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Health Policy

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156 papers 25 to 100 followers
By Gregory Gustafson Interventional Cardiologist
Susan Hingle
No abstract text is available yet for this article.
September 6, 2016: Annals of Internal Medicine
Barack Obama
IMPORTANCE: The Affordable Care Act is the most important health care legislation enacted in the United States since the creation of Medicare and Medicaid in 1965. The law implemented comprehensive reforms designed to improve the accessibility, affordability, and quality of health care. OBJECTIVES: To review the factors influencing the decision to pursue health reform, summarize evidence on the effects of the law to date, recommend actions that could improve the health care system, and identify general lessons for public policy from the Affordable Care Act...
August 2, 2016: JAMA: the Journal of the American Medical Association
Bruce L Lambert, Nichola M Centomani, Kelly M Smith, Lorens A Helmchen, Dulal K Bhaumik, Yash J Jalundhwala, Timothy B McDonald
OBJECTIVE: To determine whether a communication and resolution approach to patient harm is associated with changes in medical liability processes and outcomes. DATA SOURCES/STUDY SETTING: Administrative, safety, and risk management data from the University of Illinois Hospital and Health Sciences System, from 2002 to 2014. STUDY DESIGN: Single health system, interrupted time series design. Using Mann-Whitney U tests and segmented regression models, we compared means and trends in incident reports, claims, event analyses, patient communication consults, legal fees, costs per claim, settlements, and self-insurance expenses before and after the implementation of the "Seven Pillars" communication and resolution intervention...
August 24, 2016: Health Services Research
Young Joo Park, Erika G Martin
OBJECTIVE: To update a past systematic review on whether Medicare Part D changed drug utilization and out-of-pocket (OOP) costs overall and within subpopulations, and to identify evidence gaps. DATA SOURCES/STUDY SETTING: Published and gray literature from 2010 to 2015 meeting prespecified screening criteria, including having a comparison group, and utilization or OOP cost outcomes. STUDY DESIGN: We conducted a systematic literature review with a quality assessment...
August 1, 2016: Health Services Research
Charles Roehrig
Estimates of annual health spending for a comprehensive set of medical conditions are presented for the entire US population and with totals benchmarked to the National Health Expenditure Accounts. In 2013 mental disorders topped the list of most costly conditions, with spending at $201 billion.
June 1, 2016: Health Affairs
Arthur E Attema, Werner B F Brouwer, Olivier l'Haridon, Jose Luis Pinto
This paper performs several tests of decision analysis applied to the health domain. First, we conduct a test of the normative expected utility theory. Second, we investigate the possibility to elicit the more general prospect theory. We observe risk aversion for gains and losses and violations of expected utility. These results imply that mechanisms governing decisions in the health domain are similar to those in the monetary domain. However, we also report one important deviation: utility is universally concave for the health outcomes used in this study, in contrast to the commonly found S-shaped utility for monetary outcomes, with concave utility for gains and convex utility for losses...
July 2016: Journal of Health Economics
Sarah Lewington, Ben Lacey, Robert Clarke, Yu Guo, Xiang Ling Kong, Ling Yang, Yiping Chen, Zheng Bian, Junshi Chen, Jinhuai Meng, Youping Xiong, Tianyou He, Zengchang Pang, Shuo Zhang, Rory Collins, Richard Peto, Liming Li, Zhengming Chen
IMPORTANCE: Hypertension is a leading cause of premature death in China, but limited evidence is available on the prevalence and management of hypertension and its effect on mortality from cardiovascular disease (CVD). OBJECTIVES: To examine the prevalence, diagnosis, treatment, and control of hypertension and to assess the CVD mortality attributable to hypertension in China. DESIGN, SETTING AND PARTICIPANTS: This prospective cohort study (China Kadoorie Biobank Study) recruited 500 223 adults, aged 35 to 74 years, from the general population in China...
April 2016: JAMA Internal Medicine
Mitchell H Katz
No abstract text is available yet for this article.
May 1, 2016: JAMA Internal Medicine
Roy M Poses, Wally R Smith
No abstract text is available yet for this article.
March 8, 2016: Annals of Internal Medicine
Yan Xu, Philip S Wells
In past decades, stark differences in practice pattern, cost, and outcomes of care across regions with similar health demographics have prompted calls for reform. As health systems answer the growing call for accountability in the form of quality indices, while responding to increased scrutiny on practice variation in the form of pay for performance (P4P), a rift is widening between the system and individual patients. Currently, three areas are inadequately considered by P4P structures based largely on physician adherence to guidelines: diversity of patient values and preferences; time and financial burden of therapy in the context of multimorbidity; and narrow focus on quantitative measures that distract clinicians from providing optimal care...
July 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Balázs Nagy, Adriána Zsólyom, László Nagyjánosi, Gergő Merész, Tamás Steiner, Eszter Papp, Zoltán Dessewffy, György Jermendy, Gábor Winkler, Zoltán Kaló, Zoltán Vokó
OBJECTIVE: The objective of this study was to develop a long term economic model for type 2 diabetes to describe the entire spectrum of the disease over a wide range of health care programmes. The model evaluates a public health, risk based screening program in a country specific setting. METHODS: The lifespan of persons and important phases of the disease and related interventions are recorded in a Markov model, which first simulates the effect of screening, then replicates important complications of diabetes, follows the progression of individuals through physiological variables and finally calculates outcomes in monetary and naturalistic units...
February 17, 2016: Diabetes/metabolism Research and Reviews
Keith Kranker
In recent decades, most states' Medicaid programs have introduced disease management programs for chronically ill beneficiaries. Interventions assist beneficiaries and their health care providers to appropriately manage chronic health condition(s) according to established clinical guidelines. Cost containment has been a key justification for the creation of these programs despite mixed evidence they actually save money. This study evaluates the effects of a disease management program in Georgia by exploiting a natural experiment that delayed the introduction of high-intensity services for several thousand beneficiaries...
March 2016: Journal of Health Economics
Howard S Gordon, Richard L Street
The purpose of this study was to compare several different measures of physician-patient communication. We compared data derived from different measures of three communication behaviors, patient participation, physician information giving, and physician participatory decision-making (PDM) style, from 83 outpatient visits to oncology or thoracic surgery clinics for pulmonary nodules or lung cancer. Communication was measured with rating scales completed by patients and physicians after the consultation and by two different groups of external observers who used rating scales or coded the frequency of communication behaviors, respectively, after listening to an audio recording of the consultation...
January 10, 2016: Evaluation & the Health Professions
Patricia A McDonald, Robert S Mecklenburg, Lindsay A Martin
To tame its soaring health care costs, intel tried many popular approaches: "consumer-driven health care" offerings such as high-deductible/low-premium plans, on-site clinics and employee wellness programs. But by 2009 intel realized that those programs alone would not enable the company to solve the problem, because they didn't affect its root cause: the steadily rising cost of the care employees and their families were receiving. Intel projected that its health care expenditures would hit a whopping $1 billion by 2012...
July 2015: Harvard Business Review
Heather Wipfli, Jonathan M Samet
Today's global tobacco epidemic may represent one of the first instances of the globalization of a noninfectious cause of disease. This article focuses on the first century of the global tobacco epidemic and its current status, reviewing the current and projected future of the global tobacco epidemic and the steps that are in progress to end it. In the United States and many countries of Western Europe, tobacco consumption peaked during the 1960s and 1970s and declined as tobacco control programs were initiated, motivated by the evidence indicting smoking as a leading cause of disease...
2016: Annual Review of Public Health
Daifeng He, Jennifer M Mellor
OBJECTIVE: To describe the amount of hospital outpatient care provided to the uninsured and its association with Medicare payment rate cuts following the implementation of Medicare's Outpatient Prospective Payment System. DATA SOURCES/STUDY SETTING: We use hospital outpatient discharge records from Florida from 1997 through 2008. STUDY DESIGN: We estimate multivariate regression models of hospital outpatient care provided to the uninsured in separate samples of nonprofit and for-profit hospitals...
August 2016: Health Services Research
Deborah Korenstein, Raphael Falk, Elizabeth A Howell, Tara Bishop, Salomeh Keyhani
BACKGROUND: Overuse, the provision of health care services for which harms outweigh benefits, represents poor quality and contributes to high costs. A better understanding of overuse in US health care could inform efforts to reduce inappropriate care. We performed an extensive search for studies of overuse of therapeutic procedures, diagnostic tests, and medications in the United States and describe the state of the literature. METHODS: We searched MEDLINE (1978-2009) for studies measuring US rates of overuse of procedures, tests, and medications, augmented by author tracking, reference tracking, and expert consultation...
January 23, 2012: Archives of Internal Medicine
Philip Wesley Barker, Dawn Marie Heisey-Grove
OBJECTIVES: This study provides information on the types of practices that employ 2 types of advance practice providers (APPs), nurse practitioners (NPs) and physician assistants (PAs), and the association between employment of APPs and health information technology (IT) adoption by the practice. STUDY DESIGN: Three outcomes predicted the likelihood that practices employed at least 1 NP, at least 1 PA, or at least 1 of either type of APP; one outcome estimated electronic health record (EHR) adoption across practices; and 4 models assessed the EHR functionalities used by practices...
December 2015: American Journal of Managed Care
Jie Chen, Arturo Vargas-Bustamante, Karoline Mortensen, Alexander N Ortega
OBJECTIVE: To examine racial and ethnic disparities in health care access and utilization after the Affordable Care Act (ACA) health insurance mandate was fully implemented in 2014. RESEARCH DESIGN: Using the 2011-2014 National Health Interview Survey, we examine changes in health care access and utilization for the nonelderly US adult population. Multivariate linear probability models are estimated to adjust for demographic and sociodemographic factors. RESULTS: The implementation of the ACA (year indicator 2014) is associated with significant reductions in the probabilities of being uninsured (coef=-0...
February 2016: Medical Care
Mark Schlesinger, Rachel Grob, Dale Shaller
OBJECTIVE: To assess what is known about the relationship between patient experience measures and incentives designed to improve care, and to identify how public policy and medical practices can promote patient-valued outcomes in health systems with strong financial incentives. DATA SOURCES/STUDY SETTING: Existing literature (gray and peer-reviewed) on measuring patient experience and patient-reported outcomes, identified from Medline and Cochrane databases; evaluations of pay-for-performance programs in the United States, Europe, and the Commonwealth countries...
December 2015: Health Services Research
2015-11-21 23:30:26
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