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Source: BMJ Open
Management: Insurance

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Total 21 results found since Jan 2013.

Association between diseases of despair and atherosclerotic cardiovascular disease among insured adults in the USA: a retrospective cohort study from 2017 to 2021
Conclusions Among this cohort of insured adults, documented DoD was associated with increased ASCVD risk. Further research to understand and address cardiovascular disease prevention in those with DoD could reduce costs, morbidity and mortality. Further examination of overlapping structural factors that may be contributing to concurrent rises in ASCVD and DoD in the USA is needed.
Source: BMJ Open - September 6, 2023 Category: General Medicine Authors: Nudy, M., Galper, K., George, D. R., Williams, B. A., Kraschnewski, J. L., Sinoway, L., Brignone, E. Tags: Open access, Cardiovascular medicine Source Type: research

Efficiency and effectiveness of intensive multidisciplinary follow-up of patients with stroke/TIA or myocardial infarction compared to usual monitoring: protocol of a pragmatic randomised clinical trial. DiVa (Dijon vascular) study
We describe the protocol of a randomised clinical trial that aims to evaluate the efficiency and effectiveness of an intensive multidisciplinary follow-up of patients compared with standard care. Methods and analysis The DiVa study is a randomised, prospective, controlled, multicentre trial including patients >18 years old with a first or recurrent stroke (ischaemic or haemorrhagic) or TIA, or a type I or II MI, managed in one of the participating hospitals of the study area, with a survival expectancy >12 months. Patients will be randomised with an allocation ratio of 1:1 in two parallel groups: one group assigned ...
Source: BMJ Open - April 26, 2023 Category: General Medicine Authors: Bejot, Y., Soilly, A.-L., Bardou, M., Duloquin, G., Pommier, T., Laurent, G., Cottin, Y., Vadot, L., Adam, H., Boulin, M., Giroud, M. Tags: Open access, Cardiovascular medicine Source Type: research

Primary healthcare needs and service utilisation of people with disability: a data linkage protocol
Introduction General practitioners (GPs) play a crucial role in the early management and treatment of the comorbidities and complications experienced by people with disability. However, GPs experience multiple constraints, including limited time and disability-related expertise. Knowledge gaps around the health needs of people with disability as well as the frequency and extent of their engagement with GPs mean evidence to inform practice is limited. Using a linked dataset, this project aims to enhance the knowledge of the GP workforce by describing the health needs of people with disability. Methods and analysis This pro...
Source: BMJ Open - April 19, 2023 Category: General Medicine Authors: Douglas, J., Winkler, D., McLeod, A., Oliver, S., Gardner, K., Supple, J., Pearce, C. Tags: Open access, Health services research Source Type: research

Vitamin-K-antagonist phenprocoumon versus direct oral anticoagulants in patients with atrial fibrillation: a real-world analysis of German claims data
Conclusions The small superiority or non-inferiority of DOACs over warfarin seen in the RCTs might not translate into relevant advantages of DOACs over phenprocoumon. To confirm the hypothesis, an RCT with phenprocoumon is needed. Next to the safety and effectiveness assessments other factors might also play a substantial role in the decision on the right OAC for stroke prevention.
Source: BMJ Open - January 2, 2023 Category: General Medicine Authors: Warkentin, L., Klohn, F., Deiters, B., Kühlein, T., Hueber, S. Tags: Open access, Pharmacology and therapeutics Source Type: research

Estimation and predictors of direct hospitalisation expenses and in-hospital mortality for patients who had a stroke in a low-middle income country: evidence from a nationwide cross-sectional study in Iranian hospitals
Conclusion Applying cost-effective stroke prevention strategies among the younger population (≤49 years old) is strongly recommended. Migration to universal health insurance can effectively reduce the inequality gap among all insured patients.
Source: BMJ Open - December 13, 2022 Category: General Medicine Authors: Kazemi, Z., Emamgholipour Sefiddashti, S., Daroudi, R., Ghorbani, A., Yunesian, M., Hassanvand, M. S., Shahali, Z. Tags: Open access, Neurology Source Type: research

Risk of cardiovascular events leading to hospitalisation after Streptococcus pneumoniae infection: a retrospective cohort LIFE Study
Conclusions S. pneumoniae infections elevate the risk of subsequent stroke and AF occurrence. These findings indicate that pneumococcal infections have short-term effects on patients’ health and increase their midterm to long-term susceptibility to serious cardiovascular events.
Source: BMJ Open - November 4, 2022 Category: General Medicine Authors: Nishimura, N., Fukuda, H. Tags: Open access, Cardiovascular medicine Source Type: research

Health economic evaluation of the 'Flying Intervention Team as a novel stroke care concept for rural areas: study protocol of the TEMPiS-GÖA study
The objective of the present paper is to describe the methods for the economic evaluation (TEMPiS-Gesundheitsökonomische Analyse (TEMPiS-GÖA)) alongside the TEMPiS-FIT study to determine whether the new form of care is cost-effective compared with standard care. Methods and analysis The within-trial cost-effectiveness analysis (CEA) and cost–utility analysis (CUA) will be performed from a statutory health insurance perspective as well as from a societal perspective over the time horizon of 12 months after the patients’ hospital discharge. Direct costs from outpatient and inpatient care are coll...
Source: BMJ Open - September 20, 2022 Category: General Medicine Authors: Coors, M., Flemming, R., Schüttig, W., Hubert, G. J., Hubert, N. D., Sundmacher, L. Tags: Open access, Health economics Source Type: research

Temporal trend of first-ever ischaemic stroke incidence from 2010 to 2019 in South Korea: a nationwide retrospective cohort study
Conclusions Age-standardised incidence rate of ischaemic stroke has decreased from 2010 to 2019 for both man and women. The incidence rate was stable in the younger age groups and decreased in the older age groups, and the disparities between income groups have widened over the past decade. Stroke prevention strategies are needed for the younger age group and the low-income group. Further research is needed to study the risk factors contributing to the incidence of ischaemic stroke in different groups.
Source: BMJ Open - August 24, 2022 Category: General Medicine Authors: Lee, J., Kim, H., Moon, J., Shin, J., Jeong, H., Kim, Y. Tags: Open access, Epidemiology Source Type: research

Outcome disparities in patients with atrial fibrillation based on insurance plan and educational attainment: a nationwide, multicenter and prospective cohort trial
Conclusion Educational attainment was independently associated with all-cause mortality and ischaemic stroke in patients with AF, but adverse clinical outcomes were not related to the types of health insurance in Thailand. Trial registration number Thai Clinical Trial Registration; Study ID: TCTR20160113002.
Source: BMJ Open - August 10, 2022 Category: General Medicine Authors: Apiyasawat, S., Thongsri, T., Jongpiputvanich, K., Krittayaphong, R., for the COOL-AF Investigators Tags: Open access, Cardiovascular medicine Source Type: research

Kidney transplantation waiting times and risk of cardiovascular events and mortality: a retrospective observational cohort study in Taiwan
Conclusions Our results demonstrate that early KT is associated with superior long-term cardiovascular outcomes compared with late KT in selected patients with ESRD receiving uncomplicated KT, suggesting that an early KT could be a better treatment option for patients with ESRD who are eligible for transplantation.
Source: BMJ Open - May 24, 2022 Category: General Medicine Authors: Chen, H.-H., Chern, Y.-B., Hsu, C.-Y., Tang, P.-L., Lai, C.-C. Tags: Open access, Epidemiology Source Type: research

Decreasing rates of cost-related medication non-adherence by age advancement among American generational cohorts 2004-2014: a longitudinal study
Conclusion The paradox of decreasing CRN rates, independent of disease burden, income and insurance status, suggests populations’ CRN behaviours change as Americans age, bearing implications to social policy.
Source: BMJ Open - May 6, 2022 Category: General Medicine Authors: Zhang, J., Bhaumik, D., Meltzer, D. Tags: Open access, Health economics Source Type: research

Prevalence and associated relating factors in patients with hereditary retinal dystrophy: a nationwide population-based study in Taiwan
Conclusions 74% of the diagnosed HRD are retinitis pigmentosa. Population-based data suggested an increased incidence of cataract in younger patients, whereas older HRD patients are more susceptible to develop CME. Further work is needed to elucidate the mechanism between these ophthalmological disorders and HRD.
Source: BMJ Open - April 8, 2022 Category: General Medicine Authors: Woon, P. Y., Chien, J.-Y., Wang, J.-H., Chou, Y.-Y., Lin, M.-C., Huang, S.-P. Tags: Open access, Ophthalmology Source Type: research

Comparison of the effects on cardiovascular events between use of metformin and dipeptidyl peptidase-4 inhibitors as the first-line hypoglycaemic agents in Japanese patients with type 2 diabetes mellitus: a claims database analysis
Conclusions Patients who received metformin as first-line therapy may have reduced cardiovascular events than those receiving DPP-4i. This study conforms to previous Japanese database studies, despite the consideration of its limitation being an observational design.
Source: BMJ Open - March 11, 2022 Category: General Medicine Authors: Nishimura, R., Takeshima, T., Iwasaki, K., Aoi, S. Tags: Open access, Diabetes and Endocrinology Source Type: research

Hypertension in the South African public healthcare system: a cost-of-illness and burden of disease study
Conclusion Hypertension exerts a heavy health and economic burden on South Africa. Establishing cost-effective best practice guidelines for hypertension treatment requires further research. Such research will be essential if South Africa is to make progress in its efforts to implement universal healthcare.
Source: BMJ Open - February 22, 2022 Category: General Medicine Authors: Kohli-Lynch, C. N., Erzse, A., Rayner, B., Hofman, K. J. Tags: Open access, Health economics Source Type: research

Assessment of the effects of methodological choice in continuity of care research: a real-world example with dyslipidaemia cohort
Conclusions The study design in continuity of care studies should be planned carefully because the results are sensitive to the temporal relationship between continuity and outcome and the population selection criteria.
Source: BMJ Open - December 30, 2021 Category: General Medicine Authors: Choo, E., Choi, E., Lee, J., Siachalinga, L., Jang, E. J., Lee, I.-H. Tags: Open access, Health services research Source Type: research