Researchers Develop Mercury-Free Dental Material / WSDA Aims to Improve Access to Care / Per Capita Health Care Spending Varies from Region to Region, Says HCFA Study / ADA Legal Affairs Division Answers HIV Questions / Appointments/Elections/Awards / Calendar of Events / Health Media Watch / Book Reviews

1993 ◽  
Vol 124 (12) ◽  
pp. 20-30
Author(s):  
Daniel McCann ◽  
Julie A. Jacob ◽  
Anita Mark
Keyword(s):  
Health Care ◽  
Access To Care ◽  
Dental Material ◽  
Health Care Spending ◽  
Per Capita ◽  
Improve Access

Telemedicine in Cancer Care

2018 ◽  
pp. 540-545 ◽  
Author(s):  
S. Joseph Sirintrapun ◽  
Ana Maria Lopez
Keyword(s):  
Health Care ◽  
Access To Care ◽  
Cancer Care ◽  
Symptom Management ◽  
Lifestyle Modification ◽  
Clinical Settings ◽  
Home Based ◽  
Home Based Care ◽  
Care Costs ◽  
Improve Access

Telemedicine uses telecommunications technology as a tool to deliver health care to populations with limited access to care. Telemedicine has been tested in multiple clinical settings, demonstrating at least equivalency to in-person care and high levels of patient and health professional satisfaction. Teleoncology has been demonstrated to improve access to care and decrease health care costs. Teleconsultations may take place in a synchronous, asynchronous, or blended format. Examples of successful teleoncology applications include cancer telegenetics, bundling of cancer-related teleapplications, remote chemotherapy supervision, symptom management, survivorship care, palliative care, and approaches to increase access to cancer clinical trials. Telepathology is critical to cancer care and may be accomplished synchronously and asynchronously for both cytology and tissue diagnoses. Mobile applications support symptom management, lifestyle modification, and medication adherence as a tool for home-based care. Telemedicine can support the oncologist with access to interactive tele-education. Teleoncology practice should maintain in-person professional standards, including documentation integrated into the patient’s electronic health record. Telemedicine training is essential to facilitate rapport, maximize engagement, and conduct an accurate virtual exam. With the appropriate attachments, the only limitation to the virtual exam is palpation. The national telehealth resource centers can provide interested clinicians with the latest information on telemedicine reimbursement, parity, and practice. To experience the gains of teleoncology, appropriate training, education, as well as paying close attention to gaps, such as those inherent in the digital divide, are essential.

An Economic Perspective on the Affordable Care Act: Expectations and Reality

2020 ◽  
Vol 45 (5) ◽  
pp. 889-904
Author(s):  
Sayeh Nikpay ◽  
India Pungarcher ◽  
Austin Frakt
Keyword(s):  
Health Care ◽  
Labor Market ◽  
Access To Care ◽  
Affordable Care Act ◽  
Health Care Spending ◽  
Financial Security ◽  
Health Care Coverage ◽  
The Affordable Care Act ◽  
Labor Market Decisions ◽  
Judicial Actions

Abstract The Affordable Care Act (ACA) was enacted in 2010 to address both high uninsured rates and rising health care spending through insurance expansion reforms and efforts to reduce waste. It was expected to have a variety of impacts in areas within the purview of economics, including effects on health care coverage, access to care, financial security, labor market decisions, health, and health care spending. To varying degrees, legislative, executive, and judicial actions have altered its implementation, affecting the extent to which expectations in each of these dimensions have been realized. We review the ACA's reforms, the subsequent actions that countered them, and the expected and realized effects on coverage, access to care, financial security, health, labor market decisions, and health care spending.

scholarly journals Expanding Virtual Health Capabilities Into Trainee Health

2021 ◽  
Author(s):  
Elizabeth A Poindexter ◽  
Amanda Rodriguez ◽  
Timothy Switaj
Keyword(s):  
Health Care ◽  
Access To Care ◽  
San Antonio ◽  
Clinical Staff ◽  
Medical Clinic ◽  
Secure Messaging ◽  
Care Clinic ◽  
Instruction Time ◽  
Key Concepts ◽  
Improve Access

ABSTRACT Virtual health and secure messaging gained newfound relevance in medicine during the coronavirus disease (COVID)-19 pandemic. For a military trainee health care clinic located on Joint Base San Antonio, the McWethy Troop Medical Clinic (TMC), implementation of virtual health and secure messaging services meant decreased risk of COVID-19 exposure for trainees and clinical staff. Through ongoing utilization, these services also made impacts to reduce loss of instruction time and improve access to care for the McWethy TMC trainee population. In defining the challenges, successes, and future implications for virtual health and secure messaging at the McWethy TMC, key lessons emerge for other military trainee clinics. The key concepts explored in this article are virtual health and secure messaging.

Spending Too Much on the Wrong Things

Pained ◽  
2020 ◽  
pp. 107-110
Author(s):  
Michael D. Stein ◽  
Sandro Galea
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Health System ◽  
Social Services ◽  
Health Care Providers ◽  
Entire Population ◽  
Health Care Spending ◽  
Care Providers ◽  
The Social ◽  
Per Capita

This chapter addresses overspending in health care. Americans spend half as many days in hospital as persons living in other high-income countries. They take fewer pills per person, and they have fewer doctors per capita. Yet Americans spend two to three times as much on health care as other countries, and they have poorer health outcomes. This is because they overpay. Talking about overspending suggests that certain partners in the health system are charging more than they should. Since about one third of health care spending is related to hospitals and another 20% is paid to health care providers, these are the obvious culprits. If Americans spent less on hospitals and clinicians, they could spend more on the social services required to prevent or reduce illness, to make their entire population healthier.

Estimates of global spending and financing of mental health

2011 ◽  
Vol 08 (01) ◽  
pp. 05-08 ◽  
Author(s):  
R. M. Scheffler
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Capita Income ◽  
Health Spending ◽  
The United States ◽  
Health Care Spending ◽  
Per Capita Income ◽  
Per Capita

SummaryThis paper illustrates the wide variation in the spending and financing of mental health services around the globe. As would be expected, mental health spending in high-income countries is a larger percent of overall health care spending, which in the United States, United Kingdom, and France is about 10% of health care spending, compared to countries such as Japan, Portugal, the Czech Republic, and Hungary, where the spending is around 6%. In OECD countries, mental health spending is approximately 7.4% of total health care spending. Our analysis of the relationship between per capita spending on mental health and per capita income shows that the elasticity of mental health spending is 0.49, suggesting that a 10% change in per capita income produces a 4.9% increase in mental health spending per capita. In LMIC, we found that the spending levels for mental health was approximately 1–2% of the total health care budget. The dominant payer for mental health services throughout the globe still appears to be that of the government sector. The case studies that we present in Korea, Spain, and Ghana show dramatically different approaches to the financing and spending of mental health.

scholarly journals Improving Access to Care by Allowing Self-Referral to a Hepatitis C Clinic

2009 ◽  
Vol 23 (6) ◽  
pp. 421-424 ◽  
Author(s):  
Karen Doucette ◽  
Vicki Robson ◽  
Stephen Shafran ◽  
Dennis Kunimoto
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Hepatitis C ◽  
Access To Care ◽  
Support Program ◽  
Genotype 1 ◽  
Hcv Treatment ◽  
Similar Treatment ◽  
Primary Risk Factor ◽  
Improve Access

BACKGROUND: Estimates suggest that more than 250,000 Canadians are infected with hepatitis C virus (HCV), but less than 10% have been treated. Access to specialists in Canada is usually via health care professional (HCP) referral and, therefore, may be a barrier to HCV care. However, clinics that operate in conjunction with the Hepatitis Support Program, Edmonton, Alberta, allow self-referral. It is hypothesized that this improves access to care without increasing inappropriate referrals.OBJECTIVE: To compare the baseline characteristcs and outcomes of HCV patients who self-referred with those who were HCP-referred.METHODS: Data were collected from the Hepatitis Support Program HCV database and chart reviews.RESULTS: Between December 17, 2002, and December 31, 2007, 1563 patients were referred including 336 self- (21.5%) and 1227 HCP- referrals (78.5%). Self- and HCP-referred patients were similar in terms of age (mean [± SD] 43.0±10.3 years versus 43.9±10.0 years, respectively; P=0.18), sex (56.8% versus 62.0% [men], respectively; P=0.08) and risk factors for HCV (P=0.3), with 49.7% and 52.6%, respectively, identifying injection drug use as the primary risk factor. The two groups had similar HCV genotype distributions and liver biopsy fibrosis scores with similar treatment rates (31.3% versus 33.2%; P=0.6). Treatment outcomes were excellent (sustained virological response 40.2% for genotype 1, 67% for genotypes 2 and 3) in patients completing therapy and were similar between the two groups.Conclusion: Self-referred patients comprised 21.5% of patients accessing care in the clinic. Self- and HCP-referred patients had similar characteristics, treatment rates and outcomes. Facilitating self- referral to an HCV clinic can improve access to care, including risk reduction education and HCV treatment.

Inequities in Access to Care and Health Care Spending for Asian Americans With Cancer

Medical Care ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Sungchul Park ◽  
Jie Chen ◽  
Grace X. Ma ◽  
Alexander N. Ortega
Keyword(s):  
Health Care ◽  
Access To Care ◽  
Asian Americans ◽  
Health Care Spending

Obstacles to Developing and Using Technology: The Case of the Artificial Heart

1986 ◽  
Vol 2 (3) ◽  
pp. 411-424 ◽  
Author(s):  
James H. Maxwell ◽  
David Blumenthal ◽  
Harvey M. Sapolsky
Keyword(s):  
Health Care ◽  
Access To Care ◽  
Health Care System ◽  
Opportunity Cost ◽  
Artificial Heart ◽  
Health Benefits ◽  
Improve Access ◽  
Care System

For some observers, the artificial heart represents the latest, and perhaps the most flagrant example of the health system's tendency to favor the rapid introduction of expensive but ineffective technologies over efforts to prevent disease and to improve access to care (5;6;19;44;45). Even if it can be perfected, they argue, its opportunity cost in terms of other foregone health benefits would be exorbitant. The ultimate failing of the health care system, it would seem, is its failure to establish mechanisms to select among alternative uses of resources. If such mechanisms had existed, some critics believe that the quest for an artificial heart never would have begun and certainly its premature clinical uses could have been prevented (6;45).

Decomposing Trends in U.S. Health Care Spending Among Nonelderly Adults, 2007-2016

2019 ◽  
pp. 107755871986508
Author(s):  
Fredric Blavin ◽  
Michael Karpman ◽  
Diane Arnos
Keyword(s):  
Health Care ◽  
Medical Expenditure Panel Survey ◽  
Medical Expenditure ◽  
Health Care Spending ◽  
Policy Changes ◽  
The Great Recession ◽  
Technological Developments ◽  
Capita Spending ◽  
Per Capita ◽  
Spending Growth

Using the 2007 to 2016 Medical Expenditure Panel Survey–Household Component, this study analyzes trends in per capita health expenditures among nonelderly adults from the Great Recession to the period following full implementation of the Affordable Care Act. We find that the growth in total per capita spending—and specifically for prescription drug and emergency room spending—from 2007-2009 to 2014-2016 was largely driven by increases in expenditures per unit, that is, increases in per unit prices, quality, and/or intensity of treatment. We also find that changes in the health insurance distribution were the largest driver behind the increase in total per capita expenditures over this period, while changes in prevalence of chronic conditions explained a smaller portion of the increase. Identifying policies for containing health care spending growth requires a detailed understanding of the sources of that growth, particularly during periods of economic fluctuations, policy changes, and technological developments.

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