Health affairs (Project Hope)最新文献_第5页

Accelerated Approval Of Cancer Drugs: No Economic Reward For Drug Makers That Conduct Confirmatory Trials. 加速批准抗癌药物:对进行验证性试验的制药商没有经济奖励。

IF 9.7

Health affairs (Project Hope) Pub Date : 2022-09-01 Epub Date: 2022-08-17 DOI: 10.1377/hlthaff.2022.00119

Richard G Frank, Mahnum Shahzad, Ezekiel J Emanuel

{"title":"Accelerated Approval Of Cancer Drugs: No Economic Reward For Drug Makers That Conduct Confirmatory Trials.","authors":"Richard G Frank, Mahnum Shahzad, Ezekiel J Emanuel","doi":"10.1377/hlthaff.2022.00119","DOIUrl":"https://doi.org/10.1377/hlthaff.2022.00119","url":null,"abstract":"The Food and Drug Administration uses expedited approval of drugs to speed the development and assessment of drugs that address unmet needs related to serious or life-threatening conditions. Drugs approved via this route rely on surrogate endpoints or other clinical indicators that are not direct measures of benefits to patients, such as survival or quality of life. Companies are required to conduct a clinical trial confirming that a drug provides long-term benefits that are clinically meaningful, but prompt completion of these trials frequently does not occur. Theory suggests that because confirmatory trials reduce uncertainty, they should provide an economic reward in the form of higher prices for a positive finding. We used a sample of physician-administered cancer drugs and data on average sales price to test this hypothesis. We found no significant relationship between confirmatory trial completion with a positive outcome and elevated prices. This represents a failure of the market to reward reduced uncertainty about a cancer drug's true benefits. This inefficiency would be mitigated if major payers such as Medicare built price schedules that directly rewarded completion of confirmatory trials. More completed trials would ensure that patients are receiving truly effective chemotherapies and not suffering the adverse effects of drugs that are ultimately not effective.","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"1273-1280"},"PeriodicalIF":9.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40717599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Enrollment Brokers Did Not Increase Medicaid Enrollment, 2008-18. 注册经纪人没有增加医疗补助的注册，2008-18年。

IF 9.7

Health affairs (Project Hope) Pub Date : 2022-09-01 DOI: 10.1377/hlthaff.2022.00182

Becky Staiger, Anran Li, Diane Alexander, Molly Schnell

引用次数: 1

A Health System That Won't Learn From Its Mistakes. 一个不会从错误中吸取教训的卫生系统。

IF 9.7

Health affairs (Project Hope) Pub Date : 2022-09-01 DOI: 10.1377/hlthaff.2022.00581

Chandra Keller

引用次数: 0

Nurses, Care Delivery, Pharmaceuticals, And More. 采购产品护士，护理交付，药品，和更多。

IF 9.7

Health affairs (Project Hope) Pub Date : 2022-09-01 DOI: 10.1377/hlthaff.2022.01080

Alan R Weil

引用次数: 0

Private Equity Acquisitions Of Ambulatory Surgical Centers Were Not Associated With Quality, Cost, Or Volume Changes. 私募股权收购流动外科中心与质量、成本或数量变化无关。

IF 9.7

Health affairs (Project Hope) Pub Date : 2022-09-01 DOI: 10.1377/hlthaff.2021.01904

Joseph Dov Bruch, Sameer Nair-Desai, E John Orav, Thomas C Tsai

{"title":"Private Equity Acquisitions Of Ambulatory Surgical Centers Were Not Associated With Quality, Cost, Or Volume Changes.","authors":"Joseph Dov Bruch, Sameer Nair-Desai, E John Orav, Thomas C Tsai","doi":"10.1377/hlthaff.2021.01904","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.01904","url":null,"abstract":"Ambulatory surgical centers (ASCs) are increasingly being acquired by private equity firms, yet the implications for patients remain understudied. In this study we employed a quasi-experimental difference-in-differences design within an event study framework to assess changes in outcomes associated with the acquisition of ASCs by private equity entities. Using a two-way fixed effects model, we assessed the baseline probability of an unplanned hospital visit, total costs, and total encounters three years preacquisition compared with three years postacquisition in ASCs acquired by private equity versus those acquired by non-private equity entities. We identified ninety-one ASCs acquired by private equity and fifty-seven ASCs acquired by non-private equity entities during the period 2011-14. There was no statistically significant observed change in the probability of an unplanned hospital visit, total costs, or total encounters after acquisition by private equity relative to acquisition by non-private equity entities. When we compared private equity-acquired ASCs with matched ASCs that were never acquired, we also found no statistically significant relative change in the probability of an unplanned hospital visit, total costs, or total encounters. Regulators should ensure that data on private equity acquisitions are transparent and that data are available to track the long-term quality and financial implications of these acquisitions.","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"1291-1298"},"PeriodicalIF":9.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40353317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Health Insurance Coverage In Low- And Middle-Income Countries Remains Far From The Goal Of Universal Coverage. 低收入和中等收入国家的医疗保险覆盖率仍远未达到全民覆盖的目标。

IF 9.7

Health affairs (Project Hope) Pub Date : 2022-08-01 DOI: 10.1377/hlthaff.2021.00951

Simiao Chen, Pascal Geldsetzer, Qiushi Chen, Mosa Moshabela, Lirui Jiao, Osondu Ogbuoji, Ali Sie, Rifat Atun, Till Bärnighausen

{"title":"Health Insurance Coverage In Low- And Middle-Income Countries Remains Far From The Goal Of Universal Coverage.","authors":"Simiao Chen, Pascal Geldsetzer, Qiushi Chen, Mosa Moshabela, Lirui Jiao, Osondu Ogbuoji, Ali Sie, Rifat Atun, Till Bärnighausen","doi":"10.1377/hlthaff.2021.00951","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.00951","url":null,"abstract":"This study aimed to determine levels of health insurance coverage in low- and middle-income countries and how coverage varies by people's sociodemographic characteristics. We conducted a population size-weighted, one-stage individual participant data meta-analysis of health insurance coverage, using a population-based sample of 2,035,401 participants ages 15-59 from nationally representative household surveys in fifty-six countries during the period 2006-18. One in five people (20.3 percent) across the fifty-six countries in our study had health insurance. Health insurance coverage exceeded 50 percent in only seven countries and 70 percent in only three countries. Substantially more people had public health insurance than private health insurance (71.4 percent versus 28.6 percent). We found that men and older, more educated, and wealthier people were more likely to have health insurance; these sociodemographic gradients in health insurance coverage were strongest in sub-Saharan Africa and followed traditional lines of privilege. Low- and middle-income countries need to massively expand health insurance coverage if they intend to use insurance to achieve universal health coverage.","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"1142-1152"},"PeriodicalIF":9.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40663202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

ACO Participation Associated With Decreased Spending For Medicare Beneficiaries With Serious Mental Illness. 参与ACO与严重精神疾病医疗保险受益人支出减少有关。

IF 9.7

Health affairs (Project Hope) Pub Date : 2022-08-01 DOI: 10.1377/hlthaff.2022.00096

José F Figueroa, Jessica Phelan, Helen Newton, E John Orav, Ellen R Meara

{"title":"ACO Participation Associated With Decreased Spending For Medicare Beneficiaries With Serious Mental Illness.","authors":"José F Figueroa, Jessica Phelan, Helen Newton, E John Orav, Ellen R Meara","doi":"10.1377/hlthaff.2022.00096","DOIUrl":"https://doi.org/10.1377/hlthaff.2022.00096","url":null,"abstract":"Serious mental illness (SMI) is a major source of suffering among Medicare beneficiaries. To date, limited evidence exists evaluating whether Medicare accountable care organizations (ACOs) are associated with decreased spending among people with SMI. Using national Medicare data from the period 2009-17, we performed difference-in-differences analyses evaluating changes in spending and use associated with enrollment in the Medicare Shared Savings Program (MSSP) among beneficiaries with SMI. After five years, participation in MSSP ACOs was associated with small savings for beneficiaries with SMI (-$233 per person per year) in total health care spending, primarily related to savings from chronic medical conditions (excluding mental health; -$227 per person per year) and not from savings related to mental health services (-$6 per person per year). Savings were driven by reductions in acute and postacute care for medical conditions. Further work is needed to ensure that Medicare ACOs invest in strategies to reduce potentially unnecessary care related to mental health disorders and to improve health outcomes.","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"1182-1190"},"PeriodicalIF":9.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40684495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Virginia Medicaid Expansion: New Members Report Reduced Financial Concerns During The COVID-19 Pandemic. 弗吉尼亚州医疗补助扩张:新成员报告在COVID-19大流行期间减少了财务担忧。

IF 9.7

Health affairs (Project Hope) Pub Date : 2022-08-01 Epub Date: 2022-07-20 DOI: 10.1377/hlthaff.2021.01910

Hannah Shadowen, Mathew Alexander, Lauren Guerra, Xue Zhao, Jennifer Palazzolo, Lauryn Walker, Peter J Cunningham, Andrew J Barnes

{"title":"Virginia Medicaid Expansion: New Members Report Reduced Financial Concerns During The COVID-19 Pandemic.","authors":"Hannah Shadowen, Mathew Alexander, Lauren Guerra, Xue Zhao, Jennifer Palazzolo, Lauryn Walker, Peter J Cunningham, Andrew J Barnes","doi":"10.1377/hlthaff.2021.01910","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.01910","url":null,"abstract":"Medicaid is a critical antipoverty program. Since the Affordable Care Act expanded Medicaid eligibility, millions of newly eligible people have enrolled, creating positive financial improvements for low-income families. We examined the association of Virginia's 2019 Medicaid expansion and changes in health care-related and non-health-care-related financial needs among newly eligible Medicaid enrollees. Our unique survey collected responses between December 2018 and April 2019 from newly enrolled members reporting on experiences in the year before enrollment and between July 2020 and May 2021 from members reporting on experiences one year after enrollment. The follow-up period coincided with the COVID-19 pandemic. Medicaid enrollment was associated with decreases in concern about all financial needs assessed: housing, food, monthly bills, credit card and loan payments, and health care costs. These reductions were broadly similar across demographic subgroups and across the months of the pandemic that overlapped with the follow-up period. We add to the evidence that Medicaid expansion is a social safety-net policy that could improve equity among low-income families, potentially encouraging states that have yet to expand to do so.","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"1078-1087"},"PeriodicalIF":9.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40522694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Spending, Payment, And More. 消费、支付等等。

IF 9.7

Health affairs (Project Hope) Pub Date : 2022-08-01 DOI: 10.1377/hlthaff.2022.00926

Alan R Weil

引用次数: 0

Predicting Race And Ethnicity To Ensure Equitable Algorithms For Health Care Decision Making. 预测种族和民族以确保医疗保健决策的公平算法。

IF 9.7

Health affairs (Project Hope) Pub Date : 2022-08-01 DOI: 10.1377/hlthaff.2022.00095

Irineo Cabreros, Denis Agniel, Steven C Martino, Cheryl L Damberg, Marc N Elliott

{"title":"Predicting Race And Ethnicity To Ensure Equitable Algorithms For Health Care Decision Making.","authors":"Irineo Cabreros, Denis Agniel, Steven C Martino, Cheryl L Damberg, Marc N Elliott","doi":"10.1377/hlthaff.2022.00095","DOIUrl":"https://doi.org/10.1377/hlthaff.2022.00095","url":null,"abstract":"Algorithms are currently used to assist in a wide array of health care decisions. Despite the general utility of these health care algorithms, there is growing recognition that they may lead to unintended racially discriminatory practices, raising concerns about the potential for algorithmic bias. An intuitive precaution against such bias is to remove race and ethnicity information as an input to health care algorithms, mimicking the idea of \"race-blind\" decisions. However, we argue that this approach is misguided. Knowledge, not ignorance, of race and ethnicity is necessary to combat algorithmic bias. When race and ethnicity are observed, many methodological approaches can be used to enforce equitable algorithmic performance. When race and ethnicity information is unavailable, which is often the case, imputing them can expand opportunities to not only identify and assess algorithmic bias but also combat it in both clinical and nonclinical settings. A valid imputation method, such as Bayesian Improved Surname Geocoding, can be applied to standard data collected by public and private payers and provider entities. We describe two applications in which imputation of race and ethnicity can help mitigate potential algorithmic biases: equitable disease screening algorithms using machine learning and equitable pay-for-performance incentives.","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"1153-1159"},"PeriodicalIF":9.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40663197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6