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Health Policy

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165 papers 100 to 500 followers
By Gregory Gustafson Interventional Cardiologist
https://www.readbyqxmd.com/read/29978481/medical-group-characteristics-and-the-cost-and-quality-of-care-for-medicare-beneficiaries
#1
Lawrence P Casalino, Patricia Ramsay, Laurence C Baker, Michael F Pesko, Stephen M Shortell
OBJECTIVE: To estimate the relationship between outcomes of care and medical practices' structure and use of organized care improvement processes. DATA SOURCES/STUDY SETTING: We linked Medicare claims data to our national survey of physician practices (2012-2013). Fifty percent response rate; 1,040 responding practices; 31,888 physicians; 868,213 attributed Medicare beneficiaries. STUDY DESIGN: Cross-sectional observational analysis of the relationship between practice characteristics and total spending, readmissions, and ambulatory care-sensitive admissions (ACSAs), for all beneficiaries and five categories of beneficiary defined by predicted need for care...
July 5, 2018: Health Services Research
https://www.readbyqxmd.com/read/29896800/medicaid-incentives-for-preventing-chronic-disease-effects-of-financial-incentives-for-smoking-cessation
#2
Allison Witman, Joseph Acquah, Maria Alva, Thomas Hoerger, Melissa Romaire
OBJECTIVE: To test the effectiveness of financial incentives for smoking cessation in the Medicaid population. DATA SOURCES: Secondary data from the Medicaid Incentives for Prevention of Chronic Disease (MIPCD) program and Medicaid claims/encounter data from 2010 to 2015 for five states. STUDY DESIGN: Beneficiaries were randomized into receipt or no receipt of financial incentives. We ran multivariate regression models testing the impact of financial incentives on the use of counseling services, smoking behavior, and Medicaid expenditures and utilization...
June 12, 2018: Health Services Research
https://www.readbyqxmd.com/read/29477400/a-comparison-of-different-approaches-for-costing-medication-use-in-an-economic-evaluation
#3
COMPARATIVE STUDY
Margaret Heslin, Oluwagbemisola Babalola, Fowzia Ibrahim, Dominic Stringer, David Scott, Anita Patel
BACKGROUND: Estimating individual-level medication costs in an economic evaluation can involve extensive data collection and handling. Implications of detailed versus general approaches are unclear. OBJECTIVES: To compare costing approaches in a trial-based economic evaluation. METHODS: We applied four costing approaches to prescribed medication data from the Tumour necrosis factor inhibitors Against Combination Intensive Therapy randomized controlled trial...
February 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29906764/end-of-life-healthcare-expenditure-testing-economic-explanations-using-a-discrete-choice-experiment
#4
Barbara Fischer, Harry Telser, Peter Zweifel
Healthcare expenditure (HCE) spent during an individual's last year of life accounts for a high share of lifetime HCE. This finding is puzzling because an investment in health is unlikely to have a sufficiently long payback period. However, Becker et al. (2007) and Philipson et al. (2010) have advanced a theory designed to explain high willingness to pay (WTP) for an extension of life close to its end. Their testable implications are complemented by the concept of 'pain of risk bearing' introduced by Eeckhoudt and Schlesinger (2006)...
June 7, 2018: Journal of Health Economics
https://www.readbyqxmd.com/read/29695887/a-global-campaign-to-combat-ageism
#5
Alana Officer, Vânia de la Fuente-Núñez
No abstract text is available yet for this article.
April 1, 2018: Bulletin of the World Health Organization
https://www.readbyqxmd.com/read/29851451/the-role-of-managed-care-professionals-and-pharmacists-in-combating-opioid-abuse
#6
Kirk Moberg
Substance misuse is a critical and costly public health problem in the United States. Data as of 2016 show 11,517 cases of opioid analgesic misuse, with the majority (6924 cases) related to hydrocodone misuse. Substance misuse impacts our society significantly with high costs related to healthcare, crime, and lost productivity. Opioid analgesic pain relievers are one of the most prescribed classes of medications and are among the most common drugs related to misuse. Increases in emergency department visits of over 200% have been associated with a dramatic surge in written prescriptions for opioid pain relievers...
May 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/28747321/the-affordable-care-act-reduced-socioeconomic-disparities-in-health-care-access
#7
Kevin Griffith, Leigh Evans, Jacob Bor
The United States has the largest socioeconomic disparities in health care access of any wealthy country. We assessed changes in these disparities in the United States under the Affordable Care Act (ACA). We used survey data for the period 2011-15 from the Behavioral Risk Factor Surveillance System to assess trends in insurance coverage, having a personal doctor, and avoiding medical care due to cost. All analyses were stratified by household income, education level, employment status, and home ownership status...
July 26, 2017: Health Affairs
https://www.readbyqxmd.com/read/28318667/paying-medicare-advantage-plans-to-level-or-tilt-the-playing-field
#8
Jacob Glazer, Thomas G McGuire
Medicare beneficiaries are eligible for health insurance through the public option of traditional Medicare (TM) or may join a private Medicare Advantage (MA) plan. Both are highly subsidized but in different ways. Medicare pays for most of costs directly in TM, and subsidizes MA plans based on a "benchmark" for each beneficiary choosing a private plan. The level of this benchmark is arguably the most important policy decision Medicare makes about the MA program. Many analysts recommend equalizing Medicare's subsidy across the options - referred to in policy circles as a "level playing field...
December 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/27856648/in-new-survey-of-eleven-countries-us-adults-still-struggle-with-access-to-and-affordability-of-health-care
#9
Robin Osborn, David Squires, Michelle M Doty, Dana O Sarnak, Eric C Schneider
Surveys of patients' experiences with health care services can reveal how well a country's health system is meeting the needs of its population. Using data from a 2016 survey conducted in eleven countries-Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States-we found that US adults reported poor health and well-being and were the most likely to experience material hardship. The United States trailed other countries in making health care affordable and ranked poorly on providing timely access to medical care (except specialist care)...
December 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27595501/electronic-health-records-an-unfulfilled-promise-and-a-call-to-action
#10
COMMENT
Susan Hingle
No abstract text is available yet for this article.
December 6, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27400401/united-states-health-care-reform-progress-to-date-and-next-steps
#11
REVIEW
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
https://www.readbyqxmd.com/read/27558861/the-seven-pillars-response-to-patient-safety-incidents-effects-on-medical-liability-processes-and-outcomes
#12
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...
December 2016: Health Services Research
https://www.readbyqxmd.com/read/27480577/medicare-part-d-s-effects-on-drug-utilization-and-out-of-pocket-costs-a-systematic-review
#13
REVIEW
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...
October 2017: Health Services Research
https://www.readbyqxmd.com/read/27193027/mental-disorders-top-the-list-of-the-most-costly-conditions-in-the-united-states-201-billion
#14
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
https://www.readbyqxmd.com/read/27179198/an-elicitation-of-utility-for-quality-of-life-under-prospect-theory
#15
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
https://www.readbyqxmd.com/read/26975032/the-burden-of-hypertension-and-associated-risk-for-cardiovascular-mortality-in-china
#16
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
https://www.readbyqxmd.com/read/26977893/opioid-prescribing-for-chronic-pain-not-for-the-faint-of-heart
#17
EDITORIAL
Mitchell H Katz
No abstract text is available yet for this article.
May 1, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/26954915/how-employed-physicians-contracts-may-threaten-their-patients-and-professionalism
#18
Roy M Poses, Wally R Smith
No abstract text is available yet for this article.
March 8, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/26839943/getting-along-with-the-guidelines-reconciling-patient-autonomy-and-quality-improvement-through-shared-decision-making
#19
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
https://www.readbyqxmd.com/read/26888326/cost-effectiveness-of-a-risk-based-secondary-screening-programme-of-type-2-diabetes
#20
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 healthcare programmes. The model evaluates a public health, risk-based screening programme 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...
October 2016: Diabetes/metabolism Research and Reviews
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