Costs of Care in Hemophilia and Possible Implications of Health Care Reform

Hematology ◽  
2011 ◽  
Vol 2011 (1) ◽  
pp. 413-418 ◽  
Author(s):  
Kathleen A. Johnson ◽  
Zheng-Yi Zhou
Keyword(s):  
Health Care ◽  
Health Care Reform ◽  
Rural Areas ◽  
Care Delivery ◽  
Insurance Coverage ◽  
Cost Of Care ◽  
Life Assessment ◽  
Clotting Factor ◽  
Care Providers

Economic evaluation in health care is increasingly used to assist policy makers in their difficult task of allocating limited resources. The high cost of care, including that for clotting factor concentrates, makes hemophilia a potential target for cost-cutting efforts by health care payers. Although the appropriate management of hemophilia is key to minimizing and preventing long-term morbidity, comparative effectiveness studies regarding the relative benefit of different treatment options are lacking. Cost-of-illness (COI) analysis, which includes direct and indirect costs from a societal perspective, can provide information to be used in cost-effectiveness and other economic analyses. Quality-of-life assessment provides another methodology with which to measure outcomes and benefits of appropriate disease management. Health care reform has implications for individuals with hemophilia and their families through changes in payment, insurance coverage expansion, and health care delivery system changes that reward quality and stimulate cooperative, team-based care. Providers will benefit from the expansion of insurance coverage and some financial benefits in rural areas, and from the expansion of coverage for preventive services. Accountable care organizations will potentially change the way providers are paid and financial incentives under reform will reward high quality of care.

scholarly journals Costs of Care in Hemophilia and Possible Implications of Health Care Reform

Hematology ◽  
2011 ◽  
Vol 2011 (1) ◽  
pp. 413-418
Author(s):  
Kathleen A. Johnson ◽  
Zheng-Yi Zhou
Keyword(s):  
Health Care ◽  
Health Care Reform ◽  
Rural Areas ◽  
Care Delivery ◽  
Insurance Coverage ◽  
Cost Of Care ◽  
Life Assessment ◽  
Clotting Factor ◽  
Care Providers

Abstract Economic evaluation in health care is increasingly used to assist policy makers in their difficult task of allocating limited resources. The high cost of care, including that for clotting factor concentrates, makes hemophilia a potential target for cost-cutting efforts by health care payers. Although the appropriate management of hemophilia is key to minimizing and preventing long-term morbidity, comparative effectiveness studies regarding the relative benefit of different treatment options are lacking. Cost-of-illness (COI) analysis, which includes direct and indirect costs from a societal perspective, can provide information to be used in cost-effectiveness and other economic analyses. Quality-of-life assessment provides another methodology with which to measure outcomes and benefits of appropriate disease management. Health care reform has implications for individuals with hemophilia and their families through changes in payment, insurance coverage expansion, and health care delivery system changes that reward quality and stimulate cooperative, team-based care. Providers will benefit from the expansion of insurance coverage and some financial benefits in rural areas, and from the expansion of coverage for preventive services. Accountable care organizations will potentially change the way providers are paid and financial incentives under reform will reward high quality of care.

scholarly journals Standards and outcome measures in Cardiovascular Rehabilitation. Position Paper GICR/IACPR

2015 ◽  
Vol 78 (4) ◽  
Author(s):  
Raffaele Griffo ◽  
Marco Ambrosetti ◽  
Giuseppe Furgi ◽  
Roberto Carlon ◽  
Carmine Chieffo ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Cardiovascular Diseases ◽  
Health Care Providers ◽  
Professional Competence ◽  
Care Delivery ◽  
Position Paper ◽  
Care Providers ◽  
Cardiac Events

Despite major improvements in diagnostics and interventional therapies, cardiovascular diseases remain a major health care and socio-economic problem in Italy. Costs and resources required are increasing in close correlation to both the improved quality of care and to the population ageing. There is an overwhelming evidence of the efficacy of cardiac rehabilitation (CR) in terms of reduction in morbidity and mortality after acute cardiac events. CR services are by definition multi-factorial and comprehensive. Furthermore, systematic analysis and monitoring of the process of delivery and outcomes is of paramount importance. The aim of this position paper promoted by the Italian Association for Cardiovascular Prevention and Rehabilitation (GICR-IACPR) is to provide specific recommendations to assist CR staff in the design, evaluation and development of their care delivery organization. The position paper should also assist health care providers, insurers, policy makers and consumers in the recognition of the quality of care requirements, standards and outcome measure, quality and performance indicators, and professional competence involved in such organization and programs. The position paper i) include comprehensive CR definition and indications, ii) describes priority criteria based on the clinical risk for admission to both inpatient or outpatient CR, and iii) defines components and technological, structural and organizing requirements for inpatient or outpatient CR services, with specific indicators and standards, performance measures and required professional skills. A specific chapter is dedicated to the requirements for highly specialized CR services for patients with more advanced cardiovascular diseases.

A comprehensive Overview of Decision Fusion Technique in Healthcare: A Systematic Scoping Review

2020 ◽  
Keyword(s):  
Health Care ◽  
Health Informatics ◽  
Holistic Approach ◽  
Decision Fusion ◽  
Cost Of Care ◽  
Management Technique ◽  
Care Providers ◽  
Comprehensive Overview ◽  
Fusion Technique

Introduction: Decision fusion has emerged as a data management technique due to the diversity and scalability of data in health care. This first-scope review aimed to investigate the use of this technique in health care. Materials and Methods: A query was carried out on PubMed, Science Direct, and EMBASE within 1960-2017 using such keywords as decision fusion, information fusion, symbolic fusion, distributed decisions, expert fusion, and sensor fusion, in conjunction with med-* and health-care. The articles were analyzed in terms of methodology and results. Results: The literature search yielded 106 articles. Based on the results, in the field of health care, the articles were related to image processing (29%), sensors (22%), diagnosis area(10%), biology (6%), health informatics (8%), and signal process (15%). The majority of articles were published in 2011, 2012, and 2015, and the USA had the largest number of articles. Most of the articles were about engineering and basic sciences. Regarding healthcare, the majority of studies were conducted on the diagnosis of diseases (80%), while 9% and 11% of articles were about prevention and treatment, respectively. These studies applied the following methods: intelligent methods (44%), new methods (36%), probabilistic (13%), and evidential methods (7%). The dataset was as follows: research project data (49%), online dataset (42%), and simulation (9%). Furthermore, 49% of articles mentioned the applied software, among which classification and interpretation were reportedly the most and the least used methods. Discussion and Conclusion: Decision fusion is a holistic approach to evaluate all areas of health care and elucidate diverse techniques that can lead to improved quality of care. Innovation: This article is the first scope review article about the application of the decision fusion technique in the field of health care, building on an established protocol. Decision fusion can reduce the cost of care and improve the quality of health care provision. Therefore, this article can help care providers understand the benefits of this technique and overcome challenges in adopting decision fusion technology.

scholarly journals Investigating Patients’ Intention to Continue Using Teleconsultation to Anticipate Postcrisis Momentum: Survey Study

10.2196/22081 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e22081
Author(s):  
Antoine Grenier Ouimet ◽  
Gerit Wagner ◽  
Louis Raymond ◽  
Guy Pare
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Technology Use ◽  
Care Delivery ◽  
Cost Of Care ◽  
Equation Modeling ◽  
Direct Effects ◽  
Care Providers ◽  
Continuance Intention ◽  
Intention To Continue

Background The COVID-19 crisis has drastically changed care delivery with teleconsultation platforms experiencing substantial spikes in demand, helping patients and care providers avoid infections and maintain health care services. Beyond the current pandemic, teleconsultation is considered a significant opportunity to address persistent health system challenges, including accessibility, continuity, and cost of care, while ensuring quality. Objective This study aims at identifying the determinants of patients’ intention to continue using a teleconsultation platform. It extends prior research on information technology use continuance intention and teleconsultation services. Methods Data was collected in November 2018 and May 2019 with Canadian patients who had access to a teleconsultation platform. Measures included patients’ intention to continue their use; teleconsultation usefulness; teleconsultation quality; patients’ trust toward the digital platform, its provider. and health care professionals; and confirmation of patients’ expectations toward teleconsultation. We used structural equation modeling employing the partial least squares component-based technique to test our research model and hypotheses. Results We analyzed a sample of 178 participants who had used teleconsultation services. Our findings revealed that confirmation of expectations had the greatest influence on continuance intention (total effects=0.722; P<.001), followed by usefulness (total effects=0.587; P<.001) and quality (total effects=0.511; P<.001). Usefulness (β=.60; P<.001) and quality (β=.34; P=.01) had direct effects on the dependent variable. The confirmation of expectations had direct effects both on usefulness (β=.56; P<.001) and quality (β=.75; P<.001) in addition to having an indirect effect on usefulness (indirect effects=0.282; P<.001). Last, quality directly influenced usefulness (β=.34; P=.002) and trust (β=.88; P<.001). Trust does not play a role in the context under study. Conclusions Teleconsultation is central to care going forward, and it represents a significant lever for an improved, digital delivery of health care in the future. We believe that our findings will help drive long-term teleconsultation adoption and use, including in the aftermath of the current COVID-19 crisis, so that general care improvement and greater preparedness for exceptional situations can be achieved.

scholarly journals Lived Experiences of Diabetes Patients in Rural Areas of Ghana: Discovering the Forces that Determine Psychosocial Care

2021 ◽  
pp. 20-34
Author(s):  
Isaac Nyarko Kwakye ◽  
James Antwi ◽  
Thomas Hormenu
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Lived Experiences ◽  
Care Delivery ◽  
Psychosocial Care ◽  
Health Care Facilities ◽  
Eastern Region ◽  
Care Providers ◽  
Emotional Needs ◽  
Diabetes Patients

Aim: Diabetes has been identified to cause prolonged ill health in many people living in rural communities in Ghana where access to health care delivery appears to be inadequate and of low quality due to financial constraints, limited health resources, poor road network, low literacy levels and limited access to specialist care. Individuals diagnosed with diabetes often express varied psychological and emotional imbalances. Therefore, immediate psychosocial care is needed to prevent patients living in rural areas from getting into severe depression mode and other mental health complications. Yet, understanding how people diagnosed with diabetes should react in order to prevent severe psychological implications has not been adequately explored in Ghana. This study explored the lived experiences of diabetes patients living in rural areas of the Eastern Region of Ghana with the aim of discovering the forces that determine appropriate psychosocial care for patients. Study Design: Using the Interpretative Phenomenological Analysis (IPA), 31 diabetes patients were purposively selected from four hospitals in the region, and interviewed using a semi-structured interview guide to investigate participants’ perceptions, thoughts, feelings, and experiences about the disease and how the participants own experiences could be used to construct a framework of immediate care applicable in their own social certain. Results: The study generated themes along productive and unproductive lines to demonstrate the lived experiences of diabetes patients. Psycho-emotional reactions, psychological shock and emotional outbursts constitute unproductive forces. This caused some of the patients to express suicidal ideations at the extreme point. On the other hand, individual resilience and disposition, guidance and support from care providers, family and community members constitute the productive forces that provide an appropriate framework for psychosocial care for diabetes patients. Conclusion: The study has shown the need to adequately address the psychological and emotional needs of diabetes patients to prevent extreme forms of psychological distress (anxiety and depression). The authors, therefore, recommend an integrated care model for diabetes patients’ in rural areas that encompass a psychosocial therapy built around the primary healthcare concept with the establishment of counseling units in all Primary Health Care facilities. This will offer a platform to generate personal and community actions and decisions to adequately address the immediate psychological and emotional needs of diabetes patients in rural areas.

scholarly journals Investigating Patients’ Intention to Continue Using Teleconsultation to Anticipate Postcrisis Momentum: Survey Study (Preprint)

2020 ◽  
Author(s):  
Antoine Grenier Ouimet ◽  
Gerit Wagner ◽  
Louis Raymond ◽  
Guy Pare
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Technology Use ◽  
Care Delivery ◽  
Cost Of Care ◽  
Equation Modeling ◽  
Direct Effects ◽  
Care Providers ◽  
Continuance Intention ◽  
Intention To Continue

BACKGROUND The COVID-19 crisis has drastically changed care delivery with teleconsultation platforms experiencing substantial spikes in demand, helping patients and care providers avoid infections and maintain health care services. Beyond the current pandemic, teleconsultation is considered a significant opportunity to address persistent health system challenges, including accessibility, continuity, and cost of care, while ensuring quality. OBJECTIVE This study aims at identifying the determinants of patients’ intention to continue using a teleconsultation platform. It extends prior research on information technology use continuance intention and teleconsultation services. METHODS Data was collected in November 2018 and May 2019 with Canadian patients who had access to a teleconsultation platform. Measures included patients’ intention to continue their use; teleconsultation usefulness; teleconsultation quality; patients’ trust toward the digital platform, its provider. and health care professionals; and confirmation of patients’ expectations toward teleconsultation. We used structural equation modeling employing the partial least squares component-based technique to test our research model and hypotheses. RESULTS We analyzed a sample of 178 participants who had used teleconsultation services. Our findings revealed that confirmation of expectations had the greatest influence on continuance intention (total effects=0.722; <i>P</i>&lt;.001), followed by usefulness (total effects=0.587; <i>P</i>&lt;.001) and quality (total effects=0.511; <i>P</i>&lt;.001). Usefulness (β=.60; <i>P</i>&lt;.001) and quality (β=.34; <i>P</i>=.01) had direct effects on the dependent variable. The confirmation of expectations had direct effects both on usefulness (β=.56; <i>P</i>&lt;.001) and quality (β=.75; <i>P</i>&lt;.001) in addition to having an indirect effect on usefulness (indirect effects=0.282; <i>P</i>&lt;.001). Last, quality directly influenced usefulness (β=.34; <i>P</i>=.002) and trust (β=.88; <i>P</i>&lt;.001). Trust does not play a role in the context under study. CONCLUSIONS Teleconsultation is central to care going forward, and it represents a significant lever for an improved, digital delivery of health care in the future. We believe that our findings will help drive long-term teleconsultation adoption and use, including in the aftermath of the current COVID-19 crisis, so that general care improvement and greater preparedness for exceptional situations can be achieved.

scholarly journals Telehealth in the COVID-19 Era: A Balancing Act to Avoid Harm

10.2196/24785 ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. e24785
Author(s):  
J Jeffery Reeves ◽  
John W Ayers ◽  
Christopher A Longhurst
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Access ◽  
Care Delivery ◽  
Patient Characteristics ◽  
Virtual Patient ◽  
Care Providers ◽  
Health Crisis ◽  
Care Access

The telehealth revolution in response to COVID-19 has increased essential health care access during an unprecedented public health crisis. However, virtual patient care can also limit the patient-provider relationship, quality of examination, efficiency of health care delivery, and overall quality of care. As we witness the most rapidly adopted medical trend in modern history, clinicians are beginning to comprehend the many possibilities of telehealth, but its limitations also need to be understood. As outcomes are studied and federal regulations reconsidered, it is important to be precise in the virtual patient encounter approach. Herein, we offer some simple guidelines that could assist health care providers and clinic schedulers in determining the appropriateness of a telehealth visit by considering visit types, patient characteristics, and chief complaint or disease states.

Implications of Negligent Selection and Retention of Physicians in the Age of ERISA

1995 ◽  
Vol 21 (4) ◽  
pp. 383-418
Author(s):  
Torin A. Dorros ◽  
T. Howard Stone
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Quality Of Health Care ◽  
Care Delivery ◽  
The United States ◽  
Care Providers ◽  
Insurance Reform

Enormous and fundamental changes are currently taking place in health care delivery. These changes include the consolidation of health care providers—from hospitals, physicians, and insurance companies, to medical supply businesses, managed care networks, and other health care providers—and numerous health care and insurance reform efforts by government at all levels. These changes pose significant implications for the delivery of health care in the United States, and will impact the manner, cost, and accessibility of health care delivery. These changes will almost certainly affect the quality of health care services as well. The quality of health care in the United States has for many years been a central concern of government, industry, health care providers, payors, and consumers. Quality in health care is essential to overall national health, the guarantor of a productive and healthy populace, and an important indicator of United States social and technological preeminence.

scholarly journals Quality Improvement Goals for Acute Kidney Injury

2019 ◽  
Vol 14 (6) ◽  
pp. 941-953 ◽  
Author(s):  
Kianoush Kashani ◽  
Mitchell Howard Rosner ◽  
Michael Haase ◽  
Andrew J.P. Lewington ◽  
Donal J. O'Donoghue ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health Care Providers ◽  
Care Delivery ◽  
Quality Care ◽  
Hospital Setting ◽  
Kidney Injury ◽  
Cost Of Care ◽  
Care Providers ◽  
Improvement Programs

AKI is a global concern with a high incidence among patients across acute care settings. AKI is associated with significant clinical consequences and increased health care costs. Preventive measures, as well as rapid identification of AKI, have been shown to improve outcomes in small studies. Providing high-quality care for patients with AKI or those at risk of AKI occurs across a continuum that starts at the community level and continues in the emergency department, hospital setting, and after discharge from inpatient care. Improving the quality of care provided to these patients, plausibly mitigating the cost of care and improving short- and long-term outcomes, are goals that have not been universally achieved. Therefore, understanding how the management of AKI may be amenable to quality improvement programs is needed. Recognizing this gap in knowledge, the 22nd Acute Disease Quality Initiative meeting was convened to discuss the evidence, provide recommendations, and highlight future directions for AKI-related quality measures and care processes. Using a modified Delphi process, an international group of experts including physicians, a nurse practitioner, and pharmacists provided a framework for current and future quality improvement projects in the area of AKI. Where possible, best practices in the prevention, identification, and care of the patient with AKI were identified and highlighted. This article provides a summary of the key messages and recommendations of the group, with an aim to equip and encourage health care providers to establish quality care delivery for patients with AKI and to measure key quality indicators.

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