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Insurance-associated disparities in cancer screening and adult immunization in a predominantly Asian immigrant community: a cross-sectional survey at two community health fairs in Garland, Texas.

BACKGROUND: Preventive screening and adult immunizations reduce morbidity and mortality, yet uptake remains uneven. Immigrant communities, particularly those facing language barriers, limited insurance coverage, and preventive health hesitancy, experience persistent gaps in preventive care. Asian immigrant populations, including Vietnamese immigrants, remain underrepresented in preventive health research. METHODS: A cross-sectional survey was conducted at two community health fairs held in September and October 2025 in Garland, Texas: one at a Vietnamese church and one at the Dallas Police As…

Willingness and perceived ability to pay for Uganda's proposed national health insurance scheme among informal sector workers in Iganga and Mayuge districts, Uganda: A contingent valuation method.

High out-of-pocket expenditures (OOPE) continue to make access to healthcare a challenge among informal sector workers in most low-income countries. In response, Uganda has proposed a national health insurance scheme (NHIS), although the informal sector's willingness and ability to pay for it remains unexplored. This study assessed the willingness and perceived ability to pay for the proposed NHIS, along with their determinants, among informal sector workers in Iganga and Mayuge Districts, Uganda. A cross-sectional study was conducted in Iganga and Mayuge Districts between April and May 2019. …

Utilization and determinants of rehabilitation in patients receiving extracorporeal membrane oxygenation in South Korea (2014-2018): A study based on Health Insurance Review and Assessment (HIRA) data.

Although the use of extracorporeal membrane oxygenation (ECMO) is increasing globally, survivors often face long-term physical and functiona … . Patients aged between 20 and 90 years who had received ECMO treatment, based on the Korean Health Insurance Review and Assessment database, were selected. Cases with hospital stays of <3 days were excluded. Patients admitted for respiratory illness were more likely to undergo rehabilitation than those admitted for circulatory disease (adjusted odds ratio …

Changes in General Thoracic Surgery Volume during the Medical-Political Conflict in South Korea by Institutional Type and Surgical Complexity: An Analysis of National Health Insurance Claims.

BACKGROUND: In February 2024, South Korea experienced a major healthcare disruption following the mass resignation of approximately 86% of r … A retrospective analysis was performed using nationwide claims data from the Korean National Health Insurance Service, accessed via the Health Insurance Review and Assessment Service (HIRA). General thoracic surgery volumes from February to July 2023 (pre-crisis) were compared to the same period in 2024 (post-crisis) across tertiary hospitals (n=47), genera …

Correction: Association between long COVID and nonsteroidal anti-inflammatory drug use by patients with acute-phase COVID-19: A nationwide Korea National Health Insurance Service cohort study.

[This corrects the article DOI: 10.1371/journal.pone.0312530.].

Enrichment of health insurance claims data with official death certificate information from three German cancer registries: Proportions of successful linkages and differences by region, year, and age.

Evaluating breast cancer mortality in the German mammography screening program with health insurance claims data requires the availability of claims data with information on causes of death. This work aimed to determine the proportions of successful cause-of-death linkages between the second-largest German statutory health insurance fund and three federal cancer registries and to investigate whether linked proportions differed by region, year, and age. Women aged 40-90 years whose insurance was terminated between 2006 and 2018 were included. Proportions successfully linked to the official deat…

Impact of dementia and hip fracture onset on the healthcare and long-term care burden: Healthcare and long-term care insurance data analyses in Sendai City, Japan.

AIM: This study aimed to examine the differences in the impact of dementia and hip fracture onset on the burden of healthcare and long-term care. METHODS: This retrospective cohort study utilized electronic medical receipt data issued between April 2019 and March 2023 from the National Health Insurance scheme and the medical care system for older individuals aged ≥75 years from Sendai City. Female patients aged ≥65 years who were newly registered as patients with dementia (n = 2696) and/or hip fracture (n = 1118) were investigated. Monthly healthcare and long-term care costs for 12 months bef…

Lessons learned from the movement behind the first over-the-counter daily birth control pill in the United States and recommended strategies for implementing full insurance coverage.

July 13, 2023, marked a historic day for contraception access when the Food and Drug Administration (FDA) approved the first-ever daily over … a prescription in the United States and ensure all forms of OTC contraception are fully covered by insurance without a prescription. This paper captures lessons learned from the movement-driven effort leading to the FDA approval of the first OTC daily OCP in the United States. It also provides recommendations for how to achieve the coalition's vision for m …

Accuracy of Clinical Suspicion for Rotator Cuff Tears by Orthopedic Surgeons When MRI Was Ordered on Initial Visits: Should Physical Therapy Be Mandated by Insurance Before MRI?

INTRODUCTION: Insurance companies often mandate six weeks of physical therapy (PT) prior to approving MRIs for patients with atraumatic rotator cuff (RTC) tears. While this is designed to limit unnecessary imaging orders, it can increase healthcare costs and delay diagnosis and surgery. This study investigated the incidence of full- and partial-thickness tears when an MRI was ordered at the time of initial consultation for shoulder pain by an orthopedic provider. METHODS: A retrospective review of patients who had an MRI ordered upon initial orthopedic consultation for chronic shoulder pain w…

[Life insurance after percutaneous revascularization in a patient with severe left ventricular dysfunction and left bundle branch block: benefit of revascularization in the post-REVIVED-BCIS2 era].

The recent results of the REVIVED-BCIS2 randomized clinical trial added further controversy on the utility of myocardial revascularization in patients with chronic coronary syndrome with reduced ejection fraction. However, coronary artery disease still represents the leading cause of heart failure with reduced ejection fraction, with the potential for functional recovery following complete revascularization due to the restoration of the so-called hibernating myocardium. We report an emblematic case of a patient with recovery of contractile function and normalization of the left bundle branch b

Prevalence of and risk factors associated with chronic opioid use after traumatic injury: A historical cohort study using the Korean National Health Insurance Service sample cohort data.

Chronic opioid use (COU) after traumatic injuries is a global health concern. COU after trauma delays recovery and increases the risk of long-term drug dependence. However, the population-prevalence and factors associated with COU after traumatic injury in South Korea remain unclear. We aimed to estimate the prevalence of COU and associated risk factors in patients after trauma in South Korea. A historical cohort study using the population-representative database including 1,103,405 South Korean subjects, patients admitted due to a newly diagnosed trauma (n = 65,444) or nontraumatic etiologies

Liver Cirrhosis as a Predictor of Infection Risk in Patients Undergoing Ventriculoperitoneal Shunt Surgery: A Retrospective Cohort Analysis from the Taiwan National Health Insurance Research Database (NHIRD).

BACKGROUND Ventriculoperitoneal (VP) shunt surgery is a widely used procedure for managing hydrocephalus; however, postoperative infections … without liver cirrhosis following VP shunt surgery, utilizing data from the Taiwan National Health Insurance Research Database (NHIRD). MATERIAL AND METHODS A retrospective cohort study analyzed 1766 patients with and 37 995 patients without liver cirrhosis who underwent their first VP shunt surgery between January 2010 and December 2019. Infection risk wa …

Medicaid Insurance is a Predictor of Prolonged Hospital Length of Stay After Traumatic Brain Injury: A Stratified National Trauma Data Bank Cohort Analysis of 552 949 Patients.

BACKGROUND AND OBJECTIVES: Hospital length of stay (HLOS) is a metric of injury severity, resource utilization, and healthcare access. Recent evidence has shown an association between Medicaid insurance and increased HLOS after traumatic brain injury (TBI). This study aims to validate the association between Medicaid and prolonged HLOS after TBI using the National Trauma Data Bank. METHODS: National Trauma Data Bank Trauma Quality Programs Participant Use Files (2003-2021) were queried for adult patients with TBI using traumatic intracranial injury ICD-9/ICD-10 codes. Patients with complete H…

Trend of incidence rate of age-related diseases: results from the National Health Insurance Service-National Sample Cohort (NHIS-NSC) database in Korea: a cross- sectional study.

BACKGROUND: This study aimed to identify and select age-related diseases (ARDs) in Korea, which is about to have a super-aged society, and to elucidate patterns in their incidence rates. METHODS: The National Health Insurance Service-National Sample Cohort, comprising 1 million health insurance and medical benefit beneficiaries in Korea from 2002 to 2019, was utilized. We selected 14 diseases with high disease burden and prevalence among Koreans from the 92 diseases defined in the Global Burden of Diseases, Injuries, and Risk Factors Study as ARDs. The annual incidence rate represented the nu…

Multimorbidity, Polypharmacy, Severe Hypoglycemia, and Glycemic Control in Patients Using Glucose-Lowering Drugs for Type 2 Diabetes: A Retrospective Cohort Study Using Health Insurance Claims in Japan.

INTRODUCTION: This study aimed to understand the actual status of multimorbidity and polypharmacy among patients with type 2 diabetes using glucose-lowering drugs, and to assess the effects of patient characteristics on severe hypoglycemia and glycemic control. METHODS: We designed a retrospective cohort study using health insurance claims and medical checkup data in Japan from April 2016 to February 2021 and identified patients with type 2 diabetes who were prescribed glucose-lowering drugs. We analyzed data on patient characteristics, including multimorbidity and polypharmacy, calculated th…

The risk of stroke according to statin medication compliance in older people with chronic periodontitis: an analysis using the Korea National Health Insurance Service-Senior Cohort Database.

OBJECTIVES: We investigated the risk of stroke according to statin medication compliance in older people with chronic periodontitis. METHODS: Chronic periodontitis patients were extracted from the National Health Insurance Service-Senior Cohort Database from 2002 to 2014. Among 255,056 chronic periodontitis patients, 41,412 patients with statin prescriptions for 28 days or more were included. The study population was divided into the top 25% of medication compliance group (TSG) and the lower 25% of medication compliance group (BSG). After 1:1 propensity score matching was performed, the final…

Cost-savings and potential cost-savings through the distribution of generic antiretroviral drugs within the statutory health insurance market of Germany between January 2017 and June 2019.

BACKGROUND: Recent patent losses for antiretroviral drugs (ARV) have led to the debate of cost-saving through the replacement of patented drugs with generic drugs. The split of recommended single-tablet regimens (STR) into their single substance partners is one of the considerations mentioned in said debate. Particularly, generic tenofovir disoproxil/emtricitabine (TDF/FTC) is expected to hold untapped cost-saving potential, which may curb increasing overall expenditures for combined antiretroviral therapy (cART) within the statutory health insurance (SHI) of Germany. METHODS: Data of ARV rei…

Secondary Primary Cancer after Primary Gastric Cancer: Literature Review and Big Data Analysis Using the Health Insurance Review and Assessment Service (HIRA) Database of Republic of Korea.

Advances in cancer screening and early detection, as well as improvements in surgical techniques and therapeutics, have contributed to decreasing gastric cancer mortality. The number of gastric cancer survivors continues to rise; however, long-term follow-up has revealed an increase in the risk of post-gastrectomy symptoms or other health problems, such as extra-gastric secondary primary cancer (SPC), in these survivors. Therefore, evidence-based screening for new primary cancer is needed in these populations; however, the incidence of SPC varies by country or continent and its characteristics

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… Materials and Methods Nationwide population and cancer data were obtained from the public medical insurance system of Republic of Korea, the National Health Insurance (NHI) system. … The Health Insurance Review & Assessment (HIRA) database is an involuntary government-operated organization that builds accurate review and quality assessments for the NHI system. …

A global cautionary tale: discrimination and violence against trans women worsen despite investments in public resources and improvements in health insurance access and utilization of health care.

BACKGROUND: To determine if improvements in social determinants of health for trans women and decreases in transphobic discrimination and violence occurred over three study periods during which extensive local programs were implemented to specifically address longstanding inequities suffered by the transgender community. METHODS: Interviewer-administered surveys from repeated cross-sectional Transwomen Empowered to Advance Community Health (TEACH) studies in 2010, 2013 and 2016-2017 in San Francisco collected experiences with transphobia violence and discrimination. Respondent-driven sampling

Associations Between Insurance Provider and Assistive Technology Use for Computer and Electronic Devices 1 Year After Tetraplegia: Findings From the Spinal Cord Injury Model Systems National Database.

OBJECTIVE: To investigate the association between insurance provider and reported assistive technology (AT) use to access computers and electronic devices 1 year after sustaining tetraplegia. DESIGN: Multicenter cross-sectional study. SETTING: Participants enrolled in the Spinal Cord Injury Model Systems (SCIMS) National Database. INTERVENTIONS: Not applicable. PARTICIPANTS: Men and women with tetraplegia (N=498) enrolled in the SCIMS National Database were included in the analysis. MAIN OUTCOME MEASURES: The primary study outcome was the use of AT when operating a computer or other mobil…