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1.
BMC Health Serv Res ; 23(1): 1087, 2023 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-37821937

RESUMO

BACKGROUND: Nearly 30 years post legalisation and introduction, midwifery is still not optimally integrated within the health system of Canada's largest province, Ontario. Funding models have been identified as one of the main barriers. METHODS: Using a constructivist perspective, we conducted a qualitative descriptive study to examine how antepartum, intrapartum, and postpartum funding arrangements in Ontario impact midwifery integration. We conceptualized optimal 'integration' as circumstances in which midwives' knowledge, skills, and model of care are broadly respected and fully utilized, interprofessional collaboration and referral support the best possible care for patients, and midwives feel a sense of belonging within hospitals and the greater health system. We collected data through semi-structured telephone interviews with midwives, obstetricians, family physicians, and nurses. The data was examined using thematic analysis. RESULTS: We interviewed 20 participants, including 5 obstetricians, 5 family physicians, 5 midwives, 4 nurses, and 1 policy expert. We found that while course-of-care-based midwifery funding is perceived to support high levels of midwifery client satisfaction and excellent clinical outcomes, it lacks flexibility. This limits opportunities for interprofessional collaboration and for midwives to use their knowledge and skills to respond to health system gaps. The physician fee-for-service funding model creates competition for births, has unintended consequences that limit midwives' scope and access to hospital privileges, and fails to appropriately compensate physician consultants, particularly as midwifery volumes grow. Siloing of midwifery funding from hospital funding further restricts innovative contributions from midwives to respond to community healthcare needs. CONCLUSIONS: Significant policy changes, such as adequate remuneration for consultants, possibly including salary-based physician funding; flexibility to compensate midwives for care beyond the existing course of care model; and a clearly articulated health human resource plan for sexual and reproductive care are needed to improve midwifery integration.


Assuntos
Atenção à Saúde , Serviços de Saúde Materna , Tocologia , Médicos de Família , Feminino , Humanos , Gravidez , Serviços de Saúde Materna/economia , Serviços de Saúde Materna/organização & administração , Tocologia/economia , Tocologia/organização & administração , Ontário , Médicos de Família/economia , Médicos de Família/organização & administração , Pesquisa Qualitativa , Conhecimentos, Atitudes e Prática em Saúde , Atenção à Saúde/economia , Atenção à Saúde/organização & administração
2.
BMC Health Serv Res ; 23(1): 964, 2023 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-37679729

RESUMO

BACKGROUND: Bangladesh outperforms its Least Developed Country (LDC) status on a range of health measures including life expectancy. Its frontline medical practitioners, however, are not formally trained medical professionals, but instead lightly-trained 'village doctors' able to prescribe modern pharmaceuticals. This current study represents the most complete national survey of these practitioners and their informal 'clinics'. METHODS: The study is based on a national Computer Assisted Telephone Interviewing (CATI) of 1,000 informal practitioners. Participants were sampled from all eight divisions and all 64 districts of Bangladesh, including 682 participants chosen from the purposively recruited Refresher Training program conducted by the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), supplemented with 318 additional participants recruited through snowball sampling. PRIMARY AND SECONDARY OUTCOME MEASURES: In addition to demographics, village doctors were asked about the characteristics of their 'clinics' including their equipment, their training, income and referral practices. RESULTS: Three quarters of the wholly male sample had not completed an undergraduate program, and none of the sample had received any bachelor-level university training in medicine. Medical training was confined to a range of short-course offerings. Village doctor 'clinics' are highly dependent on the sale of pharmaceuticals, with few charging a consultation fee. Income was not related to degree of short-course uptake but was related positively to degree of formal education. Finally, practitioners showed a strong tendency to refer patients to the professional medical care system. CONCLUSIONS: Bangladesh's village doctor sector provides an important pathway to professional, trained medical care, and provides some level of care to those who cannot afford or otherwise access the nation's established healthcare system. However, the degree to which relatively untrained paramedical practitioners are prescribing conventional medicines has concerning health implications.


Assuntos
Pessoal de Saúde , Médicos , Humanos , Masculino , Bangladesh , Comércio , Preparações Farmacêuticas
3.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-934572

RESUMO

Objective:To understand the medical cost ratio and its influencing factors of breast cancer chemotherapy and molecular targeted therapy in a hospital, for reference for reasonable control of medical cost.Methods:The first page data of all breast cancer chemotherapy and molecular targeted therapy cases in a tertiary hospital from January to June 2021 were selected to extract the data of age, hospitalization expenses, hospitalization time, complications or complications. The influence of each index on the distribution of medical expense ratio was analyzed by single factor analysis and chi-square test was used for comparison between groups.Results:A total of 3 109 cases of chemotherapy and molecular targeted therapy for breast malignant tumors were included, of which very low-rate, low-rate, high-rate and very high-rate accounted for 7.04%(219 cases), 58.32%(1 813 cases), 30.81%(958 cases) and 3.83%(119 cases) respectively. In addition to the way of admission, there were significant differences in the distribution of medical cost rates under different ages, time consumption index, complications or concomitants, admission departments, treatment methods and medical insurance types( P<0.01). Conclusions:There were many factors affecting the medical cost rate of breast malignant tumors. Relevant departments should expand the pilot scope of DRG payment, promote the multi-disciplinary diagnosis and treatment mode of tumors, refine the DRG grouping scheme, to provide standardized and homogeneous diagnosis and treatment services for tumor patients, and reasonably control the excessive growth of medical costs.

4.
Journal of Chinese Physician ; (12): 1331-1334, 2022.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-956304

RESUMO

Objective:To evaluate the effect of clinical pathway implementation on medical efficiency and medical expenses of patients with two common rheumatic immune diseases " rheumatoid arthritis" and " ankylosing spondylitis" diseases by using diagnosis related group (DRG) related indicators.Methods:The data of patients with two common rheumatic immune diseases " rheumatoid arthritis" and " ankylosing spondylitis" included in the clinical pathway management from January 2017 to December 2019 in the Department of Rheumatology and Immunology of Jinhua Hospital, Zhejiang University School of Medicine were carried out. The impact of clinical pathway implementation on the average hospital stay, average cost and average drug cost of patients with the two diseases were analyzed and compared , so as to evaluate the effect of the implementation of the clinical pathway.Results:From the implementation of clinical pathway in 2017 to 2019, the number of patients admitted and total medical specialty services in the two groups of " rheumatoid arthritis" and " ankylosing spondylitis" increased year by year ( P<0.01). The average length of stay, average cost and average drug cost of patients in the " rheumatoid arthritis" disease group decreased year by year, with statistically significant differences between groups (all P<0.01). The average length of stay in the ankylosing spondylitis group was shortened year by year, and the difference was statistically significant ( P<0.01). Compared with 2017, the average cost in 2018 decreased significantly, and the difference was statistically significant ( P<0.01). There was no significant difference in average cost between 2018 and 2019 ( P>0.05). The average cost in 2018 was significantly higher than that in 2017 ( P<0.05). After analyzing the causes and optimizing the clinical pathway, the average cost in 2019 was significantly lower than that in 2018 ( P<0.01). Conclusions:Through the implementation of clinical pathways and continuous optimization of pathway connotation during use, the diagnosis and treatment efficiency of patients with " rheumatoid arthritis" and " ankylosing spondylitis" can be significantly improved, and medical costs can be reduced, which is in line with the current medical reform needs.

5.
Chinese Journal of School Health ; (12): 928-930, 2021.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-881439

RESUMO

Objective@#To analyze public health emergencies in schools and associated economic loss in Luoyang from 2010 to 2019, and to provide suggestions for developing evaluation mechanism for economic loss of public health emergencies in school settings.@*Methods@#Data of public health emergencies in schools during 2010-2019 in Luoyang was analyzed by descriptive epidemiological method; the integrity and logicality of the economic losses reports in emergencies were assessed; the overall economic losses of emergent events of public health in schools were evaluated.@*Results@#Among the 60 public health emergencies reported during 2010 to 2019 in Luoyang, 24 (40.00%) occurred in schools. Infectious diseases accounted for 91.67%(22). The peaks of public health emergencies were in May and December. Among the 24 public health emergencies, 50.00%(12) occurred in primary schools, with 386 (58.22%) cases. Nearly 75.00% (18/24) of public health emergencies in schools were reported, among them, reports with reasonable integrity accounted for 5.56% (1/18) and reports with logicality accounted for 38.89% (7/18). The highest integrity rate was found in disease prevention and control system (75.00%), while health supervision and law enforcement ranked the lowest (20.83%). According to the economic losses, the expense used for disease control and prevention was in front of the row(¥429 000), while the expense used for health supervision ranked at the bottom(¥20 800).@*Conclusion@#The reporting rate of economic losses of school public health emergencies in Luoyang is relatively high, but there is still a big gap in the integrality and logicality of the data. It is necessary to improve the standard of direct network reports of economic losses and to establish an effective evaluation mechanism for accurately responding to public health emergencies and evaluating economic losses.

7.
Fa Yi Xue Za Zhi ; 36(6): 848-851, 2020 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-33550734

RESUMO

ABSTRACT: In cases on compensation for personal injury, the issue of medical expense compensation involves the vital interests of the compensation obligor, the injured party and the medical institution. The rationality of medical expenses is likely to be controversial, however, there is no unified standard and stipulation for the medical expense rationality identification in forensic clinical identification at present, therefore, in the practice of judicial expertise, expert opinions easily become confused, and the legitimate rights of the parties could be infringed, which affects the impartiality and authority of judicial expertise. This article starts with the concept of medical expense and the rationality of medical expense and the reasons for disputes over the rationality of medical expense, to put forward the basic principles that should be followed in the identification of rationality of medical expenses, for peer reference.


Assuntos
Prova Pericial , Medicina Legal , Dissidências e Disputas
8.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-799647

RESUMO

Objective@#To investigate the clinical effect of transanal stapler partial rectal resection for rectocele.@*Methods@#From January 2012 to January 2018, 90 patients with rectocele treated in Changzhi Traditional Chinese Medicine Hospital were divided into control group (45 cases) and observation group (45 cases) according to the operation method.The control group was treated with closed transrectal repair, while the observation group was treated with partial rectal resection with anal stapler.The operative effect, incidence of postoperative complications, recurrence rate, degree of pain after operation, length of hospital stay and cost of treatment were compared between the two groups.@*Results@#The total effective rate of the two groups was 100.0%.The incidence of complications in the observation group was 2.2%(1/45), which was lower than that in the control group [17.8%(8/45)] (χ2=4.444, P=0.035). The recurrence rate in the observation group was 0(0/45), which was lower than that in the control group [13.3%(6/45)] (χ2=4.464, P=0.035). The hospitalization time in the observation group was shorter than that in the control group[(7.01±2.06)d vs.(11.31±2.42)d]. Compared with the control group, the treatment cost of the observation group was higher[(0.836±0.164)×104CNY vs.(0.605±0.136)×104CNY], and the post-operative pain score was lower[(4.24±1.33) vs.(6.45±1.17)](t=9.076, 7.273, 8.369, all P<0.001).@*Conclusion@#Transanal stapler partial rectal resection is effective in the treatment of rectocele, with less complications, lower recurrence rate and less pain after operation, but the cost of treatment is higher.

9.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-824164

RESUMO

Objective To investigate the clinical effect of transanal stapler partial rectal resection for rectocele.Methods From January 2012 to January 2018,90 patients with rectocele treated in Changzhi Traditional Chinese Medicine Hospital were divided into control group (45 cases) and observation group (45 cases) according to the operation method.The control group was treated with closed transrectal repair ,while the observation group was treated with partial rectal resection with anal stapler.The operative effect ,incidence of postoperative complications , recurrence rate,degree of pain after operation ,length of hospital stay and cost of treatment were compared between the two groups.Results The total effective rate of the two groups was 100.0%.The incidence of complications in the observation group was 2.2%(1/45),which was lower than that in the control group [17.8%(8/45)] (χ2 =4.444, P=0.035).The recurrence rate in the observation group was 0(0/45),which was lower than that in the control group [13.3%(6/45)] (χ2 =4.464,P=0.035).The hospitalization time in the observation group was shorter than that in the control group[(7.01 ±2.06)d vs.(11.31 ±2.42)d].Compared with the control group ,the treatment cost of the observation group was higher[(0.836 ±0.164)×104CNY vs.(0.605 ±0.136)×104CNY],and the post-operative pain score was lower [(4.24 ±1.33) vs.(6.45 ±1.17)] ( t=9.076,7.273,8.369,all P<0.001).Conclusion Transanal stapler partial rectal resection is effective in the treatment of rectocele , with less complications, lower recurrence rate and less pain after operation ,but the cost of treatment is higher.

10.
Chinese Journal of School Health ; (12): 405-408, 2020.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-820830

RESUMO

Objective@#This study aims to estimate the economic burden of disease of outbreak of norovirus gastroenteritis in the Pearl River Delta Region, and provide scientific evidence for the government’s decision-making and control measures.@*Methods@#Using a unified questionnaire, a survey was conducted to the schools and students’ families which had suffered an outbreak of norovirus gastroenteritis in the Pearl River Delta Region from October 2017 to April 2018.@*Results@#The survey found that the mean total economic burden of sick students was 720.41(95%UI=640.45-804.63)RMB. The mean economic burden of sick students who were inpatient, outpatient and self-treatment were 1 712.75(95%UI=328.50-34 00.00), 213.70(95%UI=191.83-236.33) and 58.97(95%UI=43.00-77.69)RMB, respectively. The mean economic burden of transport, extra tutoring and cost of lost labor were 53.63(95%UI=43.98-63.58), 558.49(95%UI=381.40-774.01) and 695.62(95UI=630.25-767.29)RMB. The mean total economic burden of health students was 382.62(95%UI=343.29-424.45)RMB. The mean total economic burden of school was 49 264.53(95%UI=22 363.38-79 976.25)RMB. The total economic burden of disease increases as the level of outbreak increases. The larger the epidemic level, the proportion of sick students’ financial burden gradually decreased, 56.58%,23.27% and 10.93%.@*Conclusion@#The high economic burden of disease of norovirus gastroenteritis in the Pearl River Delta Region, respectively, indicating that relevant departments should strengthen the prevention, control and education in order to mitigate the disease economic burden.

11.
Journal of Forensic Medicine ; (6): 848-851, 2020.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-985183

RESUMO

In cases on compensation for personal injury, the issue of medical expense compensation involves the vital interests of the compensation obligor, the injured party and the medical institution. The rationality of medical expenses is likely to be controversial, however, there is no unified standard and stipulation for the medical expense rationality identification in forensic clinical identification at present, therefore, in the practice of judicial expertise, expert opinions easily become confused, and the legitimate rights of the parties could be infringed, which affects the impartiality and authority of judicial expertise. This article starts with the concept of medical expense and the rationality of medical expense and the reasons for disputes over the rationality of medical expense, to put forward the basic principles that should be followed in the identification of rationality of medical expenses, for peer reference.


Assuntos
Dissidências e Disputas , Prova Pericial , Medicina Legal
12.
Chinese Journal of School Health ; (12): 1384-1387, 2020.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-829134

RESUMO

Objective@#To understand the economic burden caused by hand-foot-mouth disease (HFMD) in Xi’an, in order to provide scientific basis for government departments to allocate health resources rationally.@*Methods@#New cases of HFMD were selected randomly from designated hospitals in city and district level in Xi’an, 2018, Direct and indirect economic costs of patients caused by HFMD were collected using a questionnaire survey, hospital charging system inquiry as well as follow-up survey. Factors affecting the economic burden of HFMD were analyzed.@*Results@#A total of 438 mild as well as 60 severe cases were surveyed, with the overall medical insurance participation rate of 89.76%(447/498). The median of per capita direct economic burden of mild and severe cases were 635 and 7 972 yuan respectively, and the median of per capita indirect economic burden of mild and severe cases were 130 and 233 yuan respectively, in Xi’an. The overall economic burden attributable to HFMD was 23.1 million yuan in Xi’an 2018, in which the direct economic burden was 19.3 million yuan, indirect economic burden was 3.8 million yuan. Multiple Logistic regression analysis showed that the approach of diagnosis, type of cases, days of treatment and type of pathogen had significant influence on the economic burden of HFMD(P<0.05).@*Conclusion@#The economic burden of HFMD was heavy in Xi’an. Controling and reducing the incidence rate, as well as increasing the medical insurance coverage and reimbursement rate would lighten the economic burden caused by HFMD effectively.

13.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(10): 1043-1048, 2019 Oct 06.
Artigo em Chinês | MEDLINE | ID: mdl-31607053

RESUMO

Objectives: To understand the status of studies about influenza economic burden in mainland China and summarize their major results. Methods: The words of influenza, flu, cost, economic, burden, effectiveness, benefit, utility, China, and Chinese, were used as search keywords. Journal papers published during 2000-2018 were searched from Chinese electronic databases (CNKI and Wanfang) and English electronic databases (PubMed, Web of science, EconLit and Cochrane Library). The language of literature was restricted to Chinese and English. A total of 23 effective documents were included, and the descriptive characteristics, research indexes and methods included in the literature were analyzed. The monetary unit used in this review is Chinese Yuan (CNY). Results: The 23 study sites were mainly in the relatively developed and populous regions. The total cost per capita of laboratory-confirmed influenza,of all age-group was reported in 6 literatures, and only 4 literatures reported it in out-patients (range: 768.0-999.9 CNY), Only one study reported this indicator in inpatients (9 832.0 CNY). One literature reported the total cost per capita of influenza-like illness,, which was 205.1 CNY. And one literature reported that the direct medical cost of inpatients per capita in children under 5 years of age was 6 072.0 CNY while two literature reported this index for the elderly over 60 years of age, ranging from 14 250.0 to 19 349.1 CNY. Four articles reported the economic burden of influenza in urban and rural areas, one of which showed that the related expenses of urban influenza inpatients accounted for 31% of the average annual income, while which for the rural flow was 113%. Conclusion: The average economic burden of lab-confirmed influenza case is higher than that of influenza-like illness, and there are differences in outpatient indirect expenses and inpatients direct medical expenses. The direct medical burden for the hospitalized 60-years-and-beyond influenza case group is heavier thar other age group. By region, the influenza associated individual economic burden in rural area is higher than that of urban area..


Assuntos
Efeitos Psicossociais da Doença , Influenza Humana/epidemiologia , Idoso , Criança , Pré-Escolar , China/epidemiologia , Humanos , Renda , Pessoa de Meia-Idade , População Rural
14.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-797026

RESUMO

Objectives@#To understand the status of studies about influenza economic burden in mainland China and summarize their major results.@*Methods@#The words of influenza, flu, cost, economic, burden, effectiveness, benefit, utility, China, and Chinese, were used as search keywords. Journal papers published during 2000-2018 were searched from Chinese electronic databases (CNKI and Wanfang) and English electronic databases (PubMed, Web of science, EconLit and Cochrane Library). The language of literature was restricted to Chinese and English. A total of 23 effective documents were included, and the descriptive characteristics, research indexes and methods included in the literature were analyzed. The monetary unit used in this review is Chinese Yuan (CNY).@*Results@#The 23 study sites were mainly in the relatively developed and populous regions. The total cost per capita of laboratory-confirmed influenza,of all age-group was reported in 6 literatures, and only 4 literatures reported it in out-patients (range: 768.0-999.9 CNY), Only one study reported this indicator in inpatients (9 832.0 CNY). One literature reported the total cost per capita of influenza-like illness,, which was 205.1 CNY. And one literature reported that the direct medical cost of inpatients per capita in children under 5 years of age was 6 072.0 CNY while two literature reported this index for the elderly over 60 years of age, ranging from 14 250.0 to 19 349.1 CNY. Four articles reported the economic burden of influenza in urban and rural areas, one of which showed that the related expenses of urban influenza inpatients accounted for 31% of the average annual income, while which for the rural flow was 113%.@*Conclusion@#The average economic burden of lab-confirmed influenza case is higher than that of influenza-like illness, and there are differences in outpatient indirect expenses and inpatients direct medical expenses. The direct medical burden for the hospitalized 60-years-and-beyond influenza case group is heavier thar other age group. By region, the influenza associated individual economic burden in rural area is higher than that of urban area..

15.
Chinese Journal of Geriatrics ; (12): 397-399, 2019.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-745528

RESUMO

Objective To compare the average hospitalization costs in cerebral infarction patients at different ages and analyze the causes.Methods Data of hospitalization expenses in cerebral infarction patients at different ages at our hospital from June 2013 to May 2018 were collected and analyzed by using SPSS18.0 software.The lengths of hospital stay and hospitalization costs were compared among patients at different ages.Results The average lengths of hospital stay were (11.5 ±6.2) d,(11.6±6.5) d and (12.5±9.4) d in the middle-aged,older age and advanced-age groups respectively(F=23.61,P =0.00).The hospitalization expenses were (11971.50± 12610.40) yuan,(12510.22±14075.46) yuan and (14765.59±19907.66) yuan and the medicine costs were (5401.66 ±5688.98) yuan,(5595.21±6152.13) yuan and (7184.69±9696.47) yuan in the middle-aged,older age and advanced-age groups respectively (F =34.12 and 73.52,P =0.00).The average drug proportion was 45.12%,44.73 % and 48.65 % in the middle-aged,older age and advanced-age groups respectively(x2 =19.03,P =-0.00).Hospitalization costs,drug costs and length of hospital stay were increased with aging.Conclusions Age significantly affects the total hospitalization costs and drug costs in hospitalized patients with cerebral infarction.Hospitalization expenses and drug charges are increased along with aging in cerebral infarction patients aged 45 years and older.

16.
Zhonghua Yan Ke Za Zhi ; 54(8): 580-585, 2018 Aug 11.
Artigo em Chinês | MEDLINE | ID: mdl-30107650

RESUMO

Objective: To analyze the changes of cataract surgery volume and related influencing factors in Shanghai during 2013 and 2015. Methods: The information of Cataract patients during the period of 2013 and 2015 was collected from Shanghai Cataract Operations Database. The cataract surgery volume and CSR of Shanghai residents and non-registered ones were compared. The cataract surgery volume and CSR of registered Shanghai residents in urban, suburban and exurban areas were calculated, respectively. In addition, the sources of surgery cost, hospitals where surgeries were performed were analyzed. Results: In Shanghai, the cataract surgery volume grew from 63 915 to 114 688 and the total CSR grow from 2 686 to 4 729 during the years between 2013 and 2015. In this period, the cataract surgery volume of registered Shanghai residents in urban, suburban and exurban areas increased from 27 203, 21 921, 8 847 to 46 415, 40 463, 18 171, respectively. The CSR1 (CSR of registered Shanghai residents) grew rapidly from 4 081 to 7 363, while the CSR2 (CSR of non-registered Shanghai residents) grew slowly from 619 to 949. According to statistics, 93.08% of the registered Shanghai residents paid the medical expenses with their medical insurance, while more than 80% non-registered Shanghai residents afforded it at their own expenses. The number of total CSR in urban, suburban and exurban areas increased from 5 085, 3 600, 3 205 to 3 600, 6 588, 6 513 respectively. In 2015, the number of cataract surgery cases in non-public hospitals exceeded that in public hospital, accounting for 54.71% of the total cataract surgeries. In the same year, 55.44% of the total cases come from suburban and exurban residents. Conclusions: From 2013 to 2015, there had been a dramatic increase in cataract surgery volume in nonpublic hospitals and exurban area in Shanghai, which effectively solved the problem of low CSR in suburban and exurban area, however the 1ow level of CSR of non-registered Shanghai residents was the key factor that significantly reduced the total CSR in Shanghai. (Chin J Ophthalmol, 2018, 54:580-585).


Assuntos
Extração de Catarata , Catarata , Catarata/epidemiologia , China/epidemiologia , Humanos , Estudos Retrospectivos
17.
Manag Care ; 27(6): 7-8, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29989902

RESUMO

State laws that make meaningful price information available-e.g., paid claims, not charges, or prices for episode level bundles, and make these prices broadly available to the public-are an important step in enhancing price transparency. But the jury is still out on whether these efforts will make people buy health care based on quality.


Assuntos
Atenção à Saúde/economia , Honorários e Preços , Disseminação de Informação , Revelação da Verdade , Estados Unidos
18.
Manag Care ; 27(6): 23, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29989907

RESUMO

Health care is increasingly becoming like other retail encounters-a transaction between buyers and sellers. Patients, providers, payers-everybody needs to adjust. With the right technology and the will to change, the process of paying for health care can become as simple-and as painless-as getting a haircut.


Assuntos
Atenção à Saúde/economia , Financiamento Pessoal/economia , Benefícios do Seguro/economia , Custo Compartilhado de Seguro , Revelação da Verdade , Estados Unidos
19.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wpr-766466

RESUMO

Surgery is a very hands-on area of medical care, in that surgeons identify problems in patients' bodies and directly change them through operations. Therefore, it is not only necessary for surgeons to have a high level of expertise, but also to take considerable responsibility for the outcomes of each operation. However, surgery, which was once an object of envy, has long been a process to avoid, due to various circumstances, such as abnormal medical expenses in the medical field and social phenomena that avoids difficult work. It is unfortunate that medical professionals do not receive sympathy from others within the same medical field because of the general difficulties of the profession. The fundamental problem in this situation is the abnormal profit structure of the Korean medical system. Efforts by various related organizations will be needed to objectively evaluate the problems of the current medical insurance system and to make reasonable adjustments considering the difficulty, frequency, and resource-intensiveness of medical care.


Assuntos
Grupos Diagnósticos Relacionados , Honorários Médicos , Seguro , Coreia (Geográfico) , Cirurgiões
20.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-733598

RESUMO

Objective:To analyze hospitalization cost of patients with coronary heart disease (CHD) undergoing per-cutaneous coronary intervention (PCI) in recent years and its influencing factors.Methods:Hospitalization cost data of CHD patients undergoing PCI in a hospital of Anhui province from 2012 to 2016 were collected.Changes of hos-pitalization costs and its influencing factors were statistically analyzed.Results:Number of hospitalized CHD pa-tients undergoing PCI gradually rose year by year.From 2012 to 2016,there was significant rise in mean examina-tion fee per time (except 2012 vs.2013),significant reductions in mean medicine fee per time,mean bed fee and other fees (except 2013 vs.2014 ) and mean hospitalization duration per time (except 2012 vs.2013,2014 vs.2015),P<0.05 or < 0.01.Patients with full public insurance possessed the highest mean hospitalization fee per time.Mean medicine fee per time of male group was significantly higher than that of female group [5368.66 (3831.01,7974.22) RMB vs.5045.16 (3721.97,7308.26) RMB],P=0.019.Mean treatment fee per time of 50~70 years group was significantly higher than that of ≤50 years group [ (36351.63 (27925.86,47714.41) RMB vs.34622.20 (27296.66,46504.87) RMB],P=0.024;compared with ≤50 years group and 50~70 years group,there were significant rise in all fees in >70 years group,P<0.05 or <0.01.Compared with hospitalization ≤7d group,there were significant rise in all fees in 7~14d group and >14d group,and those of >14d group were signif-icantly higher than those of 7~14d group,P=0.001 all.Multifactor linear regression analysis indicated that hospi-talization duration was independent risk factor for hospitalization fee of CHD patients undergoing PCI (β=0.461,P=0.001),while insurance way was its independent protective factor (β= -0.078,P=0.001).Conclusion:Eco- nomic burden of CHD inpatients undergoing PCI is still heavy,we must improve theraputic effect,reduce hospital stays,in order to reduce patients′economic burden.

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