The American journal of managed care
-
Randomized Controlled Trial Comparative Study
Shared medical appointments in a residency clinic: an exploratory study among Hispanics with diabetes.
To assess the feasibility and effectiveness of shared medical appointments (SMAs) among Hispanic patients with diabetes mellitus attending a family medicine residency clinic. ⋯ Implementing SMAs is feasible and effective among Hispanic patients with diabetes attending a family medicine residency clinic.Health plan managers and policy makers can work with family medicine residents to encourage the use of this model as an alternative approach or in addition to conventional one-on-one interactions with patients.
-
To evaluate the healthcare costs associated with treatment of opioid-dependence disorder with medications versus no medication, and with the 4 agents approved by the US Food and Drug Administration (FDA). ⋯ Patients with opioid dependence who received medication for this disorder had lower hospital utilization and total costs than patients who did not receive pharmacologic therapy. Patients who received XR-NTX had lower inpatient healthcare utilization at comparable or lower total costs than those receiving oral medications.
-
To examine the effect of an integrated, clinician-focused telehealth monitoring system on the probability of hospitalization within the first 30-day episode of home healthcare. ⋯ The use of an integrated, clinician focused telehealth monitoring system can substantially reduce the 30-day probability of hospitalization for home healthcare patients. Telehealth monitoring systems that integrate skilled clinicians can lead to substantial hospitalization-related cost savings.
-
Decision makers must make decisions without complete information. That uncertainty can be decreased when economic evaluations use local data and can be quantified by considering the variability of all model inputs concurrently per international evaluation guidelines. It is unclear how these recommendations have been implemented in evaluations of targeted cancer therapy. By using economic evaluations of adjuvant trastuzumab, we have assessed the extent to which decision support recommendations were adopted. ⋯ Authors of adjuvant trastuzumab economic evaluations rarely use local data beyond costs. Quantification of uncertainty and its representation also fell short of guideline recommendations. This review demonstrates that economic evaluations of adjuvant trastuzumab, as an example of targeted cancer therapy, can be improved for decision-making support.
-
To determine whether trends in psychological distress exist in the United States and whether trends in healthcare expenditures and outpatient visits were associated with psychological distress. ⋯ The upward trend in total and outpatient healthcare expenditures in the United States appears unrelated to psychological distress, although healthcare expenditures are consistently higher among those with greater psychological distress. Future work will explore the impact of treatment on costs and stability of the nation's mental health over time.