Effects of change in price of medical care on daily living of people in the USA

2011 ◽  
Vol 2 (4) ◽  
pp. 205-210
Author(s):  
Kumar Mukherjee ◽  
Richard Segal ◽  
Lawrence Kenny ◽  
Teresa Kauf ◽  
Steven M. Slutsky
Keyword(s):  
Medical Care ◽  
Daily Living ◽  
The Usa

scholarly journals Performance of national COVID-19 ‘symptom checkers’: a comparative case simulation study

2021 ◽  
Vol 28 (1) ◽  
pp. e100187
Author(s):  
Fatma Mansab ◽  
Sohail Bhatti ◽  
Daniel Goyal
Keyword(s):  
Medical Care ◽  
Simulation Study ◽  
Bacterial Pneumonia ◽  
Assessment Tools ◽  
Basic Tenet ◽  
The Us ◽  
The Usa ◽  
Case Simulation ◽  
Pandemic Response ◽  
Key Features

ObjectivesIdentifying those individuals requiring medical care is a basic tenet of the pandemic response. Here, we examine the COVID-19 community triage pathways employed by four nations, specifically comparing the safety and efficacy of national online ‘symptom checkers’ used within the triage pathway.MethodsA simulation study was conducted on current, nationwide, patient-led symptom checkers from four countries (Singapore, Japan, USA and UK). 52 cases were simulated to approximate typical COVID-19 presentations (mild, moderate, severe and critical) and COVID-19 mimickers (eg, sepsis and bacterial pneumonia). The same simulations were applied to each of the four country’s symptom checkers, and the recommendations to refer on for medical care or to stay home were recorded and compared.ResultsThe symptom checkers from Singapore and Japan advised onward healthcare contact for the majority of simulations (88% and 77%, respectively). The USA and UK symptom checkers triaged 38% and 44% of cases to healthcare contact, respectively. Both the US and UK symptom checkers consistently failed to identify severe COVID-19, bacterial pneumonia and sepsis, triaging such cases to stay home.ConclusionOur results suggest that whilst ‘symptom checkers’ may be of use to the healthcare COVID-19 response, there is the potential for such patient-led assessment tools to worsen outcomes by delaying appropriate clinical assessment. The key features of the well-performing symptom checkers are discussed.

Trends in the Contribution of Emergency Departments to the Provision of Hospital-Associated Health Care in the USA

2017 ◽  
Vol 48 (2) ◽  
pp. 267-288 ◽  
Author(s):  
David Marcozzi ◽  
Brendan Carr ◽  
Aisha Liferidge ◽  
Nicole Baehr ◽  
Brian Browne
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Emergency Departments ◽  
The United States ◽  
National Hospital ◽  
Patient Centered ◽  
National Hospital Discharge Survey ◽  
Delivery Of Care ◽  
The Usa

Traditional approaches to assessing the health of populations focus on the use of primary care and the delivery of care through patient-centered homes, managed care resources, and accountable care organizations. The use of emergency departments (EDs) has largely not been given consideration in these models. Our study aimed to determine the contribution of EDs to the health care received by Americans between 1996 and 2010 and to compare it with the contribution of outpatient and inpatient services using National Hospital Ambulatory Medical Care Survey and National Hospital Discharge Survey databases. We found that EDs contributed an average of 47.7% of the hospital-associated medical care delivered in the United States, and this percentage increased steadily over the 14-year study period. EDs are a major source of medical care in the United States, especially for vulnerable populations, and this contribution increased throughout the study period. Including emergency care within health reform and population health efforts would prove valuable to supporting the health of the nation.

scholarly journals Average medical cost of fatal and non-fatal injuries by type in the USA

2019 ◽  
pp. injuryprev-2019-043544 ◽  
Author(s):  
Cora Peterson ◽  
Likang Xu ◽  
Curtis Florence
Keyword(s):  
Medical Care ◽  
Medical Cost ◽  
Cost Effective ◽  
Medical Care Cost ◽  
Body Region ◽  
Injury Type ◽  
Inpatient Settings ◽  
The Usa ◽  
Multivariable Regression ◽  
Fatal Injuries

ObjectiveTo estimate the average medical care cost of fatal and non-fatal injuries in the USA comprehensively by injury type.MethodsThe attributable cost of injuries was estimated by mechanism (eg, fall), intent (eg, unintentional), body region (eg, head and neck) and nature of injury (eg, fracture) among patients injured from 1 October 2014 to 30 September 2015. The cost of fatal injuries was the multivariable regression-adjusted average among patients who died in hospital emergency departments (EDs) or inpatient settings as reported in the Healthcare Cost and Utilization Project Nationwide Emergency Department Sample and National Inpatient Sample, controlling for demographic (eg, age), clinical (eg, comorbidities) and health insurance (eg, Medicaid) factors. The 1-year attributable cost of non-fatal injuries was assessed among patients with ED-treated injuries using MarketScan medical claims data. Multivariable regression models compared total medical payments (inpatient, outpatient, drugs) among non-fatal injury patients versus matched controls during the year following injury patients’ ED visit, controlling for demographic, clinical and insurance factors. All costs are 2015 US dollars.ResultsThe average medical cost of all fatal injuries was approximately $6880 and $41 570 per ED-based and hospital-based patient, respectively (range by injury type: $4764–$10 289 and $31 912–$95 295). The average attributable 1-year cost of all non-fatal injuries per person initially treated in an ED was approximately $6620 (range by injury type: $1698–$80 172).Conclusions and relevanceInjuries are costly and preventable. Accurate estimates of attributable medical care costs are important to monitor the economic burden of injuries and help to prioritise cost-effective public health prevention activities.

The Place of the General Practitioner in Modern Medical Care-Some International Comparisons

1970 ◽  
Vol 63 (2) ◽  
pp. 205-209
Author(s):  
John Fry
Keyword(s):  
General Practitioner ◽  
Medical Care ◽  
International Comparisons ◽  
Comprehensive Service ◽  
The Usa ◽  
The Cost ◽  
Changing World

Dr J Fry considers the role of medical care in a changing world in relation to social demands and the cost of providing a comprehensive service. A consideration of services in other countries, such as the USA, USSR, Europe and Australia, provides lessons towards improving the NHS and also warnings of the faults inherent in these differing systems of medical care.

Delayed entry into HIV medical care in a nationally representative sample of HIV-infected adults receiving medical care in the USA

AIDS Care ◽  
2015 ◽  
Vol 28 (3) ◽  
pp. 325-333 ◽  
Author(s):  
McKaylee Robertson ◽  
Stanley C. Wei ◽  
Linda Beer ◽  
Demilade Adedinsewo ◽  
Sandra Stockwell ◽  
...  
Keyword(s):  
Medical Care ◽  
Representative Sample ◽  
Delayed Entry ◽  
The Usa ◽  
Nationally Representative

scholarly journals A Duty to treat? A Right to refrain? Bangladeshi physicians in moral dilemma during COVID-19

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Norman K. Swazo ◽  
Md. Munir Hossain Talukder ◽  
Mohammad Kamrul Ahsan
Keyword(s):  
Medical Care ◽  
Medical Practice ◽  
Clinical Care ◽  
Moral Dilemma ◽  
Moral Motivation ◽  
Standards Of Care ◽  
Care Hospital ◽  
Medical Practitioners ◽  
Routine Medical Care ◽  
The Usa

Abstract Background Normally, physicians understand they have a duty to treat patients, and they perform accordingly consistent with codes of medical practice, standards of care, and inner moral motivation. In the case of COVID-19 pandemic in a developing country such as Bangladesh, however, the fact is that some physicians decline either to report for duty or to treat patients presenting with COVID-19 symptoms. At issue ethically is whether such medical practitioners are to be automatically disciplined for dereliction of duty and gross negligence; or, on the contrary, such physicians may legitimately claim a professional right of autonomous judgment, on the basis of which professional right they may justifiably decline to treat patients. Methods This ethical issue is examined with a view to providing some guidance and recommendations, insofar as the conditions of medical practice in an under-resourced country such as Bangladesh are vastly different from medical practice in an industrialized nation such as the USA. The concept of moral dilemma as discussed by philosopher Michael Shaw Perry and philosopher Immanuel Kant’s views on moral appeal to “emergency” are considered pertinent to sorting through the moral conundrum of medical care during pandemic. Results Our analysis allows for conditional physician discretion in the decision to treat COVID-19 patients, i.e., in the absence of personal protective equipment (PPE) combined with claim of duty to family. Physicians are nonetheless expected to provide a minimum of initial clinical assessment and stabilization of a patient before initiating transfer of a patient to a “designated” COVID-19 hospital. The latter is to be done in coordination with the national center control room that can assure admission of a patient to a referral hospital prior to ambulance transport. Conclusions The presence of a moral dilemma (i.e., conflict of obligations) in the pandemic situation of clinical care requires institutional authorities to exercise tolerance of individual physician moral decision about the duty to care. Hospital or government authority should respond to such decisions without introducing immediate sanction, such as suspension from all clinical duties or termination of licensure, and instead arrange for alternative clinical duties consistent with routine medical care.

An idea alien to both worlds: why health care rationing is not acceptable in the USA and Russia

2019 ◽  
Vol 7 (3) ◽  
pp. 231-240
Author(s):  
Vasiliy V. Vlassov ◽  
Sergey V. Shishkin ◽  
Alla E. Chirikova ◽  
Anna V. Vlasova
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Medical Profession ◽  
Treatment Options ◽  
Legal Framework ◽  
Health Care Rationing ◽  
Essential Drug List ◽  
More Care ◽  
The Usa ◽  
The Right

The simple idea of rationing appears unacceptable both for the relatively poor "socialist" health care in Russia and for the most expensive USA health care. In Russia the idea of rationing is unacceptable, because the Constitution promises free and unlimited medical care. Therefore, discussion is blocked from the top. In the USA the idea is unacceptable, because citizens are understood as having the right to free choice of legal access to any care, without intervention of a 'death jury'.<br/> We analyse the similarities and differences in the arguments rejecting explicit rationing in health care in the USA and Russia. We describe the legal framework in Russia related to rationing, and the results of a qualitative study of the understanding of the concept of rationing by Russian doctors and of the practices in Russian health care organizations to limit the use of expensive diagnostic and treatment options.<br/> While the Russian Constitution promises free medical care, unlimited, legally there are limits imposed by the quota of specific treatments, limited access to care abroad, and problematic access to drugs not included on the essential drug list for inpatient care. Explicit rationing is not rejected by society or by the medical profession. In medical organizations the more explicit techniques are a second opinion by a committee (physicians' commission), especially in the case of prescription of drugs and diagnostic tests. Physicians tend to behave as medical professionals do: provide more care to people in greater need.

Social Work in the Camps

2019 ◽  
pp. 168-201
Author(s):  
Yoosun Park
Keyword(s):  
Social Work ◽  
Medical Care ◽  
Daily Living ◽  
Public Assistance ◽  
Economic Structure ◽  
Concentration Camps ◽  
Welfare Programs ◽  
War Relocation Authority ◽  
Basic Medical

Welfare programs took months to develop in the War Relocation Authority camps. When aid finally reach the impoverished, it proved not only inadequate, but delivered through a Kafkaesque system designed to uphold the “radically abnormal” economic structure of the camps. Many conflicting factors were at play. Public assistance was a new phenomenon for the Nikkei; the deep reluctance to accept aid was slow to ebb and never entirely jettisoned. The concentration camps were, however, costly places to live; while subsistence food, shelter, and basic medical care were provided, private funds were necessary to purchase all else required for daily living. While the Nikkei Welfare Section workers believed public assistance was necessary reparation rather than unearned charity, a deeply held censure of aid—lest it breed dependency, fund the undeserving, coddle the enemy—existed on the part of the Caucasian administrators. Even the begrudgingly doled and unequivocally insufficient aid was difficult to obtain.

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