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Variables Affecting 90-Day Overall Reimbursement After Anterior Cruciate Ligament Reconstruction: Analysis of Nearly 250,000 Patients in the United States.
Orthop J Sports Med
December 2024
Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA.
Background: Anterior cruciate ligament reconstruction (ACLR) is a commonly performed orthopaedic procedure. As the number of ACLRs continues to increase in incidence, understanding the variability and drivers of cost to the health care system may help target cost-saving measures.
Purposes: To examine the variability in overall 90-day reimbursements (amount paid for health care services) for ACLR using a national, multi-insurance, administrative database and to assess factors associated with variability.
Effects of national health benefits expansion policy on out-of-pocket payments and utilization of patients with four major catastrophic diseases.
Health Open Res
February 2024
School of Social and Behavioral Sciences, College of Public Health and Human Sciences, Health Management and Policy, Oregon State University, Corvallis, Oregon, USA.
Background: As South Korea achieved universal health care (UHC) in 1989, patients' access to low-cost health services has highly increased. However, as liability for high-cost procedures is still high, patients' accessibility to high-cost services is has been limited. For this reason, the Korean government has implemented an initiative of the "Mid-term Health Benefits Security Plan" to expand the health benefits coverage since 2005.
View Article and Find Full Text PDF[Medicine and Law: an Introduction - Part 1].
Ther Umsch
October 2024
Praxis für Personalisierte Medizin, Klinik Hirslanden, Zürich.
The development of Swiss medical law is closely linked to social and medical development. In the early days and in the Middle Ages, healers and monasteries shaped medical care, with canon law playing an important role. In the early modern period, the first regional regulations for the medical profession emerged.
View Article and Find Full Text PDF[Medicine and Law: an Introduction - Part 2].
Ther Umsch
October 2024
Praxis für Personalisierte Medizin, Klinik Hirslanden, Zürich.
Article Synopsis
- Swiss medical law separates substantive law (which defines rights and duties) from procedural law (which governs how those rights are enforced).
- It also differentiates between objective law (the overall legal norms) and subjective law (individual rights).
- Private regulations like the FMH Code and SAMS guidelines add ethical standards to the legal framework, while social insurance law's definition of illness is crucial for legal clarity in medical practice.
[Medical liability and insurance].
Ther Umsch
October 2024
Rechtsdienst, Direktion Corporate Center Funktionen, Universitätsspital Zürich, Zürich.
The basic principles of medical liability in Switzerland are the same regardless of whether a physician is self-employed or employed. The first part of this article provides an overview of the jurisdiction of the Federal Supreme Court on the requirements for medical liability under civil law and state liability law, which is aimed at financial compensation for damages suffered by patients. The second part describes the insurance cover and important obligations that the physician has in the event of a claim.
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