Utilization Impact of Cost-Sharing Elimination for Preventive Care Services: A Rapid Review

2021 ◽  
pp. 107755872110273
Author(s):  
Hope C. Norris ◽  
Haley M. Richardson ◽  
Marie-Anais C. Benoit ◽  
Beth Shrosbree ◽  
Judith E. Smith ◽  
...  

Consumer cost-sharing has been shown to diminish utilization of preventive services. Recent efforts, including provisions within the Affordable Care Act, have sought to increase use of preventive care through elimination of cost-sharing for clinically indicated services. We conducted a rapid review of the literature to determine the impact of cost-share elimination on utilization of preventive services. Searches were conducted in PubMed, Scopus, and CINAHL Complete databases as well as in grey literature. A total of 35 articles were included in qualitative synthesis and findings were summarized for three clinical service categories: cancer screenings, contraceptives, and additional services. Impacts of cost-sharing elimination varied depending on clinical service, with a majority of findings showing increases in use. Studies that included socioeconomic status reported that those who were financially vulnerable incurred substantial increases in utilization. Future investigations on additional clinical services are warranted as is research to better elucidate populations who most benefit from cost-sharing elimination.

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e047283
Author(s):  
Rosalind Gittins ◽  
Louise Missen ◽  
Ian Maidment

IntroductionThere is a growing concern about the misuse of over the counter (OTC) and prescription only medication (POM) because of the impact on physical and mental health, drug interactions, overdoses and drug-related deaths. These medicines include opioid analgesics, anxiolytics such as pregabalin and diazepam and antidepressants. This protocol outlines how a systematic review will be undertaken (during June 2021), which aims to examine the literature on the pattern of OTC and POM misuse among adults who are accessing substance misuse treatment services. It will include the types of medication being taken, prevalence and demographic characteristics of people who access treatment services.Methods and analysisAn electronic search will be conducted on the Cochrane, OVID Medline, Pubmed, Scopus and Web of Science databases as well as grey literature. Two independent reviewers will conduct the initial title and abstract screenings, using predetermined criteria for inclusion and exclusion. If selected for inclusion, full-text data extraction will be conducted using a pilot-tested data extraction form. A third reviewer will resolve disagreements if consensus cannot be reached. Quality and risk of bias assessment will be conducted for all included studies. A qualitative synthesis and summary of the data will be provided. If possible, a meta-analysis with heterogeneity calculation will be conducted; otherwise, Synthesis Without Meta-analysis will be undertaken for quantitative data. The reporting of this protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Ethics and disseminationEthical approval is not required. Findings will be peer reviewed, published and shared verbally, electronically and in print, with interested clinicians and policymakers.PROSPERO registration numberCRD42020135216.


BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e047051
Author(s):  
Gemma F Spiers ◽  
Tafadzwa Patience Kunonga ◽  
Alex Hall ◽  
Fiona Beyer ◽  
Elisabeth Boulton ◽  
...  

ObjectivesFrailty is typically assessed in older populations. Identifying frailty in adults aged under 60 years may also have value, if it supports the delivery of timely care. We sought to identify how frailty is measured in younger populations, including evidence of the impact on patient outcomes and care.DesignA rapid review of primary studies was conducted.Data sourcesFour databases, three sources of grey literature and reference lists of systematic reviews were searched in March 2020.Eligibility criteriaEligible studies measured frailty in populations aged under 60 years using experimental or observational designs, published after 2000 in English.Data extraction and synthesisRecords were screened against review criteria. Study data were extracted with 20% of records checked for accuracy by a second researcher. Data were synthesised using a narrative approach.ResultsWe identified 268 studies that measured frailty in samples that included people aged under 60 years. Of these, 85 studies reported evidence about measure validity. No measures were identified that were designed and validated to identify frailty exclusively in younger groups. However, in populations that included people aged over and under 60 years, cumulative deficit frailty indices, phenotype measures, the FRAIL Scale, the Liver Frailty Index and the Short Physical Performance Battery all demonstrated predictive validity for mortality and/or hospital admission. Evidence of criterion validity was rare. The extent to which measures possess validity across the younger adult age (18–59 years) spectrum was unclear. There was no evidence about the impact of measuring frailty in younger populations on patient outcomes and care.ConclusionsLimited evidence suggests that frailty measures have predictive validity in younger populations. Further research is needed to clarify the validity of measures across the adult age spectrum, and explore the utility of measuring frailty in younger groups.


2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Tracy Robinson ◽  
Cate Bailey ◽  
Heather Morris ◽  
Prue Burns ◽  
Angela Melder ◽  
...  

Abstract Background Large-scale partnerships between universities and health services are widely seen as vehicles for bridging the evidence–practice gap and for accelerating the adoption of new evidence in healthcare. Recently, different versions of these partnerships – often called academic health science centres – have been established across the globe. Although they differ in structure and processes, all aim to improve the integration of research and education with health services. Collectively, these entities are often referred to as Research Translation Centres (RTCs) and both England and Australia have developed relatively new and funded examples of these collaborative centres. Methods This paper presents findings from a rapid review of RTCs in Australia and England that aimed to identify their structures, leadership, workforce development and strategies for involving communities and service users. The review included published academic and grey literature with a customised search of the Google search engine and RTC websites. Results RTCs are complex system-level interventions that will need to disrupt the current paradigms and silos inherent in healthcare, education and research in order to meet their aims. This will require vision, leadership, collaborations and shared learnings, alongside structures, processes and strategies to deliver impact in the face of complexity. The impact of RTCs in overcoming the deeply entrenched silos across organisations, disciplines and sectors needs to be captured at the systems, organisation and individual levels. This includes workforce capacity and public and patient involvement that are vital to understanding the evolution of RTCs. In addition, new models of leadership are needed to support the brokering and mobilisation of knowledge in complex organisations. Conclusions The development and funding of RTCs represents one of the most significant shifts in the health research landscape and it is imperative that we continue to explore how we can progress the integration of research and healthcare and ensure research meets stakeholder needs and is translated via the collaborations supported by these organisations. Because RTCs are a recent addition to the healthcare landscape in Australia, it is instructive to review the processes and infrastructure needed to support their implementation and applied health research in England.


2021 ◽  
Author(s):  
Lisa Affengruber ◽  
Andreea Dobrescu ◽  
Emma Persad ◽  
Irma Klerings ◽  
Gernot Wagner ◽  
...  

Abstract Background: Due to the growing need to provide evidence syntheses under time constraints, researchers have begun focusing on the exploration of rapid review methods, which often employ single-reviewer literature screening. However, single-reviewer screening misses, on average, 13% of relevant studies, compared to 3% with dual-reviewer screening. Little guidance exists regarding methods to recover studies falsely excluded during literature screening. Likewise, it is unclear whether specific study characteristics can predict an increased risk of false exclusion. This systematic review aimed to identify supplementary search methods that can be used to recover studies falsely excluded during literature screening. Moreover, it strove to identify study-level predictors that indicate an elevated risk of false exclusions of studies during literature screening. Methods: We performed literature searches for eligible studies in Medline, Science Citation Index Expanded, Social Sciences Citation Index, Current Contents Connect, Embase, Epistemonikos.org, and Information Science & Technology Abstracts from 1999 to June 23, 2020. We searched for grey literature, checked reference lists, and conducted hand searches in two relevant journals and similar articles searches current to January 28, 2021. Two investigators independently screened the literature; one investigator performed the data extraction, a second investigator checked for correctness and completeness. Two reviewers assessed the risk of bias of eligible studies. We synthesized the results narratively. Results: Three methods studies, two with a case study design and one with a case series design, met the inclusion criteria. One study reported that all falsely excluded publications (8%) could be recovered through reference list checking compared to other supplementary search methods. No included methods study analyzed the impact of recovered studies on conclusions or meta-analyses. Two studies reported that up to 8% of studies were falsely excluded due to uninformative titles and abstracts, and one study showed that 11% of non-English studies were falsely excluded. Conclusions: Due to the limited evidence based on two case studies and one case series, we can draw no firm conclusion about the most reliable and most valid method to recover studies falsely excluded during literature screening or about the characteristics that might predict a higher risk of false exclusion. Systematic review registration: https://osf.io/v2pjr/


2016 ◽  
Vol 19 (7) ◽  
pp. A461
Author(s):  
K Kyriklidis ◽  
D Kaitelidou ◽  
G Angelopoulos ◽  
A Samoutis ◽  
O Konstantakopoulou ◽  
...  

Author(s):  
Adyya Gupta ◽  
Anne Kavanagh ◽  
George Disney

Objective—To collate evidence on (1) the risk of infection for people with disability during infectious disease outbreaks and/or pandemics and (2) government responses and pandemic plans for people with disability. Methods—Through two rapid reviews, relevant peer-reviewed studies and grey literature published from 2002 onwards in the English language were identified. Data were synthesised narratively. Results—Aim 1: Of the 680 studies, two studies were included in the review. No grey literature was eligible for inclusion. The evidence regarding risk was inconclusive. Aim 2: Of the 50 studies, three peer-review studies, along with four government reports were included. The literature largely reported on measures being taken to maximise the prevention of transmission of COVID-19 for the general population, with only a few programs including people with disability. Conclusion—Overall, there is inconclusive evidence on the risk of infection for people with disability during infectious disease outbreaks and/or pandemics and the government preparedness and planning for disease outbreaks and/or pandemics largely exclude people with disability. From a population health perspective, during disease outbreaks and pandemics, including the COVID-19 pandemic, along with the general population, it is important for governments to include people with disability in their pandemic planning and response.


2020 ◽  
Vol 39 (5) ◽  
pp. 819-827 ◽  
Author(s):  
Benjamin Lê Cook ◽  
Michael Flores ◽  
Samuel H. Zuvekas ◽  
Joseph P. Newhouse ◽  
John Hsu ◽  
...  

Author(s):  
David Henderson

ABSTRACT ObjectivesHealth and social care is an area of high policy importance in the UK. Integration of health boards with local authority provided social care in Scotland in 2016 is a major structural change in delivery of care. Improvements in service and efficiency are expected and indeed required in an era of declining budgets.  Intuitively, health and social care are closely linked, particularly for those with multiple morbidities. However, little is known about the relationship between health and social care services and how usage of one has an impact on the other in terms of outcomes and costs. The study aims to describe the methods that have been used to analyse the relationship between social care, primary care and secondary care services. Findings will inform the analysis of a large linked dataset of health care, social care and benefits data that will investigate the interactions between health and social care, multimorbidity and socioeconomic status. ApproachA Scoping review of literature aiming to identify academic studies that have made an assessment of the relationship between health care and social care. A search of academic databases will be augmented by a search of grey literature aiming to identify the extent, range and nature of studies. Data will be extracted on populations, study designs, results and recommendations. Results will be visualised in charts alongside a descriptive qualitative synthesis. ResultsExpected June 2016


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 502-502
Author(s):  
Lauren Palmer ◽  
Jennifer Howard ◽  
Helena Voltmer ◽  
Abigail Ferrell ◽  
Natalie Mulmule ◽  
...  

Abstract Even prior to the COVID-19 Public Health and Medical Emergency, the experiences of chronic social isolation and loneliness (SIL) were growing among older adults. Countries began increasing national visibility for these issues and implementing programs and services focused on addressing them. In the United States (US), however, little is known about successful national interventions or their effectiveness in tackling SIL among older Americans. We conducted a rapid review of the peer-reviewed and grey literature from 2009-2019, focusing on existing federal programs, health systems, and health care models in the US that address SIL among older adults. Of the 110 articles identified, 36 met the inclusion criteria and were synthesized. Our review found few federal interventions that directly address SIL; several may be addressing SIL as an auxiliary outcome to addressing social determinants of health, such as group exercise, transportation support, or food insecurity. While these interventions may provide a promising opportunity, implementation and evaluation challenges were identified. Thus, federal and state agencies face significant obstacles to understanding the impact of existing interventions and their effectiveness in addressing SIL, hampering progress toward large scale implementation. As SIL receives increasing attention, we add another voice to existing literature that indicates significant heterogeneity among existing programs; we found that few evidence-based, scalable federal initiatives exist in the US that target SIL. Without resources from federal and state agencies, the ability of health entities, community-based organizations, and direct care providers to implement effective interventions is significantly diminished.


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