Medicare & medicaid research review最新文献

{"title":"Linkages between utilization of prostate surgical pathology services and physician self-referral.","authors":"Jean M Mitchell","doi":"10.5600/mmrr.002.03.a02","DOIUrl":"https://doi.org/10.5600/mmrr.002.03.a02","url":null,"abstract":"<p><strong>Objective: </strong>Federal law prohibits a physician from referring Medicare patients for procedures or services to health care entities in which the physician has a financial relationship. This law has exceptions which enable physicians to self-refer under certain conditions. This study evaluates the effects of self-referral on use rates of surgical pathology services performed in conjunction with prostate biopsies and whether such changes are linked to urologist self-referral arrangements.</p><p><strong>Data and sample: </strong>A targeted market area case study design was employed to identify the sample from Medicare claims data. The sample included male beneficiaries who resided in geographically dispersed counties; were continuously enrolled in Medicare fee-for-service (FFS) during 2005-2007; and who met the criteria to be a potential candidate to undergo a prostate biopsy.</p><p><strong>Outcomes: </strong>Prostate biopsy procedures per 1000 male Medicare beneficiaries in each county; counts of surgical pathology specimens (jars) associated with prostate biopsy procedures per 1000 male Medicare beneficiaries in each county.</p><p><strong>Findings: </strong>Regression analysis shows the self-referral share (percentage) of total utilization was associated with significant increases in the use rate of prostate surgical pathology specimens (p<.01). The use rate of prostate surgical pathology specimens (jars) would be 41.5 units higher in a county where the self-referral share of total utilization was 50% compared to a county with no self-referral (share equals 0%).</p><p><strong>Conclusions: </strong>The findings show that urologist self-referral of prostate surgical pathology services results in increased utilization and higher Medicare spending. The results suggest that exceptions in federal and state self-referral prohibitions need to be reevaluated.</p>","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5600/mmrr.002.03.a02","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32319589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer outcomes in low-income elders: is there an advantage to being on Medicaid?","authors":"Siran M Koroukian,&nbsp;Paul M Bakaki,&nbsp;Cynthia Owusu,&nbsp;Craig C Earle,&nbsp;Gregory S Cooper","doi":"10.5600/mmrr.002.02.a06","DOIUrl":"https://doi.org/10.5600/mmrr.002.02.a06","url":null,"abstract":"<p><strong>Background: </strong>Because of reduced financial barriers, dual Medicare-Medicaid enrollment of low-income Medicare beneficiaries may be associated with receipt of definitive cancer treatment and favorable survival outcomes.</p><p><strong>Methods: </strong>We used a database developed by linking records from the Ohio Cancer Incidence Surveillance System with Medicare and Medicaid files, death certificates, and U.S. Census data. The study population included community-dwelling Medicare fee-for-service beneficiaries, age 66 years or older, with low incomes, residing in Ohio, and diagnosed with incident loco-regional breast (n=838), colorectal (n=784), or prostate cancer (n=946) in years 1997-2001. We identified as \"duals\" Medicare beneficiaries who were enrolled in Medicaid at least three months prior to cancer diagnosis. Multivariable logistic regression and survival models were developed to analyze the association between dual status and (1) receipt of definitive treatment; and (2) overall and disease-specific survival, after adjusting for tumor stage and patient covariates.</p><p><strong>Results: </strong>DUAL STATUS WAS ASSOCIATED WITH A SIGNIFICANTLY LOWER LIKELIHOOD TO RECEIVE DEFINITIVE TREATMENT AMONG COLORECTAL CANCER PATIENTS (ADJUSTED ODDS RATIO: 0.60, 95% Confidence Interval, or CI, [0.38, 0.95]), but not among breast or prostate cancer patients. Furthermore, dual status was associated with decreased overall survival among prostate cancer patients (Adjusted Hazard Ratio, or AHR, 1.45, 95% CI [1.05, 2.02]), and decreased disease-specific survival among colorectal cancer patients (AHR: 1.52 [1.05, 2.19]).</p><p><strong>Conclusion: </strong>Enrollment of low-income Medicare beneficiaries in Medicaid is not associated with favorable treatment patterns or survival outcomes. Differences in health and functional status between community-dwelling duals and non-duals might help explain the observed disparities.</p>","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006380/pdf/mmrr2012-002-02-a06.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32318079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public reporting and market area exit decisions by home health agencies.","authors":"Kyoungrae Jung,&nbsp;Roger Feldman","doi":"10.5600/mmrr.002.04.a06","DOIUrl":"https://doi.org/10.5600/mmrr.002.04.a06","url":null,"abstract":"<p><strong>Objective: </strong>To examine whether home health agencies selectively discontinue services to areas with socio-economically disadvantaged people after the introduction of Home Health Compare (HHC), a public reporting program initiated by Medicare in 2003.</p><p><strong>Study design /methods: </strong>We focused on agencies' initial responses to HHC and examined selective market-area exits by agencies between 2002 and 2004. We measured HHC effects by the percentage of quality indicators reported in public HHC data in 2003. Socio-economic status was measured by per capita income and percent college-educated at the market-area level.</p><p><strong>Data sources: </strong>2002 and 2004 Outcome and Assessment Information Set (OASIS); 2000 US Census file; 2004 Area Resource File; and 2002 Provider of Service File.</p><p><strong>Principal findings: </strong>WE FOUND A SMALL AND WEAK EFFECT OF PUBLIC REPORTING ON SELECTIVE EXITS: a 10-percent increase in reporting (reporting one more indicator) increased the probability of leaving an area with less-educated people by 0.3 percentage points, compared with leaving an area with high education.</p><p><strong>Conclusion: </strong>The small level of market-area exits under public reporting is unlikely to be practically meaningful, suggesting that HHC did not lead to a disruption in access to home health care through selective exits during the initial year of the program.</p>","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006480/pdf/mmrr2012-002-04-a06.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32319486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial performance of health plans in Medicaid managed care.","authors":"Mike McCue","doi":"10.5600/mmrr.002.02.a07","DOIUrl":"https://doi.org/10.5600/mmrr.002.02.a07","url":null,"abstract":"<p><strong>Objective: </strong>This study assesses the financial performance of health plans that enroll Medicaid members across the key plan traits, specifically Medicaid dominant, publicly traded, and provider-sponsored.</p><p><strong>Data and methods: </strong>National Association of Insurance Commissioners (NAIC) financial data, coupled with selected state financial data, were analyzed for 170 Medicaid health plans for 2009. A mean test compared the mean values for medical loss, administrative cost, and operating margin ratios across these plan traits. Medicaid dominant plans are plans with 75 percent of their total enrollment in the Medicaid line of business.</p><p><strong>Findings: </strong>Plans that are Medicaid dominant and publicly traded incurred a lower medical loss ratio and higher administrative cost ratio than multi-product and non-publicly traded plans. Medicaid dominant plans also earned a higher operating profit margin. Plans offering commercial and Medicare products are operating at a loss for their Medicaid line of business.</p><p><strong>Policy implications: </strong>Health plans that do not specialize in Medicaid are losing money. Higher medical cost rather than administrative cost is the underlying reason for this financial loss. Since Medicaid enrollees do not account for their primary book of business, these plans may not have invested in the medical management programs to reduce inappropriate emergency room use and avoid costly hospitalization.</p>","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006395/pdf/mmrr2012-002-02-a07.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32318082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing measurement error in Medicare coverage from the National Health Interview Survey.","authors":"Renee Gindi,&nbsp;Robin A Cohen","doi":"10.5600/mmrr.002.02.a05","DOIUrl":"https://doi.org/10.5600/mmrr.002.02.a05","url":null,"abstract":"<p><strong>Objectives: </strong>Using linked administrative data, to validate Medicare coverage estimates among adults aged 65 or older from the National Health Interview Survey (NHIS), and to assess the impact of a recently added Medicare probe question on the validity of these estimates.</p><p><strong>Data sources: </strong>Linked 2005 NHIS and Master Beneficiary Record and Payment History Update System files from the Social Security Administration (SSA).</p><p><strong>Study design: </strong>We compared Medicare coverage reported on NHIS with \"benchmark\" benefit records from SSA.</p><p><strong>Principal findings: </strong>With the addition of the probe question, more reports of coverage were captured, and the agreement between the NHIS-reported coverage and SSA records increased from 88% to 95%. Few additional overreports were observed.</p><p><strong>Conclusions: </strong>Increased accuracy of the Medicare coverage status of NHIS participants was achieved with the Medicare probe question. Though some misclassification remains, data users interested in Medicare coverage as an outcome or correlate can use this survey measure with confidence.</p>","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006379/pdf/mmrr2012-002-02-a05.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32318203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The national market for Medicare clinical laboratory testing: implications for payment reform.","authors":"Amy M Gass Kandilov,&nbsp;Gregory C Pope,&nbsp;John Kautter,&nbsp;Deborah Healy","doi":"10.5600/mmrr.002.02.a04","DOIUrl":"https://doi.org/10.5600/mmrr.002.02.a04","url":null,"abstract":"<p><p>Current Medicare payment policy for outpatient laboratory services is outdated. Future reforms, such as competitive bidding, should consider the characteristics of the laboratory market. To inform payment policy, we analyzed the structure of the national market for Medicare Part B clinical laboratory testing, using a 5-percent sample of 2006 Medicare claims data. The independent laboratory market is dominated by two firms--Quest Diagnostics and Laboratory Corporation of America. The hospital outreach market is not as concentrated as the independent laboratory market. Two subgroups of Medicare beneficiaries, those with end-stage renal disease and those residing in nursing homes, are each served in separate laboratory markets. Despite the concentrated independent laboratory market structure, national competitive bidding for non-patient laboratory tests could result in cost savings for Medicare.</p>","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006399/pdf/mmrr2012-002-02-a04.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32318083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wisconsin's experience with Medicaid auto-enrollment: lessons for other states.","authors":"Thomas DeLeire,&nbsp;Lindsey Leininger,&nbsp;Laura Dague,&nbsp;Shannon Mok,&nbsp;Donna Friedsam","doi":"10.5600/mmrr.002.02.a02","DOIUrl":"https://doi.org/10.5600/mmrr.002.02.a02","url":null,"abstract":"<p><p>The Patient Protection and Affordable Care Act (ACA) relies heavily on the expansion of Medicaid eligibility to cover uninsured populations. In February 2008, Wisconsin expanded and reformed its Medicaid/CHIP program and, as part of program implementation, automatically enrolled a set of newly eligible parents and children. This process of \"auto-enrollment\" targeted newly eligible parents and older children whose children/siblings were already enrolled in the state's Medicaid/CHIP program. Auto-enrollment brought over 44,000 individuals into the program, representing more than 60% of all enrollees in the first month of the reformed program. Individuals who were auto-enrolled were modestly more likely to leave the program relative to other individuals who enrolled in February 2008, unless their incomes were high enough to be required to pay premiums; these auto-enrollees were much more likely to exit relative to other enrollees subject to premium payments. The higher exit rates exhibited by non-premium paying auto-enrollees were likely due to the fact that over 40% of auto-enrollees were covered by a private insurance policy in the month of their enrollment, compared to approximately 30% for regular enrollees. A national simulation of an auto-enrollment process similar to Wisconsin's, including the expansion of adult Medicaid eligibility to 133% of the federal poverty level under the ACA, suggests that 2.5 million of the 5.6 million newly eligible parents could be auto-enrolled, and approximately 25% of this population would be privately insured. These results suggest that auto-enrollment may be appropriate for other states, especially in their efforts to enroll eligible populations who are not subject to premium requirements.</p>","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006387/pdf/mmrr2012-002-02-a02.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32318080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Medicare's hospital-acquired conditions policy to encompass readmissions.","authors":"Peter D McNair,&nbsp;Harold S Luft","doi":"10.5600/mmrr.002.02.a03","DOIUrl":"https://doi.org/10.5600/mmrr.002.02.a03","url":null,"abstract":"<p><strong>Background: </strong>The current Medicare policy of non-payment to hospitals for Hospital-Acquired Conditions (HAC) seeks to avoid payment for preventable complications identified within a single admission. The financial impact ($1 million-$50 million/yr) underestimates the true financial impact of HACs when readmissions are taken into account.</p><p><strong>Objective: </strong>Define and quantify acute inpatient readmissions arising directly from, or completing the definition of, the current HACs.</p><p><strong>Research design: </strong>Observational study.</p><p><strong>Subjects: </strong>All non-federal inpatient admissions to California hospitals, July 2006 to June 2007 with a recorded Social Security number.</p><p><strong>Measures: </strong>Readmission to acute care within 1 day for acute complications of poor glycemic control; 7 days for iatrogenic air emboli, incompatible blood transfusions, catheter-associated urinary tract infections and vascular catheter-associated infections; 30 days for deep vein thromboses or pulmonary emboli following hip or knee replacement surgery; and 183 days for foreign objects retained after surgery, mediastinitis following coronary artery bypass grafts, injuries sustained during inpatient care, infections following specific joint or bariatric surgery procedures, and pressure ulcers stages III & IV.</p><p><strong>Results: </strong>An additional estimated $103 million in payments would be withheld if Medicare expands the policy to include non-payment for HAC related readmissions. The majority (90%) of this impact involves mediastinitis, post-orthopedic surgery infection, or fall related injury.</p><p><strong>Conclusions: </strong>Limiting the current HAC policy focus to complications identified during the index admission omits consideration of many complications only identified in a subsequent admission. Non-payment for HAC-related readmissions would enhance incentives for prevention by increasing the frequency with which hospitals are held accountable for HACs.</p>","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006390/pdf/mmrr2012-002-02-a03.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32318081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying the 2003 Beers update to elderly Medicare enrollees in the Part D program.","authors":"Steven A Blackwell,&nbsp;Melissa A Montgomery,&nbsp;Dave K Baugh,&nbsp;Gary M Ciborowski,&nbsp;Gerald F Riley","doi":"10.5600/mmrr.002.02.a01","DOIUrl":"https://doi.org/10.5600/mmrr.002.02.a01","url":null,"abstract":"<p><strong>Background: </strong>Inappropriate prescribing of certain medications known as Beers drugs may be harmful to the elderly, because the potential risk for an adverse outcome outweighs the potential benefit.</p><p><strong>Objectives: </strong>(1) To assess Beers drug use in dual enrollees compared to non-duals; (2) to explore the association between dual enrollment status and Beers use, controlling for the effects of age, gender, race/ethnicity, census region, and health status; (3) to assess which medication therapeutic category had the highest Beers use.</p><p><strong>Design: </strong>Cross sectional retrospective review of 2007 Centers for Medicare & Medicaid Service Part D data. Potentially inappropriate medication use was assessed, independent of diagnosis, using the 2003 update by Fick et al.</p><p><strong>Findings: </strong>The likelihood of Beers drug use among duals approximates that of non-duals (OR 1.023, 95% CI 1.020-1.026). Characteristics associated with the receipt of a Beers medication include Hispanic origin, younger age, female gender, poor health status, and residence outside of the U.S.' Northeast region. Genitourinary products had the highest Beers use within medication therapeutic categories among both dual and non-dual enrollees (21.1% and 19.9%, respectively).</p><p><strong>Conclusions: </strong>Part D data can be successfully used to monitor Beers drug use. With adjustments for several important and easily measured demographic, health, and prescription drug use covariates, Beers drug use appears to be as common among non-dual enrollees as it is among dual enrollees in the Part D program. New Part D drug utilization policies that apply to all beneficiaries may need to be enacted to reduce Beers drug use.</p>","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006423/pdf/mmrr2012-002-02-a01.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32318084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of premium changes on ALL Kids, Alabama's CHIP program.","authors":"Michael A Morrisey,&nbsp;Justin Blackburn,&nbsp;Bisakha Sen,&nbsp;David Becker,&nbsp;Meredith L Kilgore,&nbsp;Cathy Caldwell,&nbsp;Nir Menachemi","doi":"10.5600/mmrr.002.03.a01","DOIUrl":"https://doi.org/10.5600/mmrr.002.03.a01","url":null,"abstract":"<p><strong>Objective: </strong>Describe the trends in enrollment and renewal in the Alabama Children's Health Insurance Plan (CHIP), ALL Kids, since its creation in 1998, and to estimate the effect that an annual premium increase, along with coincident increases in service copays, had on the decision to renew participation.</p><p><strong>Background: </strong>Unlike many other CHIP programs, ALL Kids is a standalone program that provides year long enrollment and contracts with the state's Blue Cross and Blue Shield program for its network of providers and its provider fee structure. In October 2003 premiums for individual coverage were increased by $50 per year and copays by $1 to $3 per visit.</p><p><strong>Population studied: </strong>This study is based upon a sample of 569,650 person-year observations of 230,255 children enrolled in the ALL Kids program between 1999 and 2009.</p><p><strong>Study design: </strong>The study models enrollment as a time series of cross section renewal decisions and specifies a series of linear probability regression models to estimate the effect of changes in the premium shift on the decision to renew. A second analysis includes interaction effects of the premiums shift with demographics, health status, income and previous enrollment to estimate differential response across subgroups.</p><p><strong>Principal findings: </strong>The increases in premiums and copays are estimated to have reduced program renewals by 6.1 to 8.3 percent depending upon how much time one allows for families to renew. Families with a child who has a chronic condition were more likely to renew coverage. However, those with chronic conditions, African-Americans and those with lower family incomes were more price-sensitive.</p><p><strong>Conclusions: </strong>An increase in annual premiums and visit copays had a modest impact on program reenrollment with effects comparable to those found in Florida, New Hampshire, Kansas and Arizona, but smaller than those in Kentucky and Georgia.</p>","PeriodicalId":89601,"journal":{"name":"Medicare & medicaid research review","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006389/pdf/mmrr2012-002-03-a01.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32319591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}