-stage cancer diagnosis. However, this has not been consistently shown looking at non-small-cell lung cancer (NSCLC) in isolation. Despite the extremely high prevalence of lung cancer and disparities in access to healthcare based on health insurance in South Africa, there is a paucity of data on the influence of health insurance (as a surrogate for SES) on stage at presentation of NSCLC. OBJECTIVE: To assess the relationship between health insurance status (and invariably SES) and staging (and therefore resectability) of patients with primary NCSLC at the time of initial presentation...
July 28, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28808427/public-engagement-in-setting-healthcare-priorities-a-ranking-exercise-in-cyprus
#16
Antonis Farmakas, Mamas Theodorou, Petros Galanis, Georgios Karayiannis, Stefanos Ghobrial, Nikos Polyzos, Evridiki Papastavrou, Eirini Agapidaki, Kyriakos Souliotis
BACKGROUND: In countries such as Cyprus the financial crisis and the recession have severely affected the funding and priority setting of the health care system. There is evidence highlighting the importance of population' preferences in designing priorities for health care settings. Although public preferences have been thorough analysed in many countries, there is a research gap in terms of simultaneously investigating the relative importance and the weight of differing and competing criteria for determining healthcare priority settings...
2017: Cost Effectiveness and Resource Allocation: C/E
https://www.readbyqxmd.com/read/28806455/association-of-state-access-standards-with-accessibility-to-specialists-for-medicaid-managed-care-enrollees
#17
Chima D Ndumele, Michael S Cohen, Paul D Cleary
Importance: Medicaid recipients have consistently reported less timely access to specialists than patients with other types of coverage. By 2018, state Medicaid agencies will be required by the Center for Medicare and Medicaid Services (CMS) to enact time and distance standards for managed care organizations to ensure an adequate supply of specialist physicians for enrollees; however, there have been no published studies of whether these policies have significant effects on access to specialty care...
August 14, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28804011/functional-outcomes-subsequent-healthcare-utilization-and-mortality-of-stroke-postacute-care-patients-in-taiwan-a-nationwide-propensity-score-matched-study
#18
Li-Ning Peng, Wan-Hsuan Lu, Chih-Kuang Liang, Ming-Yueh Chou, Chih-Ping Chung, Shu-Ling Tsai, Zhi-Jun Chen, Fei-Yuan Hsiao, Liang-Kung Chen
OBJECTIVE: To evaluate the benefits of the national stroke postacute care (PAC) program on clinical outcomes and subsequent healthcare utilization. DESIGN: Propensity score-matched case-control study using the National Health Insurance data. PARTICIPANTS: A total of 1480 stroke cases receiving PAC services and 3159 matched controls with similar stroke severity but without PAC services. MEASUREMENTS: Demographic characteristics, functional outcomes (modified Rankin Scale, Barthel Index, Lawton-Brody Instrumental Activities of Daily Living, Functional Oral Intake Scale, Mini-Nutritional Assessment, Berg Balance Test, Usual Gait Speed Test, 6-Minute Walk Test, Fugl-Meyer Assessment (modified sensation and motor), Mini-Mental State Examination, Motor Activity Log, and the Concise Chinese Aphasia Test), subsequent healthcare utilization (90-day stroke re-admission and emergency department visits), and 90-day mortality...
August 10, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28803076/palliative-care-in-vietnam-long-term-partnerships-yield-increasing-access
#19
Eric L Krakauer, Dang Huy Quoc Thinh, Quach Thanh Khanh, Hoang Thi Mong Huyen, Tran Diep Tuan, Than Ha Ngoc The, Do Duy Cuong, Tran Van Thuan, Nguyen Phi Yen, Pham Van Anh, Nguyen Thi Phuong Cham, Kathleen P Doyle, Nguyen Thi Hai Yen, Luong Ngoc Khue
Palliative care began in Vietnam in 2001, but steady growth in palliative care services and education commenced several years later when partnerships for ongoing training and technical assistance by committed experts were created with the Ministry of Health (MoH), major public hospitals, and medical universities. An empirical analysis of palliative care need by the MoH in 2006 was followed by national palliative care clinical guidelines, initiation of clinical training for physicians and nurses, and revision of opioid prescribing regulations...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28801816/are-tkas-performed-in-high-volume-hospitals-less-likely-to-undergo-revision-than-tkas-performed-in-low-volume-hospitals
#20
Elke Jeschke, Mustafa Citak, Christian Günster, Andreas Matthias Halder, Karl-Dieter Heller, Jürgen Malzahn, Fritz Uwe Niethard, Peter Schräder, Josef Zacher, Thorsten Gehrke
BACKGROUND: High-volume hospitals have achieved better outcomes for THAs and unicompartmental knee arthroplasties (UKAs). However, few studies have analyzed implant survival after primary TKA in high-volume centers. QUESTIONS/PURPOSES: Is the risk of revision surgery higher when receiving a TKA in a low-volume hospital than in a high-volume hospital? METHODS: Using nationwide billing data of the largest German healthcare insurer for inpatient hospital treatment, we identified 45,165 TKAs in 44,465 patients insured by Allgemeine Ortskrankenkasse who had undergone knee replacement surgery between January 2012 and December 2012...
August 11, 2017: Clinical Orthopaedics and related Research
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