scholarly journals Health insurance deductions in Iranian public hospitals before and after the health transformation plan

2020 ◽  
Author(s):  
Alireza Mazdaki ◽  
Hamed Zandian ◽  
Aein Zarrin ◽  
Telma Zahirian Moghadam
Keyword(s):  
Health Insurance ◽  
Public Hospitals ◽  
Before And After

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 DIFFERENCE URINARY INCONTINENCE BEFORE AND AFTER CONDUCTED MASSAGE, KEGEL EXERCISE IN ELDERLY PATIENTS AT PUBLIC HOSPITALS SEMBIRING DELI TUA

2018 ◽  
Vol 1 (1) ◽  
pp. 26-31
Author(s):  
Rahmad Gurusinga ◽  
Elsaria Br Sembiring
Keyword(s):  
Urinary Incontinence ◽  
Elderly Patients ◽  
Pelvic Floor Muscle ◽  
Incidence Rates ◽  
T Test ◽  
Public Hospitals ◽  
Control Group ◽  
Control Group Design ◽  
Need For Treatment ◽  
Before And After

Urinary Incontinence is involuntary urination, or leakage of urinary that is very real and pose a social. High incidence rates urinary incontinence causes the need for treatment with massage, kegel exercise aimed at rebuilding pelvic floor muscle strength. The purpose of this study was to determine whether there is a difference in urinary incontinence before and after the massage, kegel exercise in elderly patients in public hospitals deliberate delitua in 2018. The study design used is quasy experiment, using the design of pre-test and post-test control group design. Population and samples used in this study were 15 elderly who have urinary incontinence taken by accidental sampling. Based on the result of statistical test by using T-test with paired sample T-test obtained dat analysis showed that based on age af patient based on age patient urinary incontinence most aged 60-65 years (66,7%), while at age 66-70 (20,0%), and at least 71-74 (13,3%). Can be known urinary incontinence before given massage, kegel exercise counted 14 people (93,3%) medium incontinence and as many as 1 person (6,7%) severe incontinence. After given message, kegel exercise can be seen that there are descrease that is as much as 7 people (46,7%) light incontinence and as many as 8 people (53,3%) medium incontinence. The conclusions of these result indicate that there is an effect of massage, kegel exercise to urinary incontinence in elderly patients in public hospitals deliberate delitua.

scholarly journals Impact of the Health Transformation Plan on the Number of Surgical Operations and Their Cancelation

2019 ◽  
Vol 56 ◽  
pp. 004695801984638
Author(s):  
MahmoodReza Miri Bonjar ◽  
Mohammad Khammarnia ◽  
Mahdie Bakhshi ◽  
Alireza Ansari-Moghaddam ◽  
Hassan Okati–Aliabad ◽  
...  
Keyword(s):  
Health Insurance ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Outpatient Service ◽  
Public Hospitals ◽  
Inpatient Service ◽  
Treatment Needs ◽  
Study Population ◽  
The Impact ◽  
Surgical Operations

Operation cancelations are a serious problem with undesirable consequences. The Health Transformation Plan was launched in the health system of Iran on May 5, 2014, to enhance the efficiency and quality of services in public hospitals. Comprehensive coverage of patients’ basic treatment needs and reduction of patients’ out-of-pocket expenditures through insurance for all are other objectives of Health Transformation Plan as well. Then, the present study aimed to determine the impact of the Health Transformation Plan on the number of surgical operations and the cancelation of elective surgeries within public hospitals of Iran. This retrospective comparative study was conducted in 2017 within 2 tertiary public hospitals in the South-East of Iran. Using systematic random sampling method and census, 8138 scheduled surgical files and all canceled operations files were reviewed from April 2012 to March 2017, respectively. A standard checklist was used for data collection. The data were analyzed using χ2 test and a logistic regression model in SPSS, version 21. The study population was 8138 patients with mean age of 33 ± 19 years. Female patients comprised about 51% of the study population (n = 4115), and nearly two-third of them were married (n = 5192 [63.79%]). Coverage by Iranian health insurance was reported in more than half of patients (n = 4415 [54.79%]). The common reason for surgeries was injury and poisoning (n = 2814 [34.52%]) followed by delivery (n = 1747 [21.46%]). The number of operations increased from 26 677 before Health Transformation Plan (cancelation rate = 1.5%) to 33 190 after Health Transformation Plan (cancelation rate = 2.0%). The cancelation rate had a significant relationship with age (odds ratio = 1.009; confidence interval: 1.00-1.01), health insurance status (odds ratio = 2.12; confidence interval: 1.33-3.38), outpatient service referrals (odds ratio = 0.5; confidence interval: 0.43-0.62), inpatient service referrals (odds ratio = 1.5; confidence interval: 1.36-1.77), and surgical types ( P < .05). In general, the Health Transformation Plan was markedly associated with a rise in the number of surgeries and cancelation rate in the public hospitals. The information obtained in the present study concerning the causes of operation cancelations can be used to decrease the number of future cancelations.

Welfare Reform and the Health Insurance Coverage of Women and Children

2005 ◽  
Vol 8 (1) ◽  
Author(s):  
John H Cawley ◽  
Mathis Schroeder ◽  
Kosali Ilayperu Simon
Keyword(s):  
Health Insurance ◽  
Welfare Reform ◽  
Personal Responsibility ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Program Participation ◽  
Percent Increase ◽  
Before And After ◽  
Women And Children ◽  
The Difference

There is tremendous interest in understanding the effects of welfare reform enacted by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996. Our interest lies in one possible consequence of welfare reform: the loss of health insurance.This paper advances the literature by utilizing the 1992-1996 panels of the Survey of Income and Program Participation, matching type of insurance coverage to the presence of waivers from AFDC or TANF implementation in each state in specific months. We utilize a difference in differences method. Specifically, we estimate the difference before and after welfare reform in the insurance coverage of women and children who were likely to be eligible for welfare compared to those who were likely to be ineligible for welfare.We find that AFDC waivers prior to 1996 and the implementation of TANF after 1996 raised the probability that welfare-eligible women lack health insurance coverage. Specifically, TANF implementation is associated with a 7.8 percent increase in the probability that a welfare-eligible woman was uninsured. Welfare reform had less of an impact on the health insurance coverage of children. We find no evidence that AFDC waivers increased the probability that welfare-eligible children were uninsured. However, TANF implementation was associated with a 2.8 percent increase in the probability that a welfare-eligible child lacked health insurance.

scholarly journals Health service utilisation by people living with chronic non-cancer pain: findings from the Pain and Opioids IN Treatment (POINT) study

2016 ◽  
Vol 40 (5) ◽  
pp. 490 ◽  
Author(s):  
Suzanne Nielsen ◽  
Gabrielle Campbell ◽  
Amy Peacock ◽  
Kimberly Smith ◽  
Raimondo Bruno ◽  
...  
Keyword(s):  
Health Insurance ◽  
Cancer Pain ◽  
Private Health Insurance ◽  
Healthcare Services ◽  
Opioid Therapy ◽  
Limited Evidence ◽  
Financial Barriers ◽  
Different Types ◽  
Before And After

Objective The aims of the present study were to describe the use, and barriers to the use, of non-medication pain therapies and to identify the demographic and clinical correlates of different non-opioid pain treatments. Methods The study was performed on a cohort (n = 1514) of people prescribed pharmaceutical opioids for chronic non-cancer pain (CNCP). Participants reported lifetime and past month use of healthcare services, mental and physical health, pain characteristics, current oral morphine equivalent daily doses and financial and access barriers to healthcare services. Results Participants reported the use of non-opioid pain treatments, both before and after commencing opioid therapy. Services accessed most in the past month were complementary and alternative medicines (CAMs; 41%), physiotherapy (16%) and medical and/or pain specialists (15%). Higher opioid dose was associated with increased financial and access barriers to non-opioid treatment. Multivariate analyses indicated being younger, female and having private health insurance were the factors most commonly associated with accessing non-opioid treatments. Conclusions Patients on long-term opioid therapy report using multiple types of pain treatments. High rates of CAM use are concerning given limited evidence of efficacy for some therapies and the low-income status of most people with CNCP. Financial and insurance barriers highlight the importance of considering how different types of treatments are paid for and subsidised. What is known about the topic? Given concerns regarding long-term efficacy, adverse side-effects and risk of misuse and dependence, prescribing guidelines recommend caution in prescribing pharmaceutical opioids in cases of CNCP, typically advising a multidisciplinary approach to treatment. There is a range of evidence supporting different (non-drug) treatment approaches for CNCP to reduce pain severity and increase functioning. However, little is known about the non-opioid treatments used among those with CNCP and the demographic and clinical characteristics that may be associated with the use of different types of treatments. Understanding the use of non-drug therapy among people with CNCP is crucial given the potential to improve pain control for these patients. What does this paper add? The present study found that a wide range of non-opioid treatments was accessed by the study sample, both before and after commencing opioids, indicating that in this sample opioids were not the sole strategy used for pain management. The most common treatment (other than opioids) was CAM, reported by two-fifths of the sample. Having private health insurance was associated with increased use of non-opioid treatments for pain, highlighting the importance of considering how treatments are paid for and potential financial barriers to effective treatments. What are the implications for practitioners? Patients’ beliefs and financial barriers may affect the uptake of different treatments. Many patients may be using complementary and alternative approaches with limited evidence to support their use, highlighting the need for clinicians to discuss with patients the range of prescribed and non-prescribed treatments they are accessing and to help them understand the benefits and risks of treatments that have not been tested sufficiently, or have inconsistent evidence, as to their efficacy in improving pain outcomes.

scholarly journals Private health insurance and the Pharmaceutical Benefits Scheme: how effective has recent government policy been?

2004 ◽  
Vol 28 (1) ◽  
pp. 34 ◽  
Author(s):  
Jeff R J Richardson ◽  
Leonie Segal
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Public Hospitals ◽  
Common Element ◽  
Cost Shifting ◽  
The Public ◽  
Pharmaceutical Expenditures ◽  
The Government ◽  
The Cost ◽  
Pharmaceutical Benefits Scheme

The cost to government of the Pharmaceutical Benefits Scheme (PBS) is rising at over 10 percent per annum. The government subsidy to Private Health Insurance (PHI) is about $2.4 billion and rising. Despite this, the queues facing public patients ? which were the primary justification for the assistance to PHI ? do not appear to be shortening. Against this backdrop, we seek to evaluate recent policies. It is shown that the reason commonly given for the support of PHI ? the need to preserve the market share of private hospitals and relieve pressure upon public hospitals ? is based upon a factually incorrect analysis of the hospital sector in the last decade. It is similarly true that the ?problem? of rising pharmaceutical expenditures has been exaggerated. The common element in both sets of policies is that they result in cost shifting from the public to the private purse and have little to do with the quality or quantity of health services.

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