Analysis Of End-Of-Life Care, Out-Of-Pocket Spending, And Place Of Death In 16 European Countries And Israel [International Experience]
We examined a large, multicountry data set with waves of data from the period 2006–13 to determine the differences in health care usage, out-of-pocket spending, and place of death in sixteen European countries and Israel. Our results reveal the importance of the funding mechanisms of long-term care. They also illuminate the effect of patients’ characteristics on end-of-life care pathways. We found that in countries where public financing and organization of long-term care are particularly strong, patients at the end of life are more likely to have reduced hospitalizations and a higher share of out-of-hospital d...
Source: Health Affairs - July 5, 2017 Category: International Medicine & Public Health Authors: Orlovic, M., Marti, J., Mossialos, E. Tags: International Issues, Health Spending International Experience Source Type: research
Medicare Beneficiaries With Advanced Lung Cancer Experience Diverse Patterns Of Care From Diagnosis To Death [Care At The End Of Life]
Characterizations of average end-of-life care for people with cancer can obscure important differences in patients’ experiences. Using Medicare claims data for 14,257 patients diagnosed with extensive-stage small-cell lung cancer in the period 1995–2009, we used latent class analysis to identify classes of people with different care patterns. We characterized care trajectories from diagnosis to death using time spent in five care settings—home, hospital inpatient unit (acute), hospital intensive care unit (ICU), postacute skilled nursing facility, and hospice—and transitions across these settings. W...
Source: Health Affairs - July 5, 2017 Category: International Medicine & Public Health Authors: Schuler, M. S., Joyce, N. R., Huskamp, H. A., Lamont, E. B., Hatfield, L. A. Tags: Medicare, Health Spending, Variations, Elderly Care At The End Of Life Source Type: research
A National Profile Of End-Of-Life Caregiving In The United States [Care At The End Of Life]
To date, knowledge of the experiences of older adults’ caregivers at the end of life has come from studies that were limited to specific diseases and so-called primary caregivers and that relied on the recollections of people in convenience samples. Using nationally representative, prospective data for 2011, we found that 900,000 community-dwelling Medicare beneficiaries ages sixty-five and older who died within the following twelve months received support from 2.3 million caregivers. Nearly nine in ten of these caregivers were unpaid. Compared to other caregivers, end-of-life caregivers provided nearly twice as...
Source: Health Affairs - July 5, 2017 Category: International Medicine & Public Health Authors: Ornstein, K. A., Kelley, A. S., Bollens-Lund, E., Wolff, J. L. Tags: Long-Term Care, Elderly Care At The End Of Life Source Type: research
Epidemiology And Patterns Of Care At The End Of Life: Rising Complexity, Shifts In Care Patterns And Sites Of Death [Care At The End Of Life]
In 2015 an estimated 2.7 million people in the United States (1 percent of the population) died. Although decedents’ illness experience varies substantially, important trends in care at the end of life are evident. To identify the most pressing health care policy issues related to end-of-life care, we present a comprehensive picture of the epidemiology and care patterns of people in the last stage of life. We identify three key trends in end-of-life care: increasing diversity in the primary diagnoses of decedents, increases in multimorbidity and illness complexity among people with terminal illnesses, and s...
Source: Health Affairs - July 5, 2017 Category: International Medicine & Public Health Authors: Aldridge, M. D., Bradley, E. H. Tags: Health Reform, Long-Term Care, Quality Of Care, Elderly Care At The End Of Life Source Type: research
ACA Replacement Battle Moves To Senate [Web First]
As the Senate struggles to craft its version of legislation replacing Obamacare, the Trump administration puts its stamp on health care regulation. (Source: Health Affairs)
Source: Health Affairs - July 5, 2017 Category: International Medicine & Public Health Authors: Jost, T. S. Tags: Health Reform, Affordable Care Act Web First Source Type: research
Advance Care Planning With Alzheimers: A Tortuous Path [Entry Point]
In striving to honor the wishes of patients with cognitive impairment, caregivers face great uncertainty. (Source: Health Affairs)
Source: Health Affairs - July 5, 2017 Category: International Medicine & Public Health Authors: Gale, R. Tags: Ethical Issues, Chronic Care, Elderly Entry Point Source Type: research
Advanced Illness & End-Of-Life Care [DataGraphic]
Health care systems worldwide are facing macro-scale changes involving advanced illness and end-of-life care that could affect both the quality of care and the quality of life for patients and their caregivers. For example, growth in mortality from cancer and Alzheimer disease, along with the increased prevalence of multiple morbidities for those near the end of life, raise questions about how the health system will provide adequate care and pain relief for patients, and addresses the needs of their caregivers–many of whom are unpaid family members. In addition, despite a growing tendency for people to prefer hospice...
Source: Health Affairs - July 5, 2017 Category: International Medicine & Public Health Tags: Access To Care, Health Reform, Hospitals, Medicaid, Medicare, Quality Of Care, Health Spending, Elderly DataGraphic Source Type: research
Advanced Illness And End-Of-Life Care [From The Editor-in-Chief]
(Source: Health Affairs)
Source: Health Affairs - July 5, 2017 Category: International Medicine & Public Health Authors: Weil, A. R. Tags: Health Reform From The Editor-in-Chief Source Type: research
Medicare Advantage Associated With More Racial Disparity Than Traditional Medicare For Hospital Readmissions [Web First]
We compared racial disparities in thirty-day readmissions between traditional Medicare and Medicare Advantage beneficiaries who underwent one of six major surgeries in New York State in 2013. We found that Medicare Advantage was associated with greater racial disparity, compared to traditional Medicare. After controlling for patient, hospital, and geographic characteristics in a propensity score based approach, we found that in traditional Medicare, black patients were 33 percent more likely than white patients to be readmitted, whereas in Medicare Advantage, black patients were 64 percent more likely than white ...
Source: Health Affairs - June 21, 2017 Category: International Medicine & Public Health Authors: Li, Y., Cen, X., Cai, X., Thirukumaran, C. P., Zhou, J., Glance, L. G. Tags: Hospitals, Medicare, Minority Health Web First Source Type: research
ACA Replacement Battle Moves To Senate [Web First]
As the Senate struggles to craft its version of legislation replacing Obamacare, the Trump administration puts its stamp on health care regulation. (Source: Health Affairs)
Source: Health Affairs - June 15, 2017 Category: International Medicine & Public Health Authors: Jost, T. S. Tags: Health Reform, Affordable Care Act Web First Source Type: research
Health Spending By State 1991-2014: Measuring Per Capita Spending By Payers And Programs [Web First]
This study examines per capita health spending by state of residence and per enrollee spending for the three largest payers (Medicare, Medicaid, and private health insurance) through 2014. Moreover, it discusses in detail the impacts of the Affordable Care Act implementation and the most recent economic recession and recovery on health spending at the state level. According to this analysis, these factors affected overall annual growth in state health spending and the payers and programs that paid for that care. They did not, however, substantially change state rankings based on per capita spending levels over the period. ...
Source: Health Affairs - June 14, 2017 Category: International Medicine & Public Health Authors: Lassman, D., Sisko, A. M., Catlin, A., Barron, M. C., Benson, J., Cuckler, G. A., Hartman, M., Martin, A. B., Whittle, L. Tags: Health Care Finance, Medicaid, Medicare, State/Local Issues, Health Spending Web First Source Type: research
ACA Replacement Battle Moves To Senate [Web First]
As the Senate struggles to craft its version of legislation replacing Obamacare, the Trump administration puts its stamp on health care regulation. (Source: Health Affairs)
Source: Health Affairs - June 12, 2017 Category: International Medicine & Public Health Authors: Jost, T. S. Tags: Health Reform, Affordable Care Act Web First Source Type: research
Preventing Newborn Deaths In Romania And Hungary [From the Publisher]
(Source: Health Affairs)
Source: Health Affairs - June 5, 2017 Category: International Medicine & Public Health Authors: Kuchna, D., Hovsepyan, A., Leonard, S. Tags: Health Professions Education, International Issues, Maternal And Child Health From the Publisher Source Type: research
Acknowledgments [Acknowledgments]
(Source: Health Affairs)
Source: Health Affairs - June 5, 2017 Category: International Medicine & Public Health Tags: Acknowledgments Source Type: research
Poverty And Health Care Reform: The Author Replies [Letters]
(Source: Health Affairs)
Source: Health Affairs - June 5, 2017 Category: International Medicine & Public Health Authors: Sage, W. M. Tags: Health Reform Letters Source Type: research
