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Preventable hospitalizations through ED: does the number of hospital beds matter under the global budget in a single-payer system in Taiwan?
Front Public Health
January 2025
Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan.
Background: Taiwan implemented global hospital budgeting with a floating-point value, which created a prisoner's dilemma. As a result, hospitals increased service volume, which caused the floating-point value to drop to less than one New Taiwan Dollar (NTD). The recent increase in the number of hospital beds and the call to enhance the floating-point value to one NTD raise concerns about the potential for increased financial burden without adding value to patient care if hospitals expand their bed capacity for volume-based competition.
View Article and Find Full Text PDFImplementation and evaluation of a novel community-based urban mobile health clinic in Toronto, Ontario.
Can J Public Health
January 2025
University Health Network, Toronto, ON, Canada.
Setting: Despite Canada's single-payer health system, marginalized populations often experience poor health outcomes and barriers to healthcare access. In response, mobile health clinics (MHCs) have been deployed in several cities across Canada. MHCs are well established in the United States; however, little is known about their role and impact in a country with universal healthcare.
View Article and Find Full Text PDFCost-Effectiveness of Breast Cancer Screening Using Digital Mammography in Canada.
JAMA Netw Open
January 2025
Medical Oncology, The Ottawa Hospital Cancer Centre, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada.
Importance: Evolving breast cancer treatments have led to improved outcomes but carry a substantial financial burden. The association of treatment costs with the cost-effectiveness of screening mammography is unknown.
Objective: To determine the cost-effectiveness of population-based breast cancer screening in the context of current treatment standards.
Pediatric Patients With Acute Flaccid Myelitis: Long-term Respiratory and Neurologic Outcomes.
Pediatr Infect Dis J
December 2024
From the Pediatric Hospital Medicine Fellowship, Kaiser Permanente Oakland Medical Center, Oakland, CA.
Background: Acute flaccid myelitis (AFM), an infection-mediated neurologic condition, may be accompanied by respiratory failure and subsequent variable recovery. This study assessed and provided prescriptive data on long-term respiratory and neurologic outcomes according to respiratory status at the time of presentation.
Methods: This was a retrospective cohort study using a large, single-payer healthcare database to identify children 1-18 years old, diagnosed with AFM between January 1, 2011 and December 31, 2019.
Modeling the health and economic implications of adopting a 1-dose 9-valent human papillomavirus vaccination program in adolescents in low/middle-income countries: An analysis of Indonesia.
PLoS One
November 2024
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, United States of America.
Background: Recent evidence suggests that 1 dose of the human papillomavirus (HPV) vaccine may have similar effectiveness in reducing HPV infection risk compared to 2 or 3 doses.
Objective: To evaluate the public health impact and cost-effectiveness of implementing a 1-dose or a 2-dose program of the 9-valent HPV vaccine in a low- and middle-income country (LMIC).
Methods: We adapted a dynamic transmission model to the Indonesia setting, and conducted a probabilistic sensitivity analysis using distributions reflecting the uncertainty in levels and durability of protection of a 1-dose that were estimated under a Bayesian framework incorporating 3-year vaccine efficacy data from the KEN SHE trial (base-case) and 10 year effectiveness data from the India IARC study (alternative analysis).
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