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medical insurance

Klariz Tucker, Tyra Dark, Jeffrey S Harman
PURPOSE: Given that out-of-pocket (OOP) costs impact adherence to treatment and recent and proposed changes to the health insurance system that impact OOP costs, it is imperative to understand the OOP cost burden faced by individuals with anxiety disorders depending upon type of insurance coverage. The objective of this study was to determine the annual OOP cost burden faced by individuals with anxiety disorders and the variation of these costs by type of insurance coverage. METHODS: Using weighted nationally representative data from the 2011-2014 Medical Expenditure Panel Surveys, total OOP health care costs were assessed for all respondents who indicated that they had an anxiety disorder (N = 9985)...
June 15, 2018: Journal of Anxiety Disorders
Anne G Sammarco, Daniel M Morgan, Neil S Kamdar, Carolyn W Swenson
OBJECTIVES: To (1) determine the proportion of hysterectomy cases with documentation of pessary counseling prior to prolapse surgery and (2) identify variables associated with women offered a pessary. STUDY DESIGN: The Michigan Surgical Quality Collaborative (MSQC) is a hysterectomy improvement initiative. Hysterectomies from 2013 to 2015 in which prolapse was the principal diagnosis were included. "Pessary offer" was defined as documentation showing the patient declined, could not tolerate, or failed a pessary trial...
June 22, 2018: International Urogynecology Journal
Won Kyung Lee, Chang Wan Oh, Heeyoung Lee, Kun Sei Lee, Hyeonseon Park
BACKGROUND: Despite increasing usage of endovascular treatments for intracranial aneurysms, few research studies have been conducted on the incidence of unruptured aneurysm (UA) and subarachnoid hemorrhage (SAH), and could not show a decrease in the incidence of SAH. Moreover, research on socioeconomic disparities with respect to the diagnosis and treatment of UA and SAH is lacking. METHOD: Trends in the incidences of newly detected UA and SAH and trends in the treatment modalities used were assessed from 2005 to 2015 using the nationwide database of the Korean National Health Insurance Service in South Korea...
June 22, 2018: Journal of Neurointerventional Surgery
Alyna T Chien, Sara L Toomey, Dennis Z Kuo, Jeanne Van Cleave, Amy J Houtrow, Megumi J Okumura, Matthew Y Westfall, Carter R Petty, Jessica A Quinn, Karen A Kuhlthau, Mark A Schuster
OBJECTIVE: To identify opportunities to improve care value for children with disabilities (CWD), we examined CWD prevalence within a commercially insured population and compared outpatient care quality and annual health plan spending levels for CWD relative to children with complex medical conditions without disabilities, children with chronic conditions that are not complex, and children without disabling, complex, or chronic conditions. METHODS: Cross-sectional study of 1,118,081 person-years of Blue Cross Blue Shield Massachusetts data for beneficiaries aged 1-19 years old during 2008-2012...
June 19, 2018: Academic Pediatrics
Stephanie F Polites, Bentley B Rodrigue, Carol Chute, Adrienne Hammill, Roshni Dasgupta
BACKGROUND: There has been a paradigm shift from steroids to propranolol for the pharmacologic treatment of infantile hemangiomas (IH); however, the outcomes for ulcerated IH are not well studied. The purpose of this study was to compare the efficacy of steroids and propranolol specifically for ulcerated IH. METHODS: A retrospective review was conducted on patients with ulcerated IH treated with propranolol or steroids at a single tertiary care institution between 2007 and 2014...
June 22, 2018: Pediatric Blood & Cancer
Chung-Yuan Hsu, Yu-Sheng Lin, Tien-Tsai Cheng, Ya-Jhu Syu, Ming-Shyan Lin, Hsing-Fen Lin, Yu-Jih Su, Ying-Chou Chen, Jia-Feng Chen, Tien-Hsing Chen
Objectives: HCQ, which is known to decrease SLE activity, may have a protective effect on survival, but this has not been proven in Asia. This study aimed to determine whether HCQ treatment is associated with increased survival in patients with SLE. Methods: We designed this prospective SLE cohort study using data from the Taiwan National Health Insurance Research Database. The participants were divided into HCQ and control groups according to whether HCQ was prescribed during the first year after an SLE diagnosis...
June 20, 2018: Rheumatology
Julie Rotival, Youri Yordanov, Pierre-Clément Thiebaud, Nathalie Pelletier-Fleury, Elsa Jacquet, Erwan Debuc, Dominique Pateron, Diane Naouri
Background: Some studies have demonstrated an association between poor continuity of care, high likelihood of 'inappropriate' use of emergency departments (EDs) and avoidable hospitalization. However, we lack data concerning primary care use after an ED visit. Objective: Identify the determinants of a visit to the general practitioner (GP) after an ED visit. Design: Observational study (single-centre cohort). Setting: One emergency department in Paris, France...
June 21, 2018: Family Practice
Ashley Walker, John G Peden, Morgan Emter, Gavin Colquitt
The purpose of this study was to examine predictors of coordinated and comprehensive care within a medical home among children with special health care needs (CSHCN). The latest version of the National Survey of Children with Special Health Care Needs (NS-CSHCN) employed a national random-digit-dial sample whereby US households were screened, resulting in 40,242 eligible respondents. Logistic regression analyses were performed modeling the probability of coordinated, comprehensive care in a medical home based on shared decision-making and other factors...
2018: Frontiers in Public Health
Samuel Videholm, Sven-Arne Silfverdal, Georges Reniers
OBJECTIVE: The aim of this study was to examine this association between maternal weight during pregnancy and the incidence of hospitalisations for infectious diseases during early childhood. DESIGN: A population-based cohort study. SETTING: A national cohort was created by combining data from the Swedish Medical Birth Register, the National Inpatient Register, the Cause of Death Register, the Total Population Register and the Longitudinal integration database for health insurance and labour market studies...
June 21, 2018: Archives of Disease in Childhood
Alexandra M Falvo, Frances Hite Philp, George M Eid
BACKGROUND: Obesity is a serious health problem that affects a wide range of patients and disease processes. OBJECTIVE: The purpose of this study is to evaluate perceptions, knowledge, and practice habits of primary care providers (PCPs) regarding the care of patients with obesity, including barriers to effective care and their experience with bariatric surgery in our integrated health network. SETTING: Integrated health network. METHODS: A 16-question survey was distributed electronically to 160 PCPs at our integrated health network...
June 5, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Yu-Yen Chen, Yun-Ju Lai, Jen-Pang Wang, Ying-Cheng Shen, Chun-Yuan Wang, Hsin-Hua Chen, Hsiao-Yun Hu, Pesus Chou
BACKGROUND: Previous cross-sectional studies revealed a higher prevalence of depression among glaucoma patients. However, cohort studies were in lack to build the risk of incident depression after the diagnosis of glaucoma. The aim of our study was to investigate the association between glaucoma and the subsequent risk of developing depression and to assess risk factors associated with depression in glaucoma patients. METHODS: A population-based retrospective cohort study using the Taiwan National Health Insurance Research Database was conducted from January 1, 2001 through December 31, 2011...
June 22, 2018: BMC Ophthalmology
Jessica Y Shim, Jessica M Madrigal, Juan Aparicio, Ashlesha Patel
STUDY OBJECTIVE: To evaluate the prevalence of anemia among female adolescents and young adults seeking abortion care at a county hospital, and to determine its associated factors. DESIGN: A cross-sectional retrospective study. SETTING: John H. Stroger, Jr. Hospital of Cook County, Chicago, IL. PARTICIPANTS: 2,916 young females (ages 11 to 24 years) who underwent first trimester medical or surgical termination in 2016...
June 18, 2018: Journal of Pediatric and Adolescent Gynecology
Carolyn W Swenson, Neil S Kamdar, Kristian Seiler, Daniel M Morgan, Paul Lin, Sawsan As-Sanie
BACKGROUND: Opioids used for postoperative pain control after surgery have been associated with an increased risk of chronic opioid use. Hysterectomy is the most common major gynecologic procedure in the United States; however, we lack a data-driven definition of new persistent opioid use specific to hysterectomy. OBJECTIVE: 1) Determine a data-driven definition of new persistent opioid use among opioid naïve women undergoing hysterectomy; 2) Determine the prevalence of and risk factors for new persistent opioid use...
June 18, 2018: American Journal of Obstetrics and Gynecology
Steffani R Bailey, John Heintzman, R Lorie Jacob, Jon Puro, Miguel Marino
OBJECTIVES: To examine associations between patient factors and smoking cessation assistance in US safety-net clinics. METHODS: Using electronic health record data from the OCHIN network, we identified adults with at least 1 primary care visit to a study clinic (n = 143 clinics in 12 states) with at least 1 documented "current smoker" status during 2014 to 2016 (n = 136 314; 29.8%). We estimated odds ratios (ORs) of smoking cessation assistance receipt (none [reference], counseling, medication, or both) by patient covariates...
June 21, 2018: American Journal of Public Health
Ji Young Hong, Young Ae Kang
Pneumonia is an important cause of morbidity and mortality. Since 2014, the Health Insurance Review and Assessment Service (HIRA) has assessed the overall quality of care among hospitalized adult patients with community-acquired pneumonia (CAP) provided by all medical institutions in Korea. A committee of the Korea Academy of Tuberculosis and Respiratory Diseases developed the hospital inpatient quality measures set for CAP consisting of eight core measures and five monitoring measures. The composite measure score was calculated...
June 19, 2018: Tuberculosis and Respiratory Diseases
Guanshen Dou, Qun Wang, Xiaohua Ying
The aims of this study were to describe health insurance reforms initiated by the Chinese government over the past two decades, to review their achievements in reducing the medical economic burden, and to summarize the challenges that still exist regarding a further reduction in out-of-pocket expenditures in this country. China has successfully attained the goal of providing health insurance coverage to almost the entire population by developing a mixed health insurance system, which consists of Urban Employees Basic Medical Insurance (UEBMI), Urban Resident Basic Medical Insurance (URBMI), New Rural Cooperative Medical Scheme (NCMS), and supplementary Catastrophic Health Insurance...
June 20, 2018: Bioscience Trends
Kashif Iqbal, Ya-Lin A Huang, Philip Peters, Paul Weidle, Karen Hoover
In 2012, antiretroviral (ARV) treatment guidelines expanded indications and recommended antiretroviral treatment for all HIV-infected persons in the United States, regardless of CD4 cell count. This analysis describes ARV prescriptions among commercially insured HIV-infected adults from 2012 to 2014. We analyzed persons aged 18-64 years from 2012 to 2014 Truven Health MarketScan Commercial Claims and Encounters® database. We identified HIV-infected persons who had at least one inpatient or two outpatient medical claims and identified pharmacy claims using National Drug Codes...
June 20, 2018: AIDS Care
Stacy M Scofield-Kaplan, Kristen Dunbar, Gregory Stein, Michael Kazim
PURPOSE: To evaluate the improvement in primary and eccentric gaze ocular alignment in thyroid eye disease (TED) patients undergoing horizontal strabismus surgery with Tenon's recession. METHODS: This is an Institutional Review Board-approved retrospective analysis of TED patients undergoing horizontal strabismus surgery for esotropia. The study included all patients from 2007 to 2016 operated on by a single surgeon at Columbia University Medical Center. Surgical success was defined as the ability to fuse at both near and distance either without prismatic correction or with less than 10 prism diopters (PD) of correction...
June 18, 2018: Ophthalmic Plastic and Reconstructive Surgery
Justin J Elhoff, Kimberly E McHugh, Jason R Buckley, Shaine A Morris, Kit N Simpson, Mark A Scheurer
IntroductionFamilies of children born with CHD face added stress owing to uncertainty about the magnitude of the financial burden for medical costs they will face. This study seeks to assess the family responsibility for healthcare bills during the first 12 months of life for commercially insured children undergoing surgery for severe CHD. METHODS: The MarketScan ® database from Truven was used to identify commercially insured infants in 39 states from 2010 to 2012 with an ICD-9 diagnosis code for transposition of the great arteries, tetralogy of Fallot, or truncus arteriosus, as well as the corresponding procedure code for complete repair...
June 20, 2018: Cardiology in the Young
Ang Zheng, Wenjuan Duan, Lin Zhang, Xintong Bao, Xiaoyun Mao, Zhuojun Luo, Feng Jin
In recent years, the incidence and mortality of cancer have witnessed a dramatic increase. Cancer has already caused severe economic burdens on society, especially in developing countries and has become a major public health concern. This study evaluates the medical economic burden, including total current curative expenditure (CCE) and catastrophic health expenditure (CHE) on cancer in Liaoning Province, China. A total of 252 medical institutions were investigated with multistage stratified cluster random sampling...
June 20, 2018: Cancer Medicine
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