Les Nouveaux Miserables: Modem Victims of Social Asphyxia

PEDIATRICS ◽  
1995 ◽  
Vol 96 (4) ◽  
pp. 851-857
Author(s):  
David R. Smith
Keyword(s):  
Health Care ◽  
Health Status ◽  
Medical Care ◽  
Health Care Costs ◽  
Health Care Services ◽  
Preventive Services ◽  
Medical Care System ◽  
Care Services ◽  
Care Costs ◽  
Care System

During the past 30 years, social and economic barriers to health care services have increased for many Americans, especially for the nation's most vulnerable populations. Health status actually has declined for certain populations during this time. Meanwhile, national attention has been focused primarily on containing health care costs and on devising strategies for reforming the financing of health care rather than strategies for achieving improvements in the health status of the population. Existing methods of financing health care services, health research priorities, the increasing centralization and compartmentalization of health care services, and the recent failure of national health reform all serve to hinder this nation's progress towards developing a comprehensive and accountable health care system focused on promoting and achieving improved health as well as treating sickness. Recent changes in the health care marketplace, however, including a growing movement toward measuring the outcomes of medical treatments and an emphasis on improving the quality of services, have increased interest among payers and providers of health care services in investing in preventive services. Health maintenance organizations and other integrated health care delivery systems are beginning to devise incentives for increasing preventive care as well as for containing costs. The transformation of the nation's current medical care system into a true health care system will require innovative strategies designed to merge the existing fragmented array of services into coordinated and comprehensive systems for delivering primary and preventive health care services in community settings. The community-Oriented Primary Care concept successfully blends these functions and has achieved measurable results in reducing health care costs and improving access to preventive services for identified populations. There is flexibility in existing funding sources to promote preventive services in various public and private health care settings and to assist in the transformation from a disease-oriented medical care system to one focused on health.

scholarly journals Outpatient health care utilization and health expenditures of asylum seekers in Halle (Saale), Germany - an analysis of claims data

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Andreas Niedermaier ◽  
Anna Freiberg ◽  
Daniel Tiller ◽  
Andreas Wienke ◽  
Amand Führer
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Asylum Seekers ◽  
Health Care Services ◽  
Claims Data ◽  
Care Utilization ◽  
Care Services ◽  
Outpatient Sector ◽  
Analysis Of Claims Data ◽  
Care Costs

Abstract Background Asylum seekers are a vulnerable group with special needs in health care due to their migration history and pre-, peri- and postmigratory social determinants of health. However, in Germany access to health care is restricted for asylum seekers by law and administrative regulations. Methods Using claims data generated in the billing process of health care services provided to asylum seekers, we explore their utilization of health care services in the outpatient sector. We describe the utilization of outpatient specialties, prevalences of diagnoses, prescribed drugs and other health care services, as well as total costs of health care provision. Results The estimated prevalence for visiting an ambulatory physician at least once per year was 67.5% [95%-Confidence-Interval (CI): 65.1–69.9%], with a notably higher prevalence for women than men. The diagnoses with the highest one-year prevalence were “Acute upper respiratory infections” (16.1% [14.5–18.0%]), “Abdominal and pelvic pain” (15.6% [13.9–17.4%]) and “Dorsalgia” (13.8% [12.2–15.5%]). A total of 21% of all prescriptions were for common pain killers. Women received more diagnoses across most diagnosis groups and prescribed drugs from all types than men. Less than half (45.3%) of all health care costs were generated in the outpatient sector. Conclusion The analysis of claims data held in a municipal social services office is a novel approach to gain better insight into asylum seekers’ utilization of health services on an individual level. Compared to regularly insured patients, four characteristics in health care utilization by asylum seekers were identified: low utilization of ambulatory physicians; a gender gap in almost all services, with higher utilization by women; frequent prescription of pain killers; and a low proportion of overall health care costs generated in the outpatient sector. Further research is needed to describe structural and individual factors producing these anomalies.

Government Resources on Mental Health

2020 ◽  
Vol 35 (12) ◽  
pp. 573-573
Author(s):  
Paul Baldwin
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Clinical Research ◽  
Health Care Costs ◽  
Health Care Services ◽  
Disease Prevalence ◽  
Statistical Information ◽  
Care Services ◽  
Care Costs

State and federal governments collect massive amounts of data, both in their role as sponsors of research and as payers for an increasing share of health care services. The information available includes definitive clinical research as well as statistical information about disease prevalence and contribution to health care costs.

scholarly journals Rural American Indian Medicaid Health Care Services Use and Health Care Costs in California

2006 ◽  
Vol 96 (2) ◽  
pp. 363-370 ◽  
Author(s):  
Sabrina T. Wong ◽  
Chi Kao ◽  
James A. Crouch ◽  
Carol C. Korenbrot
Keyword(s):  
Health Care ◽  
American Indian ◽  
Health Care Costs ◽  
Health Care Services ◽  
Care Services ◽  
Care Costs ◽  
Services Use

The effects of payments for pharmaceuticals: a systematic literature review

2017 ◽  
Vol 14 (03) ◽  
pp. 337-354 ◽  
Author(s):  
Katarzyna Kolasa ◽  
Marta Kowalczyk
Keyword(s):  
Health Care ◽  
Literature Review ◽  
Health Outcomes ◽  
Health Care Costs ◽  
Drug Cost ◽  
Systematic Literature Review ◽  
Cost Sharing ◽  
Health Care Services ◽  
Care Services ◽  
Care Costs

AbstractThe existence of different forms of out-of-pocket payments (OOPs) for pharmaceuticals across the globe provokes the question whether they can achieve more negative or positive consequences. A systematic literature review was conducted to assess the association between drug cost sharing and health care services utilization, health care costs as well as health outcomes. Studies published in The Cochrane Library, PubMed, Embase were searched with such keywords as: drug, pharmaceutical, cost sharing, out of pocket, co-payments paired with the following: impact, health outcomes, health care costs and utilization. The final review included 18 articles. A total of 11 publications reported the association between drug cost sharing and health care utilization patterns, of which nine found a statistically significant direct relationship. In all 10 publications concerned the association between drug copayments and health care costs. Majority were limited to the impact on the drug budget. Seven studies looked into the link between drug cost sharing and health outcomes, of which five reported statistically significant inverse relationship. There is some evidence for the association between drug copayments, health outcomes and health care services consumption. The optimal system of OOPs’ payments for pharmaceuticals needs to prevent drugs’ overconsumption and mitigate the risks of excessive cost sharing’s burden.

Government Resources on Mental Health

2020 ◽  
Vol 35 (12) ◽  
pp. 573-573
Author(s):  
Paul Baldwin
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Clinical Research ◽  
Health Care Costs ◽  
Health Care Services ◽  
Disease Prevalence ◽  
Statistical Information ◽  
Care Services ◽  
Care Costs

State and federal governments collect massive amounts of data, both in their role as sponsors of research and as payers for an increasing share of health care services. The information available includes definitive clinical research as well as statistical information about disease prevalence and contribution to health care costs.

scholarly journals Health Care Services Utilization and Health-Related Quality of Life of Syrian Refugees with Post-Traumatic Stress Symptoms in Germany (the Sanadak Trial)

2021 ◽  
Vol 18 (7) ◽  
pp. 3408
Author(s):  
Thomas Grochtdreis ◽  
Susanne Röhr ◽  
Franziska U. Jung ◽  
Michaela Nagl ◽  
Anna Renner ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Health Care Services ◽  
Current Treatment ◽  
Syrian Refugees ◽  
Post Traumatic Stress ◽  
Care Services ◽  
Related Quality ◽  
Health Related ◽  
Care Costs

Refugees who have fled from the ongoing civil war in Syria that arrived in Germany often develop post-traumatic stress symptoms (PTSS). The aim of this study was to determine health care services utilization (HCSU), health care costs and health-related quality of life (HrQoL) of Syrian refugees with mild to moderate PTSS without current treatment in Germany. The study was based on the baseline sample of a randomized controlled trial of a self-help app for Syrian refugees with PTSS (n = 133). HCSU and HrQoL based on the EQ-5D-5L and its visual analogue scale (EQ-VAS) were assessed with standardized interviews. Annual health care costs were calculated using extrapolated four-month HCSU and standardized unit costs. Associations between health care costs, HrQoL and PTSS severity were examined using generalized linear models. Overall, 85.0% of the sample utilized health care services within four months. The mean total annual health care costs were EUR 1920 per person. PTSS severity was not associated with health care costs. The EQ-5D-5L index score and the EQ-VAS score was 0.82 and 73.6, respectively. For Syrian refugees with higher PTSS severity, the EQ-5D-5L index score was lower (−0.17; p < 0.001). The HCSU and the resulting health care costs of Syrian refugees with mild to moderate PTSS without current treatment are low and those with a higher PTSS severity had a lower HrQoL.

scholarly journals Utilization of Telehealth Services in Libya in Response to the COVID-19 Pandemic: Cross-sectional Analysis (Preprint)

2020 ◽  
Author(s):  
Muhammed Elhadi ◽  
Ahmed Msherghi ◽  
Ahmed Elhadi ◽  
Aimen Ashini ◽  
Ahmed Alsoufi ◽  
...  
Keyword(s):  
Health Care ◽  
Health Status ◽  
Medical Care ◽  
Text Messaging ◽  
Health Care Services ◽  
Effective Means ◽  
Cross Sectional ◽  
Telemedicine System ◽  
Care Services ◽  
Alternative Modality

BACKGROUND Health care systems in transitional countries have witnessed unprecedented challenges related to adequate and continuous health care provision during the COVID-19 pandemic. In many countries, including Libya, institutions and organizations have begun to implement telehealth technology for the first time. This serves to establish an alternative modality for direct physician-patient interviews to reduce the risk of COVID-19 transmission. OBJECTIVE This study aimed to assess the usability of telehealth services in Libya and to provide an overview of the current COVID-19 scenario. METHODS In this cross-sectional study, an anonymous web-based survey was administered to Libyan residents between April and May 2020. Participants were contacted through text messaging, emails, and social media. The survey items yielded information on the sociodemographic characteristics, availability and accessibility of health care services, effects of the COVID-19 pandemic on health care services, mental health status, and the feasibility and application of the telehealth system. RESULTS We obtained 2512 valid responses, of which 1721 (68.5%) were from females. The participants were aged 28.2 (SD 7.6) years, of whom 2333 (92.9%) were aged &lt;40 years, and 1463 (58.2%) were single. Regarding the health care services and their accessibility, 786 (31.1%) participants reported having a poor health status in general, and 492 (19.6%) reported having a confirmed diagnosis of at least one chronic disease. Furthermore, 498 (19.9%) participants reported varying degrees of difficulty in accessing health care centers, and 1558 (62.0%) could not access their medical records. Additionally, 1546 (61.6%) participants experienced problems in covering medical costs, and 1429 (56.9%) avoided seeking medical care owing to financial concerns. Regarding the feasibility of the telehealth system, approximately half of the participants reported that telehealth services were useful during the COVID-19 pandemic, and 1545 (61.5%) reported that the system was an effective means of communication and of obtaining health care services. Furthermore, 1435 (57.1%) participants felt comfortable using the telehealth system, and 1129 (44.9%) felt that they were able to express themselves effectively. Moreover, 1389 (55.3%) participants found the system easy to understand, and 1354 (53.9%) reported having excellent communication with physicians through the telehealth system. However, only 1018 (40.5%) participants reported that communication was better with the telehealth system than with traditional methods. CONCLUSIONS Our study revealed high levels of usability and willingness to use the telemedicine system as an alternative modality to in-person consultations among the Libyan residents in this study. This system is advantageous because it helps overcome health care costs, increases access to prompt medical care and follow-up evaluation, and reduces the risk of COVID-19 transmission. However, internet connectivity and electricity issues could be a substantial barrier for many resource-limited communities, and further studies should address such obstacles.

scholarly journals Financing of medical services: experience of foreign countries and Ukraine

2020 ◽  
pp. 9-13
Author(s):  
Nataliia KARPYSHYN ◽  
Iryna SYDOR
Keyword(s):  
Health Care ◽  
Health Services ◽  
Medical Care ◽  
Health Care Reform ◽  
Health Care System ◽  
Health Care Costs ◽  
Medical Services ◽  
Foreign Countries ◽  
Care Costs ◽  
Care System

Introduction. Research into the sources of health care funding is necessary to develop an effective policy to improve the domestic health care system and improve the accessibility and quality of medical care. The purpose of the article is to assess the sources of funding of medical services in foreign countries and in Ukraine in order to identify and analise current trends and prospects for financing the domestic health care system in the implementation of health care reform. Results. An analysis of trends in the financing of health services in foreign countries has shown that there is a certain imbalance between the country's economic growth and its health care expenditures. The share of health services expenditures in GDP averaged 8.8 % or almost $ 4,000 per OECD citizen in 2018 y . This cost figure is 24 times higher than the per capita health care costs in Ukraine and can be a guide to the amount of funding for medicine in the world community. Citizens of OECD countries, unlike Ukrainians, pay an average of 21 % of all health care costs. The priority sources of funding for one group of countries are budget funds (Norway, Denmark, Sweden, Great Britain, Canada), and for another – compulsory health insurance (Germany, Japan, France, etc.). Сonclusion. Funds of the population are the main source of funding for medical services in Ukraine – 53 %. This indicator is critical for the country, as low-income citizens are unable to pay for medical care and the number of chronic diseases, disability and mortality are increased. The transformational reform of the health care system in Ukraine was started in 2015 and according to international experts is successful and meets international practices of accessibility, quality and efficiency of medical services. Further consistent implementation of health care reform can provide financial protection for the population from excessive out-of-pocket spending, improve access to health care, and improve public health.

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