Evaluation of the effect of the capitation compensation mechanism among pulmonary tuberculosis patients with a full period of treatment

Abstract Background PTB is an infectious disease, which not only seriously affects people’s health, but also causes a heavier disease economic burden on patients. At present, reform of the medical insurance payment can be an effective method to control medical expenses. Therefore, our study is to explore the compensation mechanism for pulmonary tuberculosis (PTB) patients with a full period of treatment, to alleviate the financial burden of PTB patients and provide a reference and basis for the reform of PTB payment methods in other regions and countries. Methods The quantitative data of PTB patients was collected from the first half of 2015 to the first half of 2018 in Dehui Tuberculosis Hospital in Jilin Province, and medical records of PTB patients registered in the first half of 2018 (n = 100) from the hospital was randomly selected. Descriptive analysis of these quantitative data summarized the number, cost, medication and compliance. Semi-structured in depth interviews with policymakers and physicians were conducted to understand the impact of interventions and its causes. Results After implementation of the compensation mechanism, the number of PTB patient visits in 2018 was increased by 14.2%, average medical costs for outpatients and inpatients were significantly reduced by 31.8% and 47.0%, respectively, and the auxiliary medication costs was reduced by 36.5%. Moreover, the hospital carried out standardized management of tuberculosis, and the patient compliance was very high, reaching almost 90%. Conclusions The capitation compensation mechanism with a full period of treatment was a suitable payment method for PTB, and it is worthy of promotion and experimentation. In addition, the model improved patient compliance and reduced the possibility of drug-resistant PTB. However, due to the short implementation time of the model in the pilot areas, the effect remains to be further observed and demonstrated.

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Evaluation of the Effect of the Capitation Compensation Mechanism among Tuberculosis Patients with a Full Period of Treatment

10.21203/rs.3.rs-138235/v1 ◽

2021 ◽

Author(s):

xingyu hu ◽

guangying gao

Keyword(s):

Pulmonary Tuberculosis ◽

Performance Management ◽

Financial Burden ◽

Medical Insurance ◽

Insurance Fund ◽

Compensation Mechanism ◽

Payment Method ◽

Tuberculosis Patients ◽

Payment Methods ◽

Full Period

Abstract Background: To explore the compensation mechanism for pulmonary tuberculosis patients with a full period of treatment, to alleviate the financial burden of pulmonary tuberculosis patients and to provide a reference and basis for the reform of tuberculosis payment methods in other regions and countries.Methods The funding operations of medical insurance institutions and the actual operating expenses of pilot hospitals from the Dehui Tuberculosis Hospital in Jilin Province were collected from the first half of 2015 to the first half of 2018, and the operational effects were analysed through quantitative and qualitative methods.Results After implementing the compensation mechanism, the medical expenses of tuberculosis patients decreased significantly, and the economic burden of the disease was reduced; the hospital's medical service capacity was improved, and internal management was significantly improved; and the medical insurance fund did not experience overspending, thus leading to a "triple win-win" situation.Conclusion The capitation compensation mechanism with a full period of treatment is a suitable payment method for TB diagnosis and treatment, and its effect is obvious, achieving a "triple win-win" for medical insurance, hospitals and patients. It is recommended to continue to promote this model to effectively reduce the financial burden of tuberculosis patients. However, in the early stage of the implementation of the plan, due to the relatively low understanding of the reform of hospitals and patients, there will be patient loss and poor compliance. Therefore, the hospital should change the management concept, incorporate the goal of payment method reform into performance management, and require all patients to be included in the treatment path to achieve standardized management of the entire treatment process. This mechanism also provides a reference for the reform of payment methods for tuberculosis in other regions or countries.

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Abstract 21: Heart Failure and Shared Decision-making: Patients’ Perspectives Regarding Medication-related Cost Discussions

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/hcq.13.suppl_1.21 ◽

2020 ◽

Vol 13 (Suppl_1) ◽

Author(s):

Birju Rao ◽

Neal W Dickert ◽

Alanna A Morris ◽

Candace Speight ◽

Graham Smith ◽

...

Keyword(s):

Heart Failure ◽

Decision Making ◽

Financial Burden ◽

Descriptive Analysis ◽

Cost Benefit ◽

Patient Specific ◽

Medication Cost ◽

Eligibility Criteria ◽

Reduced Ejection Fraction ◽

Medication Costs

Background: Patients with heart failure with reduced ejection fraction (HFrEF) take on average 6 medications daily and can face considerable out-of-pocket medication costs. This issue has become particularly salient as newer medications such as sacubitril-valsartan have emerged as beneficial. As clinicians attempt to maximize benefits for this population, discussions of medication costs between patients and clinicians are critical. However, cost discussions are known to be infrequent and often suboptimal. Objective: To explore patients’ perspectives on discussing out-of-pocket medication costs with clinicians. Methods: 49 adults, aged 44-70, with HFrEF meeting general eligibility criteria for sacubitril-valsartan were recruited from outpatient heart failure clinics and inpatient services. Descriptive quantitative analysis of closed-ended and multiple-choice responses was conducted. Qualitative descriptive analysis of open-ended text data was performed. Results: About half (49%) of participants reported any previous discussion with clinicians about out-of-pocket cost related to medication. These participants described their experience with cost discussions at the time of prescription as generally positive. Specific ways these discussions were helpful included clarifying cost-benefit tradeoffs and identifying opportunities for cost reduction. Most participants (96%) were open to cost discussions with their clinician, and many (69%) specifically preferred that clinicians initiate discussions regarding medication cost. There were no differences in cost discussion preferences between participants who employed different decision-making approaches about initiation of sacubitril-valsartan or across levels of financial burden. Conclusion: Out-of-pocket cost is a relevant component of patient-centered medical decisions, particularly for patients with HFrEF. These data suggest patients with HFrEF are receptive to incorporating cost discussions into care and identify some of the ways these discussions may be helpful. Further research is needed to clarify how best to identify patient-specific cost at the time of clinical encounters and how to work with patients to make cost-benefit assessments.

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Impact of working capital on firmâ€™s profitability

Journal of Economic Info ◽

10.31580/jei.v2i3.84 ◽

2015 ◽

Vol 2 (3) ◽

pp. 1-4

Author(s):

Agha Ammad Nabi ◽

Muhammad Matin

Keyword(s):

Regression Model ◽

Quantitative Data ◽

Positive Relationship ◽

Descriptive Analysis ◽

Working Capital ◽

The Impact ◽

The Relationship

The purpose of this research is to find the relationship between working capital and firmâ€™s profitability. Basically, to check the impact of working capital on firms profitability. The quantitative data is used in this research. The financials of the banks support me to check the impact whether it is positive or negative. I used certain test for this research i-e Regression model, Anova and descriptive analysis. These all test conclude that there is a positive relationship between working capital and firms profitability.

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The Impact of Project-Based Learning on Achievement and Student Views: The Case of AutoCAD Programming Course

Journal of Education and Learning ◽

10.5539/jel.v7n6p67 ◽

2018 ◽

Vol 7 (6) ◽

pp. 67 ◽

Cited By ~ 2

Author(s):

Halil Coşkun Çelik ◽

Haydar Ertaş ◽

Aziz İlhan

Keyword(s):

Higher Education ◽

Quantitative Data ◽

Qualitative Data ◽

Descriptive Analysis ◽

Project Based Learning ◽

Vocational School ◽

Analysis Method ◽

Academic Achievements ◽

Student Views ◽

The Impact

The aim of the study was to determine the impact of project-based learning on academic achievements of vocational school of higher education students and to investigate their views on the topic. In the study, a mixed descriptive design where qualitative and quantitative data were both collected and analyzed. The quantitative part was conducted with relational screening method and the qualitative part was conducted with descriptive analysis method. The study group included 13 freshmen students attending the vocational school of higher education, building inspection program in a university located in Eastern Anatolia region in Turkey during the 2016-2017 academic year spring semester and selected with convenience sampling method. The study was conducted during the 14 weeks long period where the related programming course was instructed. In the study, quantitative data were collected with an achievement test that measured the academic achievements of the students in AutoCAD programming course. The qualitative data were collected with a structured interview form designed to collect the student views on the related course. Quantitative data were analyzed with the t-test and the descriptive analysis method was used to analyze the qualitative data. In conclusion, it was determined that project-based learning had a positive impact on academic achievement. Furthermore, students expressed that they achieved meaningful learning as a result of the project-based learning application and the method was adequate for the instruction process, improved their interest in the course and related the content with daily life.

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Dampak Positif Ekonomi sebagai Hasil Tata Kelola Destinasi yang Berkelanjutan di Desa Kutuh Kawasan Pantai Pandawa – Bali

Jurnal Master Pariwisata (JUMPA) ◽

10.24843/jumpa.2021.v07.i02.p07 ◽

2021 ◽

pp. 484

Author(s):

Diena Mutiara Lemy ◽

Kim Min Jun ◽

Madeline Stefanie Tjang ◽

Wu Lei Lei

Keyword(s):

Quantitative Data ◽

Qualitative Data ◽

Local Community ◽

Sustainable Tourism ◽

Descriptive Analysis ◽

Research Result ◽

Economic Conditions ◽

Economic Welfare ◽

Tourism Management ◽

The Impact

The purpose of this research paper to identify the impact of sustainable tourism management towards the economic conditions of a community. In 2018, Pandawa Beach has won first rank for Indonesia Sustainable Tourism Awards (ISTA) in the field of economic utilization to local communities hence the author decided to use Pandawa Beach for the research. The qualitative data were collected from interviews and the quantitative data were collected from questionnaires. The method for analyzing the data is using descriptive analysis. The research result shows that sustainable tourism gives positive impacts towards the economic conditions on Kutuh Village. 72 people out of 90 are satisfied with the current economic welfare of the local community. The data is also valid because the AVE and CR results are all above 0.7 which means the results are acceptable. Keywords: sustainable tourism management, economic impact of tourism, Pandawa Beach Bali

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Challenges and opportunities of alternative payment models for physicians/quality officers in community/academic oncology practice sites via a national prospective survey.

Journal of Clinical Oncology ◽

10.1200/jco.2020.39.28_suppl.46 ◽

2021 ◽

Vol 39 (28_suppl) ◽

pp. 46-46

Author(s):

Aditi Kharat ◽

Rupesh Panchal ◽

Sabrina Ilham ◽

Madeline Brendle ◽

Trang Au ◽

...

Keyword(s):

Financial Risk ◽

Care Delivery ◽

Financial Burden ◽

Descriptive Analysis ◽

Full Time ◽

Administrative Burden ◽

Challenges And Opportunities ◽

Oncology Practice ◽

The Impact ◽

Payment Models

46 Background: Alternative payment models (APMs) aim to address the rising cost of cancer care ($173 billion in 2020) by promoting high-value care. This study explored the challenges and opportunities associated with implementation of APMs in oncology practice sites across the U.S. Methods: A novel survey was created through literature review and a focus group of content experts and researchers. This survey was distributed electronically (Qualtrics) to oncology/hematology physicians (MDs) and quality officers (QOs) at U.S academic (AC) and community (CO) cancer centers from August 2020 to November 2020. Each participant reported on their center’s experience with APMs. A descriptive analysis was conducted. Results: A total of 136 sites were contacted and 28 sites (13AC/15CO) participated (21% response rate). There were 30 (67%) sites that implemented an APM, the most common was the CMS Oncology Care Models (CMS OCM) (87%, n=26), which typically took 6 months or less for implementation (66%, n=20) and was reported to improve benchmark performance (63%, n=10). The most common reasons APMs were not implemented were administrative complexity (53%, n=8); difficulty with alignment of multiple payers to APM (47%, n=7); and need for a median of 5 full-time hires. A larger number of QOs indicated participation in CMS OCM compared to MDs [94% (n=15) vs. 76% (n=11)]. The biggest difficulty experienced by MDs was adoption of innovation at site’s financial risk (43%, n=6) compared to QOs who focused on administrative and financial burden (43%, n=7). Community cancer sites were more likely to use APMs (100%, n=23) compared to AC sites (31%, n=7). The largest difficulty experienced by CO sites was adoption of innovations at their own financial risk (26%, n=6) compared to high costs, administrative burden and lack of payer engagement (29%, n=2 each) for AC sites. The most common challenge with incentives among CO sites was concerns with risk adjustment of quality measures (57%, n=13) compared to increased complexity of incentive compensation (57%, n=4) for AC sites. CO sites indicated that quality measure performance reviews were primarily conducted by administrative staff compared to clinical leaders for AC sites. Conclusions: Administrative burden and access to appropriate patient data inhibit the impact of APMs. MDs are primarily concerned about the penalties and financial risk, whereas QOs focus on administrative complexities. For CO and AC sites, the adoption and implementation of APMs to improve cost and care delivery was not without significant challenges. This study demonstrates the multifaceted impact APMs have on care delivery.

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Impak Kerjasama Politik Umno-Pas Terhadap Perkembangan Islam Di Malaysia Dari Tahun 1973 Hingga 1978

Sains Insani ◽

10.33102/sainsinsani.vol2no1.14 ◽

2018 ◽

Vol 2 (1) ◽

pp. 12-16

Author(s):

Mohammad Tawfik Yaakub ◽

Osman Md Rasip

Keyword(s):

Descriptive Analysis ◽

Historical Research ◽

Radio Station ◽

The Political ◽

Coalition Government ◽

Secondary Sources ◽

Political Cooperation ◽

Islamic Religion ◽

Political Approach ◽

The Impact

This article discusses impact of UMNO-PAS political cooperation towards Islamic development in Malaysia from 1973 until 1978. The success of political cooperation in 1973 was the result of both UMNO’s leader, Tun Abdul Razak and PAS’s leader, Asri Muda willingness to explore a new political approach compared to what was being practiced at that time. Both leaders then started the development of a government known as the ‘Cooperation Government’ with the combination of UMNO and PAS in 1973 and later on, the development of the National Front’s (BN) Coalition Government in 1974. The Islamic religion benefits the most from the development of the Coalition Government which is a favourable gain for the Malays in Malaysia. Henceforth, this article will discuss in detail on the impact of the political cooperation between UMNO and PAS within the cooperation period. The methods used for this research is by interview and also by referring to secondary sources which are analyzed in a historical descriptive manner that is normally practiced in historical research. At the end of this research it is established that there are profound impacts to the Islamic religion within the UMNO-PAS cooperation period within 1973 to 1978 for example, the television and radio station beginning starting their programmes with the recitation from Quranic verses, the promulgation of ‘Adhan, alcohols are no longer served in official government’s function, lottery companies are not allowed to promote and announce the lottery results in official government’s media, the establishment of Islamic institution, the strengthening of Islamic education and the appropriate change in the relevant ministry’s symbols. This article can be utilized by subsequent researchers who wish to study the impact of political cooperation between UMNO and PAS. Keywords: political cooperation, UMNO-PAS, cooperation government ABTRAK:Makalah ini membincangkan mengenai impak kerjasama politik UMNO-PAS terhadap perkembangan Islam di Malaysia dari tahun 1973 hingga 1978. Kerjasama politik yang berjaya dibentuk bermula pada tahun 1973 adalah hasil daripada kesediaan Tun Abdul Razak dengan Mohd Asri Muda yang menerajui UMNO dan PAS pada ketika itu mencetuskan perubahan corak berpolitik yang berbeza berbanding sebelumnya. Maka, kedua-dua pemimpin ini kemudiannya merintis pembentukan sebuah kerajaan yang menggabungkan UMNO dengan PAS menerusi Kerajaan Campuran pada tahun 1973 dan Kerajaan Gabungan Barisan Nasional (BN) pada tahun 1974. Hasil daripada kejayaan penubuhan kedua-dua kerajaan ini, perkembangan Islam di negara ini bertambah pesat dan dapat dimanfaatkan oleh keseluruhan orang Melayu di Malaysia. Justeru, artikel ini membincangkan secara terperinci impak kerjasama politik antara UMNO dengan PAS dalam tempoh kerjasama politik berkenaan. Penyelidikan ini menggunapakai kaedah temubual dan menyorot sejumlah sumber sekunder yang kemudiannya dianalisis secara deskriptif sejarah (historical descriptive analysis) yang lazimnya dipraktikkan dalam kajian sejarah. Hasil kajian ini mendapati terdapat impak-impak jelas terhadap perkembangan Islam di negara ini sepanjang tempoh kerjasama politik antara UMNO dengan PAS dari tahun 1973 hingga 1978. Antara impak-impak tersebut ialah permulaan siaran televisyen dan radio dengan bacaan ayat-ayat suci Al-Quran, mengumandangkan suara azan, penghapusan arak dalam majlis-majlis kerajaan, penghapusan promosi dan keputusan judi di media kerajaan, penubuhan institusi Islam, pemerkasaan pendidikan Islam dan penukaran simbol institisu kerajaan. Akhirnya, artikel ini dapat dimanfaatkan oleh penyelidik-penyelidik berikutnya untuk menilai impak kerjasama politik antara UMNO dengan PAS.Kata kunci: kerjasama politik, UMNO-PAS, kerajaan campuran

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Analyzing Factors Affecting the Sustainability of Land Management Practices in Mecha Woreda, Northwestern Ethiopia

Sustainability ◽

10.3390/su13137007 ◽

2021 ◽

Vol 13 (13) ◽

pp. 7007

Author(s):

Habtamu Nebere ◽

Degefa Tolossa ◽

Amare Bantider

Keyword(s):

Decision Making ◽

Land Management ◽

Land Degradation ◽

Quantitative Data ◽

Management Practices ◽

Short Term ◽

Factors Affecting ◽

Decision Making Processes ◽

Household Heads ◽

The Impact

In Ethiopia, the practice of land management started three decades ago in order to address the problem of land degradation and to further boost agricultural production. However, the impact of land management practices in curbing land degradation problems and improving the productivity of the agricultural sector is insignificant. Various empirical works have previously identified the determinants of the adoption rate of land management practices. However, the sustainability of land management practices after adoption, and the various factors that control the sustainability of implemented land management practices, are not well addressed. This study analyzed the factors affecting the sustainability of land management practices after implementation in Mecha Woreda, northwestern Ethiopia. The study used 378 sample respondents, selected by a systematic random sampling technique. Binary logistic regression was used to analyze the quantitative data, while the qualitative data were qualitatively and concurrently analyzed with the quantitative data. The sustained supply of fodder from the implemented land management practices, as well as improved cattle breed, increases the sustainability of the implemented land management practices. While lack of agreement in the community, lack of enforcing community bylaws, open cattle grazing, lack of benefits of implemented land management practices, acting as barrier for farming practices, poor participation of household heads during planning and decision-making processes, as well as the lack of short-term benefits, reduce the sustainability of the implemented land management practices. Thus, it is better to allow for the full participation of household heads in planning and decision-making processes to bring practical and visible results in land management practices. In addition, recognizing short-term benefits to compensate the land lost in constructing land management structures must be the strategy in land management practices. Finally, reducing the number of cattle and practicing stall feeding is helpful both for the sustainability of land management practices and the productivity of cattle. In line with this, fast-growing fodder grass species have to be introduced for household heads to grow on land management structures and communal grazing fields for stall feeding.

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936. Evaluating the Impact of Polypharmacy on Virologic Success in People with HIV

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1122 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S501-S502

Author(s):

Humberto R Jimenez ◽

Naana Boachie ◽

Sangwon Park ◽

Jin Suh

Keyword(s):

Hiv Transmission ◽

Virologic Failure ◽

Descriptive Analysis ◽

Virologic Response ◽

Transmission Risk ◽

Pill Burden ◽

Cross Sectional ◽

Hiv Rna ◽

Aids Diagnosis ◽

The Impact

Abstract Background As people with HIV (PWH) have experienced reductions in antiretroviral pill burden, there has been an increase in medications to manage non-AIDS-related co-morbidities. Previous studies have linked virologic failure to an increased pill burden. This study assessed whether polypharmacy and other variables affect success of HIV management in our population. Methods A retrospective, cross-sectional analysis of PWH receiving care at a Ryan White-funded clinic in New Jersey was performed. Eligible patients were ≥18 years old, had ≥2 visits in 2019 and were receiving antiretroviral therapy (ART). The primary endpoints were to determine the effect polypharmacy (defined as 5 or more non-ART pills per day) on virologic response rates (HIV RNA < 200 copies/mL). Secondary endpoints accounted for the impact of age, gender, race/ethnicity, HIV transmission risk factor, and AIDS diagnosis on virologic response. A descriptive analysis of comorbidities and medication classes was also completed. Logistic regression, chi square and student’s t test were used for statistical analysis. Results 964 patients were included in the analysis, with 355 (37%) meeting the criteria for polypharmacy. Most patients were male (60%) and the mean age was 49 years of age. The racial/ethnic breakdown was 46% Hispanic, 45% Black and 8% White. Polypharmacy was associated with higher rates of virologic success compared to those with a lower pill burden: 94% vs 86% had an HIV RNA < 200 copies/mL (P=0.0003), respectively. ART pill burden was statistically, but not clinically higher among those with polypharmacy (1.34 vs 1.45, P=0.025). Virologic response was found to be higher among Hispanics and Whites in comparison to Black patients (OR 2.2, CI 1.4-3.5 and 3.0, CI 1.1-8.2). Patients with an AIDS diagnosis were less likely to achieve virologic response (OR 0.64, CI 0.42-0.99). Conclusion Patients with polypharmacy were more likely to achieve virologic success than paitents with a low pill burden in our population. Disclosures Humberto R. Jimenez, PharmD, BCPS, AAHIVP, Gilead (Speaker’s Bureau)

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Assessing the impact of a combined nutrition counselling and cash transfer intervention on women’s empowerment in rural Bangladesh: a randomised control trial protocol

BMJ Open ◽

10.1136/bmjopen-2020-044263 ◽

2021 ◽

Vol 11 (6) ◽

pp. e044263

Author(s):

Elizabeth K Kirkwood ◽

Michael John Dibley ◽

John Frederick Hoddinott ◽

Tanvir Huda ◽

Tracey Lea Laba ◽

...

Keyword(s):

Quantitative Data ◽

Women's Empowerment ◽

Cash Transfer ◽

Women’S Empowerment ◽

Randomised Control Trial ◽

Call Centre ◽

Rural Bangladesh ◽

Nutrition Counselling ◽

The Impact ◽

Unconditional Cash Transfer

IntroductionThere is growing interest in assessing the impact of health interventions, particularly when women are the focus of the intervention, on women’s empowerment. Globally, research has shown that interventions targeting nutrition, health and economic development can affect women’s empowerment. Evidence suggests that women’s empowerment is also an underlying determinant of nutrition outcomes. Depending on the focus of the intervention, different domains of women’s empowerment will be influenced, for example, an increase in nutritional knowledge, or greater control over income and access to resources.ObjectiveThis study evaluates the impact of the Shonjibon Cash and Counselling (SCC) Trial that combines nutrition counselling and an unconditional cash transfer, delivered on a mobile platform, on women’s empowerment in rural Bangladesh.Methods and analysisWe will use a mixed-methods approach, combining statistical analysis of quantitative data from 2840 women in a cluster randomised controlled trial examining the impact of nutrition behaviour change communications (BCCs) and cash transfers on child undernutrition. Pregnant participants will be given a smartphone with a customised app, delivering nutrition BCC messages, and will receive nutrition counselling via a call centre and an unconditional cash transfer. This study is a component of the SCC Trial and will measure women’s empowerment using a composite indicator based on the Project-Level Women’s Empowerment in Agriculture Index, with quantitative data collection at baseline and endline. Thematic analysis of qualitative data, collected through longitudinal interviews with women, husbands and mothers-in-law, will elicit a local understanding of women’s empowerment and the linkages between the intervention and women’s empowerment outcomes. This paper describes the study protocol to evaluate women’s empowerment in a nutrition-specific and sensitive intervention using internationally validated, innovative tools and will help fill the evidence gap on pathways of impact, highlighting areas to target for future programming.Ethics and disseminationEthical approval has been obtained from the International Centre for Diarrhoeal Disease Research (Ref. PR 17106) and The University of Sydney (Ref: 2019/840). Findings from this study will be shared in Bangladesh with dissemination sessions in-country and internationally at conferences, and will be published in peer-reviewed journals.

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