scholarly journals Society of Behavioral Medicine (SBM) position statement: support increased knowledge and efforts to address the financial burden associated with cancer treatment

2020 ◽  
Author(s):  
Carl V Asche ◽  
Karriem Watson ◽  
Meredith Greer Baumgartner ◽  
Joanna Buscemi ◽  
Marian Fitzgibbon ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Financial Burden ◽  
Healthcare Research ◽  
Robert Wood Johnson Foundation ◽  
Critical Element ◽  
Care Providers ◽  
Financial Toxicity ◽  
Cost Information ◽  
Substantial Impact

Abstract Millions of individuals and their families struggle with both treatment-related and out-of-pocket (OOP) economic repercussions of a cancer diagnosis, an effect increasingly referred to as “financial toxicity.” In 2014, the Agency for Healthcare Research and Quality (AHRQ) estimated the total U.S. expenditures for cancer at $87.8 billion dollars with patient OOP costs accounting for $3.9 billion dollars (2014). These figures do not take into account indirect costs, such as those from lost earnings. As a result, financial toxicity can extend well beyond the active treatment phase and have a substantial impact on a household’s economic reserve and financial resilience well into the future. Of the 9.5 million U.S. adults aged 50 years and older diagnosed with cancer (2000–2012), 42.2% have depleted their assets at 2 years and 38.2% were financially insolvent in 4 years. Bankruptcy rates are 2.65 times higher among cancer survivors than matched controls. A full 70% of Americans want to have conversations about the costs of care with their health care providers, but only 28% report doing so. Delaying or deferring these conversations can have major financial consequences for patients. According to a polling conducted for the Robert Wood Johnson Foundation (RWJF) by Avalere Health, almost 20% of patients report forgoing care when they have questions about costs. A critical element to achieve this is to have accurate cost information, including health care insurance coverage policies. Specifically, while patients and their families look to their health care providers to help them better navigate the cost implication of their treatment choices, most who are willing to undertake this challenging task need to have accessible and comprehensive (including direct and indirect) cost information to facilitate the discussion.

scholarly journals Perspectives of Clients and Providers on Factors Influencing Medication Assisted Treatment Uptake Among People Who Use Drugs in Indonesia, Ukraine and Vietnam: HPTN 074 Study

2020 ◽  
Author(s):  
Tetiana Kiriazova ◽  
Vivian F. Go ◽  
Rebecca B. Hershow ◽  
Erica L. Hamilton ◽  
Riza Sarasvita ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Addiction Treatment ◽  
Financial Burden ◽  
Hiv Treatment ◽  
People Who Use Drugs ◽  
Care Providers ◽  
Medication Assisted Treatment ◽  
Lack Of Information ◽  
Living With Hiv

Abstract Background: Medication-assisted treatment (MAT) is an effective method of addiction treatment and HIV prevention. However, globally, people who inject drugs (PWID) have insufficient MAT uptake. To expand MAT access and uptake, policy-makers, program-developers and health care providers should be aware of barriers to and facilitators of MAT uptake among PWID. Methods: As a part of the HPTN 074 study, which assessed the feasibility of an intervention to facilitate HIV treatment and MAT in PWID living with HIV in Indonesia, Ukraine, and Vietnam, we conducted in-depth interviews with 37 HIV-positive PWID and 25 health care providers to explore barriers to and facilitators of MAT uptake. All interviews were audio-recorded, transcribed, translated into English, and coded in NVivo for analysis. We developed matrices to identify emergent themes and patterns. Results: Despite some reported country-specific factors, PWID and health care providers at all geographic locations reported similar barriers to MAT initiation, such as complicated procedures to initiate MAT, problematic clinic access, lack of information on MAT, misconceptions about methadone, financial burden, and stigma towards PWID. However, while PWID reported fear of drug interaction (MAT and antiretroviral therapy), providers perceived that PWID prioritized drug use over caring for their health and hence were less motivated to take up ART and MAT. Motivation for a life change and social support were reported to be facilitators.Conclusion: These results highlight a need for support for PWID to initiate and retain in drug treatment. To expand MAT in all three countries, it is necessary to facilitate access and ensure low-threshold, financially affordable MAT programs for PWID, accompanied with supporting interventions. PWID attitudes and beliefs about MAT indicate the need for informational campaigns to counter misinformation and stigma associated with addiction and MAT (especially methadone).

scholarly journals 2017 National Standards for Diabetes Self-Management Education and Support

2018 ◽  
Vol 45 (1) ◽  
pp. 34-49 ◽  
Author(s):  
Joni Beck ◽  
Deborah A. Greenwood ◽  
Lori Blanton ◽  
Sandra T. Bollinger ◽  
Marcene K. Butcher ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Management Education ◽  
Positive Impact ◽  
National Standards ◽  
Self Management ◽  
Current Evidence ◽  
Critical Element ◽  
Care Providers ◽  
Health Care Environment

Purpose The purpose of this study is to review the literature for Diabetes Self-Management Education and Support (DSMES) to ensure the National Standards for DSMES (Standards) align with current evidence-based practices and utilization trends. Methods The 10 Standards were divided among 20 interdisciplinary workgroup members. Members searched the current research for diabetes education and support, behavioral health, clinical, health care environment, technical, reimbursement, and business practice for the strongest evidence that guided the Standards revision. Results Diabetes Self-Management Education and Support facilitates the knowledge, skills, and ability necessary for diabetes self-care as well as activities that assist a person in implementing and sustaining the behaviors needed to manage their condition on an ongoing basis. The evidence indicates that health care providers and people affected by diabetes are embracing technology, and this is having a positive impact of DSMES access, utilization, and outcomes. Conclusion Quality DSMES continues to be a critical element of care for all people with diabetes. The DSMES services must be individualized and guided by the concerns, preferences, and needs of the person affected by diabetes. Even with the abundance of evidence supporting the benefits of DSMES, it continues to be underutilized, but as with other health care services, technology is changing the way DSMES is delivered and utilized with positive outcomes.

Making the Case for a Nurse-Led Vascular Access Team Utilizing a Quality Assurance Conceptual Framework

2009 ◽  
Vol 14 (2) ◽  
pp. 77-82 ◽  
Author(s):  
Amanda L. Beerman
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Financial Burden ◽  
Central Venous Access ◽  
Venous Access ◽  
Care Providers ◽  
Quality Of Patient Care ◽  
The Cost ◽  
Venous Access Devices

Abstract The cost of complications of central venous access devices (CVADs) in today's health care setting is creating a financial burden, increasing the expenditures of resources, and consuming the time of health care providers to resolve. As the roles of nurses continue to evolve, nurses may be in a position to recognize and prevent many of these complications. This paper proposes a conceptual model to address the issues related to caring for and monitoring CVADs, while reducing complications and increasing quality of patient care.

scholarly journals Perspectives of clients and providers on factors influencing opioid agonist treatment uptake among HIV-positive people who use drugs in Indonesia, Ukraine and Vietnam: HPTN 074 study

2020 ◽  
Author(s):  
Tetiana Kiriazova ◽  
Vivian F. Go ◽  
Rebecca B. Hershow ◽  
Erica L. Hamilton ◽  
Riza Sarasvita ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Addiction Treatment ◽  
Financial Burden ◽  
Hiv Treatment ◽  
Hiv Positive ◽  
People Who Use Drugs ◽  
Care Providers ◽  
Opioid Agonist ◽  
Opioid Agonist Treatment

Abstract Background: Opioid agonist treatment (OAT) is an effective method of addiction treatment and HIV prevention. However, globally, people who inject drugs (PWID) have insufficient OAT uptake. To expand OAT access and uptake, policy-makers, program-developers and health care providers should be aware of barriers to and facilitators of OAT uptake among PWID. Methods: As a part of the HPTN 074 study, which assessed the feasibility of an intervention to facilitate HIV treatment and OAT in PWID living with HIV in Indonesia, Ukraine, and Vietnam, we conducted in-depth interviews with 37 HIV-positive PWID and 25 health care providers to explore barriers to and facilitators of OAT uptake. All interviews were audio-recorded, transcribed, translated into English, and coded in NVivo for analysis. We developed matrices to identify emergent themes and patterns. Results: Despite some reported country-specific factors, PWID and health care providers at all geographic locations reported similar barriers to OAT initiation, such as complicated procedures to initiate OAT, problematic clinic access, lack of information on OAT, misconceptions about methadone, financial burden, and stigma towards PWID. However, while PWID reported fear of drug interaction (OAT and antiretroviral therapy), providers perceived that PWID prioritized drug use over caring for their health and hence were less motivated to take up ART and OAT. Motivation for a life change and social support were reported to be facilitators.Conclusion: These results highlight a need for support for PWID to initiate and retain in drug treatment. To expand OAT in all three countries, it is necessary to facilitate access and ensure low-threshold, financially affordable OAT programs for PWID, accompanied with supporting interventions. PWID attitudes and beliefs about OAT indicate the need for informational campaigns to counter misinformation and stigma associated with addiction and OAT (especially methadone).

scholarly journals Evaluation of Big Data Analytics in Medical Science

2019 ◽  
Vol 8 (6S3) ◽  
pp. 717-720
Keyword(s):  
Health Care ◽  
Big Data ◽  
Health Care Providers ◽  
Care Delivery ◽  
Medical Science ◽  
Big Data Analytics ◽  
Healthcare Research ◽  
Care Providers ◽  
Treatment Pathways ◽  
Efficient Treatment

In medical science the concept of big data is very important because in the diseases prevention outcome prediction of co-morbidities, mortality and it save the cost of medical treatment it can used. In the evolution of healthcare research and practices the continuously growing field of analytics of big data has play a pivotal role. To analyze, accumulate, assimilate and manage huge volume of structured, disparate and unstructured data that produced by recent system of healthcare, it provide the tools. To inform providers about most effective and efficient treatment pathways and to revamp the health care delivery process the big data of healthcare has the potential. Both insurers and health care providers are incenting by Value-based purchasing programs. To estimate the efficiency and quality of care to find the new ways to leverage health care data defined the insures. During routine health care in data collection current advances in the form of EHR (Electronic Health Records), for clinical application in biological discoveries medical device data have created major opportunities

2017 National Standards for Diabetes Self-Management Education and Support

2018 ◽  
Vol 44 (1) ◽  
pp. 35-50 ◽  
Author(s):  
Joni Beck ◽  
Deborah A. Greenwood ◽  
Lori Blanton ◽  
Sandra T. Bollinger ◽  
Marcene K. Butcher ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Management Education ◽  
Positive Impact ◽  
National Standards ◽  
Self Management ◽  
Current Evidence ◽  
Critical Element ◽  
Care Providers ◽  
Health Care Environment

Purpose The purpose of this study is to review the literature for Diabetes Self-Management Education and Support (DSMES) to ensure the National Standards for DSMES (Standards) align with current evidence-based practices and utilization trends. Methods The 10 Standards were divided among 20 interdisciplinary workgroup members. Members searched the current research for diabetes education and support, behavioral health, clinical, health care environment, technical, reimbursement, and business practice for the strongest evidence that guided the Standards revision. Results Diabetes Self-Management Education and Support facilitates the knowledge, skills, and ability necessary for diabetes self-care as well as activities that assist a person in implementing and sustaining the behaviors needed to manage their condition on an ongoing basis. The evidence indicates that health care providers and people affected by diabetes are embracing technology, and this is having a positive impact of DSMES access, utilization, and outcomes. Conclusion Quality DSMES continues to be a critical element of care for all people with diabetes. The DSMES services must be individualized and guided by the concerns, preferences, and needs of the person affected by diabetes. Even with the abundance of evidence supporting the benefits of DSMES, it continues to be underutilized, but as with other health care services, technology is changing the way DSMES is delivered and utilized with positive outcomes.

Aging, Genetic Variations, and Ethnopharmacology

2016 ◽  
Vol 28 (1) ◽  
pp. 56-62 ◽  
Author(s):  
Diana Lynn Woods ◽  
Janet C. Mentes ◽  
Mary Cadogan ◽  
Linda R. Phillips
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Care Providers ◽  
Genetic Variations ◽  
Healthcare Research ◽  
Genetic Differences ◽  
Care Providers ◽  
Drug Responses ◽  
Age Related ◽  
Age Related Changes

Unique drug responses that may result in adverse events are among the ethnocultural differences described by the Agency for Healthcare Research and Quality. These differences, often attributed to a lack of adherence on the part of the older adult, may be linked to genetic variations that influence drug responses in different ethnic groups. The paucity of research coupled with a lack of knowledge among health care providers compound the problem, contributing to further disparities, especially in this era of personalized medicine and pharmacogenomics. This article examines how age-related changes and genetic differences influence variations in drug responses among older adults in unique ethnocultural groups. The article starts with an overview of age-related changes and ethnopharmacology, moves to describing genetic differences that affect drug responses, with a focus on medications commonly prescribed for older adults, and ends with application of these issues to culturally congruent health care.

Family Expenditure on Sickness Episodes of Pre-School Children in Urban Slums of Lucknow, North India

1998 ◽  
Vol 28 (3) ◽  
pp. 141-146 ◽  
Author(s):  
Shally Awasthi ◽  
Vinod Kumar Pande
Keyword(s):  
Health Care ◽  
Health Care Provider ◽  
Health Care Providers ◽  
School Children ◽  
Care Provider ◽  
Financial Burden ◽  
Respiratory Illness ◽  
Urban Slums ◽  
North India ◽  
Care Providers

This study investigated family expenditure on the sickness episodes of pre-school children in 32 urban slums of Lucknow, North India. Between July 1995 and January 1996, 396 children between the ages of 1.5 to 3.5 years were contacted. The main objective was to discover the direct medical cost of illness incurred by their families in the preceding months. Point prevalence of major morbidities, in the preceding month, were as follows: 17.2% respiratory and 6.3% diarrhoeal. A health care provider saw 31.4% [95% confidence interval (CI): 26.9–36.01] children. In >95% of the cases, the health care provider was a self-employed, non-governmental dispenser (NGD). More than half of NGDs did not have a recognized medical degree. The mean family expenditure on sickness in 1 month was RS 12.27 [standard deviation (SD): RS 23.81], approximately 1% of their income (1 US$ = RS 32). Respiratory illness was the primary cause of financial burden to the community. The isolated symptom of fever was the most expensive to treat, with diarrhoea and dysentery costs being similar. Immunizing a child saved money. We conclude that since the NGDs are the predominant health care providers in the urban slums, and since neither the nature of medicines dispensed by them nor their additional costs can be ascertained, steps must be taken to monitor their dispensing practices and to educate them about rational drug therapy.

scholarly journals Illness perceptions of leprosy-cured individuals in Surinam with residual disfigurements – “I am cured, but still I am ill”

2016 ◽  
Vol 13 (2) ◽  
pp. 117-127 ◽  
Author(s):  
Mark AC van Haaren ◽  
Melinda Reyme ◽  
Maggie Lawrence ◽  
Jack Menke ◽  
Ad A Kaptein
Keyword(s):  
Health Care ◽  
Theoretical Model ◽  
Health Care Providers ◽  
Illness Perceptions ◽  
Negative Impact ◽  
Social Consequences ◽  
Chronic Illnesses ◽  
Care Providers ◽  
Structured Interviews ◽  
Substantial Impact

Objective Leprosy has rarely been the subject of health psychology research despite its substantial impact. Our aim was to explore illness perceptions in patients and their health care providers in Surinam. The Common Sense Model (CSM) was the guiding theoretical model. Design Patients with biomedically cured leprosy and their health care providers completed the B-IPQ and took part in semi-structured interviews. The literature on illness perceptions in patients with leprosy was reviewed. Main outcome measures Patients’ B-IPQ scores were compared with samples of patients with other (chronic) illnesses, and with health care providers completing the questionnaire as if they were visibly disfigured patients. Quotations from the semi-structured interviews were used to contextualise the illness perceptions. Results Patients’ B-IPQ scores reflected the chronic nature of leprosy and were comparable with those with other chronic illnesses. Health care providers perceived leprosy to have a greater negative impact than did the patients. Perceived understanding of causes differed considerably between patients and health care providers. Conclusion Leprosy continues to be experienced as an illness with major psychological and social consequences such as stigmatisation, even after biomedical cure. Interventions that target patients, health care providers, and society at large may help reduce perceived shame and stigma. The CSM is a helpful theoretical model in studying this population.

scholarly journals Impact of Powered Air-Purifying Respirator Devices on Word Recognition in Health Care Providers

2021 ◽  
pp. 019459982110583
Author(s):  
Emily J. Moldoff ◽  
Miranda K. Eubank ◽  
Anne Y. Feng ◽  
C. Eduardo Corrales ◽  
Jennifer J. Shin
Keyword(s):  
Health Care ◽  
Word Recognition ◽  
Health Care Providers ◽  
Auditory Perception ◽  
Normal Hearing ◽  
Care Providers ◽  
Noise Levels ◽  
Substantial Impact ◽  
Speech Presentation ◽  
Adequate Communication

The coronavirus 2019 pandemic has increased the use of powered air-purifying respirator (PAPR) devices, which produce appreciable noise levels during filtration. Our objective was to determine if active PAPR usage significantly impairs auditory communication in health care providers. We additionally sought to assess what volume of speech presentation was required for adequate communication with providers wearing a PAPR. In subjects with normal hearing at baseline, audiometric data demonstrated a 93% (95% CI, 86%-99%) decrease in word recognition scores during active PAPR usage. Presentation at 85 to 90 dB was needed to obtain word recognition scores similar to baseline in subjects with normal hearing without a PAPR. Pure tone averages also significantly decreased with PAPR usage, by 54 dB (95% CI, 46-62). Active PAPR usage has a substantial impact on auditory perception when utilized by health care providers. The potential longer-term effect of these devices on providers with regular active usage is of interest for future study.

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