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https://www.readbyqxmd.com/read/28092107/rsv-associated-hospitalizations-in-children-in-karachi-pakistan-implications-for-vaccine-prevention-strategies
#1
Asad Ali, Mohammad Tahir Yousafzai, Rabbia Waris, Fatima Jafri, Fatima Aziz, Imran Naeem Abbasi, Anita Zaidi
Major progress is being made in vaccines against Respiratory Syncytial Virus (RSV), with multiple vaccine candidates currently in the clinical phase of development. Making an investment case for public sector financing of RSV vaccine will require estimation of burden, cost-effectiveness and impact. The aim of this study is to determine the proportion, age distribution and clinical spectrum of RSV associated hospitalizations in children in Karachi, Pakistan. A three years prospective study was conducted at the Aga Khan University hospital in Karachi, a city of 20 million in south Pakistan, from August 2009 to June 2012...
January 16, 2017: Journal of Medical Virology
https://www.readbyqxmd.com/read/28071952/the-decline-of-elective-operating-at-major-trauma-centres
#2
A Memarzadeh, H Taki, E K Tissingh, P Hull
INTRODUCTION Major trauma is a leading cause of death in those aged under 40 years. In order to improve the care for multiply injured patients, the major trauma network was activated in April 2012 in England. Its goal was to link all district hospitals to major trauma centres (MTCs) and allow for rapid transfer of patients. Anecdotally, this has affected elective orthopaedic operating at MTCs. The aim of this study was to compare the number of lower limb arthroplasty procedures performed before and after the establishment of the trauma network...
January 10, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28060238/single-institution-early-experience-with-the-bundled-payments-for-care-improvement-initiative
#3
Richard Iorio, Joseph Bosco, James Slover, Yousuf Sayeed, Joseph D Zuckerman
The Centers for Medicare & Medicaid Services (CMS) implemented the Bundled Payments for Care Improvement (BPCI) initiative in 2011. Through BPCI, organizations enlisted into payment agreements that include both performance and financial accountability for episodes of care. To succeed, BPCI requires quality maintenance and care delivery at lower costs. This necessitates physicians and hospitals to merge interests. Orthopaedic surgeons must assume leadership roles in cost containment, surgical safety, and quality assurance to deliver cost-effective care...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28050680/combined-social-and-private-health-insurance-versus-catastrophic-out-of-pocket-payments-for-private-hospital-care-in-greece
#4
Nikolaos Grigorakis, Christos Floros, Haritini Tsangari, Evangelos Tsoukatos
The high level of out of pocket (OOP) payments constitutes a major concern for Greece and several other European and OECD countries as a result of the significant down turning of their public health finances due to the 2008 financial crisis. The basic objective of this study is to provide empirical evidence on the effect of combining social health insurance (SHI) and private health insurance (PHI) on OOP payments. Further, this study examines the catastrophic impact of OOP payments on insured's welfare using the incidence and intensity methodological approach of measuring catastrophic health care expenditures...
January 3, 2017: Int J Health Econ Manag
https://www.readbyqxmd.com/read/28028130/does-tax-based-health-financing-offer-protection-from-financial-catastrophe-findings-from-a-household-economic-impact-survey-of-ischaemic-heart-disease-in-malaysia
#5
Surianti Sukeri, Masoud Mirzaei, Stephen Jan
BACKGROUND: Malaysia is an upper-middle income country with a tax-based health financing system. Health care is relatively affordable, and safety nets are provided for the needy. The objectives of this study were to determine the out-of-pocket health spending, proportion of catastrophic health spending (out-of-pocket spending >40% of non-food expenditure), economic hardship and financial coping strategies among patients with ischaemic heart disease (IHD) in Malaysia under the present health financing system...
January 2017: International Health
https://www.readbyqxmd.com/read/28025323/role-of-emerging-private-hospitals-in-a-post-soviet-mixed-health-system-a-mixed-methods-comparative-study-of-private-and-public-hospital-inpatient-care-in-mongolia
#6
Uranchimeg Tsevelvaanchig, Hebe Gouda, Peter Baker, Peter S Hill
BACKGROUND: The collapse of the Soviet Union in 1990 severely impacted the health sector in Mongolia. Limited public funding for the post-Soviet model public system and a rapid growth of poorly regulated private providers have been pressing issues for a government seeking to re-establish universal health coverage. However, the evidence available on the role of private providers that would inform sector management is very limited. This study analyses the current contribution of private hospitals in Mongolia for the improvement of accessibility of health care and efficiency...
December 26, 2016: Health Policy and Planning
https://www.readbyqxmd.com/read/28024239/hospitals-as-complex-adaptive-systems-a-case-study-of-factors-influencing-priority-setting-practices-at-the-hospital-level-in-kenya
#7
Edwine W Barasa, Sassy Molyneux, Mike English, Susan Cleary
There is a dearth of literature on priority setting and resource allocation (PSRA) practices in hospitals, particularly in low and middle income countries (LMICs). Using a case study approach, we examined PSRA practices in 2 public hospitals in coastal Kenya. We collected data through a combination of in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), review of documents such as hospital plans and budgets, minutes of meetings and accounting records, and non-participant observations of PSRA practices in case study hospitals over a period of 7 months...
December 20, 2016: Social Science & Medicine
https://www.readbyqxmd.com/read/28003942/clinical-usage-and-economic-effectiveness-of-a-recently-developed-epidermal-autograft-harvesting-system-in-13-chronic-wound-patients-in-a-university-based-wound-center
#8
Angela Hulsey, Paul Linneman, Jeff Litt
INTRODUCTION:  Chronic wounds are a significant healthcare problem in the United States. Their costs approach 25 billion dollars in the United States. Current wound-care treatments of local wound care, moist dressings, and source control, while necessary for wound healing, are frequently not enough to ensure complete wound closure. The current surgical technique of split-thickness skin grafting is an operative procedure, painful, time-consuming, and leaves significant donor site wounds...
November 14, 2016: Curēus
https://www.readbyqxmd.com/read/27995269/-new-legal-regulations-for-palliative-care-with-implications-for-politics-and-practice
#9
Heiner Melching
In December 2015 two different laws were adopted. Both are of importance for palliative care. One of the laws criminalizes commercial, "business-like" assisted suicide (§ 217 German Criminal Code), the other one aims to improve hospice and palliative care in Germany. Through the latter far-reaching changes in Social Code Books V and XI, as well as of the Hospital Finance Act have been made. This new Act to Improve Hospice and Palliative Care (HPG) focuses, amongst others, on: (a) Better funding of hospice services, by raising the minimum grant for patients in inpatient hospices paid per day by the health insurance funds by about 28...
January 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/27993960/patterns-of-informal-patient-payments-in-bulgaria-hungary-and-ukraine-a-comparison-across-countries-years-and-type-of-services
#10
Tetiana Stepurko, Milena Pavlova, Irena Gryga, Péter Gaál, Wim Groot
Informal payments for health care are a well-known phenomenon in many health care systems around the world. While informal payments could be an important source of health care financing, they have an adverse impact on efficiency and access to care, and are a major impediment to ongoing health care reforms. This paper aims to study the scale and patterns of informal patient payments for out-patient and in-patient services in three former-socialist countries: Bulgaria, Hungary and Ukraine. The data are collected in 2010 and 2011 based on national representative samples and are analysed in pooled models to explain variations in payments...
December 19, 2016: Health Policy and Planning
https://www.readbyqxmd.com/read/27991985/-administrative-efficiency-in-the-mexican-fund-for-the-prevention-of-catastrophic-expenditures-in-health
#11
Emanuel Orozco-Núñez, Jaqueline Alcalde-Rabanal, Juan Navarro, Rafael Lozano
Objective: To show that the administrative regime of specialized hospitals has some influence on the administrative processes to operate the Mexican Fund for Catastrophic Expenditures in Health (FPGC, in Spanish), for providing health care to breast cancer, cervical cancer and child leukemia. Materials and methods: The variable for estimating administrative efficiency was the time estimated from case notification to reimbursement. For its estimation, semistructured interviews were applied to key actors involved in management of cancer care financed by FPGC...
September 2016: Salud Pública de México
https://www.readbyqxmd.com/read/27983624/sharing-the-load-amish-healthcare-financing
#12
Kristyn Rohrer, Lauren Dundes
When settling healthcare bills, the Old Order Amish of Lancaster County, Pennsylvania rely on an ethos of mutual aid, independent of the government. Consonant with this philosophy, many Amish do not participate in or receive benefits from Social Security or Medicare. They are also exempted from the Affordable Care Act of 2010. This study expands the limited documentation of Amish Hospital Aid, an Amish health insurance program that covers major medical costs. Interview data from 11 Amish adults in Lancaster County depict how this aid program supplements traditional congregational alms coverage of medical expenses...
December 14, 2016: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/27968875/attitudes-to-personalised-versus-standardised-practice-in-traditional-chinese-medicine-a-national-cross-sectional-survey-of-practitioners-in-china
#13
Mengyu Liu, Chi Zhang, Qinglin Zha, Wei Yang, Ya Yuwen, Linda Zhong, Zhaoxiang Bian, Xuejie Han, Aiping Lu
BACKGROUND: Critics argue that traditional Chinese medicine should focus on a personalised patient experience, and that standardised practices risk killing the traditional art. The development of clinical practice guidelines (CPGs) for Chinese medicine, which began 30 years ago, has risen remarkably over the years. However, for individual practitioners for whom these guidelines are recommended, the impact of the CPGs on clinical practice and their acceptability remain unknown. The aim of this study was to investigate acceptability of standardisation guidelines in traditional Chinese medicine practitioners in China, and the effect of CPGs on clinical practice...
October 2016: Lancet
https://www.readbyqxmd.com/read/27966310/lung-transplantation-in-turkey-lessons-from-surgeons-and-pulmonologists
#14
Gül Dabak, Levent Dalar, Erdal Taşçı, Stephen Clark
BACKGROUND/AIM: In order to actualize an efficient lung transplantation program, it is necessary to determine priorities and set up strategies. This study aimed to estimate the present situation in Turkey by determining the level of interest and knowledge of pulmonologists and thoracic surgeons regarding lung transplantation. MATERIALS AND METHODS: A questionnaire was prepared to establish the level of interest and knowledge of physicians on lung transplantation...
November 17, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/27935801/maternal-and-neonatal-health-impact-of-obstetrical-risk-insurance-scheme-in-mauritania-a-quasi-experimental-before-and-after-study
#15
Aline Philibert, Marion Ravit, Valéry Ridde, Inès Dossa, Emmanuel Bonnet, Florent Bedecarrats, Alexandre Dumont
A variety of health financing schemes shaped on pre-payment scheme have been implemented across Sub-Saharan Africa (SSA) to address the Millennium Development Goals (MDGs). In Mauritania, the Obstetric Risk Insurance package (ORI) focusing on maternal and perinatal health has been progressively implemented at the health district level since 2002. Here, our main objective was to assess the effectiveness of the ORI in increasing facility-based delivery rates, as well as increases in family planning, antenatal and postnatal care, caesarean delivery and neonatal health, from demographic and health survey data between 2002 and 2011...
October 22, 2016: Health Policy and Planning
https://www.readbyqxmd.com/read/27924740/so-let-me-find-my-way-whatever-it-will-cost-me-rather-than-leaving-myself-in-darkness-experiences-of-glaucoma-in-nigeria
#16
Fatima Kyari, Clare I Chandler, Martha Martin, Clare E Gilbert
BACKGROUND: Blindness from glaucoma is associated with socio-economic deprivation, presumed to reflect poor access to care and poor adherence to treatment. OBJECTIVES: To determine why people with glaucoma are presenting late for treatment and to understand access to glaucoma care. Additionally, we sought to identify what patients and the community know, do and think about the condition and why the poor are the most affected with glaucoma blindness. DESIGN: Study participants were from four communities and two hospitals in Abuja-FCT and Kaduna State, Nigeria...
2016: Global Health Action
https://www.readbyqxmd.com/read/27922910/impact-of-medicare-s-nonpayment-program-on-hospital-acquired-conditions
#17
Caroline P Thirukumaran, Laurent G Glance, Helena Temkin-Greener, Meredith B Rosenthal, Yue Li
BACKGROUND: Medicare's Nonpayment Program of 2008 (hereafter called Program) withholds hospital reimbursement for costs related to hospital-acquired conditions (HACs). Little is known whether a hospital's Medicare patient load [quantified by the hospital's Medicare utilization ratio (MUR), which is the proportion of inpatient days financed by Medicare] influences its response to the Program. OBJECTIVE: To determine whether the Program was associated with changes in HAC incidence, and whether this association varies across hospitals with differential Medicare patient load...
December 5, 2016: Medical Care
https://www.readbyqxmd.com/read/27920316/for-disproportionate-share-hospitals-taxes-and-fees-curtail-medicaid-payments
#18
Robert Nelb, James Teisl, Allen Dobson, Joan E DaVanzo, Lane Koenig
After accounting for supplemental payments, we found that in 2011, disproportionate-share hospitals, on average, received gross Medicaid payments that totaled 108 percent of their costs for treating Medicaid patients but only 89 percent of their costs for Medicaid and uninsured patients combined. However, these payments were reduced by approximately 4-11 percent after we accounted for provider taxes and local government contributions that are used to help finance Medicaid payments.
December 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27917662/validating-a-benchmarking-tool-for-audit-of-early-outcomes-after-operations-for-head-and-neck-cancer
#19
D Tighe, I Sassoon, M McGurk
INTRODUCTION In 2013 all UK surgical specialties, with the exception of head and neck surgery, published outcome data adjusted for case mix for indicator operations. This paper reports a pilot study to validate a previously published risk adjustment score on patients from separate UK cancer centres. METHODS A case note audit was performed of 1,075 patients undergoing 1,218 operations for head and neck squamous cell carcinoma under general anaesthesia in 4 surgical centres. A logistic regression equation predicting for all complications, previously validated internally at sites A-C, was tested on a fourth external validation sample (site D, 172 operations) using receiver operating characteristic curves, Hosmer-Lemeshow goodness of fit analysis and Brier scores...
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27904842/the-challenges-of-cardiothoracic-surgery-practice-in-nigeria-a-12-years-institutional-experience
#20
Bode Falase, Michael Sanusi, Adeola Animasahun, Ogadinma Mgbajah, Adetinuwe Majekodunmi, Onyekwelu Nzewi, Jonathan Nwiloh, David Oke
BACKGROUND: Although the specialty of cardiothoracic surgery has been practiced in Nigeria for many years, open heart surgery (OHS) has only in the last decade become relatively more frequent, mainly through visiting foreign cardiac surgical teams. At this early phase of development it is faced with multiple challenges, especially financing and local skilled manpower for which solutions have to be identified in order to ensure sustainability and future growth. This study is aimed at highlighting these obstacles to growth of cardiothoracic surgery based on our own institutional experience at Lagos State University Teaching Hospital (LASUTH) and the current status of OHS activity in other cardiothoracic centers in Nigeria...
October 2016: Cardiovascular Diagnosis and Therapy
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