scholarly journals Out-of-Pocket Spending for Health Care Within 90 Days of COVID-19 Hospitalization

2021 ◽  
Author(s):  
Kao-Ping Chua ◽  
Rena M Conti ◽  
Nora V Becker
Keyword(s):  
Health Care ◽  
Private Insurance ◽  
Health Care Needs ◽  
Medicare Advantage ◽  
Care Needs ◽  
Post Discharge ◽  
Cross Sectional ◽  
Discharge Care ◽  
Sectional Analysis ◽  
Privately Insured

INTRODUCTION: Millions of U.S. patients have been hospitalized for coronavirus disease 2019 (COVID-19). After discharge, these patients often have extensive health care needs, but out-of-pocket burden for this care is poorly described. Using national data, we assessed out-of-pocket spending during the 90 days after COVID-19 hospitalization among privately insured and Medicare Advantage patients. METHODS: In May 2021, we conducted a cross-sectional analysis of the IQVIA PharMetrics Plus for Academics Database, a national de-identified claims database. Among privately insured and Medicare Advantage patients hospitalized for COVID-19 between March-June 2020, we calculated mean out-of-pocket spending for care within 90 days of discharge. To contextualize results, we repeated analyses for patients hospitalized for bacterial pneumonia. RESULTS: Among 1,465 COVID-19 patients included, 516 (35.2%) and 949 (64.8%) were covered by private insurance and Medicare Advantage plans. Among these patients, mean (SD) post-discharge out-of-pocket spending was $534 (1,045) and $680 (1,360); spending exceeded $2,000 for 7.0% and 10.3%. Compared with patients with pneumonia, mean post-discharge out-of-pocket spending among COVID-19 patients was higher among the privately insured ($534 vs $445) and lower among Medicare Advantage patients ($680 vs $918). CONCLUSIONS: Out-of-pocket spending for immediate post-discharge care can be substantial for many patients hospitalized for COVID-19. Among Medicare Advantage patients, post-discharge out-of-pocket spending was higher after pneumonia hospitalizations, potentially because insurer cost-sharing waivers fully covered the costs of COVID-19-related readmissions during the study period. As many insurers allowed such waivers to expire in 2021, it is important to repeat analyses among patients more recently hospitalized for COVID-19.

scholarly journals CRITERIA FOR SELECTING SPECIAL HEALTH CARE NEEDS PATIENTS FOR GENERAL ANESTHESIA IN DENTAL TREATMENT: A SYSTEMATIC REVIEW

2021 ◽  
Vol 9 (12) ◽  
pp. 507-515
Author(s):  
Nourah Al-Lwemi ◽  
◽  
Nuha Al-Shalabi ◽  
Noor Al-Basheeti ◽  
Hafsa Yasser ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Dental Treatment ◽  
Oral Health Status ◽  
Special Health Care Needs ◽  
Health Care Needs ◽  
Care Needs ◽  
Cross Sectional ◽  
Special Health Care ◽  
Special Health

Objective:This systematic review aimed to investigate the available evidence on how to decide whether your special health care needs patient needs GA for dental treatments or not. Materials and methods:A systematic search was conducted in four electronic databases PubMed, Google Scholar, ResearchGate and SDL. The search was restricted to articles published between 2005 and 2020. Publications reporting on the special health care needs patients dental treatment were included. The papers were analyzed regarding title and abstract contents to eliminate the ones that were out of context and not relevant to the review. Results:The search strategy resulted in 99 unique and potentially relevant articles. In total, 6 publications which include 5 retrospective articles and one cross-sectional study were selected. Conclusions:The main standards for selecting patients for hospitalized dental treatments include a full analysis of SNP including their medical history, behavior and emotional factors, oral health status, allergies, social and non-clinical factors, and caregivers factors. It is important for general dentists and families of these patients to be acquainted with the procedure, its need, and its contraindications.

scholarly journals Unmet health care needs of elderly residing on urban areas of Sunsari District, Nepal. A Cross Sectional Study

2019 ◽  
Author(s):  
Mukesh Poudel ◽  
Asmita Ojha ◽  
Deepak Kumar Yadav ◽  
Ram Bilakshan Sah ◽  
Avaniendra Chakravartty ◽  
...  
Keyword(s):  
Health Care ◽  
Urban Areas ◽  
Cross Sectional Study ◽  
Health Problems ◽  
Ageing Population ◽  
Health Care Needs ◽  
Sectional Study ◽  
Care Needs ◽  
Cross Sectional ◽  
Unmet Health Care Needs

Abstract Background : Global ageing population is in increasing trend. Morbidity increases with age and enhances the burden of health problems that results in new challenges to meet the additional demands. There can be various types of issues such as health problems, health care utilization, physical and social care which should be carefully assessed and addressed.Objective : This study aimed to assess the unmet health care needs among elderly.Methodology : A Community based, House to House, Cross sectional study was conducted in urban areas of sunsari district using face to face interview. Sample size of 530 elderly were selected by Systematic proportionate random sampling technique.Results : This study unfurled the prevalence of unmet need for consultation for Near vision 52.3%, Far vision 53.7%%, Hearing 79.7%, Dental 79.4%, Hypertension 6.7%, Diabetes 3.9%, CVD 5.3 %, and of at least one Unmet Health care need to be 64.9%. At least one unmet health need was significantly associated with higher odds among elderly of age more than 70, of dalit and janajati ethnicity, illiterate, poor, those with difficulty leaving home, distance of health facility > 30 mins, and those with depressive symptoms.Conclusion : The study highlighted higher prevalence and associated factors related to unmet health care needs among elderly. There is an urgent need to promote geriatric health services and make it available at the primary health care level.

scholarly journals A Survey of Geriatrics Courses in North American Chiropractic Programs

2009 ◽  
Vol 23 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Cara L. Borggren ◽  
Paul J. Osterbauer ◽  
Michael R. Wiles
Keyword(s):  
Health Care ◽  
North American ◽  
Independent Study ◽  
Health Care Needs ◽  
Care Needs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Course Syllabi ◽  
The Status ◽  
English Speaking

Purpose: There has been a growing interest in meeting the health care needs of the anticipated “age wave.” In order to prepare for the current demographic trends, we sought to describe the status of geriatrics curricula in the 18 North American English-speaking chiropractic colleges by reviewing geriatric course syllabi. Methods: A cross-sectional survey was conducted using syllabi and catalog information solicited from each English-speaking chiropractic college in North America, collected from January 1, 2007 through June 30, 2007. Information was then summarized. Results: As of June 30, 2007, roughly 78% of colleges submitted their current geriatrics course syllabi. The remaining 4 colleges were estimated using online course catalog information. Sixty-one percent of colleges offered a course that was solely dedicated to the topic of geriatrics. Additionally, 37.5% of syllabi indicating credit load offer 4 or more credits to the course containing the geriatrics component. Also, 31.3% of courses include non-classroom clinical experience, while 50% require an independent study project that provides further geriatrics experience. Furthermore, 41.2% of reported courses classify the teaching strategies as lecture only. Conclusions: These results warrant a proposal for improved curricula in this specialty population. It is proposed that more time be dedicated for this topic, more experiential learning be required, and more clinical focus be given on the needs of this population. A restructure of curricula will provide more clinical experiences for students to better equip future doctors of chiropractic for the increase in geriatric health care needs.

scholarly journals Unmet health care needs of elderly residing on urban areas of Sunsari District, Nepal. A Cross Sectional Study

2020 ◽  
Author(s):  
Mukesh Poudel ◽  
Asmita Ojha ◽  
Deepak Kumar Yadav ◽  
Ram Bilakshan Sah ◽  
Avaniendra Chakravartty ◽  
...  
Keyword(s):  
Health Care ◽  
Urban Areas ◽  
National Health System ◽  
Cross Sectional Study ◽  
Health Problems ◽  
Health Care Needs ◽  
Sectional Study ◽  
Care Needs ◽  
Cross Sectional ◽  
Unmet Health Care Needs

Abstract Background: The global aging population is in increasing trend. Morbidity increases with age and enhances the burden of health problems that result in new challenges to meet additional demands. There can be various types of issues such as health problems, health care utilization, physical and social care which should be carefully assessed and addressed. This study aimed to assess the unmet health care needs among elderly. Methods: A Community based, House to House, Cross-sectional study was conducted in urban areas of the sunsari district using face to face interviews. The sample size of 530 elderly was selected by a systematic proportionate random sampling technique. Results: This study unfurled the prevalence of unmet need for consultation for Nearsightedness 52.3%, Farsightedness 53.7%%, Hearing 79.7%, Dental 79.4%, Hypertension 6.7%, Diabetes 3.9%, CVD 5.3 % among those with these specific health needs and of at least one Unmet Health care need to be 64.9% among the studied participants. At least one unmet health need was significantly associated with higher odds among elderly age more than 70, of dalit and janajati ethnicity, illiterate, poor, those with difficulty leaving home, the distance of health facility > 30 mins, and those with depressive symptoms. Conclusion: The study highlighted the higher prevalence and associated factors related to unmet health care needs among the elderly which should be addressed to promote healthy ageing. There is an urgent need to promote geriatric health services and make it available at the primary health care level the first level of contact with a national health system.

Oral Findings of Children, Adolescents and Young Adults Affected by Muccopolysaccharidosis

2021 ◽  
Vol 13 ◽  
pp. 64-70
Author(s):  
Vinod Anju ◽  
Raj Sunil N ◽  
Chinnappa Anitha
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Oral Care ◽  
Oral Health Care ◽  
Cross Sectional Study ◽  
Health Care Needs ◽  
Poor Oral Hygiene ◽  
Care Needs ◽  
Cross Sectional ◽  
Lysosomal Disorder

Objectives: Mucopolysaccharidosis (MPS) comprises of a set of rare inherited lysosomal disorder which results in deposition of glycosaminoglycans (GAGs) in various tissues and organs resulting in disturbances in the developing structures. The aim of the study was to systematically record the oral findings of patients diagnosed with MPS and subsequently assess their oral health needs. Methodology: A cross- sectional study was conducted on patients diagnosed with MPS (n=57). Complete soft tissue and hard tissue examination was done and the findings recorded. DMFT or def indices were recorded in accordance with WHO criteria and methods. Results: The study showed that the patients diagnosed with MPS have higher oral health care needs owing to the anatomical and pathological changes. The study showed that the patients diagnosed with MPS had poor oral hygiene and high caries incidence. However, the number of filled teeth in spite of high caries index wassignificantly less which showed neglected oral care. Interpretation and Conclusion: The patients diagnosed with MPS have higher oral health care needs. Hence, regular dental evaluation and treatment must be incorporated in their health care regimen.

scholarly journals Utilisation of dental services for people with special health care needs in Australia

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mathew Albert Wei Ting Lim ◽  
Sharon Andrea Corinne Liberali ◽  
Gelsomina Lucia Borromeo
Keyword(s):  
Health Care ◽  
Special Needs ◽  
Access To Health Care ◽  
Health Care Needs ◽  
Medical Patients ◽  
Specialist Care ◽  
Care Needs ◽  
Cross Sectional ◽  
Dental Hospital ◽  
Patients With Special Needs

Abstract Background To explore the profile of patients and treatment delivered at specialist referral centres for individuals with special needs. Methods A cross-sectional audit was conducted of the health records of all patients with appointments at two of Australia’s largest referral centres for patients with special needs, the Integrated Special Needs Department at the Royal Dental Hospital of Melbourne and the Special Needs Unit at the Adelaide Dental Hospital, for the month of August 2015. Results The profile of patients treated at these specialist units demonstrates the diversity of individuals with additional health care needs that general dentists feel require specialised oral health care. The Adelaide-based clinic had a greater proportion of complex medical patients in comparison to those treated in Melbourne who were more likely to have a disability or psychiatric condition and were less likely to be able to self-consent for treatment. Interestingly, despite similar workforce personnel numbers, there were approximately twice as many appointments at the Special Needs Unit in Adelaide than the Integrated Special Needs Department in Melbourne during the study period which may have reflected differences in workforce composition with a greater use of dental auxiliaries at the Adelaide clinic. Conclusions The results of this study provide an initial profile of patients with special needs referred for specialist care in Australia. However, the differences in patient profiles between the two units require further investigation into the possible influence of service provision models and barriers to access of care for individuals with special needs and to ensure equitable access to health care.

scholarly journals Trends in Pediatric Private Insurance and Medicaid Spending: A Repeated Cross-Sectional Analysis of Data from 2002 to 2014

2021 ◽  
Vol 58 ◽  
pp. 004695802110104
Author(s):  
Anjani Sheth ◽  
Rishi Agrawal
Keyword(s):  
Health Care ◽  
Hospital Care ◽  
Private Insurance ◽  
Annual Growth ◽  
Cross Sectional ◽  
Total Spending ◽  
Capita Spending ◽  
Per Capita ◽  
Spending Growth ◽  
Sectional Analysis

Given increased focus on health spending, this investigation aims to compare trends in pediatric Medicaid and private insurance spending on type of service from 2002 to 2014 in order to inform policy and research. A repeated cross-sectional analysis of 2002 to 2014 National Health Expenditure Accounts data was conducted. Total spending, per capita spending, and compounded annual growth rates for type of service were determined for children ages 0 to 18 at the national level. Per capita spending growth was higher for private insurance than for Medicaid, and the areas of high per capita spending growth differed for private insurance and Medicaid. While Medicaid spent more per capita on hospital care than private insurance, private insurance demonstrated greater per capita spending growth on hospital care than Medicaid (8.49% vs 1.99%, respectively). Conversely, per capita spending on home health care grew more for Medicaid (6.79%) than for private insurance (3.18%). Trends in private insurance and Medicaid overall and per capita spending differ. Medicaid experienced higher annual growth in total spending than per capita spending, while private insurance had greater annual growth in per capita spending than total spending. Growth in private insurance per capita spending was higher than growth in Medicaid per capita spending, but growth in Medicaid total spending was higher than growth in private insurance total spending. These data suggest that Medicaid and private insurance may have different drivers of spending growth, highlighting the need for policy makers to examine spending patterns by payer. Further research to determine why such differences in spending growth exist will better inform efforts to increase health care value.

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