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1.
BMC Public Health ; 20(1): 880, 2020 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-32513131

RESUMO

BACKGROUND: The dynamic intersection of a pluralistic health system, large informal sector, and poor regulatory environment have provided conditions favourable for 'corruption' in the LMICs of south and south-east Asia region. 'Corruption' works to undermine the UHC goals of achieving equity, quality, and responsiveness including financial protection, especially while delivering frontline health care services. This scoping review examines current situation regarding health sector corruption at frontlines of service delivery in this region, related policy perspectives, and alternative strategies currently being tested to address this pervasive phenomenon. METHODS: A scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was conducted, using three search engines i.e., PubMed, SCOPUS and Google Scholar. A total of 15 articles and documents on corruption and 18 on governance were selected for analysis. A PRISMA extension for Scoping Reviews (PRISMA-ScR) checklist was filled-in to complete this report. Data were extracted using a pre-designed template and analysed by 'mixed studies review' method. RESULTS: Common types of corruption like informal payments, bribery and absenteeism identified in the review have largely financial factors as the underlying cause. Poor salary and benefits, poor incentives and motivation, and poor governance have a damaging impact on health outcomes and the quality of health care services. These result in high out-of-pocket expenditure, erosion of trust in the system, and reduced service utilization. Implementing regulations remain constrained not only due to lack of institutional capacity but also political commitment. Lack of good governance encourage frontline health care providers to bend the rules of law and make centrally designed anti-corruption measures largely in-effective. Alternatively, a few bottom-up community-engaged interventions have been tested showing promising results. The challenge is to scale up the successful ones for measurable impact. CONCLUSIONS: Corruption and lack of good governance in these countries undermine the delivery of quality essential health care services in an equitable manner, make it costly for the poor and disadvantaged, and results in poor health outcomes. Traditional measures to combat corruption have largely been ineffective, necessitating the need for innovative thinking if UHC is to be achieved by 2030.


Assuntos
Fraude/economia , Setor de Assistência à Saúde/organização & administração , Política de Saúde/economia , Setor Privado/economia , Setor Público/economia , Ásia , Países em Desenvolvimento , Governo , Pessoal de Saúde/economia , Humanos , Renda , Assistência Médica/economia , Características de Residência
3.
Sci Rep ; 10(1): 2974, 2020 02 19.
Artigo em Inglês | MEDLINE | ID: mdl-32076084

RESUMO

The Chinese cordyceps, a complex of the fungus Ophiocordyceps sinensis and its species-specific host insects, is also called "DongChongXiaCao" in Chinese. Habitat degradation in recent decades and excessive harvesting by humans has intensified its scarcity and increased the prices of natural populations. Some counterfeits are traded as natural Chinese cordyceps for profit, causing confusion in the marketplace. To promote the safe use of Chinese cordyceps and related products, a duplex PCR method for specifically identifying raw Chinese cordyceps and its primary products was successfully established. Chinese cordyceps could be precisely identified by detecting an internal transcribed spacer amplicon from O. sinensis and a cytochrome oxidase c subunit 1 amplicon from the host species, at a limit of detection as low as 32 pg. Eleven commercial samples were purchased and successfully tested to further verify that the developed duplex PCR method could be reliably used to identify Chinese cordyceps. It provides a new simple way to discern true commercial Chinese cordyceps from counterfeits in the marketplace. This is an important step toward achieving an authentication method for this Chinese medicine. The methodology and the developmental strategy can be used to authenticate other traditional Chinese medicinal materials.


Assuntos
Cordyceps/genética , Medicamentos Falsificados/análise , Medicamentos de Ervas Chinesas/análise , Fraude/prevenção & controle , Reação em Cadeia da Polimerase , Animais , Cordyceps/química , Medicamentos Falsificados/química , Medicamentos Falsificados/economia , DNA Fúngico/isolamento & purificação , Medicamentos de Ervas Chinesas/economia , Medicamentos de Ervas Chinesas/normas , Complexo IV da Cadeia de Transporte de Elétrons/genética , Fraude/economia , Genes Fúngicos/genética , Genes de Insetos/genética , Proteínas de Insetos/genética , Insetos/genética , Insetos/microbiologia
5.
J Gerontol B Psychol Sci Soc Sci ; 75(4): 861-868, 2020 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-30561718

RESUMO

OBJECTIVES: The consequences of poor financial capability at older ages are serious and include making mistakes with credit, spending retirement assets too quickly, and being defrauded by financial predators. Because older persons are at or past the peak of their wealth accumulation, they are often the targets of fraud. METHODS: Our project analyzes a module we developed and fielded on people aged 50 an older years in the 2016 Health and Retirement Study (HRS). Using this data set, we evaluated the incidence and prospective risk factors (measured in 2010) for investment fraud and prize/lottery fraud using logistic regression (N = 1,220). RESULTS: Relatively few HRS respondents mentioned any single form of fraud over the prior 5 years, but 5.0% reported at least one form of investment fraud and 4.4% recounted prize/lottery fraud. Greater wealth (nonhousing) was associated with investment fraud, whereas lower housing wealth and symptoms of depression were associated with prize/lottery fraud. Hispanics were significantly less likely to report either type of fraud. Other suspected risk factors-low social integration and financial literacy-were not significant. DISCUSSION: Fraud is a complex phenomenon and no single factor uniquely predicts victimization across different types, even within the category of investment fraud. Prevention programs should educate consumers about various types of fraud and increase awareness among financial services professionals.


Assuntos
Vítimas de Crime/economia , Maus-Tratos ao Idoso/economia , Fraude/economia , Aposentadoria/economia , Idoso , Idoso de 80 Anos ou mais , Vítimas de Crime/estatística & dados numéricos , Maus-Tratos ao Idoso/estatística & dados numéricos , Feminino , Fraude/estatística & dados numéricos , Humanos , Aplicação da Lei/métodos , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Estudos Prospectivos , Aposentadoria/estatística & dados numéricos , Estados Unidos , Populações Vulneráveis/estatística & dados numéricos
6.
Am J Med ; 132(12): 1381-1385, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31668898

RESUMO

Previous articles have outlined the many problems that confront America in trying to humanely and efficiently deliver health care to our citizens.  First among these is that health care is unaffordable for too many. This final article describes how to expand coverage to all Americans and identifies many specific areas in which changes can be made to both improve care and lower costs.  There are many ways to reduce the cost of medications, to improve hospital care while lowering costs, to eliminate "surprise" medical bills, and to cut down fraud and waste.  The socioeconomic factors that contribute heavily to our poor health outcomes must be addressed.


Assuntos
Assistência à Saúde/organização & administração , Fraude/economia , Custos de Cuidados de Saúde/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde , Redução de Custos , Fraude/ética , Necessidades e Demandas de Serviços de Saúde , Humanos , Medicare/economia , Padrões de Prática Médica/economia , Medição de Risco , Fatores Socioeconômicos , Estados Unidos
7.
Am J Public Health ; 109(12): 1659-1663, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31622138

RESUMO

The Supplemental Nutrition Assistance Program (SNAP) provides funding to low-income households to purchase food at participating stores. The goals of the program include reducing hunger, improving nutrition, and strengthening the US food system. These are interrelated, as food access and choice depend on availability.SNAP generates data that could be useful for program evaluation and evidence-based policymaking to reach public health goals. However, the US Department of Agriculture (USDA) does not collect or disclose all SNAP-related data. In particular, the USDA does not systematically collect food expenditure data, and although it does collect transaction (sales) and redemption data (the amount retailers are reimbursed through SNAP), it does not release these data at the store level.In 2018, Congress quietly changed the law to prohibit the USDA from disclosing store-level transaction and redemption data, and in 2019, the US Supreme Court blocked disclosure of these data. These federal proceedings can inform the outcome of additional efforts to disclose SNAP-related data, as well as future research and policy evaluation to support improved public health outcomes for SNAP beneficiaries.


Assuntos
Revelação/normas , Assistência Alimentar/organização & administração , Assistência Alimentar/estatística & dados numéricos , Abastecimento de Alimentos/métodos , Abastecimento de Alimentos/estatística & dados numéricos , Revelação/legislação & jurisprudência , Assistência Alimentar/legislação & jurisprudência , Assistência Alimentar/normas , Abastecimento de Alimentos/legislação & jurisprudência , Fraude/economia , Fraude/estatística & dados numéricos , Humanos , Estados Unidos , United States Department of Agriculture/organização & administração
8.
JAMA ; 322(15): 1501-1509, 2019 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-31589283

RESUMO

Importance: The United States spends more on health care than any other country, with costs approaching 18% of the gross domestic product (GDP). Prior studies estimated that approximately 30% of health care spending may be considered waste. Despite efforts to reduce overtreatment, improve care, and address overpayment, it is likely that substantial waste in US health care spending remains. Objectives: To estimate current levels of waste in the US health care system in 6 previously developed domains and to report estimates of potential savings for each domain. Evidence: A search of peer-reviewed and "gray" literature from January 2012 to May 2019 focused on the 6 waste domains previously identified by the Institute of Medicine and Berwick and Hackbarth: failure of care delivery, failure of care coordination, overtreatment or low-value care, pricing failure, fraud and abuse, and administrative complexity. For each domain, available estimates of waste-related costs and data from interventions shown to reduce waste-related costs were recorded, converted to annual estimates in 2019 dollars for national populations when necessary, and combined into ranges or summed as appropriate. Findings: The review yielded 71 estimates from 54 unique peer-reviewed publications, government-based reports, and reports from the gray literature. Computations yielded the following estimated ranges of total annual cost of waste: failure of care delivery, $102.4 billion to $165.7 billion; failure of care coordination, $27.2 billion to $78.2 billion; overtreatment or low-value care, $75.7 billion to $101.2 billion; pricing failure, $230.7 billion to $240.5 billion; fraud and abuse, $58.5 billion to $83.9 billion; and administrative complexity, $265.6 billion. The estimated annual savings from measures to eliminate waste were as follows: failure of care delivery, $44.4 billion to $97.3 billion; failure of care coordination, $29.6 billion to $38.2 billion; overtreatment or low-value care, $12.8 billion to $28.6 billion; pricing failure, $81.4 billion to $91.2 billion; and fraud and abuse, $22.8 billion to $30.8 billion. No studies were identified that focused on interventions targeting administrative complexity. The estimated total annual costs of waste were $760 billion to $935 billion and savings from interventions that address waste were $191 billion to $286 billion. Conclusions and Relevance: In this review based on 6 previously identified domains of health care waste, the estimated cost of waste in the US health care system ranged from $760 billion to $935 billion, accounting for approximately 25% of total health care spending, and the projected potential savings from interventions that reduce waste, excluding savings from administrative complexity, ranged from $191 billion to $286 billion, representing a potential 25% reduction in the total cost of waste. Implementation of effective measures to eliminate waste represents an opportunity reduce the continued increases in US health care expenditures.


Assuntos
Redução de Custos/economia , Assistência à Saúde/economia , Gastos em Saúde , Técnicas de Laboratório Clínico/economia , Assistência à Saúde/organização & administração , Custos de Medicamentos , Fraude/economia , Humanos , Sobremedicalização/economia , Sobremedicalização/prevenção & controle , Visita a Consultório Médico/economia , Falha de Tratamento , Estados Unidos , Procedimentos Desnecessários/economia
9.
J Food Sci ; 84(10): 2705-2718, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31546281

RESUMO

The food industry is advancing at a rapid pace and consumer sensitivity to food safety scares and food fraud scandals is further amplified by rapid communication such as by social media. Academia, regulators, and industry practitioners alike struggle with an evolving issue regarding new terms and definitions including food fraud, food authenticity, food integrity, food protection, economically motivated adulteration, food crime, food security, contaminant, adulterant, and others. This research addressed some of the global need for clarification and harmonization of commonly used terminology. The 150 survey responses were received from various food-related workgroups or committee members, communication with recognized experts, and announcements to the food industry in general. Overall food fraud was identified as a "food safety" issue (86%). The food quality and manufacturing respondents focused mainly on incoming goods and adulterant-substances (<50%) rather than the other illegal activities such as counterfeiting, theft, gray market/diversion, and smuggling. Of the terms included to represent "intentional deception for economic gain" the respondents generally agreed with food fraud as the preferred term. Overall, the preference was 50% "food fraud," 15% "economically motivated adulteration" EMA, 9% "food protection," 7% "food integrity," 5% "food authenticity," and 2% "food crime." It appears that "food protection" and "food integrity" are terms that cover broader concepts such as all types of intentional acts and even possibly food safety or food quality. "Food authenticity" was defined with the phrase "to ensure" so seemed to be identified as an "attribute" that helped define fraudulent acts. PRACTICAL APPLICATION: Food Fraud-illegal deception for economic gain using food-is a rapidly evolving research topic and is facing confusion due to the use of different terms and definitions. This research survey presented common definitions and publication details to gain insight that could help provide clarity. The insight from this report provides guidance for others who are harmonizing terminology and setting the overall strategic direction.


Assuntos
Contaminação de Alimentos/legislação & jurisprudência , Fraude/legislação & jurisprudência , Terminologia como Assunto , Contaminação de Alimentos/análise , Contaminação de Alimentos/economia , Inocuidade dos Alimentos , Abastecimento de Alimentos/economia , Abastecimento de Alimentos/legislação & jurisprudência , Fraude/economia , Humanos
11.
Health Policy Plan ; 34(7): 529-543, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31377775

RESUMO

West African countries are ranked especially low in global corruption perception indexes. The health sector is often singled out for particular concern given the role of corruption in hampering access to, and utilization of health services, representing a major barrier to progress to universal health coverage and to achieving the health-related Sustainable Development Goals. The first step in tackling corruption systematically is to understand its scale and nature. We present a systematic review of literature that explores corruption involving front-line healthcare providers, their managers and other stakeholders in health sectors in the five Anglophone West African (AWA) countries: Gambia, Ghana, Liberia, Nigeria and Sierra Leone, identifying motivators and drivers of corrupt practices and interventions that have been adopted or proposed. Boolean operators were adopted to optimize search outputs and identify relevant studies. Both grey and published literature were identified from Research Gate, Yahoo, Google Scholar, Google and PubMed, and reviewed and synthesized around key domains, with 61 publications meeting our inclusion criteria. The top five most prevalent/frequently reported corrupt practices were (1) absenteeism; (2) diversion of patients to private facilities; (3) inappropriate procurement; (4) informal payments; and (5) theft of drugs and supplies. Incentives for corrupt practices and other manifestations of corruption in the AWA health sector were also highlighted, while poor working conditions and low wages fuel malpractice. Primary research on anti-corruption strategies in health sectors in AWA remains scarce, with recommendations to curb corrupt practices often drawn from personal views and experience rather that of rigorous studies. We argue that a nuanced understanding of all types of corruption and their impacts is an important precondition to designing viable contextually appropriate anti-corruption strategies. It is a particular challenge to identify and tackle corruption in settings where formal rules are fluid or insufficiently enforced.


Assuntos
Fraude/estatística & dados numéricos , Setor de Assistência à Saúde/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Absenteísmo , África Ocidental , Fraude/economia , Setor de Assistência à Saúde/economia , Setor de Assistência à Saúde/ética , Pessoal de Saúde/economia , Humanos , Roubo/estatística & dados numéricos
12.
Am J Med ; 132(10): 1129-1132, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31150642

RESUMO

Although the exact sums can only be estimated, large amounts of money are wasted by the US health care system through fraud and by spending on tests, procedures, and treatments that are of no proven benefit. The adversarial fault-finding malpractice system siphons off large amounts of money from patients to lawyers and legal costs and is a deterrent to system improvement. While electronic records have the potential to improve care and lower costs through information sharing, their current implementation neither improves care nor lowers costs. If care is to be improved while costs are reduced, changes must be made in all these areas.


Assuntos
Assistência à Saúde/economia , Assistência à Saúde/normas , Registros Eletrônicos de Saúde , Fraude , Custos de Cuidados de Saúde , Imperícia , Registros Eletrônicos de Saúde/normas , Fraude/economia , Humanos , Imperícia/economia , Estados Unidos
14.
Environ Sci Pollut Res Int ; 26(17): 17277-17283, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31012074

RESUMO

This study aims at exploring the impact of corruption control on energy efficiency in 60 countries categorized by income: lower middle (LMI), upper middle (UMI), and high (HI). Panel methodology was utilized taking the period of 2000-2017. As cross-sectional dependence is confirmed among the tested equations, the Pesaran (J Appl Econ 22(2):265-312, 2007) unit root test and the augmented mean group estimator proposed by Eberhardt and Teal (2010) were utilized to overcome this matter. The results in general indicate that the lower the corruption is, the more the energy efficiency for all income group economies. Moreover, renewable energy reduces energy efficiency in lower-middle income and high-income economies while its effect is positive in middle-income economies. In addition, the environmental Kuznets curve (EKC) found to be present in all income group economies. Lastly, causality relationships among energy efficiency, corruption, and GDP were present mostly in upper-middle income and high-income economies. From the results, it was recommended that the countries from all income groups should increase their corruption control for the purpose of enhancing energy efficiency.


Assuntos
Fraude/economia , Produto Interno Bruto , Renda , Energia Renovável/economia , Estudos Transversais , Organização para a Cooperação e Desenvolvimento Econômico
16.
J Ambul Care Manage ; 42(2): 138-146, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30768432

RESUMO

During college and medical school, the author's summer employment acquainted him with members of organized crime families. After a full career as a primary care clinician and geriatrician with research on improving health care delivery, the author opines that several insights from organized crime should be of interest to health care professionals: (1) don't damage the host; (2) protect the brand; and (3) lead necessary adaption. From these insights, the author presents symptoms of failure evidenced by the US health care system, followed by several adaptations that would reduce the system's costs, improve its image, and address future challenges.


Assuntos
Crime , Fraude/economia , Custos de Cuidados de Saúde/tendências , Setor de Assistência à Saúde/economia , Mau Uso de Serviços de Saúde/economia , Fraude/tendências , Setor de Assistência à Saúde/tendências , Mau Uso de Serviços de Saúde/tendências , Humanos , Estados Unidos
17.
Cancer ; 125(9): 1404-1409, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30695098

RESUMO

Plans to optimize health care in the United States highlight the high cost but rarely explore opportunities for redirecting resources within the existing system to increase access to care while lowering spending. This analysis indicates that, of the total national health care expenditures of $3.21 trillion in 2015, only $1.4 trillion to $2.86 trillion was used to provide care to patients. This range was reached by the subtraction of excess spending in 7 categories. Thus, many opportunities exist to repurpose wasted expenditures to increase access to health care without the need for additional funding.


Assuntos
Assistência à Saúde/economia , Assistência à Saúde/estatística & dados numéricos , Gastos em Saúde/estatística & dados numéricos , Qualidade da Assistência à Saúde/economia , Redução de Custos , Análise Custo-Benefício , Infecção Hospitalar/economia , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/terapia , Assistência à Saúde/organização & administração , Eficiência Organizacional/economia , Feminino , Fraude/economia , Fraude/estatística & dados numéricos , Custos de Cuidados de Saúde/estatística & dados numéricos , Mau Uso de Serviços de Saúde/economia , Mau Uso de Serviços de Saúde/estatística & dados numéricos , Humanos , Cobertura do Seguro/economia , Cobertura do Seguro/estatística & dados numéricos , Masculino , Erros Médicos/economia , Erros Médicos/estatística & dados numéricos , Qualidade da Assistência à Saúde/estatística & dados numéricos , Estados Unidos/epidemiologia
19.
Anesth Analg ; 128(1): 182-187, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30234529

RESUMO

Predatory publishing is an exploitative fraudulent open-access publishing model that applies charges under the pretense of legitimate publishing operations without actually providing the editorial services associated with legitimate journals. The aim of this study was to analyze this phenomenon in the field of anesthesiology and related specialties (intensive care, critical and respiratory medicine, pain medicine, and emergency care). Two authors independently surveyed a freely accessible, constantly updated version of the original Beall lists of potential, possible, or probable predatory publishers and standalone journals. We identified 212 journals from 83 publishers, and the total number of published articles was 12,871. The reported location of most publishers was in the United States. In 43% of cases (37/84), the reported location was judged as "unreliable" after being checked using the 3-dimensional view in Google Maps. Six journals were indexed in PubMed. Although 6 journals were declared to be indexed in the Directory of Open Access Journals, none were actually registered. The median article processing charge was 634.5 US dollars (interquartile range, 275-1005 US dollars). Several journals reported false indexing/registration in the Committee on Publication Ethics and International Committee of Medical Journal Editors registries and Google Scholar. Only 32% (67/212) reported the name of the editor-in-chief. Rules for ethics/scientific misconduct were reported in only 24% of cases (50/212). In conclusion, potential or probable predatory open-access publishers and journals are widely present in the broad field of anesthesiology and related specialties. Researchers should carefully check journals' reported information, including location, editorial board, indexing, and rules for ethics when submitting their manuscripts to open-access journals.


Assuntos
Anestesiologia/normas , Pesquisa Biomédica/normas , Políticas Editoriais , Fraude , Publicação de Acesso Aberto/normas , Revisão da Pesquisa por Pares/normas , Publicações Periódicas como Assunto/normas , Anestesiologia/economia , Anestesiologia/ética , Bibliometria , Pesquisa Biomédica/economia , Pesquisa Biomédica/ética , Fraude/economia , Fraude/ética , Humanos , Publicação de Acesso Aberto/economia , Publicação de Acesso Aberto/ética , Revisão da Pesquisa por Pares/ética , Publicações Periódicas como Assunto/economia , Publicações Periódicas como Assunto/ética
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