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Social Determinants of Health Needs and Perinatal Risk in Socially Vulnerable Pregnant Patients.

OBJECTIVES: To understand perinatal risks associated with social needs in pregnancy Methods. Multivariable log-binomial regression analyses adjusting for age, parity, and insurance were used to evaluate the relationship between any social need (e.g., housing, transportation, food, and intimate partner violence) and adverse perinatal outcomes (stillbirth, prematurity, maternal morbidity) in a cohort of English and Spanish-speaking patients who obtained prenatal care and birthed at our institution during a one-year period. RESULTS: Of 2,435 patients, 1,608 (66%) completed social needs screening…

Cost of Cleft Team Care at an Academic Children's Hospital.

BACKGROUND: The financial burden of cleft-craniofacial team care is substantial, and high costs can hinder successful completion of team car … en September 2019 and March 2020. Out-of-pocket costs for a single team care visit (on a commercial insurance plan) ranged from $4 to approximately $1220 and had a median (IQR) of $445 ($118, $749).

Incidence and death rate of pemphigus vulgaris and pemphigus foliaceus in Korea: A nationwide, population-based study (2006-2015).

The epidemiology of pemphigus varies among racial populations worldwide. Trends in the incidence of pemphigus have not been investigated based on the Korean National Health Insurance database. This study investigated the incidence and death rate of pemphigus with age using nationwide population data in South Korea. A nationwide population-based cohort study was performed using the Korean National Health Insurance Claims Database from 2006 to 2015. The incidence of pemphigus vulgaris (PV) per 1 000 000 person-years was 2.059 (1.885 for males and 2.234 for females), and for pemphigus foliaceus (…

Terlipressin versus noradrenaline in the treatment of hepatorenal syndrome: systematic review with meta-analysis and full economic evaluation.

OBJECTIVE: The aim of this study was to compare the efficacy and costs of terlipressin and noradrenaline for the treatment of hepatorenal syndrome from the perspective of the Brazilian public health system and that of a major private health insurance. METHODS: Comparison of efficacy was performed through a systematic review with a meta-analysis of randomized-controlled trials using a random-effects model. Economic evaluation was carried out through cost minimization. RESULTS: Four studies (154 patients) were included in the meta-analysis. There was no evidence of a difference between treatme…

[Recommendations for invasive home mechanical ventilation].

Due to chronic respiratory failure, a proportion of patients require long-term home ventilation therapy. The treating doctors, nurses and therapists, as well as employees of the health insurance provider, all require specialized knowledge in order to establish and monitor home ventilation. The following document represents a consensus formed by the participating specialist societies, the health insurers and their medical advisory services. The recommendations for accomplishing home mechanical ventilation are based on the "S2 Guidelines for Non-Invasive and Invasive Mechanical Ventilation for T…

Reconstruction of upper limb motor function using functional electrical stimulation (FES).

Functional electrical stimulation (FES) techniques progress by adopting the developments in computers and engineering, but complete functional reconstruction is not yet possible to be achieved. The attachment of the devices to the body can be complex, and training to handle FES is not easy. FES systems are expensive and their coverage by medical insurance is limited with the exception of a few systems. Hence, recognition of FES by the medical community is limited and as a result, it is not a common therapy. However, FES is the main method available for reconstruction of motor function, at pres…

Gender and racial/ethnic differences in use of outpatient mental health and substance use services by depressed adults.

This study examines depressed adults' use of mental health services, focusing on Latinos and African Americans. Self-report data for adults meeting CIDI criteria for major depression or dysthymia from the 1997-98 HealthCare for Communities Survey were analyzed. Gender stratified logistic regression models examined the relationship between race/ethnicity and outpatient mental health service use, controlling for sociodemographic, health status, insurance, and geographic characteristics. Latinas and African American women and men exhibited low use of outpatient mental health services. Similar res…

The medical responsibility: current view from the Council of Physicians side.

The medical responsibility has been clearly defined in the Royal Decree no. 78 dated November 11, 1967 concerning the medical practice. Moreover, several articles from the Ethical Code (Code de Déontologie) have clarified some social and economical responsibilities in the medical practice (articles 99 to 103) and the quality of patient care (article 36). The National Council has also published at least 31 advises facing the daily reality and the growing insecurity. That atmosphere is coming from the jurisprudence, the increasing responsibility insurance fees, the obligation of results instead …

Клинический опыт, связанный с биологическими заболеваниями, корректирующими терапию при повторном многоразовом склерозе: тематический доклад и обзор литературы.

Биологические агенты весьма эффективны в деле предотвращения/минимизации инвалидности, связанной с множественным склерозом. Однако в странах с ограниченными ресурсами диагностика и лечение множественных склерозов ограничиваются социальными и структурными детерминантами здоровья. Помощь пациентам в получении доступа к этим лекарствам в рамках государственных программ или страхования имеет важное значение для предупреждения инвалидности.

Совпадение в аннотации оригинала
Biological agents are highly effective in preventing/minimizing disability related to multiple sclerosis. However, in resource-limited countries, the diagnosis and management of multiple sclerosis are limited by social and structural determinants of health. Support for patients to access these medicines through government schemes or insurance coverage is imp…

Lives Worth Saving: The Impact of Medicaid Expansion on Individuals in Recovery.

A quarter of a million North Carolinians admit to experienc-ing opioid use disorder; over 1,000 die each year. Only 1 in 5 receives effective, evidence-based treatment. Medicaid covers treatment and will increase access for members with opioid use disorder, who have been found to fare better than those with private insurance.

Beryllium - Determination of beryllium and its inorganic compounds in workplace air using atomic absorption spectrometry (GF-AAS): Air Monitoring Method.

This analytical method is a validated measurement procedure for the determination of the respirable particle fraction of beryllium [7440-41- … 16% for the inhalable particle fraction. This analytical method has been accredited by the accident insurance companies for the detection of substances in workplace air that are carcinogenic, mutagenic or toxic to reproduction. This method has been tested and recommended for the determination of beryllium and its inorganic compounds in work areas by the Ger …

Transportation considerations in underserved patient populations receiving multidisciplinary head and neck cancer care.

BACKGROUND: Underinsured patients with advanced head and neck cancer experience worse outcomes compared to their well-insured peers. METHODS: Retrospective logistic regression analysis testing associations between demographic, geospatial, transportation, disease, and treatment factors in 50 government insured or uninsured patients receiving curative-intent, multidisciplinary cancer care. RESULTS: Forty percent of patients missed at least one treatment or surveillance appointment within the first year. Thirty-two percent reported using public transportation; 42% relied on caregivers. Patients

Weak signals in high-dimension regression: detection, estimation and prediction.

Regularization methods, including Lasso, group Lasso and SCAD, typically focus on selecting variables with strong effects while ignoring weak signals. This may result in biased prediction, especially when weak signals outnumber strong signals. This paper aims to incorporate weak signals in variable selection, estimation and prediction. We propose a two-stage procedure, consisting of variable selection and post-selection estimation. The variable selection stage involves a covariance-insured screening for detecting weak signals, while the post-selection estimation stage involves a shrinkage esti

[What can we learn in future from the data of the German Arthroplasty Registry (EPRD) in comparison to other registries?].

The German Arthroplasty Registry (EPRD) was founded in 2010 and has been in full operation since 2014. Previous attempts at a systematic data collection of elective and non-elective knee and hip replacement in Germany failed mainly because of the long-term lack of funding. The EPRD is an interdisciplinary collaborative partnership between the German Association of Orthopedics and Orthopedic Surgery (DGOOC), all implant manufacturers of the German Medical Technology Association (BVMed), health insurers (AOK and the Association of Additional Healthcare Insurance) and hospitals (German Hospital F…

Prevalence of congenital heart defects associated with Down syndrome in Korea.

Congenital heart defect (CHD) is common in infants with Down syndrome (DS), which is the principle cause of mortality. However, there is no data available for the frequency and types of CHD in infants with DS in Korea. We investigated the frequency of CHD in infants with DS in Korea. After the survey on birth defects was conducted throughout the country, the prevalence of CHD in DS in 2005-2006 was calculated. This study was conducted based on the medical insurance claims database of the National Health Insurance Corporation. The number of total births in Korea was 888,263 in 2005-2006; of the…

Impact of oral antipsychotic medication adherence on healthcare resource utilization among schizophrenia patients with Medicare coverage.

Nonadherence to antipsychotic medications is widespread and compromises the outcome of patients with schizophrenia. Using the MarketScan Medicare claims database, this study examined the impact of medication adherence on healthcare utilization among Medicare insured schizophrenia patients. The study population was separated into two cohorts defined by medication adherence, one with a medication possession ratio (MPR) ≥0.7 (high adherence) and the other with a MPR <0.7(low adherence). Of the 354 patients identified, 126 (36 %) had high adherence (mean ± SD MPR 0.94 ± 0.09) and 228 (64 %) had lo

Factors associated with colon cancer stage at diagnosis.

We analyzed data from 1998-2004 from the National Cancer Data Base to evaluate associations between patient/treatment facility factors and stage at diagnosis for all colon cancers combined and by anatomic location. Compared to patients with private insurance, uninsured patients were significantly more likely to present with advanced-stage disease; Medicaid patients had likelihoods of advanced-stage colon cancer in-between those of privately insured and uninsured patients. Increased odds of advanced-stage colon cancer at diagnosis were also observed among Black (vs. White) patients, women (vs. …

[Consumption of old and new antiepileptic drugs in the Czech Republic in 1999-2004].

Trends in antiepileptic drug (AEDs) consumption in the period from 1999 to 2004 in the Czech Republic were assessed in this study. The data from extramurally prescribed, reimbursed AEDs were obtained from the Czech Health Insurance Company Skoda Mladá Boleslav. The AEDs utilization was assessed according to ATC/DDD methodology on the fourth and fifth level of the ATC classification and expressed as the number of defined daily doses per 1000 insured per day (DDD/TID). During the study period, the AEDs consumption increased by 130%; 76% of which consisted of new AEDs. The most frequently prescri…

The workers' compensation system: worker friend or foe?

BACKGROUND: The workers' compensation system was designed to help injured workers who have substantial medical expenses and perhaps have lost a great deal of income. This study determines both similarities and differences in how workers experience their interactions with the workers' compensation systems in Florida and Wisconsin. METHODS: Ethnographic open-ended interviews with 204 workers from Florida and 198 workers in Wisconsin were conducted. All the workers had back injuries in 1990 and were either paid workers' compensation temporary disability benefits for at least 4 weeks or received

Stakeholder views on flood risk management in Hungary's Upper Tisza Basin.

With escalating costs of flood mitigation and relief, a challenge for the Hungarian government is to develop a flood mitigation and insurance/relief system that is viewed as efficient and fair by the many stakeholders involved. To aid policymakers in this task, this article reports on a recent study to elicit stakeholder views on flood risk management in the Upper Tisza Basin, including views on appropriate means of reducing losses and for transferring the residual losses from the direct victims to taxpayers or an insurance pool. This study is part of a project to develop an integrated approac…