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6.
J Orthop Sports Phys Ther ; 50(8): 413-414, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32736501

RESUMO

This editorial builds on the previous editorials in the patient partnership series, and aims to share practical advice related to compensation for patient research partners. In the authors' first publication on patient partner compensation in research and health care, they presented the "why" and "how." Here, they build on the "how" to help alleviate the awkwardness of that conversation. The compensation conversation, as a regular part of this type of partnership, allows teams to codevelop projects and focus on the output and outcomes of their collaborative work. J Orthop Sports Phys Ther 2020;50(8):413-414. doi:10.2519/jospt.2020.0106.


Assuntos
Pesquisa Biomédica/economia , Compensação e Reparação , Pesquisa sobre Serviços de Saúde/economia , Participação do Paciente/economia , Sujeitos da Pesquisa , Orçamentos , Humanos
8.
Ying Yong Sheng Tai Xue Bao ; 31(7): 2323-2331, 2020 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-32715698

RESUMO

The value evaluation of endangered species can provide important supports for policy-making in biodiversity conservation. We evaluated the stakeholders' preference and willingness to pay (WTP) from the perspective of stakeholders by the choice experiment method (CEM) and discussed the ecological compensation mechanism, with Elaeagnus mollis, a national secondary key protected plant as an example. Based on the interest demands analysis of three stakeholders, the management departments, enterprises and farmers, we measured five species attributes of E. mollis, including planting area, product classification, seedling varieties, protection investment, and far-mers' income. Furthermore, the preference of stakeholders and WTP for different attribute variables were analyzed using random parameter model (RPL). The results showed that the preference of respondents for the variable of "increase investment in protection" was the strongest and WTP was the highest (331.00 yuan·a-1·household-1). The stakeholders had stronger preference for the variables of "simultaneous development of high and low-end products" and "development of high-end products", with WTP being 242.71 and 227.57 yuan·a-1·household-1, respectively. For the variables of "farmers' income", "unchanged investment in protection", "seedling varieties" and "planting area", stakeholders showed certain preference and WTP from strong to weak. The prefe-rence for "no investment in protection" and "development of low-end products" was weaker and the WTP was negative. Through direct and indirect approaches of compensation, ecological compensation could be implemented for the objects of ecological compensation (E. mollis and associated habitat). The value of compensating surplus (CS) calculated was 285.62 yuan·a-1·household-1.


Assuntos
Elaeagnaceae , Espécies em Perigo de Extinção , Animais , Compensação e Reparação , Ecossistema , Fazendeiros , Humanos
10.
J Am Acad Orthop Surg ; 28(14): e604-e611, 2020 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-32692096

RESUMO

Physicians offer unique contributions to the orthopaedic implant design process by providing creative ideas and insightful clinical expertise. This article provides a brief overview of the pertinent considerations of transforming a concept into an orthopaedic implant and bringing it to the market. Implant concept choice should consider medical or surgical necessity, regional variability, market characteristics, cost of goods sold, and average selling price. Implant development requires adherence to regulatory requirements and device classification. Implant production incorporates design specifications, mechanical testing, sterilization, packaging, and marketing and sales. Orthopaedic implant company agreements determine physician compensation through royalties and/or the purchase of intellectual property. After rollout, physicians participate in monitoring for device safety. Bringing an orthopaedic implant from a concept to the market can be lengthy and complicated, but innovation is essential for advancing patient care and well-being.


Assuntos
Comércio/economia , Marketing/economia , Marketing/métodos , Procedimentos Ortopédicos , Médicos/economia , Próteses e Implantes/economia , Desenho de Prótese/economia , Compensação e Reparação , Segurança de Equipamentos , Humanos , Propriedade Intelectual
11.
Br J Nurs ; 29(11): 642-643, 2020 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-32516046
12.
J Am Acad Orthop Surg ; 28(22): e1020-e1028, 2020 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-32441903

RESUMO

BACKGROUND: The Sunshine Act aims to increase the transparency of physicians receiving compensation from pharmaceutical and medical device companies. Nine states have supplementary legislation in addition to the Federal Sunshine Act. The purpose of this study is to assess the characteristics of financial compensation to orthopaedic residents on the Centers for Medicare and Medicaid Services (CMS) Open Payments Database in states with more restrictive regulations compared with those without additional restrictions. METHODS: A complete list of accredited orthopaedic residency programs in the United States was compiled using the Accreditation Council for Graduate Medical Education and American Osteopathic Academy of Orthopedics websites. The website of each orthopaedic residency program was searched to compile a list of residents who attended their program from 2014 to 2016. The CMS Open Payments Database was used to search the residents identified for the corresponding years. All data available on the CMS Open Payments Database were recorded. RESULTS: Over the 3-year period, 3,622 residents were identified from 151 programs. A total of 41% of the residents were reported as receiving compensation from the industry. The percent of residents reported from programs in less restrictive states was 45% versus 28% in more restrictive states (P < 0.001). Residents had a mean of 5.3 transactions per year in less restrictive states and 2.4 transactions per year in more restrictive states (P < 0.001). The mean compensation per resident reported was $2,730 for less restrictive sates versus $1,937 for more restrictive states (P < 0.001). DISCUSSION: Overall, 41% of orthopaedic residents were reported on the CMS Open Payments Database with fewer transactions and less compensation going to residents in states with more restrictive legislature. Potential implications on resident education remain unknown.


Assuntos
Centers for Medicare and Medicaid Services, U.S. , Compensação e Reparação/legislação & jurisprudência , Bases de Dados Factuais , Internato e Residência/economia , Ortopedia/economia , Ortopedia/educação , Acreditação , Humanos , Estados Unidos
13.
J Infect Dis ; 222(3): 356-361, 2020 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-32469074

RESUMO

Trials are in development and underway to examine potential interventions for treatment and prophylaxis of coronavirus disease 2019 (COVID-19). How should we think about offering payment to participants in these trials? Payment for research participation is ethically contentious even under ideal circumstances. Here, we review 3 functions of research payment-reimbursement, compensation, and incentive-and identify heightened and novel ethical concerns in the context of a global pandemic. We argue that COVID-19 trial participants should usually be offered reimbursement for research-related expenses, and compensation for their time and effort, as for other types of research under usual circumstances. Given increased risk of undue influence against pandemic background conditions, incentive payment should be avoided unless essential to recruitment and retention in important trials whose social value outweighs this risk. Where essential, however, incentives can be ethically permissible, so long as reasonable efforts are made to minimize the possibility of undue influence.


Assuntos
Ensaios Clínicos como Assunto/economia , Infecções por Coronavirus/terapia , Voluntários Saudáveis , Pneumonia Viral/terapia , Ensaios Clínicos como Assunto/ética , Compensação e Reparação/ética , Infecções por Coronavirus/prevenção & controle , Humanos , Motivação/ética , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pesquisa/economia
14.
PLoS One ; 15(5): e0233334, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32437376

RESUMO

To update the landscape analysis of vaccine injuries no-fault compensation programmes, we conducted a scoping review and a survey of World Health Organization Member States. We describe the characteristics of existing no-fault compensation systems during 2018 based on six common programme elements. No-fault compensation systems for vaccine injuries have been developed in a few high-income countries for more than 50 years. Twenty-five jurisdictions were identified with no-fault compensation programmes, of which two were recently implemented in a low- and a lower-middle-income country. The no-fault compensation programmes in most jurisdictions are implemented at the central or federal government level and are government funded. Eligibility criteria for vaccine injury compensation vary considerably across the evaluated programmes. Notably, most programmes cover injuries arising from vaccines that are registered in the country and are recommended by authorities for routine use in children, pregnant women, adults (e.g. influenza vaccines) and for special indications. A claim process is initiated once the injured party or their legal representative files for compensation with a special administrative body in most programmes. All no-fault compensation programmes reviewed require standard of proof showing a causal association between vaccination and injury. Once a final decision has been reached, claimants are compensated with either: lump-sums; amounts calculated based on medical care costs and expenses, loss of earnings or earning capacity; or monetary compensation calculated based on pain and suffering, emotional distress, permanent impairment or loss of function; or combination of those. In most jurisdictions, vaccine injury claimants have the right to seek damages either through civil litigation or from a compensation scheme but not both simultaneously. Data from this report provide an empirical basis on which global guidance for implementing such schemes could be developed.


Assuntos
Seguro de Responsabilidade Civil , Vacinas/efeitos adversos , Adulto , Criança , Compensação e Reparação , Feminino , Saúde Global , Política de Saúde/economia , Política de Saúde/legislação & jurisprudência , Humanos , Responsabilidade Legal/economia , Masculino , Imperícia/economia , Imperícia/legislação & jurisprudência , Programas Nacionais de Saúde/economia , Programas Nacionais de Saúde/legislação & jurisprudência , Gravidez , Inquéritos e Questionários , Vacinação/efeitos adversos , Vacinação/economia , Vacinação/legislação & jurisprudência , Vacinas/economia , Organização Mundial da Saúde
15.
N Z Med J ; 133(1515): 97-103, 2020 05 22.
Artigo em Inglês | MEDLINE | ID: mdl-32438381

RESUMO

The role of the external clinical advisor is critical to the adjudication of complex claims in the processes of the Accident Compensation Corporation (ACC). This is particularly true of claims for treatment injury that occur during birth, which are often very complicated. In most cases external clinical advisors are non-treating doctors, whose opinion strongly guides the hand of ACC. This viewpoint considers the impact of the role of the external clinical advisor by using extracts from an external clinical advisor's report to show how a power imbalance can be enacted in ACC decision making processes. Also considered are the way that the normal checks and balances in the system, particularly those provided by the Health & Disability Commissioner, are bypassed in most cases. Finally, a recommendation is made to potential external clinical advisors to precisely following the standards set by the Medical Council in all cases when writing reports for ACC.


Assuntos
Traumatismos do Nascimento/etiologia , Compensação e Reparação/legislação & jurisprudência , Prova Pericial/normas , Papel do Médico , Lesões Encefálicas/etiologia , Criança , Tomada de Decisões , Prova Pericial/legislação & jurisprudência , Feminino , Transtornos do Crescimento/complicações , Humanos , Doença Iatrogênica , Recém-Nascido , Consentimento Livre e Esclarecido/legislação & jurisprudência , Masculino , Nova Zelândia , Osteocondrodisplasias/complicações , Gravidez , Complicações na Gravidez/etiologia
16.
J Vasc Surg ; 72(4): 1161-1165, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32360683

RESUMO

The appropriate focus in managing the COVID-19 pandemic in the United States has been addressing access and delivery of care to the population affected by the outbreak. All sectors of the U.S. economy have been significantly affected, including physicians. Physician groups of all specialties and sizes have experienced the financial effects of the pandemic. Hospitals have received billions of dollars to support and enable them to manage emergencies and cover the costs of the disruption. However, many vascular surgeons are under great financial pressure because of the postponement of all nonemergency procedures. The federal government has announced a myriad of programs in the form of grants and loans to reimburse physicians for some of their expenses and loss of revenue. It is more than likely that unless the public health emergency subsides significantly, many practices will experience dire consequences without additional financial assistance. We have attempted to provide a concise listing of such programs and resources available to assist vascular surgeons who are small businesses in accessing these opportunities.


Assuntos
Agendamento de Consultas , Compensação e Reparação , Infecções por Coronavirus/economia , Procedimentos Cirúrgicos Eletivos/economia , Renda , Reembolso de Seguro de Saúde/economia , Pandemias/economia , Pneumonia Viral/economia , Cirurgiões/economia , Procedimentos Cirúrgicos Vasculares/economia , Compensação e Reparação/legislação & jurisprudência , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Procedimentos Cirúrgicos Eletivos/legislação & jurisprudência , Financiamento Governamental/economia , Financiamento Governamental/legislação & jurisprudência , Necessidades e Demandas de Serviços de Saúde/economia , Necessidades e Demandas de Serviços de Saúde/legislação & jurisprudência , Humanos , Reembolso de Seguro de Saúde/legislação & jurisprudência , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Formulação de Políticas , Cirurgiões/legislação & jurisprudência , Estados Unidos/epidemiologia , Procedimentos Cirúrgicos Vasculares/legislação & jurisprudência
17.
Milbank Q ; 98(2): 554-580, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32343032

RESUMO

Policy Points A major factor explaining government actors' failure to mitigate or avert the Flint, Michigan, water crisis is the sheer complexity of the laws regulating how governmental agencies maintain and monitor safe drinking water. Coordination across agencies is essential in dealing with multiple legal arrangements. Public health legal authority and intervention mechanisms are not self-executing. Legal preparedness is essential to efficiently navigating complex legal frameworks to address public health threats. The Flint water crisis demonstrates the importance of democracy for protecting the public's health. Laws responding to municipal fiscal distress must be consistent with expected norms of democracy and require consideration of public health in decision making. Context The Flint, Michigan, water crisis resulted from a state-appointed emergency financial manager's cost-driven decision to switch Flint's water source to the Flint River. Ostensibly designed to address Flint's long-standing financial crisis, the switch instead created a public health emergency. A major factor explaining why the crisis unfolded as it did is the complex array of laws regulating how governmental agencies maintain and monitor safe drinking water. Methods We analyzed these legal arrangements to identify what legal authority state, local, and federal public health and environmental agencies could have used to avert or mitigate the crisis and recommend changes to relevant laws and their implementation. First, we mapped the legal authority and roles of federal, state, and local agencies responsible for safe drinking water and the public's health-that is, the existing legal environment. Then we examined how Michigan's emergency manager law altered the existing legal arrangements, leading to decisions that ignored the community's long-term health. Juxtaposed on those factors, we considered how federalism and the relationship between state and local governments influenced public officials during the crisis. Findings The complex legal arrangements governing public health and safe drinking water, combined with a lack of legal preparedness (the capacity to use law effectively) among governmental officials, impeded timely and effective actions to mitigate or avert the crisis. The emergency manager's virtually unfettered legal authority in Flint exacerbated the existing complexity and deprived residents of a democratically accountable local government. Conclusions Our analysis reveals flaws in both the legal structure and how the laws were implemented that simultaneously failed to stop and substantially exacerbated the crisis. Policymakers need to examine the legal framework in their jurisdictions and take appropriate steps to avoid similar disasters. Addressing the implementation failures, including legal preparedness, should likewise be a priority for preventing future similar crises.


Assuntos
Compensação e Reparação/legislação & jurisprudência , Água Potável/química , Chumbo/análise , Saúde Pública/legislação & jurisprudência , Humanos , Governo Local , Michigan , Política , Áreas de Pobreza
18.
Ann Vasc Surg ; 67: 143-147, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32339693

RESUMO

BACKGROUND: The aim of this study was to analyze litigation involving compartment syndrome to identify the causes and outcomes of such malpractice suits. A better understanding of such litigation may provide insight into areas where clinicians may make improvements in the delivery of care. METHODS: Jury verdict reviews from the Westlaw database from January 1, 2010 to January 1, 2018 were reviewed. The search term "compartment syndrome" was used to identify cases and extract data on the specialty of the physician defendant, the demographics of the plaintiff, the allegation, and the verdict. RESULTS: A total of 124 individual cases involving the diagnosis of compartment syndrome were identified. Medical centers or the hospital was included as a defendant in 51.6% of cases. The most frequent physician defendants were orthopedic surgeons (45.96%) and emergency medicine physicians (20.16%), followed by cardiothoracic/vascular surgeons (16.93%). Failure to diagnose was the most frequently cited claim (71.8% of cases). Most plaintiffs were men, with a mean age of 36.7 years, suffering injuries for an average of 5 years before their verdict. Traumatic compartment syndrome of the lower extremity causing nerve damage was the most common complication attributed to failure to diagnose, leading to litigation. Forty cases (32.25%) were found for the plaintiff or settled, with an average award of $1,553,993.66. CONCLUSIONS: Our study offers a brief overview of the most common defendants, plaintiffs, and injuries involved in legal disputes involving compartment syndrome. Orthopedic surgeons were most commonly named; however, vascular surgeons may also be involved in these cases because of the large number of cases with associated arterial involvement. A significant percentage of cases were plaintiff verdicts or settled cases. Failure to diagnosis or delay in treatment was the most common causes of malpractice litigation. Compartment syndrome is a clinical diagnosis and requires a high level of suspicion for a timely diagnosis. Lack of objective criteria for diagnosis increases the chances of medical errors and makes it an area vulnerable to litigation.


Assuntos
Síndromes Compartimentais , Compensação e Reparação/legislação & jurisprudência , Diagnóstico Tardio/legislação & jurisprudência , Seguro de Responsabilidade Civil/legislação & jurisprudência , Imperícia/legislação & jurisprudência , Erros Médicos/legislação & jurisprudência , Procedimentos Ortopédicos/legislação & jurisprudência , Procedimentos Cirúrgicos Vasculares/legislação & jurisprudência , Adulto , Síndromes Compartimentais/diagnóstico , Síndromes Compartimentais/economia , Síndromes Compartimentais/mortalidade , Síndromes Compartimentais/terapia , Diagnóstico Tardio/economia , Feminino , Custos de Cuidados de Saúde/legislação & jurisprudência , Humanos , Seguro de Responsabilidade Civil/economia , Masculino , Imperícia/economia , Erros Médicos/economia , Procedimentos Ortopédicos/efeitos adversos , Procedimentos Ortopédicos/economia , Procedimentos Ortopédicos/mortalidade , Medição de Risco , Fatores de Risco , Fatores de Tempo , Procedimentos Cirúrgicos Vasculares/efeitos adversos , Procedimentos Cirúrgicos Vasculares/economia , Procedimentos Cirúrgicos Vasculares/mortalidade
19.
Klin Monbl Augenheilkd ; 237(6): 805-823, 2020 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-32303072

RESUMO

The ophthalmological appraisal differs significantly in the different areas of law, so there are some different causalities and standards of proof and, above all, the assessment is very different. For the three important sub-areas of private accident insurance, statutory accident insurance as well as disability law and social compensation law, there are abstract tabular guidelines which form the essential basis for a comparable and thus fair assessment. The basics of the assessment in these fields of law are presented in a comparative way, with particular emphasis on causality.


Assuntos
Prova Pericial , Oftalmologia , Compensação e Reparação , Avaliação da Deficiência , Humanos , Seguro de Acidentes
20.
PLoS One ; 15(4): e0231025, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32251480

RESUMO

Injury compensation claimants use legal services to help them navigate compensation schemes, including accessing benefits and resolving disputes. Little is known, however, about the extent of lawyer use by compensation claimants, including changes over time. This paper presents findings from one of the largest empirical investigations of lawyer use in an injury compensation setting to date. Using evidence from more than 275,000 claims in the road traffic injury scheme in the state of Victoria, Australia, this study examines the prevalence of, and changes in, lawyer use between 2000 and 2015. The analysis identifies a significant increase in the use of lawyers in the scheme, and explores possible explanations. This study provides critical insights into lawyer use in compensation settings: the steep increase in lawyer involvement has both access to justice and financial implications for compensation schemes, given the associations between lawyer use, claimant outcomes, and long-term scheme viability.


Assuntos
Acidentes de Trânsito/legislação & jurisprudência , Compensação e Reparação/legislação & jurisprudência , Advogados/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Acidentes de Trânsito/economia , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Adulto , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Fatores de Tempo , Vitória/epidemiologia , Ferimentos e Lesões/economia , Adulto Jovem
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