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https://www.readbyqxmd.com/read/27922910/impact-of-medicare-s-nonpayment-program-on-hospital-acquired-conditions
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/27870546/integrated-care-organizations-medicare-financing-for-care-at-home
#5
Karen Davis, Amber Willink, Cathy Schoen
OBJECTIVES: As the boomer population ages, there is a growing need for integrated care organizations (ICOs) that can integrate both medical care and long-term services and supports in the home. This paper presents a policy proposal to support the creation of ICOs, redesign care, and provide financing for home- and community-based services (HCBS), with the goal of enhancing financial protection for beneficiaries, coordinating care, and preventing costly hospital and nursing home use. METHODS: This study used the 2012 Medicare Current Beneficiary Survey (MCBS) Cost and Use File, inflated to 2016 figures, to describe the characteristics of Medicare beneficiaries and their healthcare utilization and spending...
November 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27864361/causes-of-male-infertility-a-9-year-prospective-monocentre-study-on-1737-patients-with-reduced-total-sperm-counts
#6
M Punab, O Poolamets, P Paju, V Vihljajev, K Pomm, R Ladva, P Korrovits, M Laan
STUDY QUESTION: What are the primary causes of severe male factor infertility? SUMMARY ANSWER: Although 40% of all patients showed primary causes of infertility, which could be subdivided into three groups based on the severity of their effect, ~75% of oligozoospermia cases remained idiopathic. WHAT IS KNOWN ALREADY: There are few large-scale epidemiological studies analyzing the causes of male factor infertility. STUDY DESIGN, SIZE, DURATION: A prospective clinical-epidemiological study was conducted at the Andrology Centre, Tartu University Hospital between 2005 and 2013, recruiting male partners of couples failing to conceive a child for over ≥12 months...
November 17, 2016: Human Reproduction
https://www.readbyqxmd.com/read/27846670/-identification-of-control-hospitals-for-the-implementation-of-the-nationwide-and-standardized-evaluation-of-model-projects-according-to-%C3%A2-%C3%A2-64b-sgb-v-analysis-of-data-from-structured-quality-reports
#7
T Petzold, A Neumann, M Seifert, D Küster, A Pfennig, J Weiß, D Häckl, E Swart, J Schmitt
Background: Health care needs of mentally ill patients make special demands on cross-sectoral health care structures. § 64b SGB V enables care of mentally ill patients through model projects that are multi-professional, work across treatment periods and sectors and implement new forms of financing. These model projects in their hospitals (case hospitals) need to be evaluated and compared with standard treatment methods. Objectives: The aim of this analysis is to identify matching hospitals according to a priori defined criteria for the establishment of a control group (control hospitals) using secondary data...
November 15, 2016: Das Gesundheitswesen
https://www.readbyqxmd.com/read/27843843/out-of-pocket-expenditure-on-surgical-and-nonsurgical-conditions-in-odisha
#8
Sarit Kumar Rout, Kirti Sundar Sahu, Subhashisa Swain, Sanghamitra Pati
BACKGROUND: Out of pocket expenditure (OOPE) for any illness is still a major problem in India. Several evidence is available regarding growing OOPE and its impact on household poverty. However, limited evidence is there regarding OOPE on multiple disease conditions in public hospitals. AIM: To estimate the OOPE for various hospitalized conditions at the secondary level of care in Odisha and find out various financial coping mechanisms adopted by the patients. METHODS: The primary survey was done in the secondary care hospitals in the two districts of Odisha using a semi-structured interview schedule...
April 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/27825187/-exposure-to-limited-resources-in-the-gastroenterology-results-of-a-survey-of-hospital-physicians
#9
L Kerkemeyer, A Reifferscheid, N Pomorin, J Wasem
Background and research question: The hospital sector is currently characterized by a high economic pressure. As well the DRG system as the investment financing by the federal states imply financial limitations. Hospitals react to this situation by trying to reduce costs and to increase case volume. It is questionable whether and to what extent patient care and the working conditions of the physicians are affected by these circumstances. Especially, gastroenterological patients were considered to be insufficiently covered by the DRG system in the past...
November 2016: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/27821398/participation-of-a-coordinating-center-pharmacy-in-a-multicenter-international-study
#10
Jihyun Esther Jeon, Janet Mighty, Karen Lane, Nichol McBee, Ryan Majkowski, Steven Mayo, Daniel Hanley
PURPOSE: The activities of a coordinating center pharmacy (CCP) supporting a multicenter, international clinical trial are described. SUMMARY: Serving in a research support role comparable to that of a commercial clinical trial supply company, a CCP within the Johns Hopkins Hospital Investigational Drug Service (JHH IDS) uses its management expertise and infrastructure to support multicenter trials, such as the recently completed Clot Lysis: Evaluating Accelerated Resolution of Intraventricular Hemorrhage, Phase III (CLEAR III) trial...
November 15, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27798047/common-diseases-as-determinants-of-menopausal-age
#11
Jingmei Li, Mikael Eriksson, Kamila Czene, Per Hall, Kenny A Rodriguez-Wallberg
STUDY QUESTION: Can the diagnosis of common diseases before menopause influence age at natural menopause (ANM) onset? SUMMARY ANSWER: Polycystic ovary syndrome (PCOS) and depression were observed to delay menopause. WHAT IS KNOWN ALREADY: It has been observed that women who undergo early menopause experience a higher burden of health problems related to metabolic syndromes, heart disease and depression, but whether ANM can be influenced by common adult diseases has not been studied extensively...
October 18, 2016: Human Reproduction
https://www.readbyqxmd.com/read/27794071/treating-dehydration-at-home-avoids-healthcare-costs-associated-with-emergency-department-visits-and-hospital-readmissions-for-adult-patients-receiving-home-parenteral-support
#12
Denise Konrad, Scott Roberts, Mandy L Corrigan, Cindy Hamilton, Ezra Steiger, Donald F Kirby
BACKGROUND: Administration of home parenteral support (HPS) has proven to be cost-effective over hospital care. Avoiding hospital readmissions became more of a focus for healthcare institutions in 2012 with the implementation of the Affordable Care Act. In 2010, our service developed a protocol to treat dehydration at home for HPS patients by ordering additional intravenous fluids to be kept on hand and to focus patient education on the symptoms of dehydration. METHODS: A retrospective analysis was completed through a clinical management database to identify HPS patients with dehydration...
October 28, 2016: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/27793760/surgery-for-degenerative-cervical-myelopathy-a-patient-centered-quality-of-life-and-health-economic-evaluation
#13
Christopher D Witiw, Lindsay A Tetreault, Fabrice Smieliauskas, Branko Kopjar, Eric M Massicotte, Michael G Fehlings
BACKGROUND CONTEXT: Degenerative Cervical Myelopathy (DCM) represents the most common cause of non-traumatic spinal cord impairment in adults. Surgery has been shown to improve neurological symptoms and functional status, but it is costly. As sustainability concerns in the field of healthcare rise, the value of care has come to the forefront of policy decision-making. Evidence for both health related quality of life outcomes and financial expenditures are needed to inform resource allocation decisions...
October 25, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27779283/-towards-a-sustainable-cost-effective-mental-health-care-a-policy-perspective
#14
P P T Jeurissen, B A Ravesteijn, R T J M Janssen, M A C Tanke
After a decade of robust growth in spending, Dutch mental healthcare is on a more stricter budgetary path since 2012. High prevalence of illness and limited spending, imply the need for efficient mental healthcare delivery.<br/> AIM: To advise how mental health care can be managed more efficiently. There will also have to be more differentiation between mild and serious psychiatric illnesses.<br/> METHOD: Review of academic articles and policy studies.<br/> RESULTS: With regard to the treatment of fairly common disorders, more attention needs to be given to integrated basic care and e-health...
2016: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/27767131/the-healthcare-system-and-the-provision-of-oral-healthcare-in-european-union-member-states-part-6-poland
#15
K Malkiewicz, E Malkiewicz, K A Eaton, E Widström
Poland is one of the largest European countries in terms of area and population. The country's economic situation does not allow for the allocation of sufficient public funds for healthcare in general and oral healthcare in particular. The health policy of the state focuses primarily on prophylaxis and treatment of diseases, directly threatening the health and lives of the inhabitants. Currently, expenditure on oral health accounts for only 2.7% of the public funds allocated to healthcare. In this context, providing oral care financed from public funds at an appropriate level constitutes a challenge for state institutions, centres providing medical and dental services and private practices...
October 21, 2016: British Dental Journal
https://www.readbyqxmd.com/read/27766964/adequacy-of-public-maternal-care-services-in-brazil
#16
Sonia Duarte de Azevedo Bittencourt, Rosa Maria Soares Madeira Domingues, Lenice Gnocchi da Costa Reis, Márcia Melo Ramos, Maria do Carmo Leal
BACKGROUND: In Brazil, hospital childbirth care is available to all, but differences in access and quality of care result in inequalities of maternal health. The objective of this study is to assess the infrastructure and staffing of publicly financed labor and birth care in Brazil and its adequacy according to clinical and obstetric conditions potentially associated with obstetric emergencies. METHODS: Nationwide cross-sectional hospital-based study "Birth in Brazil: national survey into labor and birth" conducted in 2011-2012...
October 17, 2016: Reproductive Health
https://www.readbyqxmd.com/read/27758706/self-monitoring-of-blood-glucose-among-patients-with-type-2-diabetes-mellitus-in-eastern-nigeria-need-for-multi-strategic-interventions
#17
Ejiofor T Ugwu, Casmir Jg Orjioke, Ekenechukwu E Young
BACKGROUND: Self monitoring of blood glucose (SMBG) is a useful adjunct to lifestyle modification and medications for optimal management of type 2 diabetes mellitus (DM). This study was aimed at evaluating the practice, cost and associations of SMBG in subjects with type 2 DM in Enugu, Nigeria. METHODS: In a cross-sectional survey conducted at the diabetes clinic in three hospitals, 366 type 2 diabetic subjects aged 18-65 years were consecutively interviewed. Socio-demographic and clinical information were documented and glycated hemoglobin was performed for all the participants...
October 14, 2016: Current Diabetes Reviews
https://www.readbyqxmd.com/read/27752189/exploring-factors-influencing-health-seeking-decisions-and-retention-in-childhood-cancer-treatment-programmes-perspectives-of-parents-in-ghana
#18
Lorna Awo Renner, Deborah McGill
BACKGROUND: Developing countries such as Ghana have very poor childhood cancer survival rates. There is a need to determine reasons for late presentation and treatment abandonment which are major causes of poor survival. Understanding these issues could inform effective strategies for childhood cancer control in resource-constrained settings. AIM: To explore factors influencing parental decision-making for children with cancer in Ghana with regard to health seeking and retention in treatment, in order to provide information that will guide Public Health interventions for childhood cancer control...
September 2016: Ghana Medical Journal
https://www.readbyqxmd.com/read/27748307/impact-of-community-based-health-insurance-in-rural-india-on-self-medication-financial-protection-of-the-insured
#19
David M Dror, Arpita Chakraborty, Atanu Majumdar, Pradeep Panda, Ruth Koren
BACKGROUND & OBJECTIVES: The evidence-base of the impact of community-based health insurance (CBHI) on access to healthcare and financial protection in India is weak. We investigated the impact of CBHI in rural Uttar Pradesh and Bihar s0 tates of India on insured households' self-medication and financial position. METHODS: Data originated from (i) household surveys, and (ii) the Management Information System of each CBHI. Study design was "staggered implementation" cluster randomized controlled trial with enrollment of one-third of the treatment group in each of the years 2011, 2012 and 2013...
June 2016: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/27727384/association-between-the-2014-medicaid-expansion-and-us-hospital-finances
#20
COMPARATIVE STUDY
Fredric Blavin
Importance: The Affordable Care Act expanded Medicaid eligibility for millions of low-income adults. The choice for states to expand Medicaid could affect the financial health of hospitals by decreasing the proportion of patient volume and unreimbursed expenses attributable to uninsured patients while increasing revenue from newly covered patients. Objective: To estimate the association between the Medicaid expansion in 2014 and hospital finances by assessing differences between hospitals in states that expanded Medicaid and in those states that did not expand Medicaid...
October 11, 2016: JAMA: the Journal of the American Medical Association
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