scholarly journals The Effect of Health Transformation Plan on Out-of-Pocket Payments of the Hospitalized Patients in Hamedan, Iran

2021 ◽  
Author(s):  
Shaghayegh Farhadi ◽  
Ali Akbar Fazaeli ◽  
Younes Mohammadi
Keyword(s):  
Health Insurance ◽  
Data Analysis ◽  
Health System ◽  
Analytical Study ◽  
Hospitalized Patients ◽  
Upward Trend ◽  
Health System Financing ◽  
Out Of Pocket Payments ◽  
Hospitalization Costs ◽  
Before And After

Background: Out-of-Pocket (OOP) payment is categorized among the critical indicators of health system financing. Given the high hospitalization costs of the hospitals, the ministry of health has attempted to implement Health Transformation Plan (HTP) in Iran to reduce OOP. The purpose of this paper is to show the effects of HTP on OOP payments of the hospitalized patients in Hamedan, Iran. Methods: This descriptive-analytical study was carried out on 587 patients in the educational hospitals of Hamedan. The data obtained before and after implementing the HTP was from 2013 to 2015. Data analysis was performed using SPSS16. Results: In this study, each patient's expenditures increased by 32.2 % in 2015, compared to before the implementation of the HTP. Therefore, the health insurance organization's coverage of OOP payments decreased to 8.3 % of the total costs by a 20.2 % reduction in 2015, compared to before the implementation of the plan. Conclusion: According to the study, HTP and government health subsidies were adequate, but the total hospitalization costs had an upward trend in all funds.

scholarly journals Health Insurance Reimbursement to Hosptials in Vietnam: Policy Implementation Results and Challenges

2021 ◽  
Vol 14 ◽  
pp. 117863292110101
Author(s):  
Nguyen Thu Ha ◽  
Nguyen Quynh Anh ◽  
Phan Van Toan ◽  
Nguyen Thanh Huong
Keyword(s):  
Health Insurance ◽  
Health System ◽  
Social Health Insurance ◽  
Building Blocks ◽  
World Health ◽  
Key Informants ◽  
Implementation Challenges ◽  
Insurance Reimbursement ◽  
Out Of Pocket Payments ◽  
Reimbursement Amount

In Vietnam, social health insurance (SHI) benefit package has been defined in a more explicit approach with the introduction of a regulation on the list of conditional reimbursed and non-reimbursed medical services. This paper aims to analyze the implementation results of this regulation from an economical perspective as well as the implementation challenges. Mix-method approach was employed. The quantitative component was employed to understand the implementation results. Desk study and qualitative components (2 inteviews with key informants from Ministry of Health; 6 discussions with key informants from provincial Social Security Offices and Departments of Health in Hanoi, Ho Chi Minh City, Hue, Tuyen Quang, Thai Binh and Soc Trang provinces; the other 23 discussions and 31 interviews with key informants from 23 selected hospitals) was employed to summarize the implementation challenges. The regulation seems to not able to mitigate the reimbursement of high-technology and expensive services in higher-level providers. There is a sign of increasing out-of-pocket payments for those regulated services in higher-level providers. It has also posed greater influence on lower-level providers in terms of the proportion of reimbursement amount rather than to higher-level hospitals. Applying World Health Organization’s 6 building blocks of health system to analyze the implementation challenges, we provide policymakers evidence to improve the regulation, as well as point out the relating health system weakness need to be strengthened.

scholarly journals Morbidity and hospitalization costs of chronic diseases for the Unified National Health System

Rev Rene ◽  
2015 ◽  
Vol 16 (4) ◽  
pp. 567 ◽  
Author(s):  
Pedro Henrique Teixeira Soto ◽  
Gabriela Martini Raitz ◽  
Ludmila Lopes Bolsoni ◽  
Cássia Kely Favoretto Costa ◽  
Mirian Ueda Yamaguchi ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Health System ◽  
Chronic Diseases ◽  
National Health ◽  
Respiratory Diseases ◽  
Analytical Study ◽  
National Health System ◽  
Secondary Data ◽  
Hospitalization Costs ◽  
Age Range

Objective: characterizing morbidity and hospitalization costs of chronic diseases (cardiovascular, respiratory, diabetes and cancer) for the Unified National Health System. Methods: a retrospective analytical study that used secondary data from the hospital information system of people aged ≥ 25 years. Results: among the four assessed morbidities, cancer and cardiovascular diseases have been the most prevalent. For cancer there was a predominance of females, aged between 45 and 49 years. Males had a higher incidence for cardiovascular diseases, with an age range of 55-59 years. These two diseases were the most costly for the system. The frequency of respiratory diseases follows a declining trend for both genders, while diabetes remained stable during the period. Conclusion: the highest prevalence of intervention was cancer among women and in men predominated cardiovascular diseases.

scholarly journals Epidemiology and Outcomes of Vancomycin-Resistant Enterococcus Infections in the U.S. Military Health System

2021 ◽  
Vol 186 (Supplement_1) ◽  
pp. 100-107
Author(s):  
David R Stagliano ◽  
Apryl Susi ◽  
Daniel J Adams ◽  
Cade M Nylund
Keyword(s):  
Length Of Stay ◽  
Hospital Mortality ◽  
Health System ◽  
Hospitalized Patients ◽  
Case Mix ◽  
Military Health System ◽  
Military Health ◽  
Hospitalization Costs ◽  
Vancomycin Resistant ◽  
The U.S

ABSTRACT Introduction Vancomycin-resistant enterococci (VRE) are classified by the Centers for Diseases Control and Prevention as a serious antibiotic resistance threat. Our study aims to characterize the epidemiology, associated conditions, and outcomes of VRE infections among hospitalized patients in the U.S. military health system (MHS). Materials and Methods We performed a retrospective cohort study of patients with VRE infection using the MHS database. Cases included all patients admitted to a military treatment facility for ≥2 days from October 2008 to September 2015 with a clinical culture growing Enterococcus faecalis, Enterococcus faecium, or Enterococcus species (unspecified), reported as resistant to vancomycin. Co-morbid conditions and procedures associated with VRE infection were identified by multivariable conditional logistic regression. Patient case-mix adjusted outcomes including in-hospital mortality, length of stay, and hospitalization cost were evaluated by high-dimensional propensity score adjustment. Results During the seven-year study period and among 1,161,335 hospitalized patients within the MHS, we identified 577 (0.05%) patients with VRE infection. A majority of VRE infections were urinary tract infections (57.7%), followed by bloodstream (24.7%), other site/device-related (12.9%), respiratory (2.9%), and wound infections (1.8%). Risk factors for VRE infection included invasive gastrointestinal, pulmonary, and urologic procedures, indwelling devices, and exposure to 4th generation cephalosporins, but not to glycopeptides. Patients hospitalized with VRE infection had significantly higher hospitalization costs (attributable difference [AD] $135,534, P<0.001), prolonged hospital stays (AD 20.44 days, P<0.001, and higher in-hospital mortality (case-mix adjusted odds ratio 5.77; 95% confidence interval 4.59-7.25). Conclusions VRE infections carry a considerable burden for hospitalized patients given their impact on length of stay, hospitalization costs, and in-hospital mortality. Active surveillance and infection control efforts should target those identified as high-risk for VRE infection. Antimicrobial stewardship programs should focus on limiting exposure to 4th generation cephalosporins.

PENGARUH TERAPI TERTAWA TERHADAP PENURUNAN TEKANAN DARAH LANSIA DI UPT PANTI WREDHA BUDHI DHARMA YOGYAKARTA

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Niken Setyaningrum ◽  
Andri Setyorini ◽  
Fachruddin Tri Fitrianta
Keyword(s):  
Blood Pressure ◽  
Data Analysis ◽  
The Elderly ◽  
Control Group ◽  
Group Comparison ◽  
Control Blood Pressure ◽  
Men And Women ◽  
Treatment Of Hypertension ◽  
Before And After ◽  
The Difference

ABSTRACTBackground: Hypertension is one of the most common diseases, because this disease is suffered byboth men and women, as well as adults and young people. Treatment of hypertension does not onlyrely on medications from the doctor or regulate diet alone, but it is also important to make our bodyalways relaxed. Laughter can help to control blood pressure by reducing endocrine stress andcreating a relaxed condition to deal with relaxation.Objective: The general objective of the study was to determine the effect of laughter therapy ondecreasing elderly blood pressure in UPT Panti Wredha Budhi Dharma Yogyakarta.Methods: The design used in this study is a pre-experimental design study with one group pre-posttestresearch design where there is no control group (comparison). The population in this study wereelderly aged over> 60 years at 55 UPT Panti Wredha Budhi Dharma Yogyakarta. The method oftaking in this study uses total sampling. The sample in this study were 55 elderly. Data analysis wasused to determine the difference in blood pressure before and after laughing therapy with a ratio datascale that was using Pairs T-TestResult: There is an effect of laughing therapy on blood pressure in the elderly at UPT Panti WredhaBudhi Dharma Yogyakarta marked with a significant value of 0.000 (P <0.05)

Perioperative Skin Conditioning for Patients With Skin of Color

2021 ◽  
pp. 074880682198989
Author(s):  
Alix Ferdinand ◽  
Suzan Obagi
Keyword(s):  
Treatment Regimen ◽  
Skin Care ◽  
Practical Approach ◽  
Postoperative Phase ◽  
Upward Trend ◽  
Wide Range ◽  
Before And After

The interest in cosmetic procedures for patients with skin of color is on an upward trend. Globally, dyschromia and hyperpigmentation remain the most common disorders for which patients seek treatment. The goals of a perioperative skin conditioning program include allowing a broad range of patients to be treated regardless of skin phototypes, maximizing results, and reducing risk of complications such as post-inflammatory hyperpigmentation and managing post-inflammatory hyperpigmentation if it occurs. The purpose of this article is to highlight common pigmentation concerns among patients with skin of color, the topical agents used to combat these concerns, and a practical approach to creating an effective yet straightforward topical skin care regimen that can be used across a wide range of patient skin phototypes. Before and after photos of patients with a variety of pigmentation concerns are presented along with a description of the treatment regimen used to improve their conditions and to get their skin to a safer state prior to performing any office-based procedures. By understanding the main concerns of patients with skin of color, one can use a simple and effective skincare regimen to allow these patients to be more safely treated. An effective skincare regimen both prepares the skin prior to procedures and postoperatively to help minimize dyschromias in the postoperative phase.

scholarly journals Strategies for reducing out of pocket payments in the health system: a scoping review

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Faride Sadat Jalali ◽  
Parisa Bikineh ◽  
Sajad Delavari
Keyword(s):  
Health System ◽  
Health Systems ◽  
Scoping Review ◽  
Health Financing ◽  
Developed Countries ◽  
Vulnerable Groups ◽  
System A ◽  
Out Of Pocket Payments ◽  
Review Study ◽  
Developing And Developed Countries

Abstract Background Direct out-of-pocket payments (OOP) are among the most important financing mechanisms in many health systems, especially in developing countries, adversely affecting equality and leading vulnerable groups to poverty. Therefore, this scoping review study was conducted to identify the strategies involving OOP reduction in health systems. Methods Articles published in English on strategies related to out-of-pocket payments were Searched and retrieved in the Web of Science, Scopus, PubMed, and Embase databases between January 2000 and November 2020, following PRISMA guidelines. As a result, 3710 papers were retrieved initially, and 40 were selected for full-text assessment. Results Out of 40 papers included, 22 (55%) and 18 (45%) of the study were conducted in developing and developed countries, respectively. The strategies were divided into four categories based on health system functions: health system stewardship, creating resources, health financing mechanisms, and delivering health services.As well, developing and developed countries applied different types of strategies to reduce OOP. Conclusion The present review identified some strategies that affect the OOP payments According to the health system functions framework. Considering the importance of stewardship, creating resources, the health financing mechanisms, and delivering health services in reducing OOP, this study could help policymakers make better decisions for reducing OOP expenditures.

scholarly journals Health Insurance Coverage before and after the Affordable Care Act in the USA

Sci ◽  
2021 ◽  
Vol 3 (2) ◽  
pp. 25
Author(s):  
Jesse Patrick ◽  
Philip Q. Yang
Keyword(s):  
Health Insurance ◽  
National Health ◽  
Affordable Care Act ◽  
The United States ◽  
Insurance Status ◽  
Health Insurance Status ◽  
Full Implementation ◽  
Before And After ◽  
The Affordable Care Act ◽  
Partial Implementation

The Affordable Care Act (ACA) is at the crossroads. It is important to evaluate the effectiveness of the ACA in order to make rational decisions about the ongoing healthcare reform, but existing research into its effect on health insurance status in the United States is insufficient and descriptive. Using data from the National Health Interview Surveys from 2009 to 2015, this study examines changes in health insurance status and its determinants before the ACA in 2009, during its partial implementation in 2010–2013, and after its full implementation in 2014 and 2015. The results of trend analysis indicate a significant increase in national health insurance rate from 82.2% in 2009 to 89.4% in 2015. Logistic regression analyses confirm the similar impact of age, gender, race, marital status, nativity, citizenship, education, and poverty on health insurance status before and after the ACA. Despite similar effects across years, controlling for other variables, youth aged 26 or below, the foreign-born, Asians, and other races had a greater probability of gaining health insurance after the ACA than before the ACA; however, the odds of obtaining health insurance for Hispanics and the impoverished rose slightly during the partial implementation of the ACA, but somewhat declined after the full implementation of the ACA starting in 2014. These findings should be taken into account by the U.S. Government in deciding the fate of the ACA.

scholarly journals Effects of cancer treatment on household impoverishment: a multicentre cross-sectional study in China

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044322
Author(s):  
Wenqi Fu ◽  
Jufang Shi ◽  
Xin Zhang ◽  
Chengcheng Liu ◽  
Chengyao Sun ◽  
...  
Keyword(s):  
Health Insurance ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Social Health Insurance ◽  
Poverty Line ◽  
Post Treatment ◽  
Social Health ◽  
Daily Consumption ◽  
Out Of Pocket Payments ◽  
Per Capita

ObjectivesTo determine the incidence and intensity of household impoverishment induced by cancer treatment in China.DesignAverage income and daily consumption per capita of the households and out-of-pocket payments for cancer care were estimated. Household impoverishment was determined by comparing per capita daily consumption against the Chinese poverty line (CPL, US$1.2) and the World Bank poverty line (WBPL, US$1.9) for 2015. Both pre-treatment and post-treatment consumptions were calculated assuming that the households would divert daily consumption money to pay for cancer treatment.ParticipantsCancer patients diagnosed initially from 1 January 2015 to 31 December 2016 who had received cancer treatment subsequently. Those with multiple cancer diagnoses were excluded.Data sourcesA household questionnaire survey was conducted on 2534 cancer patients selected from nine hospitals in seven provinces through two-stage cluster/convenience sampling.Findings5.89% (CPL) to 12.94% (WBPL) households were impoverished after paying for cancer treatment. The adjusted OR (AOR) of post-treatment impoverishment was higher for older patients (AOR=2.666–4.187 for ≥50 years vs <50 years, p<0.001), those resided in central region (AOR=2.619 vs eastern, p<0.01) and those with lower income (AOR=0.024–0.187 in higher income households vs the lowest 20%, p<0.001). The patients without coverage from social health insurance had higher OR (AOR=1.880, p=0.040) of experiencing post-treatment household impoverishment than those enrolled with the insurance for urban employees. Cancer treatment is associated with an increase of 5.79% (CPL) and 12.45% (WBPL) in incidence of household impoverishment. The median annual consumption gap per capita underneath the poverty line accumulated by the impoverished households reached US$128 (CPL) or US$212 (WBPL). US$31 170 395 (CPL) or US$115 238 459 (WBPL) were needed to avoid household impoverishment induced by cancer treatment in China.ConclusionsThe financial burden of cancer treatment imposes a significant risk of household impoverishment despite wide coverage of social health insurance in China.

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