scholarly journals EDUCATING MEDICAL PRACTITIONERS ABOUT MEDICAL BILLING: A SYSTEMATIC REVIEW OF THE LITERATURE

Author(s):  
Margaret Faux ◽  
Jon Adams ◽  
Jon Wardle

ABSTRACTIntroductionThe WHO has suggested the solution to leakage in health systems caused by waste, corruption and fraud is policing and prosecution. However, a growing body of evidence suggests leakage may not always be fraudulent or corrupt, with researchers suggesting medical practitioners may sometimes struggle to understand increasingly complex legal requirements around health financing and billing transactions, which may be improved through education. To explore this phenomenon further, we undertook a systematic review of the literature to identify the medical billing education needs of medical practitioners and whether those needs are being met.MethodsEligible records included English language materials published between 1 January 2000 and 4 May 2020, including empirical research, commentary, opinions and grey literature.ResultsWe identified 74 records as directly relevant to the search criteria. Despite a comprehensive international search, studies were limited to three countries (Australia, Canada, U.S), indicating a need for further work internationally. The literature suggests the education needs of medical practitioners in relation to medical billing compliance are not being met and medical practitioners desire more education on this topic. Evidence suggests education may be effective in improving medical billing compliance and reducing waste in health systems and there is broad agreement amongst medical education stakeholders in multiple jurisdictions that medical billing should be viewed as a core competency of medical education, though there is an apparent inertia to act. Penalties for non-compliant medical billing are serious and medical practitioners are at risk of random audits and investigations for breaches of sometimes incomprehensible, and highly interpretive regulations they may never have been taught.ConclusionDespite acknowledged significance of leakage in health systems due to poor practitioner knowledge of billing practices, there has been very little research to date on education interventions to improve health system efficiency at a practitioner level.

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Margaret Faux ◽  
Jon Adams ◽  
Jonathan Wardle

Abstract Introduction The World Health Organization has suggested the solution to health system waste caused by incorrect billing and fraud is policing and prosecution. However, a growing body of evidence suggests leakage may not always be fraudulent or corrupt, with researchers suggesting medical practitioners may sometimes struggle to understand increasingly complex legal requirements around health financing and billing transactions, which may be improved through education. To explore this phenomenon further, we undertook a scoping review of the literature to identify the medical billing education needs of medical practitioners and whether those needs are being met. Methods Eligible records included English language materials published between 1 January 2000 and 4 May 2020. Searches were conducted on MEDLINE, PubMed, Google Scholar, CINAHL, LexisNexis and Heinonline. Results We identified 74 records as directly relevant to the search criteria. Despite undertaking a comprehensive, English language search, with no country restrictions, studies meeting the inclusion criteria were limited to three countries (Australia, Canada, US), indicating a need for further work internationally. The literature suggests the education needs of medical practitioners in relation to medical billing compliance are not being met and medical practitioners desire more education on this topic. Evidence suggests education may be effective in improving medical billing compliance and reducing waste in health systems. There is broad agreement amongst medical education stakeholders in multiple jurisdictions that medical billing should be viewed as a core competency of medical education, though there is an apparent inertia to include this competency in medical education curricula. Penalties for non-compliant medical billing are serious and medical practitioners are at risk of random audits and investigations for breaches of sometimes incomprehensible, and highly interpretive regulations they may never have been taught. Conclusion Despite acknowledged significance of waste in health systems due to poor practitioner knowledge of billing practices, there has been very little research to date on education interventions to improve health system efficiency at a practitioner level.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Wafa Aftab ◽  
Mishal Khan ◽  
Sonia Rego ◽  
Nishant Chavan ◽  
Afifah Rahman-Shepherd ◽  
...  

Abstract Background To strengthen health systems, the shortage of physicians globally needs to be addressed. However, efforts to increase the numbers of physicians must be balanced with controls on medical education imparted and the professionalism of doctors licensed to practise medicine. Methods We conducted a multi-country comparison of mandatory regulations and voluntary guidelines to control standards for medical education, clinical training, licensing and re-licensing of doctors. We purposively selected seven case-study countries with differing health systems and income levels: Canada, China, India, Iran, Pakistan, UK and USA. Using an analytical framework to assess regulations at four sequential stages of the medical education to relicensing pathway, we extracted information from: systematically collected scientific and grey literature and online news articles, websites of regulatory bodies in study countries, and standardised input from researchers and medical professionals familiar with rules in the study countries. Results The strictest controls we identified to reduce variations in medical training, licensing and re-licensing of doctors between different medical colleges, and across different regions within a country, include: medical education delivery restricted to public sector institutions; uniform, national examinations for medical college admission and licensing; and standardised national requirements for relicensing linked to demonstration of competence. However, countries analysed used different combinations of controls, balancing the strictness of controls across the four stages. Conclusions While there is no gold standard model for medical education and practise regulation, examining the combinations of controls used in different countries enables identification of innovations and regulatory approaches to address specific contextual challenges, such as decentralisation of regulations to sub-national bodies or privatisation of medical education. Looking at the full continuum from medical education to licensing is valuable to understand how countries balance the strictness of controls at different stages. Further research is needed to understand how regulating authorities, policy-makers and medical associations can find the right balance of standardisation and context-based flexibility to produce well-rounded physicians.


2017 ◽  
Vol 126 (4) ◽  
pp. 1148-1157 ◽  
Author(s):  
Brenton Nash ◽  
Matthew L. Carlson ◽  
Jamie J. Van Gompel

OBJECTIVE The objective of this study was to examine operative outcomes in cases of microvascular decompression (MVD) of cranial nerve (CN) VIII for tinnitus through a critical review of the literature. METHODS Forty-three English-language articles were gathered from PubMed and analyzed. In this review, two different case types were distinguished: 1) tinnitus-only symptomatology, which was defined as a patient with tinnitus with or without sensorineural hearing loss; and 2) mixed symptomatology, which was defined as tinnitus with symptoms of other CN dysfunction. This review reports outcomes of those with tinnitus-only symptoms. RESULTS Forty-three tinnitus-only cases were found in the literature with a 60% positive outcome rate following MVD. Analysis revealed a 5-year cutoff of preoperative symptom duration before which a good outcome can be predicted with 78.6% sensitivity, and after which a poor outcome can be predicted with 80% specificity. CONCLUSIONS As the 60% success rate is more promising than several other therapeutic options open to the chronic tinnitus sufferer, future research into this field is warranted.


10.2196/16929 ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. e16929
Author(s):  
Michelle Helena Van Velthoven ◽  
Madison Milne-Ives ◽  
Caroline de Cock ◽  
Mary Mooney ◽  
Edward Meinert

Background The decline in the uptake of routine childhood vaccinations has resulted in outbreaks of vaccine-preventable diseases. Vaccination apps can be used as a tool to promote immunization through the provision of reminders, dissemination of information, peer support, and feedback. Objective The aim of this review is to systematically review the evidence on the use of apps to support childhood vaccination uptake, information storage, and record sharing. Methods We will identify relevant papers by searching the following electronic databases: PubMed, Embase by Ovid, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, and Education Resources Information Center (ERIC). We will review the reference lists of those studies that we include to identify relevant additional papers not initially identified using our search strategy. In addition to the use of electronic databases, we will search for grey literature on the topic. The search strategy will include only terms relating to or describing the intervention, which is app use. As almost all titles and abstracts are in English, 100% of these will be reviewed, but retrieval will be confined to papers written in the English language. We will record the search outcome on a specifically designed record sheet. Two reviewers will select observational and intervention studies, appraise the quality of the studies, and extract the relevant data. All studies will involve the use of apps relating to child vaccinations. The primary outcome is the uptake of vaccinations. Secondary outcomes are as follows: (1) use of app for sharing of information and providing vaccination reminders and (2) use of app for storage of vaccination information; knowledge and decision making by parents regarding vaccination (ie, risks and benefits of vaccination); costs and cost-effectiveness of vaccination apps; use of the app and measures of usability (eg, usefulness, acceptability, and experiences of different users: parents and health care professionals); use of technical standards for development of the app; and adverse events (eg, data leaks and misinformation). We will exclude studies that do not study an app. We anticipate a limited scope for meta-analysis and will provide a narrative overview of findings and tabular summaries of extracted data. Results This project was funded by the Sir David Cooksey Fellowship in Healthcare Translation at the University of Oxford, Oxford, United Kingdom. We will submit the full systematic review for publication in the Journal of Medical Internet Research. Conclusions This review will follow, where possible, the Cochrane Collaboration and the Centre for Review and Dissemination methodologies for conducting systematic reviews. We will report our findings based on guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The review results will be used to inform the development of a vaccination app. International Registered Report Identifier (IRRID) PRR1-10.2196/16929


2021 ◽  
Author(s):  
Marieta Gómez Montero ◽  
Gabriela Gómez Gómez1 ◽  
Luisa López-Sarasty ◽  
Valentina Moncada Cortes ◽  
Francisco Palencia-Sánchez

Objective: The purpose of this review is to collect and synthesize the information available about the strategies and recommendations established around the world, to guarantee the reopening of educational institutions, in a safe manner, in the context of the COVID-19 pandemic. In addition, it seeks to propose evidence-based recommendations, which allow the safe reopening of educational institutions in Colombia. Methods: A systematic review of the literature was carried out in databases such as Embase, Scopus, and Web of Science, as well as research in grey literature, social media, Google, and Google Scholar. In order to do this, a search equation was proposed, and subsequently, 19 articles were chosen, which met the determined inclusion criteria. Results: According to the analyzed literature, the recommendations come to light in order to guarantee a safe return. Conclusions: The COVID-19 pandemic, has caused an impact in all spheres of society, being the education, one of the most affected, because it has had a negative impact on the development of cognitive and social abilities, in particular, in the new generations, as a result of social distancing and the change of modality to remote and/or virtual education. For this reason, it is considered a priority the reopening educational institutions, in a safe manner, considering the evidence-based recommendations.


BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e018568 ◽  
Author(s):  
Jeffrey Braithwaite ◽  
Luke Testa ◽  
Gina Lamprell ◽  
Jessica Herkes ◽  
Kristiana Ludlow ◽  
...  

IntroductionThe sustainability of healthcare interventions and change programmes is of increasing importance to researchers and healthcare stakeholders interested in creating sustainable health systems to cope with mounting stressors. The aim of this protocol is to extend earlier work and describe a systematic review to identify, synthesise and draw meaning from studies published within the last 5 years that measure the sustainability of interventions, improvement efforts and change strategies in the health system.Methods and analysisThe protocol outlines a method by which to execute a rigorous systematic review. The design includes applying primary and secondary data collection techniques, consisting of a comprehensive database search complemented by contact with experts, and searching secondary databases and reference lists, using snowballing techniques. The review and analysis process will occur via an abstract review followed by a full-text screening process. The inclusion criteria include English-language, peer-reviewed, primary, empirical research articles published after 2011 in scholarly journals, for which the full text is available. No restrictions on location will be applied. The review that results from this protocol will synthesise and compare characteristics of the included studies. Ultimately, it is intended that this will help make it easier to identify and design sustainable interventions, improvement efforts and change strategies.Ethics and disseminationAs no primary data were collected, ethical approval was not required. Results will be disseminated in conference presentations, peer-reviewed publications and among policymaker bodies interested in creating sustainable health systems.


2016 ◽  
Vol 26 (4) ◽  
pp. 617-622 ◽  
Author(s):  
Sabrina M. Neeley ◽  
Catherine A. Ulman ◽  
Bette S. Sydelko ◽  
Nicole J. Borges

2018 ◽  
Vol 7 (3) ◽  
pp. 217-229 ◽  
Author(s):  
Sarah Seleznyov

Purpose The purpose of this paper is to explore the popularity of Japanese lesson study (JLS) beyond Japan and the challenges this translation might pose. It notes that there is not a universally accepted definition of lesson study (LS) and seeks to identify the “critical components” of JLS through a review of the literature. It then uses a systematic literature review of recent studies of the implementation of LS with in-service teachers beyond Japan to analyse the models of LS used against these seven critical components in order to explore the degree of fidelity to the Japanese model. Design/methodology/approach A broad review of the literature on JLS available in the English language identifies seven “critical components”. A systematic literature review of 200 recent English language studies of the implementation of LS with in-service teachers beyond Japan is then carried out. Articles published between 2005 and 2015 are explored, including peer reviewed articles, scientific journals, book chapters and PhD dissertations. This systematic review enables an analysis of the models of LS used in studies from beyond Japan against the “seven critical components” of JLS. Findings The analysis shows that there is not an internationally shared understanding of Japanese lesson study (JLS) and that many of the missing components are those which distinguish LS as a research process, not simply a collaborative professional development approach. It also reveals that UK LS models seem particularly far from the Japanese model in those critical components which connect teachers’ knowledge and understanding within groups, to knowledge and understanding that exists beyond it. The study discusses whether these differences could be attributed to structural or cultural differences between Japan and other nations. Research limitations/implications The search for descriptions of the JLS is limited to articles available in the English language, which, therefore, represent a quite limited body of authority on the “critical components” of LS. The systematic review is similarly limited to English language articles, and there is a clear bias towards the USA, with the Far East and the UK making up the majority of the remaining studies. The study suggests that future research on LS beyond Japan should consider teachers’ attitudes towards the research elements of the process as well as their skills and confidence in carrying out research into practice. Practical implications The study strikes a note of caution for schools wishing to implement JLS as an approach to teacher professional development in the UK and beyond. Japan’s systemic approach has embedded LS experience and expertise into the education system, meaning a uniform approach to LS is much more likely. In addition, other systemic challenges may arise, for example, UK professional development time and resources is not designed with JLS in mind and may therefore require a significant reworking. Originality/value Whilst several systematic reviews of LS have explored its growth, geographical spread, impact and key features, this study provides a different perspective. It analyses whether and to what degree the “lesson study” models these studies describe align with the literature on JLS, and the implications of this for researchers and practitioners.


2002 ◽  
Vol 47 (9) ◽  
pp. 833-843 ◽  
Author(s):  
Elliot M Goldner ◽  
Lorena Hsu ◽  
Paul Waraich ◽  
Julian M Somers

Objective: To present the results of a systematic review of the literature published between January 1, 1980, and December 31, 2000, that reports findings on the prevalence and incidence of schizophrenia and related disorders. Method: We conducted a literature search of schizophrenia-related epidemiological studies, using Medline and HealthSTAR databases and canvassing English-language publications. We used a set of predetermined inclusion-exclusion criteria to identify relevant studies. Eligible publications were restricted to age ranges of 18 years and over for prevalence studies and 15 years and over for incidence studies. Prevalence and incidence data were extracted and analyzed for heterogeneity. Results: A total of 18 prevalence and 8 incidence studies met eligibility criteria for the review. Heterogeneity analysis revealed significant differences across 1-year and lifetime prevalence and 1-year incidence of schizophrenia. The corresponding pooled rates were: 0.34 per 100, 0.55 per 100, and 11.1 per 100 000, respectively; the variation in rates between studies was generally between 2- and 5-fold. Conclusions: Although we restricted this review to studies using rigorous and relatively homogeneous methods, there remains significant heterogeneity of prevalence and incidence rates. This strengthens support for the hypothesis that there is real variation in the distribution of schizophrenia around the world. Health planners need to have local data on schizophrenia rates to improve the accuracy of their interventions, while clinicians and researchers need to continue to investigate the etiology of this variation.


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