Not applicable. All authors have seen and approved the final version of the manuscript.Prof. Wischmeyer reports receiving investigator-initiated grant funding related to this work from the National Institutes of Health, Department of Defense, Abbott, Baxter, and Fresenius. Dr. Wischmeyer has served as a consultant to Abbott, Fresenius, Baxter, Mend Inc, and Nutricia for research related to this work. Dr.
Dr Puthucheary reports receiving honoraria for advisory board meetings and lectures from Fresenius Kabi, Nestle, Baxter, Nutricia and Faraday Pharmaceuticals, and research funding from Baxter and Nestle. Dr. Bear reports receiving honoraria for advisory board meetings from Avanos, Cardinal Health and Nutricia and lectures from Baxter and Cardinal Health.
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Reshape your diet with super-tasty low-calorie meals from £1 with Miguel BarclayIf you're looking for nutritious and yummy meals that don't break the bank, try these recipes by Miguel Barclay who creates tasty meals on a serious budget
Source: OK_Magazine - 🏆 12. / 84 Read more »
Evaluating the accessibility and value of U.S. ambulatory care among Medicaid expansion states and non-expansion states, 2012–2015 - BMC Health Services ResearchBackground While the Affordable Care Act’s Medicaid expansion improved healthcare coverage and access for millions of uninsured Americans, less is known about its effects on the overall accessibility and quality of care across all payers. Rapid volume increases of newly enrolled Medicaid patients might have unintentionally strained accessibility or quality of care. We assessed changes in physician office visits and high- and low-value care associated with Medicaid expansion across all payers. Methods Prespecified, quasi-experimental, difference-in-differences analysis pre and post Medicaid expansion (2012–2015) in 8 states that did and 5 that did not choose to expand Medicaid. Physician office visits sampled from the National Ambulatory Medical Care Survey, standardized with U.S. Census population estimates. Outcomes included visit rates per state population and rates of high or low-value service composites of 10 high-value measures and 7 low-value care measures respectively, stratified by year and insurance. Results We identified approximately 143 million adults utilizing 1.9 billion visits (mean age 56; 60% female) during 2012–2015. Medicaid visits increased in expansion states post-expansion compared to non-expansion states by 16.2 per 100 adults (p = 0.031 95% CI 1.5–31.0). New Medicaid visits increased by 3.1 per 100 adults (95% CI 0.9–5.3, p = 0.007). No changes were observed in Medicare or commercially-insured visit rates. High or low-value care did not change for any insurance type, except high-value care during new Medicaid visits, which increased by 4.3 services per 100 adults (95% CI 1.1–7.5, p = 0.009). Conclusions Following Medicaid expansion, the U.S. healthcare system increased access to care and use of high-value services for millions of Medicaid enrollees, without observable reductions in access or quality for those enrolled in other insurance types. Provision of low-value care continued at similar rates post-expansion, informing future federal poli
Source: medical_xpress - 🏆 101. / 51 Read more »