scholarly journals Rural Health Networks and Care Coordination: Health Care Innovation in Frontier Communities to Improve Patient Outcomes and Reduce Health Care Costs

2016 ◽  
Vol 27 (4A) ◽  
pp. 91-115 ◽  
Author(s):  
Pat Conway ◽  
Heidi Favet ◽  
Laurie Hall ◽  
Jenny Uhrich ◽  
Jeanette Palche ◽  
...  
Keyword(s):  
Health Care ◽  
Rural Health ◽  
Patient Outcomes ◽  
Health Care Costs ◽  
Care Coordination ◽  
Health Networks ◽  
Health Care Innovation ◽  
Care Costs ◽  
Care Innovation ◽  
Improve Patient

Integration of Podiatric Medicine Within the Fracture Liaison Services Model

2020 ◽  
Vol 110 (1) ◽  
Author(s):  
Tyler MacRae ◽  
David W. Shofler
Keyword(s):  
Health Care ◽  
Patient Outcomes ◽  
Health Care Costs ◽  
Metabolic Disorders ◽  
Models Of Care ◽  
Treatment Of Osteoporosis ◽  
Fracture Liaison Services ◽  
Fracture Management ◽  
Care Costs ◽  
Fracture Liaison

Underlying bone metabolic disorders are often neglected when managing acute fractures. The term fracture liaison services (FLS) refers to models of care with the designated responsibility of comprehensive fracture management, including the diagnosis and treatment of osteoporosis. Although there is evidence of the effectiveness of FLS in reducing health-care costs and improving patient outcomes, podiatric practitioners are notably absent from described FLS models. The integration of podiatric practitioners into FLS programs may lead to improved patient care and further reduce associated health-care costs.

scholarly journals Can Better Care Coordination Lower Health Care Costs?

2018 ◽  
Vol 1 (7) ◽  
pp. e184295 ◽  
Author(s):  
Dhruv Khullar ◽  
Dave A. Chokshi
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Care Coordination ◽  
Lower Health ◽  
Care Costs

scholarly journals Direct Access Compared With Referred Physical Therapy Episodes of Care: A Systematic Review

2014 ◽  
Vol 94 (1) ◽  
pp. 14-30 ◽  
Author(s):  
Heidi A. Ojha ◽  
Rachel S. Snyder ◽  
Todd E. Davenport
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Physical Therapy ◽  
Patient Outcomes ◽  
Health Care Costs ◽  
Third Party ◽  
Direct Access ◽  
Physician Referral ◽  
Episodes Of Care ◽  
Care Costs

Background Evidence suggests that physical therapy through direct access may help decrease costs and improve patient outcomes compared with physical therapy by physician referral. Purpose The purpose of this study was to conduct a systematic review of the literature on patients with musculoskeletal injuries and compare health care costs and patient outcomes in episodes of physical therapy by direct access compared with referred physical therapy. Data Sources Ovid MEDLINE, CINAHL (EBSCO), Web of Science, and PEDro were searched using terms related to physical therapy and direct access. Included articles were hand searched for additional references. Study Selection Included studies compared data from physical therapy by direct access with physical therapy by physician referral, studying cost, outcomes, or harm. The studies were appraised using the Centre for Evidence-Based Medicine (CEBM) levels of evidence criteria and assigned a methodological score. Data Extraction Of the 1,501 articles that were screened, 8 articles at levels 3 to 4 on the CEBM scale were included. There were statistically significant and clinically meaningful findings across studies that satisfaction and outcomes were superior, and numbers of physical therapy visits, imaging ordered, medications prescribed, and additional non–physical therapy appointments were less in cohorts receiving physical therapy by direct access compared with referred episodes of care. There was no evidence for harm. Data Synthesis There is evidence across level 3 and 4 studies (grade B to C CEBM level of recommendation) that physical therapy by direct access compared with referred episodes of care is associated with improved patient outcomes and decreased costs. Limitations Primary limitations were lack of group randomization, potential for selection bias, and limited generalizability. Conclusions Physical therapy by way of direct access may contain health care costs and promote high-quality health care. Third-party payers should consider paying for physical therapy by direct access to decrease health care costs and incentivize optimal patient outcomes.

The consequences of early discharge after hip arthroplasty for patient outcomes and health care costs: comparison of three centres with differing durations of stay

2009 ◽  
Vol 23 (12) ◽  
pp. 1067-1077 ◽  
Author(s):  
Gillian R Hunt ◽  
Grainne Crealey ◽  
Burra VS Murthy ◽  
George M Hall ◽  
Philippa Constantine ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Outcomes ◽  
Health Care Costs ◽  
Hip Arthroplasty ◽  
Early Discharge ◽  
Care Costs

Persistence to Lenalidomide Improves Patient Outcomes While Remaining Cost-Neutral for the Treatment of Multiple Myeloma

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4688-4688
Author(s):  
Henry J Henk ◽  
Satyin Kaura ◽  
Zeba M. Khan ◽  
April Teitelbaum
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Disease Control ◽  
Disease Progression ◽  
Patient Outcomes ◽  
Health Care Costs ◽  
Medicare Advantage ◽  
Pharmacy Benefit ◽  
The Relationship ◽  
Care Costs

Abstract Abstract 4688 Background: While persistence to drug therapy is essential to achieve optimal patient benefits, poorly controlled MM results in more rapid disease progression, disease-related complications, impact on quality of life, and premature death. Additionally, the cost of delivering medical care for myeloma patients is also an important consideration for society and payers. Aim: To evaluate the real-world persistence with lenalidomide treatment in MM patients, and assess the relationship between treatment persistence and (1) indicators of poor disease control and disease-related complications and (2) the total health care costs for patients with MM. Methods: Commercial and Medicare Advantage enrollees initiating LEN for treatment of MM with pharmacy and medical benefits in the 6 months prior and 1 year following initiation of LEN were identified in a US health plan claims database (7/1/2007–6/30/2011). MM was identified by at least 2 medical claims at least 7 days apart with a MM diagnosis code (ICD-9: 203.0x). Treatment discontinuation was defined as the first appearance of a gap greater than 30 days between runout date (prescription fill date + days supply) and next lenalidomide prescription fill. Persistence was defined as days from the first LEN treatment to the earlier of either the date of discontinuation or end of the follow-up period (i.e., 6/30/2011). Disease-related complications included sepsis, indictors of relapse or disease progression (defined as the addition of bortezomib (BORT) to a LEN regimen, a switch to BORT from a LEN regimen, or discontinuation of LEN followed by restarting LEN), sepsis, and evidence of skeletal-related events (SREs) defined as fracture, spinal cord compression, surgery and/or radiation to the bone. Total health care costs include combined payer and patient paid amounts under the medical benefit (e.g., hospital, office, ER) and retail pharmacy benefit (inclusive of specialty pharmacy). Multivariate regression-based models were used to examine the relationship between persistence and measures of disease control and complications, as well as the relationship between persistence and first-year health care costs controlling for age, gender, comorbidity score, prior stem cell transplant, prior SREs, and insurance type (commercial or Medicare Advantage). Results: Among the 605 patients meeting the inclusion criteria, persistency with lenalidomide averaged 6.0 months (median = 4.9) with 57.9% of patients being persistent for the entire year. A one month increase in persistence was associated with a lower probability of SREs (OR=0.96; p=0.078), sepsis (OR=0.86; p<0.001), and relapse or disease progression (OR=0.78; p<0.001). The probability of an inpatient hospitalization (OR=0.68; p-value<0.001) and additional ER visits (OR=0.83; p=0.002) were both lower with longer duration. When examining the relationship between persistence and health care costs, a one-month increase in persistence was found to be associated with, on average, a 8% decrease in medical care costs (p=0.007) and an 8% increase in pharmacy costs (p<0.001). Conclusions: Improved persistence with lenalidomide therapy was associated with improved patient outcomes as demonstrated by fewer SREs and lower likelihood of developing sepsis, consequently leading to cost saving due to fewer hospitalizations and ER visits. The reduction in medical costs offsets the expected increase in pharmacy costs as lenalidomide is covered under the pharmacy benefit. This analysis demonstrates that continuous treatment with lenalidomide can not only improve disease control in MM patients, but in addition also reduces health care utilization and related costs as indicated by the lower risk of a hospitalization and number of ER visits, and could therefore be budget neutral in terms of overall societal burden of health care costs associated with MM. * p<0.001; ** p=0.078. Disclosures: Henk: OptumInsight: Consultancy. Kaura:Celgene: Employment. Khan:Celgene: Employment.

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