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Health Financial protection

Coleman Drake, Brett Fried, Lynn A Blewett
Reinsurance, an insurance product designed to protect health insurers against the financial risk of covering high-cost enrollees, has attracted bipartisan policy interest as a mechanism to stabilize individual health insurance markets. Three states-Alaska, Minnesota, and Oregon-have implemented state-based reinsurance programs under the Affordable Care Act's 1332 State Innovation Waivers, and reinsurance waivers have been approved though not yet enacted in Maine, Maryland, New Jersey, and Wisconsin. In this article, we estimate the costs of implementing national and state-based reinsurance programs using health spending data from the 2007-2016 Medical Expenditure Panel Survey and state demographic and health insurance coverage data from the 2015-2017 Current Population Survey Annual Social and Economic Supplement...
January 2019: Inquiry: a Journal of Medical Care Organization, Provision and Financing
Ibrahim Masoodi, Charanjit Singh, Imtiyaz Ahmad Wani, Muzafar Maqsood Wani, Tousief Irshad Ahmed, Rayees Yousuf Sheikh
BACKGROUND: The seroconversion is a significant health concern in patients with end-stage renal disease undergoing hemodialysis particularly in high endemic zones of HBV and HCV. PATIENTS AND METHODS: This prospective study was conducted from January 2009 to April 2018 at Sheri Kashmir Institute of Medical Sciences, Srinagar, Kashmir. A cohort of 459 end-stage renal disease patients on hemodialysis was enrolled from four dialysis centres and followed in a longitudinal manner...
February 28, 2019: Open Access Macedonian Journal of Medical Sciences
Tine Van Bortel, Steven Martin, Sabrina Anjara, Laura B Nellums
INTRODUCTION: Worldwide, there are between 50-67 million migrant domestic workers, the majority of whom are women. In many countries, provisions are not in place to protect female migrant domestic workers. These women may be at risk of occupational and social stressors, including exploitation and abuse, which may negatively impact on their quality of life, including psychological health. Research examining the occupational, social, and psychological needs of FMDWs from a public health perspective is critical to guide the development of policies which ensure wellbeing, prevent abuse, and align with international priorities to improve population health...
2019: PloS One
Natalia Dos Santos Cavalcante, Heverton Rodrigo Reis de Lima, Denise Ferreira Tabosa, Elisa do Socorro Sousa Barbosa, Nayara Priscila da Silva Costa, Luana Mota da Costa, Paula Cristina Rodrigues Frade, Luisa Caricio Martins, Gláucia Caroline Silva-Oliveira, Aldemir Branco de Oliveira-Filho
INTRODUCTION: Female sex workers (FSWs) are considered a bridge for transmission of pathogens from high-risk to general populations. We assessed the epidemiological status of syphilis in FSWs along the Pará highway system. METHODS: Two hundred and twenty-two FSWs were interviewed and samples were analyzed using rapid qualitative tests and real-time polymerase chain reaction. RESULTS: The prevalence of syphilis was high (36.94%). The high rate of prostitution, use of illicit drugs, and search for financial resources increased Treponema pallidum transmission through unprotected sex...
March 18, 2019: Revista da Sociedade Brasileira de Medicina Tropical
Charlotte Hanlon, Atalay Alem, Crick Lund, Damen Hailemariam, Esubalew Assefa, Tedla W Giorgis, Dan Chisholm
Background: People with mental disorders in low-income countries are at risk of being left behind during efforts to expand universal health coverage. Aims: To propose context-relevant strategies for moving towards universal health coverage for people with mental disorders in Ethiopia. Methods: We conducted a situational analysis to inform a SWOT analysis of coverage of mental health services and financial risk protection, health system characteristics and the macroeconomic and fiscal environment...
2019: International Journal of Mental Health Systems
Walid Kandeil, Petar Atanasov, Diana Avramioti, Josephine Fu, Nadia Demarteau, Xiao Li
Pertussis (whooping cough) is a vaccine-preventable disease; however, neither natural- nor vaccine-induced protection is life-long. Although generally not severe in adults, pertussis can be associated with complications in patients with chronic conditions such as asthma or chronic obstructive pulmonary disease, and can be readily transmitted to more vulnerable populations, including neonates before they complete their primary vaccination. Furthermore, as the global population ages, the health and economic burden of the disease is expected to rise...
March 19, 2019: Expert Review of Vaccines
Camilla S Hanson, Talia Gutman, Jonathan C Craig, Sarah Bernays, Gayathri Raman, Yifan Zhang, Laura J James, Angelique F Ralph, Angela Ju, Karine E Manera, Armando Teixeira-Pinto, Andrea K Viecelli, Stephen I Alexander, Tom D Blydt-Hansen, Janis Dionne, Steven McTaggart, Mini Michael, Amanda Walker, Simon Carter, Scott E Wenderfer, Wolfgang C Winkelmayer, Detlef Bockenhauer, Allison Dart, Allison A Eddy, Susan L Furth, Debbie S Gipson, Stuart L Goldstein, Jaap Groothoff, Susan Samuel, Aditi Sinha, Nicholas J A Webb, Hui-Kim Yap, Michael Zappitelli, Helen Currier, Allison Tong
RATIONALE & OBJECTIVE: Chronic kidney disease (CKD) has wide-ranging and long-term consequences for young people and their families. The omission of outcomes that are important to young people with CKD and their caregivers limits knowledge to guide shared decision making. We aimed to identify the outcomes that are important to young people with CKD and their caregivers. STUDY DESIGN: We used the nominal group technique whereby participants identified and ranked outcomes and explained their priorities...
March 15, 2019: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Aake Packness, Anders Halling, Erik Simonsen, Frans Boch Waldorff, Lene Halling Hastrup
OBJECTIVE: To evaluate if perceived barriers to accessing mental healthcare (MHC) among individuals with symptoms of depression are associated with their socio-economic position (SEP). DESIGN: Cross-sectional questionnaire-based population survey from the Lolland-Falster Health Study (LOFUS) 2016-17 of 5076 participants. PARTICIPANTS: The study included 372 individuals, with positive scores for depression according to the Major Depression Inventory (MDI), participating in LOFUS ...
March 15, 2019: BMJ Open
Otgontuya Dugee, Bolormaa Sugar, Bayarsaikhan Dorjsuren, Ajay Mahal
OBJECTIVE: To analyse the impact of non-communicable diseases (NCDs) on household out-of-pocket (OOP) expenses, catastrophic health payments and medical impoverishment in Mongolia, a middle-income country with a high population health insurance coverage rate. METHODS: Secondary data analysis of the Mongolian Household Socioeconomic Survey with 12,840 households, including information on standard of living, OOP spending, and health conditions of household members...
March 14, 2019: Tropical Medicine & International Health: TM & IH
Rajvi J Wani, Hyo Jung Tak, Shinobu Watanabe-Galloway, Donald G Klepser, Nizar K Wehbi, Li-Wu Chen, Fernando A Wilson
BACKGROUND: In 2015, the Hospital Readmissions Reduction Program mandated financial penalties to hospitals with greater rates of readmissions for certain conditions. Alcohol-related disorders (ARD) are the fourth leading cause of 30-day readmissions. Yet, there is a dearth of national-level research to identify high-risk patient populations and predictors of 30-day readmission. This study examined patient and hospital-level predictors for index hospitalizations with principal diagnosis of ARD and predicted the cost of 30-day readmissions...
March 12, 2019: Alcoholism, Clinical and Experimental Research
Junice Yi Siu Ng, Royasia Viki Ramadani, Donni Hendrawan, Duong Tuan Duc, Pham Huy Tuan Kiet
BACKGROUND: Social health insurance administrative databases were established in Indonesia, Vietnam and the Philippines in 2014, 2017 and 2012, respectively; however, these databases have been scarcely used for research, if at all. This study explored the feasibility and accessibility of using these databases for scientific research, highlighting challenges and barriers in their use. METHODOLOGY: The databases included in this evaluation comprised the Jaminan Kesehatan Nasional (JKN) from Indonesia, Vietnam Health Insurance Scheme (VHIS) from Vietnam and PhilHealth from the Philippines...
March 11, 2019: PharmacoEconomics Open
Trevor J Royce, Kathleen T Davenport, James M Dahle
Physician burnout is reported in more than one out of every two practicing clinicians and is just as prevalent in training physicians. Burnout severity is also associated with increasing levels of financial debt. Medical professionals are notable for their high and rising levels of debt - despite this, financial literacy is poor among physicians and financial education is largely absent from medical education. Radiation oncologists (RO) are no different in this regard, with 33% of residents reporting high levels of burnout symptoms, 33% carrying more than $200,000 of educational debt, and 75% reporting being unprepared to handle future financial decisions...
March 7, 2019: Practical Radiation Oncology
Gary J Young, Stephen Flaherty, E David Zepeda, Simone Singh, Sara Rosenbaum
The Patient Protection and Affordable Care Act's insurance reforms were expected to have significant and positive implications for hospital finances. In particular, state expansion of Medicaid programs held the promise of reducing hospitals' uncompensated care costs as a result of expanding health insurance to many previously uninsured individuals. Recent research indicates that in the early phases of Medicaid expansion, many hospitals did experience a substantial decline in uncompensated care costs. However, studies to date have not considered whether Medicaid expansion resulted in payment shortfalls that offset some of what hospitals saved from lower uncompensated care costs...
March 2019: Journal of Healthcare Management / American College of Healthcare Executives
Jason Rotter, Jennifer C Spencer, Stephanie B Wheeler
Patients with metastatic or advanced cancer are likely to be particularly susceptible to financial hardship for reasons related both to the characteristics of metastatic disease and to the characteristics of the population living with metastatic disease. First, metastatic cancer is a resource-intensive condition with expensive treatment and consistent, high-intensity monitoring. Second, patients diagnosed with metastatic disease are disproportionately uninsured and low income and from racial or ethnic minority groups...
March 7, 2019: Journal of Oncology Practice
Lorraine T Dean, Shadiya L Moss, Sarah I Rollinson, Livia Frasso Jaramillo, Raheem J Paxton, Jill T Owczarzak
BACKGROUND: In the United States, patients who have breast cancer experience significant economic burden compared with those who have other types of cancers. Cancer-related economic burden is exacerbated by adverse treatment effects. Strategies to resolve the economic burden caused by breast cancer and its adverse treatment effects have stemmed from the perspectives of health care providers, oncology navigators, and other subject-matter experts. For the current study, patient-driven recommendations were elicited to reduce economic burden after 1) breast cancer and 2) breast cancer-related lymphedema, which is a common, persistent adverse effect of breast cancer...
March 6, 2019: Cancer
Sheila Judge Santacroce, Shawn M Kneipp
The purpose of this article is to explicate a conceptual framework for financial toxicity in pediatric oncology to guide nursing practice and research. The framework is based on one for financial outcomes of severe illness attributed to Scott Ramsey and adapted by the National Cancer Institute to describe relationships between preexisting factors, a cancer diagnosis, financial distress, and health outcomes for adult cancer patients and survivors. The adaption for pediatric oncology was informed by the results of a systematic scoping review to identify advances and gaps in the recent literature about the personal costs of illness to parents in the pediatric oncology context...
January 2019: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
Rohit Sarin, Vikram Vohra, Neeta Singla, Beena Thomas, Rajendran Krishnan, Malaisamy Muniyandi
BACKGROUND: Tuberculosis (TB) patients often incur large costs related to illness, as well as for seeking and receiving health care. Despite TB treatment being free under RNCTP, out of pocket expenditure incurred (OOP) by patients for TB diagnosis and treatment impoverishes the households. This expenditure may turn catastrophic (more than 20% of their family income) impacting adherence and leading to poor treatment outcomes. OBJECTIVE: To estimate the proportion of households experiencing catastrophic expenditure due to TB and also to find out the various costs contributing to catastrophic expenditure...
January 2019: Indian Journal of Tuberculosis
Brian J Hall, Melissa R Garabiles, Carl A Latkin
BACKGROUND: Overseas Filipino workers (OFWs) comprise one of the largest populations of migrant workers globally. Within China, they represent the largest group of imported domestic workers. Little is known about their working conditions or how this might affect their health and wellbeing. METHODS: This qualitative study explored the working conditions and risk factors for poor health in a sample of temporary female Filipino domestic workers in Macao, China. Focus group discussions with female domestic workers (n = 22) and in-depth interviews with key informants (n = 7) were conducted...
February 23, 2019: BMC Public Health
Sean T Massa, Nosayaba Osazuwa-Peters, Eric Adjei Boakye, Ronald J Walker, Gregory M Ward
Importance: Head and neck cancer (HNC) is more common among socioeconomically disenfranchised individuals, making financial burden particularly relevant. Objective: To assess the financial burdens of HNC compared with other cancers. Design, Setting, and Participants: In this retrospective review of nationally representative, publicly available survey, data from the Medical Expenditure Panel Survey were extracted from January 1, 1998, to December 31, 2015...
February 21, 2019: JAMA Otolaryngology—Head & Neck Surgery
Boye Fang, Elsie Yan, Daniel W L Lai
OBJECTIVES: To identify risk and protective factors associated with elder abuse among older Chinese with cognitive and physical impairment in the People's Republic of China (PRC). METHODS: 1002 dyads of care recipients and family caregivers were interviewed. RESULTS: The mutually reported rates were 9.7%, 0.8%, 33.2%, and 39.7% for psychological abuse, physical abuse, financial exploitation, and caregiver neglect respectively. Caregiver burden, care recipient neuropsychiatric symptoms, and cognitive impairments are prominent risk factors, while protective factors associated with multiple abuse subtypes include caregiver's use of emotion-focused and solution-focused coping, perception of familism, and premorbid relationship rewards...
February 11, 2019: Archives of Gerontology and Geriatrics
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