Base de dados : MEDLINE
Pesquisa : N03.219.521.576.343.900 [Categoria DeCS]
Referências encontradas : 1996 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 200 ir para página                         

  1 / 1996 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29255843
[Au] Autor:Fuchs VR
[Ad] Endereço:Stanford University, Stanford, California.
[Ti] Título:Is Single Payer the Answer for the US Health Care System?
[So] Source:JAMA;319(1):15-16, 2018 Jan 02.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: National Health Insurance, United States/economia
Sistema de Fonte Pagadora Única
[Mh] Termos MeSH secundário: Redução de Custos
Sistema de Fonte Pagadora Única/economia
Sistema de Fonte Pagadora Única/organização & administração
Governo Estadual
Estados Unidos
Cobertura Universal
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180110
[Lr] Data última revisão:
180110
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.18739


  2 / 1996 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28271521
[Au] Autor:Moon AM; Green PK; Berry K; Ioannou GN
[Ad] Endereço:Divisions of General Internal Medicine, University of Washington, Seattle, WA, USA.
[Ti] Título:Transformation of hepatitis C antiviral treatment in a national healthcare system following the introduction of direct antiviral agents.
[So] Source:Aliment Pharmacol Ther;45(9):1201-1212, 2017 May.
[Is] ISSN:1365-2036
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Highly effective direct antiviral agents (DAAs) for hepatitis C virus (HCV) were introduced recently. Their utilisation has been limited by high cost and low access to care. AIM: To describe the effect of DAAs on HCV treatment and cure rates in the United States Veterans Affairs (VA) national healthcare system. METHODS: We identified all HCV antiviral treatment regimens initiated from 1 January 1999 to 31 December 2015 (n = 105 369) in the VA national healthcare system, and determined if they resulted in sustained virological response (SVR). RESULTS: HCV antiviral treatment rates were low (1981-6679 treatments/year) in the interferon era (1999-2010). The introduction of simeprevir and sofosbuvir in 2013 and ledipasvir/sofosbuvir and paritaprevir/ombitasvir/ritonavir/dasabuvir in 2014 were followed by increases in annual treatment rates to 9180 in 2014 and 31 028 in 2015. The number of patients achieving SVR was 1313 in 2010, the last year of the interferon era, and increased 5.6-fold to 7377 in 2014 and 21-fold to 28 084 in 2015. The proportion of treated patients who achieved SVR increased from 19.2% in 1999 and 36.0% in 2010 to 90.5% in 2015. Within 2015, monthly treatment rates ranged from 727 in July to 6868 in September correlating with the availability of funds for DAAs. CONCLUSIONS: DAAs resulted in a 21-fold increase in the number of patients achieving HCV cure. Treatment rates in 2015 were limited primarily by the availability of funds. Further increases in funding and cost reductions of DAAs in 2016 suggest that the VA could cure the majority of HCV-infected Veterans in VA care within the next few years.
[Mh] Termos MeSH primário: Antivirais/uso terapêutico
Hepatite C/tratamento farmacológico
[Mh] Termos MeSH secundário: Quimioterapia Combinada/tendências
Feminino
Hepacivirus/genética
Hepatite C/sangue
Hepatite C/virologia
Seres Humanos
Masculino
Meia-Idade
National Health Insurance, United States
RNA Viral/sangue
Estados Unidos
United States Department of Veterans Affairs
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antiviral Agents); 0 (RNA, Viral)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170815
[Lr] Data última revisão:
170815
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170309
[St] Status:MEDLINE
[do] DOI:10.1111/apt.14021


  3 / 1996 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27959711
[Au] Autor:Oberlander J
[Ad] Endereço:From the University of North Carolina, Chapel Hill.
[Ti] Título:The End of Obamacare.
[So] Source:N Engl J Med;376(1):1-3, 2017 Jan 05.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Política de Saúde/legislação & jurisprudência
Cobertura do Seguro/legislação & jurisprudência
Patient Protection and Affordable Care Act/legislação & jurisprudência
Política
[Mh] Termos MeSH secundário: Trocas de Seguro de Saúde/legislação & jurisprudência
Medicaid
National Health Insurance, United States/legislação & jurisprudência
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170131
[Lr] Data última revisão:
170131
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161214
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMp1614438


  4 / 1996 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27074063
[Au] Autor:Oberlander J
[Ad] Endereço:From the University of North Carolina, Chapel Hill.
[Ti] Título:The Virtues and Vices of Single-Payer Health Care.
[So] Source:N Engl J Med;374(15):1401-3, 2016 Apr 14.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: National Health Insurance, United States
Sistema de Fonte Pagadora Única
[Mh] Termos MeSH secundário: História do Século XX
História do Século XXI
Cobertura do Seguro
Pessoas sem Cobertura de Seguro de Saúde
Medicare/história
National Health Insurance, United States/história
National Health Insurance, United States/legislação & jurisprudência
Sistema de Fonte Pagadora Única/história
Sistema de Fonte Pagadora Única/legislação & jurisprudência
Estados Unidos
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE
[Em] Mês de entrada:1604
[Cu] Atualização por classe:160414
[Lr] Data última revisão:
160414
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160414
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMp1602009


  5 / 1996 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:26958790
[Au] Autor:Zogg CK; Jiang W; Chaudhary MA; Scott JW; Shah AA; Lipsitz SR; Weissman JS; Cooper Z; Salim A; Nitzschke SL; Nguyen LL; Helmchen LA; Kimsey L; Olaiya ST; Learn PA; Haider AH
[Ad] Endereço:From the Center for Surgery and Public Health, Harvard Medical School and Harvard T.H. Chan School of Public Health, Department of Surgery (C.Z., W.J., M.A.C., J.W.S., A.A.S., SRL, J.S.W., Z.C., A.S., S.L.N., L.L.N., A.H.H.), Brigham and Women's Hospital, Boston, MA; Department of Surgery (A.A.S.), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ; Division of General Internal Medicine (S.R.L.), Brigham and Women's Hospital, Boston, MA; Division of Trauma (Z.C., A.S., S.L.N., A.H.H.), Burns, Critical Care Surgery, Brigham and Women's Hospital, Boston, MA; Division of Vascular Surgery and Endovascular Surgery (L.L.N.), Brigham and Women's Hospital, Boston, MA; Department of Health Policy and Management (L.A.H.), George Washington University, Washington, DC; Jiann-Ping Hsu College of Public Health (L.K.), Georgia Southern University, Statesboro, Georgia; Department of Preventative and Biostatistics (S.T.O.), Uniformed Services University of the Health Sciences, Bethesda, MD; and Department of Surgery (P.A.L.), Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Bethesda, MD.
[Ti] Título:Racial disparities in emergency general surgery: Do differences in outcomes persist among universally insured military patients?
[So] Source:J Trauma Acute Care Surg;80(5):764-75; discussion 775-7, 2016 May.
[Is] ISSN:2163-0763
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Racial disparities in surgical care are well described. As many minority patients are also uninsured, increasing access to care is thought to be a viable solution to mitigate inequities. The objectives of this study were to determine whether racial disparities in 30-/90-/180- day outcomes exist within a universally insured population of military-/civilian-dependent emergency general surgery (EGS) patients and ascertain whether differences in outcomes differentially persist in care received at military versus civilian hospitals and among sponsors who are enlisted service members versus officers. It also considered longer-term outcomes of EGS care. METHODS: Five years (2006-2010) of TRICARE data, which provides insurance to active/reserve/retired members of the US Armed Services and dependents, were queried for adults (≥18 years) with primary EGS conditions, defined by the AAST. Risk-adjusted survival analyses assessed race-associated differences in mortality, major acute care surgery-related morbidity, and readmission at 30/90/180 days. Models accounted for clustering within hospitals and possible biases associated with missing race using reweighted estimating equations. Subanalyses considered restricted effects among operative interventions, EGS diagnostic categories, and effect modification related to rank and military- versus civilian-hospital care. RESULTS: A total of 101,011 patients were included: 73.5% white, 14.5% black, 4.4% Asian, and 7.7% other. Risk-adjusted survival analyses reported a lack of worse mortality and readmission outcomes among minority patients at 30, 90, and 180 days. Major morbidity was higher among black versus white patients (hazard ratio [95% confidence interval): 30 days, 1.23 [1.13-1.35]; 90 days, 1.18 [1.09-1.28]; and 180 days, 1.15 [1.07-1.24], a finding seemingly driven by appendiceal disorders (hazard ratio, 1.69-1.70). No other diagnostic categories were significant. Variations in military- versus civilian-managed care and in outcomes for families of enlisted service members versus officers altered associations, to some extent, between outcomes and race. CONCLUSIONS: While an imperfect proxy of interventions is directly applicable to the broader United States, the contrast between military observations and reported racial disparities among civilian EGS patients merits consideration. Apparent mitigation of disparities among military-/civilian-dependent patients provides an example for which we as a nation and collective of providers all need to strive. The data will help to inform policy within the Department of Defense and development of disparities interventions nationwide, attesting to important differences potentially related to insurance, access to care, and military culture and values. LEVEL OF EVIDENCE: Prognostic and epidemiologic study, level III.
[Mh] Termos MeSH primário: Afroamericanos/estatística & dados numéricos
Medicina de Emergência/estatística & dados numéricos
Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos
Cirurgia Geral/estatística & dados numéricos
Disparidades em Assistência à Saúde/etnologia
Militares
National Health Insurance, United States/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Feminino
Hospitais Gerais/economia
Hospitais Militares/economia
Seres Humanos
Incidência
Masculino
Meia-Idade
Estudos Retrospectivos
Procedimentos Cirúrgicos Operatórios
Estados Unidos/epidemiologia
Ferimentos e Lesões/etnologia
Ferimentos e Lesões/cirurgia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1609
[Cu] Atualização por classe:160422
[Lr] Data última revisão:
160422
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160310
[St] Status:MEDLINE
[do] DOI:10.1097/TA.0000000000001004


  6 / 1996 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:26950779
[Au] Autor:Geyman JP
[Ad] Endereço:University of Washington (professor emeritus of family medicine).
[Ti] Título:Beyond the Affordable Care Act: Alternate Futures for Family Medicine and Primary Care.
[So] Source:Fam Med;48(2):95-9, 2016 Feb.
[Is] ISSN:1938-3800
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Changes in the landscape of medical practice in recent years, accelerated since the passage of the Affordable Care Act (ACA) in 2010, have led to further fragmentation of primary care and disruption of the doctor-patient relationship for many millions of Americans. Patients face escalating costs of care and restricted choice of physician and hospital in a largely corporatized health care system. The goals of family medicine are compromised by these system trends. The ACA is unsustainable for a number of reasons, including lack of price controls and cost containment, unaffordable costs for patients and taxpayers, widespread underinsurance, and massive administrative waste. Financing reform through single-payer national health insurance will bring a fairer system of universal coverage for comprehensive care of higher quality at less cost, while enabling a renaissance of family medicine and primary care as an expanding base of our health care system.
[Mh] Termos MeSH primário: Medicina de Família e Comunidade/organização & administração
Reforma dos Serviços de Saúde
National Health Insurance, United States
Patient Protection and Affordable Care Act
Atenção Primária à Saúde/organização & administração
[Mh] Termos MeSH secundário: Previsões
Acesso aos Serviços de Saúde
Seres Humanos
Cobertura do Seguro
Patient Protection and Affordable Care Act/tendências
Relações Médico-Paciente
Sistema de Fonte Pagadora Única
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1612
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160308
[St] Status:MEDLINE


  7 / 1996 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:26927692
[Au] Autor:McCarthy M
[Ad] Endereço:Seattle.
[Ti] Título:Fraud is going unchecked, says US agency.
[So] Source:BMJ;352:i1211, 2016 Feb 29.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Fraude/prevenção & controle
Medicaid
Medicare
National Health Insurance, United States
Patient Protection and Affordable Care Act
[Mh] Termos MeSH secundário: Assistência à Saúde/legislação & jurisprudência
Fraude/legislação & jurisprudência
Seres Humanos
Medicaid/legislação & jurisprudência
Medicare/legislação & jurisprudência
National Health Insurance, United States/legislação & jurisprudência
Patient Protection and Affordable Care Act/legislação & jurisprudência
Estados Unidos
[Pt] Tipo de publicação:NEWS
[Em] Mês de entrada:1608
[Cu] Atualização por classe:160301
[Lr] Data última revisão:
160301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160302
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.i1211


  8 / 1996 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Registro de Ensaios Clínicos
PubMed Central Texto completo
Texto completo
[PMID]:26880251
[Au] Autor:Politi MC; Barker AR; Kaphingst KA; McBride T; Shacham E; Kebodeaux CS
[Ad] Endereço:Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, USA. mpoliti@wustl.edu.
[Ti] Título:Show Me My Health Plans: a study protocol of a randomized trial testing a decision support tool for the federal health insurance marketplace in Missouri.
[So] Source:BMC Health Serv Res;16:55, 2016 Feb 16.
[Is] ISSN:1472-6963
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The implementation of the ACA has improved access to quality health insurance, a necessary first step to improving health outcomes. However, access must be supplemented by education to help individuals make informed choices for plans that meet their individual financial and health needs. METHODS/DESIGN: Drawing on a model of information processing and on prior research, we developed a health insurance decision support tool called Show Me My Health Plans. Developed with extensive stakeholder input, the current tool (1) simplifies information through plain language and graphics in an educational component; (2) assesses and reviews knowledge interactively to ensure comprehension of key material; (3) incorporates individual and/or family health status to personalize out-of-pocket cost estimates; (4) assesses preferences for plan features; and (5) helps individuals weigh information appropriate to their interests and needs through a summary page with "good fit" plans generated from a tailored algorithm. The current study will evaluate whether the online decision support tool improves health insurance decisions compared to a usual care condition (the healthcare.gov marketplace website). The trial will include 362 individuals (181 in each group) from rural, suburban, and urban settings within a 90 mile radius around St. Louis. Eligibility criteria includes English-speaking individuals 18-64 years old who are eligible for the ACA marketplace plans. They will be computer randomized to view the intervention or usual care condition. DISCUSSION: Presenting individuals with options that they can understand tailored to their needs and preferences could help improve decision quality. By helping individuals narrow down the complexity of health insurance plan options, decision support tools such as this one could prepare individuals to better navigate enrollment in a plan that meets their individual needs. The randomized trial was registered in clinicaltrials.gov (NCT02522624) on August 6, 2015.
[Mh] Termos MeSH primário: Técnicas de Apoio para a Decisão
Trocas de Seguro de Saúde/economia
Seguro Saúde/economia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Gastos em Saúde
Alfabetização em Saúde
Seres Humanos
Meia-Idade
Missouri
National Health Insurance, United States
Estados Unidos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1610
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160217
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1186/s12913-016-1314-9


  9 / 1996 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:26536912
[Au] Autor:Saluja S; Zallman L; Nardin R; Bor D; Woolhandler S; Himmelstein DU; McCormick D
[Ad] Endereço:Department of Medicine, Cambridge Health Alliance, Harvard Medical School, Massachusetts, USA sonalisaluja@mail.harvard.edu.
[Ti] Título:Support for National Health Insurance Seven Years Into Massachusetts Healthcare Reform: Views of Populations Targeted by the Reform.
[So] Source:Int J Health Serv;46(1):185-200, 2016.
[Is] ISSN:0020-7314
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Before the Affordable Care Act (ACA), many surveys showed majority support for national health insurance (NHI), also known as single payer; however, little is currently known about views of the ACA's targeted population. Massachusetts residents have had seven years of experience with state health care reform that became the model for the ACA. We surveyed 1,151 adults visiting safety-net emergency departments in Massachusetts in late 2013 on their preference for NHI or the Massachusetts reform and on their experiences with insurance. Most of the patients surveyed were low-income and non-white. The majority of patients (72.0%) preferred NHI to the Massachusetts reform. Support for NHI among those with public insurance, commercial insurance, and no insurance was 68.9%, 70.3%, and 86.3%, respectively (p < .001). Support for NHI was higher among patients dissatisfied with their insurance plan (83.3% vs. 68.9%, p = .014), who delayed medical care (81.2% vs. 69.6%, p < .001) or avoided purchasing medications due to cost (87.3% vs. 71.4%; p = .01). Majority support for NHI was observed in every demographic subgroup. Given the strong support for NHI among disadvantaged Massachusetts patients seven years after state health reform, a reappraisal of the ACA's ability to meet the needs of underserved patients is warranted.
[Mh] Termos MeSH primário: Reforma dos Serviços de Saúde/organização & administração
Cobertura do Seguro/organização & administração
Seguro Saúde/organização & administração
Preferência do Paciente
Provedores de Redes de Segurança/organização & administração
[Mh] Termos MeSH secundário: Adolescente
Adulto
Feminino
Reforma dos Serviços de Saúde/economia
Nível de Saúde
Seres Humanos
Cobertura do Seguro/economia
Seguro Saúde/economia
Masculino
Massachusetts
Meia-Idade
National Health Insurance, United States
Patient Protection and Affordable Care Act/organização & administração
Satisfação do Paciente
Provedores de Redes de Segurança/economia
Fatores Socioeconômicos
Estados Unidos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1604
[Cu] Atualização por classe:160113
[Lr] Data última revisão:
160113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:151106
[St] Status:MEDLINE
[do] DOI:10.1177/0020731415615314


  10 / 1996 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:26219043
[Au] Autor:Butler S
[Ad] Endereço:Brookings Institution, Washington, DC.
[Ti] Título:Strengthening the Affordable Care Act: The Need for Strategic Building Blocks.
[So] Source:JAMA;314(4):335-6, 2015 Jul 28.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Financiamento Governamental/legislação & jurisprudência
Patient Protection and Affordable Care Act/legislação & jurisprudência
[Mh] Termos MeSH secundário: Financiamento Governamental/economia
Planos de Assistência de Saúde para Empregados/economia
Planos de Assistência de Saúde para Empregados/legislação & jurisprudência
Trocas de Seguro de Saúde/legislação & jurisprudência
Trocas de Seguro de Saúde/organização & administração
Medicare/economia
Medicare/legislação & jurisprudência
National Health Insurance, United States
Patient Protection and Affordable Care Act/organização & administração
Política
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1508
[Cu] Atualização por classe:161017
[Lr] Data última revisão:
161017
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:150729
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2015.7153



página 1 de 200 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde