Inpatient Financial Burden of Atopic Dermatitis in the United States

Orthopaedic extremity injuries present a large medical and financial burden to the United States and world-wide communities [1]. Approximately six million long bone fractures are reported annually in the United States and approximately 10% of these fractures do not heal properly. Though the exact mechanism of impaired healing is poorly understood, many of these non-unions result when there is a communited condition that does not proceed through a stabilized healing pathway [2]. Currently, clinicians may monitor healing visually by radiographs, or via manual manipulation of the bone at the fracture [3]. Unfortunately, the course of aberrant fracture healing is not easily diagnosed in the early period when standard radiographic information of the fracture is not capable of discriminating the healing pathway. Manual assessment of fracture healing is also an inadequate diagnostic tool in the early stages of healing [4].

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BITES study: A qualitative analysis among emergency medicine physicians on snake envenomation management practices

PLoS ONE ◽

10.1371/journal.pone.0262215 ◽

2022 ◽

Vol 17 (1) ◽

pp. e0262215

Author(s):

Anna Tupetz ◽

Loren K. Barcenas ◽

Ashley J. Phillips ◽

Joao Ricardo Nickenig Vissoci ◽

Charles J. Gerardo

Keyword(s):

United States ◽

Emergency Medicine ◽

Financial Burden ◽

The United States ◽

Poison Center ◽

Functional Impairments ◽

Major Barrier ◽

Snake Envenomation ◽

Depth Interviews

Introduction Antivenom is currently considered standard treatment across the full spectrum of severity for snake envenomation in the United States. Although safe and effective antivenoms exist, their use in clinical practice is not universal. Objective This study explored physicians’ perceptions of antivenom use and experience with snake envenomation treatment in order to identify factors that influence treatment decisions and willingness to administer. Methods We conducted a qualitative study including in-depth interviews via online video conferencing with physicians practicing in emergency departments across the United States. Participants were selected based on purposive sampling methods. Data analysis followed inductive strategies, conducted by two researchers. The codebook and findings were discussed within the research team. Findings Sixteen in-depth interviews with physicians from nine states across the US were conducted. The participants’ specialties include emergency medicine (EM), pediatric EM, and toxicology. The experience of treating snakebites ranged from only didactic education to having treated over 100 cases. Emergent themes for this manuscript from the interview data included perceptions of antivenom, willingness to administer antivenom and influencing factors to antivenom usage. Overall, cost-related concerns were a major barrier to antivenom administration, especially in cases where the indications and effectiveness did not clearly outweigh the potential financial burden on the patient in non-life- or limb-threatening cases. The potential to decrease recovery time and long-term functional impairments was not commonly reported by participants as an indication for antivenom. In addition, level of exposure and perceived competence, based on prior education and clinical experience, further impacted the decision to treat. Resources such as Poison Center Call lines were well received and commonly used to guide the treatment plan. The need for better clinical guidelines and updated treatment algorithms with clinical and measurable indicators was stated to help the decision-making process, especially among those with low exposure to snake envenomation patients. Conclusions A major barrier to physician use of antivenom is a concern about cost, cost transparency and cost–benefit for the patients. Those concerns, in addition to the varying degrees of awareness of potential long-term benefits, further influence inconsistent clinical treatment practices.

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Topical treatment utilization for patients with atopic dermatitis in the United States, and budget impact analysis of crisaborole ointment, 2%

Journal of Medical Economics ◽

10.1080/13696998.2018.1470520 ◽

2018 ◽

Vol 21 (8) ◽

pp. 770-777 ◽

Cited By ~ 4

Author(s):

Ryan Clark ◽

Duygu Bozkaya ◽

Mark Levenberg ◽

Steven Faulkner ◽

Timothy W. Smith ◽

...

Keyword(s):

United States ◽

Atopic Dermatitis ◽

Topical Treatment ◽

Impact Analysis ◽

Budget Impact ◽

The United States ◽

Budget Impact Analysis ◽

Treatment Utilization

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Psychological, Social and Technical Factors Influencing Electronic Medical Records Systems Adoption by U.S. Physicians: A Systematic Model

10.21203/rs.3.rs-36849/v1 ◽

2020 ◽

Author(s):

Raghid El-Yafouri ◽

Leslie Klieb ◽

Valérie Sabatier

Keyword(s):

United States ◽

Health Care ◽

Medical Care ◽

Electronic Medical Records ◽

Medical Records ◽

Service Providers ◽

Financial Burden ◽

The United States ◽

Care Providers ◽

Intention To Adopt

Abstract Background: Wide adoption of electronic medical records (EMR) systems in the United States can lead to better quality medical care at a lower cost. Despite the laws and financial subsidies by the U.S. government for service providers and suppliers, the adoption has been slow. Understanding the EMR adoption drivers for physicians and the role of policymaking can translate into increased adoption rate and enhanced information sharing between medical care providers. Methods: Physicians across the United States were surveyed to gather primary data on their psychological, social, and technical perceptions toward EMR systems. This quantitative study builds on the Theory of Planned Behavior, the Technology Acceptance Model, and the Diffusion of Innovation theory to propose, test, and validate an innovation adoption model for the health care industry. 382 responses were collected and data were analyzed via linear regression to uncover the effects of 12 variables on the intention to adopt EMR systems.Results: Regression model testing uncovers that government policymaking or mandates and other social factors have little or negligible effect on physicians’ intention to adopt an innovation. Rather, physicians are directly driven by their attitudes and ability to control, and indirectly motivated by their knowledge of the innovation, the financial ability to acquire the system, the holistic benefits to their industry, and the relative advancement of the system compared to others.Conclusions: A unidirectional mandate from the government is not sufficient for physicians to adopt an innovation. Government, health care associations, and EMR system vendors can benefit from our findings by working toward increasing the physicians’ knowledge of the proposed innovation, socializing how medical care providers and the overall industry can benefit from EMR system adoption, and solving for the financial burden of system implementation and sustainment.

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