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https://www.readbyqxmd.com/read/29784549/cost-implications-of-varying-the-surgical-technique-surgical-setting-and-anesthesia-type-for-carpal-tunnel-release-surgery
#1
Nikolas H Kazmers, Angela P Presson, Yizhe Xu, Abby Howenstein, Andrew R Tyser
PURPOSE: Carpal tunnel release (CTR) is a common surgical procedure, representing a financial burden to the health care system. The purpose of this study was to test whether the choice of CTR technique (open carpal tunnel release [OCTR] vs endoscopic carpal tunnel release [ECTR]), surgical setting (operating room vs procedure room [PR]), and anesthetic type (local, monitored anesthesia care [MAC], Bier block, general) affected costs or payments. METHODS: Consecutive adult patients undergoing isolated unilateral CTR between July 2014, and October 2017, at a single academic medical center were identified...
May 18, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29784037/pre-and-post-diagnosis-costs-of-tuberculosis-to-patients-on-directly-observed-treatment-short-course-in-districts-of-southwestern-ethiopia-a-longitudinal-study
#2
Abyot Asres, Degu Jerene, Wakgari Deressa
BACKGROUND: Financial burden on tuberculosis (TB) patients results in delayed treatment and poor compliance. We assessed pre- and post-diagnosis costs to TB patients. METHODS: A longitudinal study among 735 new TB cases was conducted from January 2015 through June 2016 in 10 woredas (districts) of southwestern Ethiopia. Direct out-of-pocket, payments, and lost income (indirect cost) were solicited from patients during the first 2 months and at the end of treatment...
May 21, 2018: Journal of Health, Population, and Nutrition
https://www.readbyqxmd.com/read/29783031/a-unique-all-payer-rate-setting-system-controls-the-cost-but-not-the-racial-disparity-in-lower-extremity-revascularization-procedures
#3
Besma Nejim, Robert J Beaulieu, Husain Alshaikh, Mohammed Hamouda, Joseph Canner, Mahmoud B Malas
BACKGROUND: Patients with peripheral arterial disease (PAD) often have high comorbidity burden that may complicate post-interventional course and drive increased healthcare expenditures. Racial disparity had been observed in lower extremity revascularization (LER) patterns and outcomes. In 2014, Maryland adopted an all-payer rate setting system to limit the rising hospitalization costs. This resulted in an aggregate payment system in which hospital compensation takes place as an overall per capita expenditure for hospital services...
May 18, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29781780/physical-therapists-know-function-an-opinion-on-mobility-and-level-of-activity-during-hospitalization-for-adult-inpatients
#4
Audrey M Johnson, Janice Kuperstein, Dana Howell, Esther E Dupont-Versteegden
Negative consequences of immobility during hospitalization are widely known and remain undisputed. Evidence of low mobility for general medicine adult inpatients persists. Patients who experience hospital acquired functional decline due to low mobility require costly post-acute care services. The impact of immobility on post-acute care physical function and quality of life is directly at odds with value-based care. New Medicare payment models emphasize value-based care to promote care improvement and better patient outcomes...
May 21, 2018: Hospital Topics
https://www.readbyqxmd.com/read/29781721/current-prescription-status-of-antihypertensive-drugs-in-japanese-patients-with-hypertension-analysis-by-type-of-comorbidities
#5
Takayuki Ishida, Akinori Oh, Shinzo Hiroi, Yukio Shimasaki, Takuya Tsuchihashi
In 2014, the Japanese Society of Hypertension (JSH) issued revised guidelines for hypertension management. To assess adherence to the guidelines, this retrospective study evaluated the real-world status of antihypertensive drug prescribing for Japanese patients with hypertension, classified by comorbidity: diabetes mellitus, dyslipidemia, gout/hyperuricemia and renal diseases. Data on 59,867 hypertensive patients who received their first prescription for antihypertensive therapy between April 2014 and March 2015, were obtained from a medical insurance claims database for hospitals participating in the Diagnosis Procedure Combination/Per-Diem payment system...
May 21, 2018: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/29780760/has-the-janani-suraksha-yojana-a-conditional-maternity-benefit-transfer-scheme-succeeded-in-reducing-the-economic-burden-of-maternity-in-rural-india-evidence-from-the-varanasi-district-of-uttar-pradesh
#6
Saradiya Mukherjee, Aditya Singh
Background: One of the constraints in the utilisation of maternal healthcare in India is the out-of-pocket expenditure. To improve the utilisation and to reduce the out-of-pocket expenditure, India launched a cash incentive scheme, Janani Suraksha Yojana (JSY), which provides monetary incentive to the mothers delivering in public facility. However, no study has yet examined the extent to which the JSY payments reduce the maternal healthcare induced catastrophic out-of-pocket expenditure burden of the households...
February 5, 2018: Journal of Public Health Research
https://www.readbyqxmd.com/read/29780297/impact-of-osteoarthritis-on-household-catastrophic-health-expenditures-in-korea
#7
Hyoungyoung Kim, Soo-Kyung Cho, Daehyun Kim, Dalho Kim, Sun-Young Jung, Eun Jin Jang, Yoon-Kyoung Sung
Background: Osteoarthritis (OA) is a disease of old age whose prevalence is increasing. This study explored the impact of OA on household catastrophic health expenditure (CHE) in Korea. Methods: We used data on 5,200 households from the Korea Health Panel Survey in 2013 and estimated annual living expenses and out-of-pocket (OOP) payments. Household CHE was defined when a household's total OOP health payments exceeded 10%, 20%, 30%, or 40% of the household's capacity to pay...
May 21, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29779553/social-work-student-and-practitioner-roles-in-integrated-care-settings
#8
Erin P Fraher, Erica Lynn Richman, Lisa de Saxe Zerden, Brianna Lombardi
INTRODUCTION: Social workers are increasingly being deployed in integrated medical and behavioral healthcare settings but information about the roles they fill in these settings is not well understood. This study sought to identify the functions that social workers perform in integrated settings and identify where they acquired the necessary skills to perform them. METHODS: Master of social work students (n=21) and their field supervisors (n=21) who were part of a Health Resources and Services Administration-funded program to train and expand the behavioral health workforce in integrated settings were asked how often they engaged in 28 functions, where they learned to perform those functions, and the degree to which their roles overlapped with others on the healthcare team...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29778507/factors-associated-with-outcomes-and-inpatient-90-day-cost-of-care-in-endometrial-cancer-patients-undergoing-hysterectomy-implications-for-bundled-care-payments
#9
Aimee Rolston, Ryan J Spencer, R Kevin Reynolds, Laurel W Rice, Shitanshu Uppal
OBJECTIVE: To investigate the association of obesity and other comorbidities as well as route of surgery with postoperative outcomes, as well as 30- and 90-day inpatient cost of care after hysterectomy for endometrial cancer. METHODS: From the 2013 National Readmission Database release, patients who underwent hysterectomy for endometrial cancer were included. Obesity was classified as non-obese (body mass index [BMI] < 35 kg/m2 ); class I/II obesity (BMI ≥ 35 but <40 kg/m2 and without obesity related medical condition qualifying it as morbid obesity), class III obesity (BMI ≥ 40 kg/m2 OR BMI ≥ 35 kg/m2 with an obesity-related medical condition)...
May 16, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29777556/electrophysiology-and-structural-interventions-in-adults-with-congenital-heart-disease-comparison-of-combined-versus-separate-procedures
#10
Ian Lindsay, Farnoosh Nik-Ahd, Jamil A Aboulhosn, Jeremy P Moore
BACKGROUND: Electrophysiologic (EP) and structural interventions in adult congenital heart disease (ACHD) are typically completed during separate hospital encounters. With planning/coordination, these cases can be combined. OBJECTIVES: We hypothesized that this integrated approach would yield patient and health system benefits. METHODS: Consecutive ACHD patients undergoing combined interventions were matched to controls with identical but separate procedures...
May 18, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29776596/surgical-procedures-in-health-professional-shortage-areas-impact-of-a-surgical-incentive-payment-plan
#11
Adrian Diaz, Katiuscha Merath, Fabio Bagante, Qinyu Chen, Ozgur Akgul, Eliza Beal, Jay Idrees, Griffin Olsen, Faiz Gani, Timothy M Pawlik
INTRODUCTION: The Affordable Care Act established a Center for Medicare/Medicaid Services based 10% reimbursement bonus for general surgeons in Health Professional Shortage Areas. We sought to assess the impact of the Affordable Care Act Surgery Incentive Payment on surgical procedures performed in Health Professional Shortage Areas. METHODS: Hospital utilization data from the California Office of Statewide Health Planning and Development between January 1, 2006, and December 31, 2015, were used to categorize hospitals according to Health Professional Shortage Area location...
May 15, 2018: Surgery
https://www.readbyqxmd.com/read/29776404/revisiting-out-of-pocket-requirements-trends-in-spending-financial-access-barriers-and-policy-in-ten-high-income-countries
#12
Thomas Rice, Wilm Quentin, Anders Anell, Andrew J Barnes, Pauline Rosenau, Lynn Y Unruh, Ewout van Ginneken
BACKGROUND: Countries rely on out-of-pocket (OOP) spending to different degrees and employ varying techniques. The article examines trends in OOP spending in ten high-income countries since 2000, and analyzes their relationship to self-assessed barriers to accessing health care services. The countries are Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. METHODS: Data from three sources are employed: OECD statistics, the Commonwealth Fund survey of individuals in each of ten countries, and country-specific documents on health care policies...
May 18, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29775468/conflicts-of-interest-of-editors-of-medical-journals
#13
Waqas Haque, Abu Minhajuddin, Arjun Gupta, Deepak Agrawal
BACKGROUND: Almost all medical journals now require authors to publicly disclose conflicts of interests (COI). The same standard and scrutiny is rarely employed for the editors of the journals although COI may affect editorial decisions. METHODS: We conducted a retrospective observational study to determine the prevalence and magnitude of financial relationships among editors of 60 influential US medical journals (10 each for internal medicine and five subspecialties: cardiology, gastroenterology, neurology, dermatology and allergy & immunology)...
2018: PloS One
https://www.readbyqxmd.com/read/29775434/births-final-data-for-2016
#14
Joyce A Martin, Brady E Hamilton, Michelle J K Osterman, Anne K Driscoll, Patrick Drake
This report presents 2016 data on U.S. births according to a wide variety of characteristics. Trends in fertility patterns and maternal and infant characteristics are described and interpreted.Descriptive tabulations of data reported on the birth certificates of the 3.95 million births that occurred in 2016 are presented. Data are presented for maternal age, live-birth order, race and Hispanic origin, marital status, tobacco use, prenatal care, source of payment for the delivery, method of delivery, gestational age, birthweight, and plurality...
January 2018: National Vital Statistics Reports
https://www.readbyqxmd.com/read/29774957/progress-and-challenges-in-consolidating-the-management-of-amazonian-protected-areas-and-indigenous-territories
#15
Raymond E Gullison, Jared Hardner
Achieving the effective management of all existing protected areas and indigenous territories in the Amazon Biome may be needed to avoid a deforestation "tipping point" beyond which regional climatic feedbacks and global climate change interact to catalyze irreversible drying and savannization of large portions of the biome. However, the time and money required to consolidate the effective management of all types of protected sites in the Amazon is still poorly understood. At present, protected areas and indigenous territories cover 45...
May 18, 2018: Conservation Biology: the Journal of the Society for Conservation Biology
https://www.readbyqxmd.com/read/29774623/medical-service-provider-networks
#16
Michel Mougeot, Florence Naegelen
In many countries, health insurers or health plans choose to contract either with any willing providers or with preferred providers. We compare these mechanisms when two medical services are imperfect substitutes in demand and are supplied by two different firms. In both cases, the reimbursement is higher when patients select the in-network provider(s). We show that these mechanisms yield lower prices, lower providers' and insurer's profits, and lower expense than in the uniform-reimbursement case. Whatever the degree of product differentiation, a not-for-profit insurer should prefer selective contracting and select a reimbursement such that the out-of-pocket expense is null...
May 17, 2018: Health Economics
https://www.readbyqxmd.com/read/29772878/spatial-heterogeneity-of-quality-use-and-spending-on-medicare-for-the-elderly
#17
Felipa De Mello-Sampayo
The spatial variation of the relations between Medicare spending (MS), use and quality in the United States was investigated employing spatial regression. A focus of the study was whether, and to what extent, MS and use vary by service type. Employing different spatial regression designs based on Medicare regional data, the impact of the heterogeneous spatial effects of hospital readmissions on MS for the elderly at the aggregate level was examined. The results were followed up by investigation whether the effects of hospital readmissions are heterogeneous with regard to service type...
May 7, 2018: Geospatial Health
https://www.readbyqxmd.com/read/29771953/mitochondrial-disease-patient-motivations-and-barriers-to-participate-in-clinical-trials
#18
Zarazuela Zolkipli-Cunningham, Rui Xiao, Amy Stoddart, Elizabeth M McCormick, Amy Holberts, Natalie Burrill, Shana McCormack, Lauren Williams, Xiaoyan Wang, John L P Thompson, Marni J Falk
BACKGROUND: Clinical treatment trials are increasingly being designed in primary mitochondrial disease (PMD), a phenotypically and genetically heterogeneous collection of inherited multi- system energy deficiency disorders that lack effective therapy. We sought to identify motivating factors and barriers to clinical trial participation in PMD. METHODS: A survey study was conducted in two independent mitochondrial disease subject cohorts. A discovery cohort invited subjects with well-defined biochemical or molecularly- confirmed PMD followed at a single medical center (CHOP, n = 30/67 (45%) respondents)...
2018: PloS One
https://www.readbyqxmd.com/read/29771724/early-impact-of-medicare-accountable-care-organizations-on-inpatient-surgical-spending
#19
Hari Nathan, Jyothi R Thumma, Andrew M Ryan, Justin B Dimick
OBJECTIVE: To evaluate whether hospital participation in accountable care organizations (ACOs) is associated with reduced Medicare spending for inpatient surgery. BACKGROUND: ACOs have proliferated rapidly and now cover more than 32 million Americans. Medicare Shared Savings Program (MSSP) ACOs have shown modest success in reducing medical spending. Whether they have reduced surgical spending remains unknown. METHODS: We used 100% Medicare claims from 2010 to 2014 for patients aged 65 to 99 years undergoing 6 common elective surgical procedures [abdominal aortic aneurysm (AAA) repair, colectomy, coronary artery bypass grafting (CABG), hip or knee replacement, or lung resection]...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29768698/financial-viability-of-emergency-department-observation-unit-billing-models
#20
Christopher W Baugh, Pawan Suri, Christopher G Caspers, Michael A Granovsky, Keith Neal, Michael A Ross
BACKGROUND: Outpatients receive observation services to determine the need for inpatient admission. These services are usually provided without the use of condition-specific protocols and in an unstructured manner, scattered throughout a hospital in areas typically designated for inpatient care. Emergency department observation units (EDOUs) use protocolized care to offer an efficient alternative with shorter lengths of stay, lower costs and higher patient satisfaction. EDOU growth is limited by existing policy barriers that prevent a "two-service" model of separate professional billing for both emergency and observation services...
May 16, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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