- Colorectal cancer screening with faecal immunochemical testing, sigmoidoscopy or colonoscopy: a microsimulation modelling study. [Journal Article]BMJ 2019; 367:l5383BMJ
- CONCLUSIONS: Over a 15 year period, all screening strategies may reduce colorectal cancer mortality to a similar extent. Colonoscopy and sigmoidoscopy may also reduce colorectal cancer incidence, while FIT shows a smaller incidence reduction. Harms are rare and of similar magnitude for all screening strategies.
- Cost effectiveness of endoscopic gallbladder drainage to treat acute cholecystitis in poor surgical candidates. [Journal Article]Surg Endosc 2019; 33(11):3567-3577SE
- CONCLUSIONS: Endoscopic GBD is cost effective compared to PGBD, favoring ERC-GBD over EUS-GBD. Further efforts are needed to make endoscopic GBD available in more medical centers, reduce equipment costs, and shorten inpatient stay.
- Impact of oral voriconazole during chemotherapy for acute myeloid leukemia and myelodysplastic syndrome: a Japanese nationwide retrospective cohort study. [Journal Article]Int J Clin Oncol 2019; 24(11):1449-1458IJ
- CONCLUSIONS: Oral VRCZ administration may benefit adult patients with AML/MDS undergoing chemotherapy.
- [Estimation of duration of formal long-term care among frail elderly people in Japanese communities using national long-term care insurance claims records]. [Journal Article]Nihon Koshu Eisei Zasshi 2019; 66(6):287-294NK
- Objective The aim of this nationwide study was to estimate the duration of formal long-term care, provided by Japanese long-term care insurance (LTCI) services, among frail Japanese elderly people living in the community.Methods The study subjects were 2,188,397 (men: 579,422, women: 1,124,022, age≥65 years) beneficiaries who used LTCI services for community living in June 2013. The duration of L…
Objective The aim of this nationwide study was to estimate the duration of formal long-term care, provided by Japanese long-term care insurance (LTCI) services, among frail Japanese elderly people living in the community.Methods The study subjects were 2,188,397 (men: 579,422, women: 1,124,022, age≥65 years) beneficiaries who used LTCI services for community living in June 2013. The duration of LTCI services for community living per diem per capita was estimated by converting the benefit amount to duration of care using the code for service in claims bills according to gender and care levels, which are a nationally certified classification of individual needs for long-term care (care level 1: lowest need, care level 5: highest need). Subsequently, LTCI services for community living were categorized into respite services and community services. Community services were further subcategorized into home visiting services and daycare services.Results The overall average duration of formal care per diem per capita for men and women were 97.4 and 112.7 minutes for care level 1, 118.3 and 149.1 for care level 2, 186.9 and 246.4 for care level 3, 215.2 and 273.2 for care level 4, and 213.1 and 261.4 for care level 5, respectively. Length of respite services increased gradually with care level, whereas duration of community services peaked at care level 3 and decreased at care levels 4 and 5. With regard to the community service subcategories, duration of home visiting services increased with care level, but duration of daycare services peaked at care level 3.Conclusion Although the care levels in the LCTI system are designed to assess the need for formal care in terms of duration of care, our results suggest that the use of formal LTCI services for community living is not vertically equitable. Services that efficiently increase duration of formal care for those with higher needs for care may improve the equity and sustainability of formal long-term care services for community living.
- Which Reimbursement System Fits Inpatient Palliative Care? A Qualitative Interview Study on Clinicians' and Financing Experts' Experiences and Views. [Journal Article]J Palliat Med 2019JP
- CONCLUSIONS: Expert opinions suggest that neither current DRGs nor per-diem rates are ideal for funding of PCUs. Suggested improvements regarding adequate funding of PCUs resemble and supplement international developments.
- Facebook advertising for recruitment of midlife women with bothersome vaginal symptoms: A pilot study. [Journal Article]Clin Trials 2019; 16(5):476-480CT
- CONCLUSIONS: Recruitment to a clinical trial testing interventions for postmenopausal vaginal symptoms is feasible through social media advertising. Variability in observed effectiveness and costs may reflect the small sample sizes and limited budget of the pilot recruitment study.
- Drug costs in long-term care facilities under a per diem bundled payment scheme in Japan. [Journal Article]Geriatr Gerontol Int 2019; 19(7):667-672GG
- CONCLUSIONS: These findings might suggest that implementation of the bundled payment scheme would be effective for the reduction of medication costs in institutional long-term care. Geriatr Gerontol Int 2019; 19: 667-672.
- Per Diem Paid to States for Care of Eligible Veterans in State Homes. Final rule. [Journal Article]Fed Regist 2018; 83(229):61250-86FR
- This rulemaking adopts as final, with changes, proposed amendments to VA's regulations governing payment of per diem to States for nursing home care, domiciliary care, and adult day health care for eligible veterans in State homes. This rulemaking reorganizes, updates, and clarifies State home regulations, authorizes greater flexibility in adult day health care programs, and establishes regulatio…
This rulemaking adopts as final, with changes, proposed amendments to VA's regulations governing payment of per diem to States for nursing home care, domiciliary care, and adult day health care for eligible veterans in State homes. This rulemaking reorganizes, updates, and clarifies State home regulations, authorizes greater flexibility in adult day health care programs, and establishes regulations regarding domiciliary care, with clarificationsregarding the care that State homes must provide to veterans in domiciliaries.
- Economic Impact of Aging on the Initial Spine Care of Patients With Acute Spine Trauma: From Bedside to Teller. [Journal Article]Neurosurgery 2019; 84(6):1251-1260N
- CONCLUSIONS: Given the escalating demand for surgical and nonsurgical spine treatment in the age of aging population, the timely results of this study underline key aspects of the economic impact of the spine care of the elderly. Further investigations are needed to fulfill significant knowledge gaps on the economics of caring for elderly with AST.
New Search Next
- Management of Animal Care and Use Programs in Research, Education, and Testing: Fiscal Management [BOOK]CRC Press/Taylor & Francis: Boca Raton (FL)BOOK
- A sound financial footing is essential for a well-run animal care program, and it is important that program directors and managers have a working knowledge of program finances. Animal care programs are being forced to do more with less while operational expenses continue to climb or remain flat at best. Given this new reality, informed and relentless financial management is more important than ev…
A sound financial footing is essential for a well-run animal care program, and it is important that program directors and managers have a working knowledge of program finances. Animal care programs are being forced to do more with less while operational expenses continue to climb or remain flat at best. Given this new reality, informed and relentless financial management is more important than ever to ensure that programs meet their various stakeholders’ needs. Innovative programs are adapting a proactive budgeting and tracking process in which every cost is challenged with the intent to reduce or eliminate it eventually, and embedding this process in a general management culture that is committed to unyielding continuous improvement through eliminating unnecessary work while providing researchers and animals with faster, better, cheaper, safer services. Effective and inventive fiscal management is of interest to many other laboratory animal constituencies, including: The parent organization, be it a university, governmental agency, or company looking for a quality program whose cost is reasonable and competitive. In addition, internal institutional groups (internal audit, budget offices, etc.) evaluate whether the program is fiscally sound. Researchers want a well-run program that is affordable. Most universities and some private companies charge daily housing (also known as per diems) and other fees”“researchers pay attention to these rates and “comparison shop””“often without appreciating that variances between institutions’ per diem rates are due to differential institutional subsidies rather than operating costs. Daily housing fees may not be as prevalent at governmental agencies or companies, but researchers still want to ensure that the animal care program provides necessary resources. Attractive wages and employee benefits are critical to maintaining animal care program staff. It is also important that fiscal managers embrace change and prepare for constant improvement and updating of resources needed by the animal program staff, such as supplies, equipment, and repairs and renovations. Funding agencies, such as the National Institutes of Health (NIH) and foundations, require the animal care program to properly charge expenses according to funding agency guidelines. Billing rates should be based on actual costs. Inspection and accrediting agencies (e.g., the U.S. Department of Agriculture [USDA] and Association for Assessment and Accreditation of Laboratory Animal Care [AAALAC]), although not interested in program finances, focus on whether necessary staffing, equipment, repairs and renovations, and so forth, have been funded and provided. These agencies help assure private and funding sources that animal use is justified and humane, and can have a favorable impact on an investigator’s proposal review. It is critical that animal program management ensure adequate financial resources to support these needs. Sound financial management should tell the financial story in clear terms. It should meet the needs and format of the institution being served, and include acceptable accounting practices, sound budget planning, and frequent monitoring and adjustments. It should constantly examine practices and expenses, striving to reduce or eliminate wasteful spending and practices. It is very important to remember that unlike most supplies and services used by the investigators, animal care and maintenance is usually a monopoly and therefore will be viewed critically. The more transparent and fiscally sound the accounting practices, the easier it will be for the manager to tell the program’s story. Financial management comprises four processes: planning, budgeting, monitoring, and cost accounting (Alford 2001). Each of the four steps should be performed on a regular (monthly is recommended) basis for both short-term and long-term management. To ignore any steps truly jeopardizes fiscal management in any organization.