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Oral Anticoagulant Discontinuation in Patients With Nonvalvular Atrial FibrillationThe risk of discontinuation of oral anticoagulant therapy (both warfarin and direct oral anticoagulant therapies [DOACs]) among nonvalvular atrial fibrillation patients was high. Although the hazard ratio for discontinuation favors DOACs, it is unlikely that the small difference in discontinuation relative to warfarin is clinically meaningful.
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Delivering on the Value Proposition of Precision Medicine: The View From Healthcare PayersGenomics-based precision medicine has the potential to transform healthcare delivery. However, effective collaborations among scientists, clinicians, and payers are needed to accelerate the translation of precision medicine to clinical practice and ensure its sustainability.
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Costs and Spillover Effects of Private Insurers' Coverage of Hepatitis C TreatmentExpanding private-payer coverage of hepatitis C treatment may yield significant long-term cost savings for private payers, reduced costs to Medicare, and increased social value.
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Measuring Patient-Centered Medical Home Access and Continuity in Clinics With Part-Time CliniciansCommonly used measures of performance for assessing patient access do not reflect PCMH-encouraged strategies to improve access that may be preferentially used by part-time physicians.
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Insomnia Risks and Costs: Health, Safety, and Quality of LifeThis review article discusses the issues surrounding the risks and costs of sleep disturbance as they relate to society and the individual.
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Have Prescription Drug Brand Names Become Generic?Prescription drug brand names no longer function as trademarks. They have become the common names of generic versions of the medicine.
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Care Coordination for Children With Special Needs in Medicaid: Lessons From MedicareAs increasing numbers of children with special healthcare needs move into Medicaid managed care, health plans can improve care coordination using evidence from Medicare.
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Molecular Testing Patterns in Metastatic Non—Small Cell Lung CancerAssessment of the timing of histologic and molecular testing indicates that testing occurred prior to treatment initiation for most patients with metastatic non—small cell lung cancer.
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Office Manager and Nurse Perspectives on Facilitators of Adult ImmunizationFactors significantly associated with adult vaccination rates in primary care practices were patients’ age, race, scheduled well-visit length, and nurses’ vaccination status.
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The Duration of Office Visits in the United States, 1993 to 2010Nationally representative data show that outpatient office visits to both primary care physicians and specialists grew longer over the period from 1993 to 2010.
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Three Proposals to Reform the 340B Drug Discount ProgramThe 340B Drug Discount Program has rapidly expanded over the last few years and may be missing its original intent. Here are 3 possible steps that could enhance the program’s function and mirror Congress’ original intent to enhance access for the poor to essential medical services.
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Cost Sharing, Adherence, and Health Outcomes in Patients With DiabetesHigher cost-sharing levels reduced adherence to antidiabetic medications in patients with type 2 diabetes.
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Electronic Consults for Improving Specialty Care Access for VeteransThe combination of electronic consultations and active triage of specialty care consults effectively reduces wait times for outpatient clinics.
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Are Benefits From Diabetes Self-Management Education Sustained?Conventional individualized diabetes self-management education resulted in sustained improvement in self-efficacy and diabetes distress. Short-term improvements in A1C, nutrition, and physical activity were not sustained.
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Cost-Effectiveness of Laparoscopic Gastric Banding and Bypass for Morbid ObesityLaparoscopic adjustable gastric banding and gastric bypass are cost-effective treatments for morbid obesity compared with no treatment.
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Standardization Improves Postoperative Patient Handoff Experience for Junior CliniciansStandardization of operating room to intensive care handoff with a “time-out for sign-out” process for health care providers was beneficial for junior clinicians.
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Healthcare Utilization and Costs in Persons With Insomnia in a Managed Care PopulationPatients with an insomnia diagnosis have higher healthcare utilization and costs than a matched control group, both before and after the diagnosis.
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A Systematic Review of Measurement Properties of Instruments Assessing PresenteeismA systematic review of presenteeism instruments found that most have been validated to some extent, but evidence for criterion validity is virtually absent.
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Depression Care Following Psychiatric Hospitalization in the Veterans Health AdministrationDifferent patient characteristics predict adequate antidepressant treatment after hospitalization, received by 58.7% of patients, versus adequate psychotherapy, received by 12.9% of patients.
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Oral Antidiabetic Medication Adherence and Glycemic Control in Managed CareIn this retrospective study of patients with diabetes, adherent patients were more likely to achieve glycemic control than nonadherent patients.
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Impact of Weekly Feedback on Test Ordering PatternsProviding a weekly feedback report significantly influences the test ordering behavior of internal medicine residents and reduces laboratory overutilization.
