Sociodemographic Correlates of Bariatric Surgery by Procedure Type among a Statewide Ethnically Diverse Patient Population

Florida Agency for Health Care Administration (AHCA) 2013 inpatient data was used to conduct a retrospective review using International Classification of Diseases 9th edition (ICD-9) procedure codes to examine the sociodemographic correlates of three bariatric procedures [Laparoscopic Roux-en-Y Gastric Bypass (RYGB), Laparoscopic Adjustable Gastric Banding (LAGB), and Sleeve Gastrectomy (SG)]. Race-ethnic groups included non-Hispanic white (NHW), non- Hispanic black (NHB), Hispanic, and other. The sample (n=6,424, mean age 46 years) was predominantly NHW (57.4%), female (74.9%), commercial-insurance carriers (51.2%), and severely obese (98.8%). SG was the most common procedure (57.9%) followed by RYGB (39.3%), and LAGB (2.8%). Regardless of bariatric procedure type, over 40% were covered by commercial insurance. The relationship between insurance status and bariatric procedure type was statistically significant (p\u3c0.01). However, race-ethnicity and bariatric procedure relationship was not significant after adjusting for age, sex, and insurance status. Despite the current high obesity frequencies across all demographics in the state of Florida, NHW women (compared to their sex-ethnic-specific counterparts) in our sample received the highest proportion of bariatric surgeries. Further research should examine why this finding continues despite obesity and its health-related consequences affecting all sex- ethnic groups

Burden of chemotherapy-induced myelosuppression among patients with ES-SCLC in US community oncology settings Supplementary materials

Burden of chemotherapy-induced myelosuppression among patients with ES-SCLC in US community oncology settings Supplementary materials</p

Non-face-to-face chronic care management: a qualitative study assessing the implementation of a new CMS reimbursement strategy

Diabetes and its comorbidities are leading causes of morbidity and mortality in the United States and disproportionately in Louisiana. Chronic care management (CCM) efforts, such as care coordination models, are important initiatives in mitigating the impact of diabetes, such as poorer health outcomes and increased costs. This study examined one such effort, the Centers for Medicare & Medicaid Services' non-face-to-face CCM reimbursement program, for patients with diabetes and at least 1 other chronic condition in Louisiana. This qualitative study included interviews with patients in this program and health care providers and system leaders implementing the program. Results include lessons learned from health system leadership relating to CCM design and implementation, challenges experienced, overlapping initiatives, perceived benefits, performance, billing, and health information technology. Another key finding is that co-pays seem to be a barrier to patient interest in participation in non-face-to-face CCM, especially given that the value of the program is not completely clear to patients. A common strategy to address this co-pay barrier is to target dual eligibles, as Medicaid will cover the co-pay. However, widespread use of such strategies may indirectly exclude individuals who need and may also benefit from non-face-to-face CCM

Barriers and Facilitators in Implementing Non-Face-to-Face Chronic Care Management in an Elderly Population with Diabetes: A Qualitative Study of Physician and Health System Perspectives

The burden of illness related to diabetes and its complications is exceedingly high and growing globally. Systematic approaches to managing chronic care are needed to address the complex nature of the disease, taking into account health system structures. This study presents data collected from interviews with physicians, health system administrators, and other healthcare staff about chronic care management for elderly people with diabetes co-morbid with other chronic conditions in light of new programs intended to reduce barriers by incentivizing care encounters that take place through telephone and electronic communications (non-face-to-face care). Results indicate that health system personnel view non-face-to-face care as potentially providing value for patients and addressing systemic needs, yet challenging to implement in practice. Barriers and facilitators to this approach for managing diabetes and chronic care management for its complications are presented, with consideration to different types of health systems, and recommendations are provided for implementation