6,291 results match your criteria enrollees

Retrospective study of glycemic variability, BMI, and blood pressure in diabetes patients in the Digital Twin Precision Treatment Program.

Sci Rep 2021 Jul 21;11(1):14892. Epub 2021 Jul 21.

Twin Health, Mountain View, CA, USA.

The objective of this retrospective observational cohort study was to measure glycemic variability and reductions in body mass index (BMI), blood pressure (BP), and use of antihypertensive medications in type 2 diabetes (T2D) patients participating in the digital twin-enabled Twin Precision Treatment (TPT) Program. Study participants included 19 females and 45 males with T2D who chose to participate in the TPT Program and adhered to program protocols. Nine additional enrollees were excluded due to major program non-adherence. Read More

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Entice With Procedures, Inspire With Primary Care: A Preclerkship Pipeline Course.

PRiMER 2021 28;5:22. Epub 2021 Jun 28.

Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA.

Background And Objectives: The growing demand for primary care clinicians in the United States continues to outstrip their dwindling supply. Many allopathic medical schools, including Stanford University School of Medicine, are not adequately meeting this shortage. We sought to develop a preclerkship elective to increase the visibility and desirability of primary care at our institution. Read More

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Mobile Technology Improves Adherence to Cardiac Rehabilitation: A Propensity Score-Matched Study.

J Am Heart Assoc 2021 Jul 19:e020482. Epub 2021 Jul 19.

Department of Medicine, Cardiology Section Boston Medical Center Boston University School of Medicine Boston MA.

Background Despite its established effectiveness, adherence to cardiac rehabilitation remains suboptimal. The purpose of our study is to examine whether mobile technology improves adherence to cardiac rehabilitation and other outcomes. Methods and Results We identified all enrollees of the cardiac rehabilitation program at Boston Medical Center from 2016 to 2019 (n=830). Read More

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Risk Factors of Carpal Tunnel Syndrome in Taiwan: A Population-Based Cohort Study.

Ann Plast Surg 2021 Jul 13. Epub 2021 Jul 13.

From the Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Keelung & Chang Gung University College of Medicine, Taoyuan, Taiwan Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou & Chang Gung University College of Medicine, Taoyuan, Taiwan Graduate Institute of Clinical Medical Sciences and Research Services Center for Health Information, Chang Gung University, Taoyuan, Taiwan.

Background: Carpal tunnel syndrome (CTS), 1 of the most common peripheral neuropathies of the upper extremity, has been studied for decades regarding its epidemiology and associated medical conditions. We conducted a large-scale, age- and gender-matched study from an Asian population database to investigate the relationship between the incidence and the demographic characteristics.

Methods: A retrospective cohort study using data of National Health Insurance Research Database was conducted. Read More

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Why do narrow network plans cost less?

Health Econ 2021 Jul 14. Epub 2021 Jul 14.

Bureau of Economics, Federal Trade Commission, Washington, DC, USA.

Narrow network health insurance plans have been shown to have lower premiums and lower costs to insurers. This paper decomposes and quantifies the magnitudes for various mechanisms by which networks may reduce premiums and costs. Using data on the Colorado non-group market, we examine three mechanisms through which a narrow network might achieve lower costs: (1) enroll a population with lower utilization, (2) negotiate lower prices, or (3) steer patients away from high-cost hospitals. Read More

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Use of Medications for Treatment of Opioid Use Disorder Among US Medicaid Enrollees in 11 States, 2014-2018.

JAMA 2021 07;326(2):154-164

AcademyHealth, Washington, DC.

Importance: There is limited information about trends in the treatment of opioid use disorder (OUD) among Medicaid enrollees.

Objective: To examine the use of medications for OUD and potential indicators of quality of care in multiple states.

Design, Setting, And Participants: Exploratory serial cross-sectional study of 1 024 301 Medicaid enrollees in 11 states aged 12 through 64 years (not eligible for Medicare) with International Classification of Diseases, Ninth Revision (ICD-9 or ICD-10) codes for OUD from 2014 through 2018. Read More

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J Trauma Acute Care Surg 2021 Jul 13. Epub 2021 Jul 13.

Atrium Health - Carolinas Medical Center.

Background: Geriatric trauma populations respond differently than younger trauma populations. Critical Care Ultrasound (CCUS) can guide resuscitation, and it has been shown to decrease intravenous fluid (IVF), lower time until operation, and lower mortality in trauma. CCUS guided resuscitation has not yet been studied in geriatric trauma. Read More

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Do high-deductible health plans affect price paid for childbirth?

Betsy Q Cliff

Health Serv Res 2021 Jul 12. Epub 2021 Jul 12.

Division of Health Policy & Administration, University of Illinois Chicago, Chicago, Illinois, USA.

Objective: To test whether out-of-pocket costs and negotiated hospital prices for childbirth change after enrollment in high-deductible health plans (HDHPs) and whether price effects differ in markets with more hospitals.

Data Sources: Administrative medical claims data from 2010 to 2014 from three large commercial insurers with plans in all U.S. Read More

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Telehealth Use for Mental Health Conditions Among Enrollees in Commercial Insurance.

Psychiatr Serv 2021 Jul 13:appips202000778. Epub 2021 Jul 13.

Department of Population Health Sciences, Weill Cornell Medicine, New York City (Yu, Casalino); Department of Psychiatry, Columbia University's College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Pincus). Tami L. Mark, Ph.D., and Alexander J. Cowell, Ph.D., are editors of this column.

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Apheresis practice patterns in the United States of America: Analysis of a market claims database.

J Clin Apher 2021 Jul 12. Epub 2021 Jul 12.

Department of Medicine, Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, Minnesota, USA.

Introduction: Indications for apheresis procedures are expanding; however, the evidence for many is low quality. A better understanding of apheresis patterns in the United States is needed to better plan prospective research studies.

Methods: Data from January 1, 2013, to September 30, 2015, were analyzed from the IBM MarketScan Research Databases of de-identified health insurance claims data of several million enrollees at all levels of care from large employers and health plans across the United States. Read More

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Determinants of racial and ethnic disparities in utilization of hospital-based care for asthma among Medi-Cal children in Los Angeles.

J Asthma 2021 Jul 12:1-13. Epub 2021 Jul 12.

LA Care Health Plan, Los Angeles, CA, United States.

: We sought to identify racial/ethnic patterns of health care utilization for asthma among asthmatic children (ages 0-18) and address unequal access to optimal asthma management as a determinant of asthma disparities.: We used children Medi-Cal (California's Medicaid program) enrollees, including African American, Asian, Hispanic, and White children in Los Angeles and retrieved individual hospital utilization records of 69,118 asthmatic children (2013-2018). We applied Hierarchical Generalized Linear Models (HGMLs) to identify the patterns of health care utilization at the individual level, controlling for demographic and neighborhood characteristics. Read More

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Impact of High Deductible Health Plans on Diabetes Care Quality and Outcomes: Systematic Review.

Endocr Pract 2021 Jul 7. Epub 2021 Jul 7.

Division of Health Care Delivery & Research, Robert D. and Patricia D. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; Division of Community Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN.

Objective: High deductible health plans (HDHPs) were introduced as a mechanism to reduce healthcare spending by incentivizing patients to be more cost-conscious while making premiums less costly. However, data on the impact of HDHPs on utilization of services required for optimal management of chronic health conditions such as diabetes and on subsequent health outcomes are scarce.

Methods: Systematic literature review of studies published between 01/01/2000 and 05/07/2021 that examined the impact of HDHP on diabetes monitoring (e. Read More

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Insurance expansions and hospital utilization: Relabeling and reabling?

J Health Econ 2021 Jun 5;78:102482. Epub 2021 Jun 5.

The World Bank. Electronic address:

The 2010 Patient Protection & Affordable Care Act (ACA) significantly expanded access to private and public health insurance for low-income individuals through income-based subsidies and income-based eligibility expansions, respectively. In this paper, we use the universe of hospitals from 2009 to 2015 to characterize how these expansions affected the financing of hospital visits, along with price, utilization, and potential spillovers in the quality of care. The insurance coverage expansions generated a shift in the composition of payers and a modest increase in the utilization of hospital outpatient services. Read More

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Randomized feasibility trial of a digital intervention for hypertension self-management.

J Hum Hypertens 2021 Jul 8. Epub 2021 Jul 8.

Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA, USA.

Home blood pressure monitoring (HBPM) can improve hypertension management. Digital tools to facilitate routinized HBPM and patient self-care are underutilized and lack evidence of effectiveness. MyBP provides video-based education and automated text messaging to support continuous BP self-monitoring with recurring feedback. Read More

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Robust Prescription Monitoring Programs and Abrupt Discontinuation of Long-term Opioid Use.

Am J Prev Med 2021 Jul 4. Epub 2021 Jul 4.

Department of Population Health Sciences, Weill Cornell Medicine, New York, New York; Department of Psychiatry, Weill Cornell Medicine, New York, New York; Department of Medicine, Weill Cornell Medicine, New York, New York.

Introduction: This study assesses the associations between the recent implementation of robust features of state Prescription Drug Monitoring Programs and the abrupt discontinuation of long-term opioid therapies.

Methods: Data were from a national commercial insurance database and included privately insured adults aged 18-64 years and Medicare Advantage enrollees aged ≥65 years who initiated a long-term opioid therapy episode between Quarter 2 of 2011 and Quarter 2 of 2017. State Prescription Drug Monitoring Programs were characterized as nonrobust, robust, and strongly robust. Read More

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When All That Glitters Is Gold: Dominated Plan Choice on Covered California for the 2018 Plan Year.

Milbank Q 2021 Jul 6. Epub 2021 Jul 6.

Margolis Center for Health Policy, Duke University.

Policy Points Purchasing health insurance is a complex task with multiple potential points of failure. In 2018, following the silver-loading price shock, 20.2% of households earning above 200% of the federal poverty level with coverage through the two Covered California insurers who sold dominated silver plans purchased the inferior, dominated silver plan. Read More

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Baseline Knowledge Attitudes Satisfaction and Aspirations With Advance Care Planning: A Cross-Sectional Study.

Am J Hosp Palliat Care 2021 Jul 6:10499091211030447. Epub 2021 Jul 6.

Department of Internal Medicine, East Tennessee State University Quillen College of Medicine, Johnson City, TN, USA.

Background: Studies have consistently demonstrated low rates of adoption of Advance Care Planning in the community.

Methods: We studied Medicare enrollees age 65 and over and non-Medicare patients using a cross-sectional survey undertaken in February and March 2019 using questionnaires completed by out-patients attending a teaching hospital clinic in East Tennessee USA. We evaluated patient knowledge, attitudes, satisfaction and aspirations towards Advance Care Planning. Read More

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Association of rural location and long acting reversible contraceptive use among Oregon Medicaid recipients.

Contraception 2021 Jul 2. Epub 2021 Jul 2.

Center for Health Systems Effectiveness, Oregon Health & Science University.

Objective: To evaluate whether the use of long-acting, reversible contraception (LARC) is equitably accessible to Medicaid recipients in rural and urban areas. We also determined whether women's health specialists' availability was associated with the type of LARC used.

Study Design: We used claims data for 242,057 adult women who were continuously enrolled in Oregon Medicaid for at least one year and at risk of pregnancy from January 1, 2015, through December 31, 2017 to assess the association between LARC utilization and (1) rurality and (2) provider supply. Read More

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Estimated Prevalence of Keratoconus in the United States From a Large Vision Insurance Database.

Eye Contact Lens 2021 Jul 1. Epub 2021 Jul 1.

Departments of Ophthalmology and Vision Sciences (S.Z.M.), and Epidemiology and Public Health (J.A.), University of Maryland School of Medicine, Baltimore, MD.

Purpose: To estimate the prevalence of keratoconus in the United States using a large vision insurance database.

Methods: We used data from the 2016 vision service plan (VSP) Global claims database to estimate the prevalence of keratoconus among enrollees by state. The VSP Global database includes cross-sectional de-identified claims data summarized by state of residence in predefined age and gender groups. Read More

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Effects of establishing a financing scheme for outpatient care on inpatient services: empirical evidence from a quasi-experiment in China.

Wen He

Eur J Health Econ 2021 Jul 5. Epub 2021 Jul 5.

School of Public Administration, Hunan University, Lushan Road (S), Yuelu District, Changsha, 410082, China.

The relationship between outpatient and inpatient care is central to the current healthcare reform debate especially in developing countries. Despite the importance of this relationship to health policy makers, empirical evidence, particularly evidence that can be interpreted as causal is limited and inconclusive. This paper examines the effects of establishing a financing scheme for outpatient care on inpatient utilization and expenditure in China's Urban Employee Basic Medical Insurance scheme. Read More

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Black clients in expansion states who used opioids were more likely to access medication for opioid use disorder after ACA implementation.

J Subst Abuse Treat 2021 Jun 11:108533. Epub 2021 Jun 11.

Boston University School of Public Health, 715 Albany Street, Suite 116W, Boston, MA 02118, United States of America. Electronic address:

Introduction: Black people in the United States who use opioids receive less treatment and die from overdoses at higher rates than White people. Medication for opioid use disorder (MOUD) decreases overdose risk. Implementation of the Affordable Care Act (ACA) in the United States was associated with an increase in MOUD. Read More

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Did the ACA's "guaranteed issue" provision cause adverse selection into nongroup insurance? Analysis using a copula-based hurdle model.

Health Econ 2021 Jul 2. Epub 2021 Jul 2.

Department of Economics, Western Kentucky University, Bowling Green, KY, USA.

Prior to the Affordable Care Act (ACA), insurance companies could charge higher premiums, or outright deny coverage, to people with preexisting health problems. But the ACA's "guaranteed issue" provision forbids such price discrimination and denials of coverage. This paper seeks to determine whether, after implementation of the ACA, nongroup private insurance plans have experienced adverse selection. Read More

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COVID-19 and eating disorder and mental health concerns in patients with eating disorders.

J Eat Disord 2021 Jul 2;9(1):80. Epub 2021 Jul 2.

Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, 02115, MA, USA.

Background: The Coronavirus (COVID-19) pandemic dramatically transformed daily life for adolescents and young adults, altering social and physical environments. Previous research has shown such shifts in daily life to be especially challenging for people living with eating disorders (ED). However, the extent of this environmental change on ED symptoms and mental health (MH) has been relatively unexplored in patients with EDs. Read More

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Medicaid Expansion and Medical Debt: Evidence From Louisiana, 2014-2019.

Am J Public Health 2021 Jul 2:e1-e7. Epub 2021 Jul 2.

Kevin Callison and Brigham Walker are with the Department of Health Policy and Management, Tulane School of Public Health and Tropical Medicine, New Orleans, LA. Brigham Walker is also with ConcertAI, Boston, MA.

To identify the association between Medicaid eligibility expansion and medical debt. We used difference-in-differences design to compare changes in medical debt for those gaining coverage through Louisiana's Medicaid expansion with those in nonexpansion states. We matched individuals gaining Medicaid coverage because of Louisiana's Medicaid expansion (n=196 556) to credit report data on medical debt and compared them with randomly selected credit reports of those living in Southern nonexpansion state zip codes with high rates of uninsurance (n=973 674). Read More

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Knowledge, Attitudes, and Practices Regarding COVID-19 among Healthcare Workers in Uganda: A Cross-Sectional Survey.

Int J Environ Res Public Health 2021 06 30;18(13). Epub 2021 Jun 30.

Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe P.O. Box 49, Uganda.

Healthcare workers (HCWs) are at high risk of COVID-19. However, data on HCWs' knowledge, attitudes, and practices (KAP) toward COVID-19 are limited. Between September and November 2020, we conducted a questionnaire-based COVID-19 KAP survey among HCWs at three hospitals in Uganda. Read More

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Acute myocardial infarction: Development and application of an ICD-10-CM-based algorithm to a large U.S. healthcare claims-based database.

PLoS One 2021 1;16(7):e0253580. Epub 2021 Jul 1.

Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, United States of America.

Background: Healthcare administrative claims data hold value for monitoring drug safety and assessing drug effectiveness. The U.S. Read More

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Baricitinib and primary biliary cholangitis.

J Transl Autoimmun 2021 1;4:100107. Epub 2021 Jun 1.

Eli Lilly & Company, Indianapolis, IN, USA.

Background And Aims: There is an unmet need for alternative treatments for patients with primary biliary cholangitis (PBC) who do not respond to treatment with ursodeoxycholic acid (UDCA). A proof-of-concept study of baricitinib, an orally administered Janus kinase 1 and 2 inhibitor, was initiated to evaluate its use in PBC patients.

Approach And Results: Patients with PBC showing inadequate response or intolerance to UDCA were eligible. Read More

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Advanced thyroid carcinomas: neural network analysis of ultrasonographic characteristics.

Thyroid Res 2021 Jun 29;14(1):16. Epub 2021 Jun 29.

Nuklearmedizinische Klinik, Universitätsklinikum Erlangen, Erlangen, Germany.

Background: Ultrasound is the first-line imaging modality for detection and classification of thyroid nodules. Certain characteristics observable by ultrasound have recently been identified that may indicate malignancy. This retrospective cohort study was conducted to test the hypothesis that advanced thyroid carcinomas show distinctive clinical and sonographic characteristics. Read More

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Geospatial distribution and bypassing health facilities among National Health Insurance Scheme enrollees: implications for universal health coverage in Nigeria.

Int Health 2021 Jun 29. Epub 2021 Jun 29.

Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria.

Background: This study was carried out to enable an assessment of geospatial distribution and access to healthcare facilities under the National Health Insurance Scheme (NHIS) of Nigeria. The findings will be useful for efficient planning and equitable distribution of healthcare resources.

Methods: Data, including the distribution of selected health facilities, were collected in Ibadan, Nigeria. Read More

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Effect of relaxing hepatitis C treatment restrictions on direct-acting antiviral use in a Medicaid program: an interrupted time series analysis.

J Manag Care Spec Pharm 2021 Jul;27(7):856-864

Oregon State University College of Pharmacy and Oregon Health & Science University, Portland.

Although direct-acting antivirals (DAA) have revolutionized the treatment of chronic hepatitis C virus (HCV), many state Medicaid programs have limited coverage because of their expense. In 2015, the Centers for Medicare & Medicaid Services (CMS) notified states about the legality of Medicaid coverage limitations, particularly within managed care programs. To (1) examine how relaxation and alignment of hepatitis C policies within the Oregon Medicaid program affected DAA utilization and (2) describe changes in DAA coverage policies and patient characteristics of treated individuals over time. Read More

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