Oocyte cryopreservation for cancer patients is inconsistently and suboptimally covered among national health insurance companies

2016 ◽  
Vol 105 (2) ◽  
pp. e36
Author(s):  
W. Salem ◽  
K. Bendikson ◽  
R. Paulson ◽  
K. Chung
Keyword(s):  
Health Insurance ◽  
Cancer Patients ◽  
National Health Insurance ◽  
National Health ◽  
Oocyte Cryopreservation ◽  
Insurance Companies ◽  
Health Insurance Companies

scholarly journals Impact of comorbidity assessment methods to predict non-cancer mortality risk in cancer patients: a retrospective observational study using the National Health Insurance Service claims-based data in Korea

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sanghee Lee ◽  
Yoon Jung Chang ◽  
Hyunsoon Cho
Keyword(s):  
Risk Assessment ◽  
Health Insurance ◽  
Cancer Patients ◽  
National Health Insurance ◽  
National Health ◽  
Cancer Mortality ◽  
Prediction Models ◽  
Assessment Methods ◽  
Chronic Obstructive ◽  
Mortality Risks

Abstract Background Cancer patients’ prognoses are complicated by comorbidities. Prognostic prediction models with inappropriate comorbidity adjustments yield biased survival estimates. However, an appropriate claims-based comorbidity risk assessment method remains unclear. This study aimed to compare methods used to capture comorbidities from claims data and predict non-cancer mortality risks among cancer patients. Methods Data were obtained from the National Health Insurance Service-National Sample Cohort database in Korea; 2979 cancer patients diagnosed in 2006 were considered. Claims-based Charlson Comorbidity Index was evaluated according to the various assessment methods: different periods in washout window, lookback, and claim types. The prevalence of comorbidities and associated non-cancer mortality risks were compared. The Cox proportional hazards models considering left-truncation were used to estimate the non-cancer mortality risks. Results The prevalence of peptic ulcer, the most common comorbidity, ranged from 1.5 to 31.0%, and the proportion of patients with ≥1 comorbidity ranged from 4.5 to 58.4%, depending on the assessment methods. Outpatient claims captured 96.9% of patients with chronic obstructive pulmonary disease; however, they captured only 65.2% of patients with myocardial infarction. The different assessment methods affected non-cancer mortality risks; for example, the hazard ratios for patients with moderate comorbidity (CCI 3–4) varied from 1.0 (95% CI: 0.6–1.6) to 5.0 (95% CI: 2.7–9.3). Inpatient claims resulted in relatively higher estimates reflective of disease severity. Conclusions The prevalence of comorbidities and associated non-cancer mortality risks varied considerably by the assessment methods. Researchers should understand the complexity of comorbidity assessments in claims-based risk assessment and select an optimal approach.

scholarly journals Development of medical insurance in the Russian Federation. At the crossroads. What's next?

2019 ◽  
Vol 14 (2) ◽  
Author(s):  
Igor M. Akulin ◽  
Lubov Yu. Zhiguleva
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
National Health ◽  
Insurance Companies ◽  
Health Insurance System ◽  
National Health Care ◽  
Health Insurance Companies ◽  
Compulsory Health Insurance ◽  
The Russian Federation ◽  
Additional Payment

The RF health care reform is gaining momentum. A thorough consideration should be given to the discussion on the need to exclude health insurance companies from the compulsory health insurance system (CHI). Formation of the National Health Care System of Russia is the main problem of the national health care at this stage of reforms. Additional payment for medical services in the CHI by the general public is not advisable. Changes in the regulatory framework of the CHI system is deemed to be the basis for reforming the system of compulsory and voluntary health insurance in Russia.   

Difference in strong opioid prescription among different cancer and care providers in advanced cancer patients in Taiwan: Analysis using national health insurance database.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 55-55
Author(s):  
Ruey Kuen Hsieh ◽  
Yu-Lin Lin ◽  
Chao-Hsiun Tang
Keyword(s):  
Health Insurance ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
National Health Insurance ◽  
National Health ◽  
Care Providers ◽  
Advanced Cancer Patients ◽  
Opioid Prescription ◽  
Strong Opioid ◽  
Strong Opioids

55 Background: Pain assessment and management had been adopted as an important criteria in hospital accreditation in Taiwan. National health insurance database may help to determine factors influencing patterns of strong opioid use in advanced cancer patients in their final 12 months of life. Methods: Cancer patients who died from cancer during 2008-2011 were included in the analysis. Data in prescription of strong opioids during their last 12 months of life were collected and analyzed using National Health Insurance Research Database (NHIRD). Patient’s characteristics, such as cancer types, birthdate and gender, as well as information on the provider’s characteristics, such as specialty, gender and age of the physician, the ownership and level of accreditation of the hospital, and the level of urbanization of the hospital where it is located, were also retrieved and included as the controlled variables in the analysis. Results: Of the 162,679 cancer deaths, 57,578 were prescribed strong opioids in their last year of life (35.4 percent). Strong opioid prescription steadily decreased with the corresponding increase in patient age. Besides there are difference in different cancer types. Association with prescription prevalence has also been noted among physician characteristics such as subspecialty, gender and age, as well among hospital characteristics, such as public vs private and accreditation level. Conclusions: There are significant difference in strong opioids prescription among different care providers for advanced cancer patients. Information from this study can guide further efforts in improving supportive care and education for advanced cancer care providers.

Association between tamoxifen and cataract risk in breast cancer patients: Analysis of a national health insurance database.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24072-e24072
Author(s):  
Cheng-wei Chou ◽  
Ching-Heng Lin ◽  
Chieh-Lin Teng ◽  
Yuh-Pyng Sher
Keyword(s):  
Breast Cancer ◽  
Health Insurance ◽  
Cataract Surgery ◽  
Cancer Patients ◽  
National Health Insurance ◽  
National Health ◽  
Female Breast Cancer ◽  
Research Database ◽  
Breast Cancer Patients ◽  
Female Breast

e24072 Background: Tamoxifen is often used for hormone-positive breast cancer. Recent trials suggested that ten years of tamoxifen use improves recurrence rate and death. Ocular side effects and cataracts were reported in previous trials. We revealed the risk of cataracts from real-world data of the Taiwan national health insurance research database. Methods: We retrieved data from the Taiwan National health insurance research database. Female breast cancer patients from 2000-2005 were enrolled in this study. Patients receiving cataract surgery were enrolled and matched with non-cataract surgery patients for comparison in the analysis. Age, cumulative days, chemotherapy, and the time interval between breast cancer and index date were included and as controlled variables. Results: Among 23,957 female breast cancer patients, a total of 1,578 patients receiving cataract surgery were enrolled and matched with patients without cataract surgery until the end of 2013. Age in patients undergoing cataract surgery group was significantly higher than the non-surgery group (59.9 and 58.3, respectively, P < 0.001). Multiple regression analyses showed an adjusted odds ratio of 1.02 (95% CI:1.01-1.03, P< 0.001). However, more prolonged exposure of tamoxifen (≧3 years) also had a higher risk of cataract development requiring surgery (adjusted odds ratio=1.32, 95% CI: 1.03–1.70, P = 0.030). Conclusions: Besides age, there is a significantly higher risk of cataract development requiring surgery among female breast cancer patients with long term tamoxifen use. Information from this study may provide further clinical surveillance efforts in cancer survivors. [Table: see text]

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