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2.
JAMA Netw Open ; 7(6): e2412886, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38837161

RESUMO

Importance: Recent changes in China's social medical insurance reimbursement policy have impacted the financial burden of patients with phenylketonuria (PKU) for special foods. However, whether this policy change is associated with their blood phenylalanine (PHE) concentration is unclear. Objective: To investigate the association between the reimbursement policy and blood PHE concentration in patients with PKU. Design, Setting, and Participants: This cohort study measured the blood PHE concentrations of 167 patients with PKU across 4 newborn screening centers in China from January 2018 to December 2021. The reimbursement policy for special foods for patients with PKU at 2 centers was canceled in 2019 and restored from 2020 onwards. In contrast, the other 2 centers consistently implemented the policy. Data were analyzed from September 10 to December 6, 2023. Exposures: The implementation and cancelation of the reimbursement policy for special foods of patients with PKU. Main Outcomes and Measures: The blood PHE concentration was regularly measured from 2018 to 2021. A 1-sided Z test was used to compare the mean of the blood PHE concentration between different years. Results: Among 167 patients with PKU (mean [SD] age, 84.4 [48.3] months; 87 males [52.1%]), a total of 4285 measurements of their blood PHE concentration were collected from 2018 to 2021. For patients at the center that canceled the reimbursement policy in 2019, the mean (SD) of the blood PHE concentrations in 2019 was 5.95 (5.73) mg/dL, significantly higher than 4.84 (4.11) mg/dL in 2018 (P < .001), 5.06 (5.21) mg/dL in 2020 (P = .006), and 4.77 (4.04) mg/dL in 2021 (P < .001). Similarly, for patients at the other center that canceled the policy in 2019, the mean (SD) of the blood PHE concentrations in 2019 was 5.95 (3.43) mg/dL, significantly higher than 5.34 (3.45) mg/dL in 2018 (P = .03), 5.13 (3.15) mg/dL in 2020 (P = .003), and 5.39 (3.46) mg/dL in 2021 (P = .03). On the contrary, no significant difference was observed between any of the years for patients at the 2 centers that consistently implemented the policy. Conclusions and Relevance: In this cohort study of patients with PKU from multiple centers, the implementation of the reimbursement policy for special foods was associated with controlling the blood PHE concentration. Special foods expenditure for patients with PKU should be included in the scope of long-term social medical insurance reimbursement.


Assuntos
Reembolso de Seguro de Saúde , Fenilalanina , Fenilcetonúrias , Humanos , Fenilcetonúrias/sangue , Fenilcetonúrias/economia , Fenilcetonúrias/dietoterapia , Fenilalanina/sangue , China , Masculino , Feminino , Reembolso de Seguro de Saúde/estatística & dados numéricos , Triagem Neonatal/economia , Triagem Neonatal/métodos , Recém-Nascido , Pré-Escolar , Criança , Alimentos Especializados/economia , Estudos de Coortes , Lactente
3.
Urol Pract ; 11(4): 678-683, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38899674

RESUMO

INTRODUCTION: Patient perceptions of physician reimbursement commonly differ from actual reimbursement. This study aims to improve health care cost transparency and trust between patients, physicians, and the health care system by evaluating patient perceptions of Medicare reimbursement for artificial urinary sphincter (AUS) placement. METHODS: We identified patients who underwent AUS placement at a single institution from 2014 to 2023. After obtaining informed consent, we administered a telephone survey to ask patients about their perceptions of Medicare reimbursement for AUS surgery and the amount they felt the physician should be compensated. RESULTS: Sixty-four patients were enrolled and completed the survey. On average, patients estimated Medicare physician reimbursement to be $18,920, 25 times the actual average procedure reimbursement. Once informed that the actual amount was $757.52, 97% of respondents felt that the reimbursement was "somewhat lower" (13%) or "much lower" (84%) than what they considered fair. The average amount that patients felt the physician should be paid was $8,844, 12 times the actual average procedure reimbursement. Fifty-four percent of patients estimated their physician's reimbursement to be higher than what they later reported as being "fair," representing a presurvey belief that their physician was overpaid. CONCLUSIONS: Patient perceptions of physician reimbursement for AUS are vastly different than the actual amount paid. The discordance between patient perception and actual reimbursement could impact how patients view health care costs and the relationship with their provider.


Assuntos
Medicare , Esfíncter Urinário Artificial , Humanos , Medicare/economia , Estados Unidos , Masculino , Feminino , Idoso , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Inquéritos e Questionários , Reembolso de Seguro de Saúde , Percepção
5.
Ann Plast Surg ; 92(5S Suppl 3): S366-S370, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38689421

RESUMO

BACKGROUND: Awareness of Medicare reimbursement is important for gender-affirming surgeons who treat transgender patients with Medicare. In 2014, Medicare began to provide coverage for medically necessary transition-related surgery. The purpose of this study was to analyze trends in Medicare reimbursement rates for gender-affirming surgery procedures from 2014 to 2022. METHODS: The Medicare Physician Fee Schedule Look-Up Tool provided by the Centers for Medicare and Medicaid Services was used, and the Current Procedural Terminology codes for 43 gender-affirming surgery services were obtained. Monetary units, conversion factors, relative value units (RVUs) for work, facility, and malpractice costs for 30 transmasculine and 13 transfeminine procedures were analyzed. Descriptive statistics were performed to account for inflation and to determine the relative differences between 2014 and 2022. RESULTS: For all gender-affirming surgery procedures covered by Medicare, the average relative difference of monetary units decreased by 2.99% between 2014 and 2022. On average, there was a 3.97% decrease of work-based RVU charges for transmasculine procedures and a 1.73% decrease of work-based RVU charges for transfeminine procedures. After adjusting for inflation, the average relative difference of monetary units for all gender-affirming surgery procedures decreased by 23.42% between 2014 and 2022. CONCLUSIONS: Reimbursement rates for gender-affirming surgery procedures covered under Medicare have decreased over the observed period, and trends in reimbursement rates have not kept up with consumer price index inflation. Gender-affirming surgeons should be conscious of these changes in reimbursement rates and advocate for fairer compensation to promote medical care among an underserved population.


Assuntos
Medicare , Cirurgia de Readequação Sexual , Humanos , Estados Unidos , Medicare/economia , Feminino , Masculino , Cirurgia de Readequação Sexual/economia , Reembolso de Seguro de Saúde/economia , Reembolso de Seguro de Saúde/tendências
6.
Ann Plast Surg ; 92(5S Suppl 3): S340-S344, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38689416

RESUMO

OBJECTIVE: This study aimed to analyze the trends of Medicare physician reimbursement from 2011 to 2021 and compare the rates across different surgical specialties. BACKGROUND: Knowledge of Medicare is essential because of its significant contribution in physician reimbursements. Previous studies across surgical specialties have demonstrated that Medicare, despite keeping up with inflation in some areas, has remained flat when accounting for physician reimbursement. STUDY DESIGN: The Physician/Supplier Procedure Summary data for the calendar year 2021 were queried to extract the top 50% of Current Procedural Terminology codes based on case volume. The Physician Fee Schedule look-up tool was accessed, and the physician reimbursement fee was abstracted. Weighted mean reimbursement was adjusted for inflation. Growth rate and compound annual growth rate were calculated. Projection of future inflation and reimbursement rates were also calculated using the US Bureau of Labor Statistics. RESULTS: After adjusting for inflation, the weighted mean reimbursement across surgical specialties decreased by -22.5%. The largest reimbursement decrease was within the field of general surgery (-33.3%), followed by otolaryngology (-31.5%), vascular surgery (-23.3%), and plastic surgery (-22.8%). There was a significant decrease in median case volume across all specialties between 2011 and 2021 (P < 0.001). CONCLUSIONS: This study demonstrated that, when adjusted for inflation, over the study period, there has been a consistent decrease in reimbursement for all specialties analyzed. Awareness of the current downward trends in Medicare physician reimbursement should be a priority for all surgeons, as means of advocating for compensation and to maintain surgical care feasible and accessible to all patients.


Assuntos
Medicare , Especialidades Cirúrgicas , Estados Unidos , Medicare/economia , Medicare/estatística & dados numéricos , Humanos , Especialidades Cirúrgicas/economia , Especialidades Cirúrgicas/estatística & dados numéricos , Inflação , Mecanismo de Reembolso/economia , Reembolso de Seguro de Saúde/economia , Reembolso de Seguro de Saúde/estatística & dados numéricos , Reembolso de Seguro de Saúde/tendências , Tabela de Remuneração de Serviços/economia
7.
J Plast Reconstr Aesthet Surg ; 94: 50-53, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38759511

RESUMO

This study evaluated trends in Medicare reimbursement for commonly performed breast oncologic and reconstructive procedures. Average national relative value units (RVUs) for physician-based work, facilities, and malpractice were collected along with the corresponding conversion factors for each year. From 2010 to 2021, there was an overall average decrease of 15% in Medicare reimbursement for both breast oncology (-11%) and reconstructive procedures (-16%). Based on these findings, breast and reconstructive surgeons should advocate for reimbursement that better reflects the costs of their practice.


Assuntos
Neoplasias da Mama , Mamoplastia , Medicare , Humanos , Estados Unidos , Neoplasias da Mama/cirurgia , Neoplasias da Mama/economia , Medicare/economia , Feminino , Mamoplastia/economia , Mamoplastia/tendências , Reembolso de Seguro de Saúde/economia , Reembolso de Seguro de Saúde/tendências , Mecanismo de Reembolso
8.
Am J Otolaryngol ; 45(4): 104361, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38729015

RESUMO

OBJECTIVES: This study aims to analyze utilization and reimbursement trends in lingual and hyoid surgery for obstructive sleep apnea (OSA). METHODS: Annual retrospective data on lingual and hyoid OSA surgeries was obtained from the 2000-2021 Medicare Part B National Summary Datafiles. Current Procedural Terminology (CPT) codes utilized included 21,685 (hyoid myotomy and suspension [HMS]), 41,512 (tongue base suspension [TBS]), 41,530 (radiofrequency ablation of the tongue [RFT]) and 42,870 (lingual tonsillectomy [LT]). RESULTS: The number of lingual and hyoid OSA surgeries rose 2777 % from 121 in 2000 to 3481 in 2015, before falling 82.9 % to 594 in 2021. Accordingly, Medicare payments rose 17,899 % from an inflation-adjusted $46,958 in 2000 to $8.45 million in 2015, before falling drastically to $341,011 in 2021. As the number of HMSs (2000: 91; 2015: 84; 2021: 165), TBS (2009: 48; 2015: 31; 2021: 16), and LTs (2000: 121; 2015: 261; 2021: 234) only experienced modest changes in utilization, this change was largely driven by RFT (2009: 340; 2015: 3105; 2021: 179). Average Medicare payments for RFT rose from $1110 in 2009 to $2994 in 2015, before falling drastically to $737 in 2021. CONCLUSION: Lingual and hyoid surgery for OSA has overall fallen in utilization among the Medicare population from 2000 to 2021. However, there was a brief spike in usage, peaking in 2015, driven by the adoption (and then quick dismissal) of RFT. The rise and fall in RFT use coincide with the rise and fall in reimbursement.


Assuntos
Osso Hioide , Apneia Obstrutiva do Sono , Língua , Apneia Obstrutiva do Sono/cirurgia , Apneia Obstrutiva do Sono/economia , Humanos , Estados Unidos , Estudos Retrospectivos , Osso Hioide/cirurgia , Língua/cirurgia , Medicare/economia , Reembolso de Seguro de Saúde/tendências , Reembolso de Seguro de Saúde/economia
9.
J Korean Med Sci ; 39(17): e141, 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38711315

RESUMO

BACKGROUND: Acute bronchiolitis, the most common lower respiratory tract infection in infants, is mostly caused by respiratory viruses. However, antibiotics are prescribed to about 25% of children with acute bronchiolitis. This inappropriate use of antibiotics for viral infections induces antibiotic resistance. This study aimed to determine the antibiotic prescription rate and the factors associated with antibiotic use in children with acute bronchiolitis in Korea, where antibiotic use and resistance rates are high. METHODS: Healthcare data of children aged < 24 months who were diagnosed with acute bronchiolitis between 2016 and 2019 were acquired from the National Health Insurance system reimbursement claims data. Antibiotic prescription rates and associated factors were evaluated. RESULTS: A total of 3,638,424 visits were analyzed. The antibiotic prescription rate was 51.8%, which decreased over time (P < 0.001). In the multivariate analysis, toddlers (vs. infants), non-capital areas (vs. capital areas), primary clinics and non-tertiary hospitals (vs. tertiary hospitals), inpatients (vs. outpatients), and non-pediatricians (vs. pediatricians) showed a significant association with antibiotic prescription (P < 0.001). Fourteen cities and provinces in the non-capital area exhibited a wide range of antibiotic prescription rates ranging from 41.2% to 65.4%, and five (35.7%) of them showed lower antibiotic prescription rates than that of the capital area. CONCLUSION: In Korea, the high antibiotic prescription rates for acute bronchiolitis varied by patient age, region, medical facility type, clinical setting, and physician specialty. These factors should be considered when establishing strategies to promote appropriate antibiotic use.


Assuntos
Antibacterianos , Bronquiolite , Humanos , Antibacterianos/uso terapêutico , Lactente , República da Coreia , Bronquiolite/tratamento farmacológico , Bronquiolite/diagnóstico , Feminino , Masculino , Doença Aguda , Programas Nacionais de Saúde , Recém-Nascido , Pré-Escolar , Padrões de Prática Médica , Reembolso de Seguro de Saúde
10.
Artigo em Inglês | MEDLINE | ID: mdl-38565482

RESUMO

OBJECTIVE: This study aimed to measure the association between orthognathic surgeon reimbursement and surgical volume over time. STUDY DESIGN: A retrospective cohort study of patients who underwent orthognathic surgery from January 1, 2010, to December 23, 2022, at an academic medical center was performed. Five patients per year were randomly selected and evaluated for insurance type and associated costs to create representative averages. Pearson correlation analysis was performed to test associations over 13 years with 2-tailed significance reported and statistical significance set at P < .05. RESULTS: A total of 618 patients who underwent 942 procedures were included. The average procedure charge was $6,153.76, and the average total surgeon collection was $1,535.75 per procedure. When monetary values were adjusted to reflect 2010 purchasing power, there was a negative correlation between the average charge per procedure and the year (r[11] = -0.59, P = .04). The year was not significantly correlated with the average amount collected (r[11] = -0.09, P = .78) or average insurance reimbursement (r[11] = -0.52, P = .07). CONCLUSIONS: Collections by surgeons did not change significantly over 13 years and were not correlated with the volume of procedures performed. Increased collections were correlated with increased patient costs. The stagnation of surgeon collection is concerning in the face of increased monetary inflation during this period. Increased volume of surgeries per year was correlated with decreases in patient cost and total collections.


Assuntos
Centros Médicos Acadêmicos , Procedimentos Cirúrgicos Ortognáticos , Humanos , Estudos Retrospectivos , Centros Médicos Acadêmicos/economia , Masculino , Feminino , Procedimentos Cirúrgicos Ortognáticos/economia , Procedimentos Cirúrgicos Ortognáticos/estatística & dados numéricos , Estados Unidos , Adulto , Reembolso de Seguro de Saúde/economia
11.
Colorectal Dis ; 26(5): 1028-1037, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38581083

RESUMO

AIM: Colorectal cancer (CRC) screening rates in the United States remain persistently below guideline targets, partly due to suboptimal patient utilization and provider reimbursement. To guide long-term national utilization estimates and set reasonable screening adherence targets, this study aimed to quantify trends in utilization of and reimbursement for CRC screenings using Medicare claims. METHOD: Inflation-adjusted reimbursements and utilization volume associated with each CRC screening code were abstracted from Medicare claims between 2000 and 2019. Screenings, screenings/100 000 enrolees and reimbursement/screening were analysed with linear regression and compared with the equality of slopes tests. Average reimbursement per screening was compared using analysis of variance with Dunnett's T3 multiple comparisons test. RESULTS: The growth rate of multitarget stool DNA tests (mt-sDNA)/100 000 was the highest at 170.4 screenings/year (R2 = 0.99, p ≤ 0.001), while that of faecal occult blood tests/100 000 was the lowest at -446.4 screenings/year (R2 = 0.90, p ≤ 0.001) (p ≤ 0.001). Provider reimbursements averaged $546.95 (95% CI $520.12-$573.78) per mt-sDNA screening, significantly higher than reimbursements for all invasive screenings. Only FOBTs significantly increased in reimbursement per screening at $0.62/year (R2 = 0.91, p ≤ 0.001). CONCLUSION: We derived forecastable trend numbers for utilization and provider reimbursement. Faecal immunochemical tests/100 000 and mt-sDNA screenings/100 000 increased most rapidly during the entire study period. The number of nearly all invasive screenings/100 000 decreased rapidly; the number of colonoscopies/100 000 increased slightly, probably due to superior diagnostic strength. These trends indicate the that replacement of other invasive modalities with accessible noninvasive screenings will account for much of future screening behaviour and thus reductions in CRC incidence and mortality, especially given providers' reimbursement incentive to screen average-risk patients with stool-based tests.


Assuntos
Neoplasias Colorretais , Detecção Precoce de Câncer , Medicare , Sangue Oculto , Humanos , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/economia , Estados Unidos , Detecção Precoce de Câncer/economia , Detecção Precoce de Câncer/estatística & dados numéricos , Detecção Precoce de Câncer/tendências , Medicare/economia , Medicare/estatística & dados numéricos , Masculino , Feminino , Idoso , Reembolso de Seguro de Saúde/tendências , Reembolso de Seguro de Saúde/estatística & dados numéricos , Reembolso de Seguro de Saúde/economia , Fezes , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Colonoscopia/economia , Colonoscopia/estatística & dados numéricos , Colonoscopia/tendências , Programas de Rastreamento/economia , Programas de Rastreamento/tendências , Programas de Rastreamento/estatística & dados numéricos
12.
Respir Care ; 69(6): 740-754, 2024 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-38688548

RESUMO

Pulmonary rehabilitation (PR) is a highly effective intervention for persons with chronic respiratory diseases, resulting in improvement in exercise capacity, dyspnea, health-related quality of life, mood, reduced hospitalization, and improved survival and cost savings post-COPD hospitalization. Despite demonstrated effectiveness, PR is underutilized in part due to lack of awareness, limited access, and inadequate PR reimbursement. Poor payment is a long-standing barrier to PR's financial stability and access. Addressing PR payment, access, and utilization is a complex challenge and requires strategic, collaborative long-term approaches to meaningful solutions. Strategies to overcome payment disparities begin with legislative approaches to address limitations of Centers for Medicare and Medicaid Services coverage. Additional priorities include permanent approval for remote physician and advanced practice provider (APP) PR supervision, PR referrals by APPs, telerehabilitation using two-way audio/video technology, and elimination of the PR lifetime maximum limit of 72 h or units/patient. Methods are needed to effectively link appropriate PR prescribing and encouragement with primary care providers, hospitalists, case managers, and hospital navigators to optimize PR referrals. There is an important need to address inadequate PR access in rural settings. Potential opportunities to improve PR referrals and access include exploration of PR synergies with value-based care models that emphasize high-quality care and cost savings. Development and use of effective PR provider tools and resources may help address the above challenges as well as financially benefit PR programs.


Assuntos
Doença Pulmonar Obstrutiva Crônica , Humanos , Estados Unidos , Doença Pulmonar Obstrutiva Crônica/reabilitação , Doença Pulmonar Obstrutiva Crônica/economia , Acessibilidade aos Serviços de Saúde/economia , Medicare/economia , Reembolso de Seguro de Saúde/economia , Encaminhamento e Consulta/economia
13.
Korean J Intern Med ; 39(3): 469-476, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38632895

RESUMO

BACKGROUND/AIMS: The reimbursement policy for cryptogenic stroke (CS) was expanded in November 2018 from recurrent strokes to the first stroke episode. No reports have demonstrated whether this policy change has affected trends in implantable loop recorder (ILR) utilization. METHODS: We identified patients who received an ILR implant using the Korea Health Insurance Review and Assessment Service database between July 2016 and October 2021. Patients meeting all the following criteria were considered to have CS indication: 1) prior stroke history, 2) no previous history of atrial fibrillation or flutter (AF/AFL), and 3) no maintenance of oral anticoagulant for ≥4 weeks within a year before ILR implant. AF/AFL diagnosed within 3 years after ILR implant or before ILR removal was considered ILR-driven. RESULTS: Among 3,056 patients, 1,001 (32.8%) had CS indications. The total ILR implant number gradually increased for both CS and non-CS indications and the number of CS indication significantly increased after implementing the expanded reimbursement policy. The detection rate for AF/AFL was 26.3% in CS patients over 3 years, which was significantly higher in patients implanted with an ILR within 2 months after stroke than those implanted later. CONCLUSION: The expanded coverage policy for CS had a significant impact on the number of ILR implantation for CS indication. The diagnostic yield of ILR for AF/AFL detection seems better when ILR is implanted within 2 months than later. Further investigation is needed to demonstrate other clinical benefits and the optimal ILR implantation timing.


Assuntos
AVC Isquêmico , Humanos , República da Coreia , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , AVC Isquêmico/diagnóstico , Bases de Dados Factuais , Fatores de Tempo , Reembolso de Seguro de Saúde , Estudos Retrospectivos , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/economia , Eletrocardiografia Ambulatorial/instrumentação , Eletrocardiografia Ambulatorial/economia , Adulto
14.
J Womens Health (Larchmt) ; 33(5): 573-583, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38488052

RESUMO

Background: To address reimbursement challenges associated with long-acting reversible contraception (LARC) in the postpartum period, state Medicaid programs have provided additional payments ("carve-outs"). Implementation has been heterogeneous, with states providing separate payments for the device only, procedure only, or both the device and procedure. Methods: Claims data were drawn from 210,994 deliveries in the United States between 2012 and 2018. Using generalized estimating equations, we assess the relationship between Medicaid carve-out policies and the likelihood of LARC placement at (1) 3 days postpartum, (2) 60 days postpartum, and (3) 1 year postpartum, in Medicaid and commercially insured populations. Results: Among Medicaid beneficiaries, the likelihood of receiving LARC was higher in states with any carve-out, compared with states without carve-outs, at 3 days (adjusted odds ratio [aOR] 1.49 [95% confidence interval: 1.33-1.67], p < 0.001), 60 days (aOR: 1.40 [95% CI: 1.35-1.46], p < 0.001), and 1 year postpartum (aOR: 1.15 [95% CI: 1.11-1.20], p < 0.001). Adjustments were made for geographic region, seasonality, and patient age. Heterogeneity was observed by carve-out type; device carve-outs were consistently associated with greater likelihood of postpartum LARC placement, compared with states with no carve-outs. Similar trends were observed among commercially insured patients. Conclusion: Findings support the effectiveness of Medicaid carve-outs on postpartum LARC provision, particularly for device carve-outs, which were associated with increased postpartum LARC placement at 3 days, 60 days, and 1 year postpartum. This outcome suggests that policies to address cost-related barriers associated with LARC devices may prove most useful in overcoming barriers to immediate postpartum LARC placement, with the overarching aim of promoting reproductive autonomy.


Assuntos
Reembolso de Seguro de Saúde , Contracepção Reversível de Longo Prazo , Medicaid , Revisão da Utilização de Seguros , Reembolso de Seguro de Saúde/economia , Reembolso de Seguro de Saúde/estatística & dados numéricos , Contracepção Reversível de Longo Prazo/economia , Contracepção Reversível de Longo Prazo/estatística & dados numéricos , Período Pós-Parto , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Tempo , Fatores Socioeconômicos
15.
Curr Oncol ; 31(3): 1460-1469, 2024 03 11.
Artigo em Inglês | MEDLINE | ID: mdl-38534943

RESUMO

Canada has one of the most complex and rigorous drug approval and public reimbursement processes and is, unfortunately, one of the countries with the longest delays in drug access. To assess the overall impact of systemic delays in access to cancer therapy, a targeted literature review (TLR) was performed to identify studies associated with the clinical, economic, and quality of life impacts of delayed access to oncology drugs. Using MEDLINE/PubMed databases and snowballing, four unique records met the eligibility criteria. Results revealed that clinical outcomes were the most impacted by systemic delays in access to oncology drugs (e.g., life years lost, overall survival, and progression-free survival). The four articles retrieved by the TLR specifically illustrated that a substantial number of life years could potentially be saved by increasing systemic efficiency regarding the development, approval, and reimbursement processes of new drugs for advanced malignancies. It is imperative that initiatives are put in place to improve the performance and speed of Canadian drug regulatory and health technology assessment (HTA) processes, especially for new cancer therapeutics. The proposed solutions in this paper include better coordination between HTA and Canadian payers to harmonize coverage decisions, international collaborations, information sharing, and national standards for timeliness in oncology drug access.


Assuntos
Neoplasias , Qualidade de Vida , Humanos , Canadá , Neoplasias/tratamento farmacológico , Aprovação de Drogas , Reembolso de Seguro de Saúde
16.
Oncology (Williston Park) ; 38(3): 115-116, 2024 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-38517411

RESUMO

In a recent Hot Topics article, reimbursement rates for Medicare physicians are discussed, and how it will impact their practice.


Assuntos
Medicare , Médicos , Idoso , Estados Unidos , Humanos , Mecanismo de Reembolso , Reembolso de Seguro de Saúde
17.
Oncology (Williston Park) ; 38(3): 115-116, 2024 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-38517413

RESUMO

In a recent Hot Topics article, reimbursement rates for Medicare physicians are discussed, and how it will impact their practice.


Assuntos
Medicare , Médicos , Idoso , Estados Unidos , Humanos , Mecanismo de Reembolso , Reembolso de Seguro de Saúde
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