The American journal of managed care
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Surgical patients often leave the hospital with many questions and concerns after their surgery and will contact their providers to get answers. The growth of patient-provider communication (PPC) technologies allows for many new opportunities to study postoperative patient-initiated communication. We aimed to characterize a growing body of literature on postoperative patient-initiated communication. ⋯ As health systems adopt new technologies for PPC, understanding how and why patients initiate contact with providers postoperatively can inform efforts to strengthen PPC broadly. Moreover, research on sociodemographic variation in communication patterns after surgery can help address communication gaps that patient groups may experience. Future research can build upon this work to improve patient outcomes and increase clinic efficiency.
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The relatively few examples of commercially funded condition-specific bundled payments provide insights into how to spread this alternative payment model further in the private insurance market.
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Chronic cough, defined as cough lasting 8 weeks or more in adults, accounts for approximately 16 million outpatient visits per year. Chronic cough exerts a significant burden on the quality of life of patients, which is often why they initially seek treatment. Various factors have contributed to the high cost associated with the burden of chronic cough, from multiple referrals and unnecessary repeat testing to polypharmacy and development of comorbidities due to lack of proper treatment. ⋯ New targeted therapies in the clinical pipeline are expected to expand the treatment landscape and meet the unaddressed gaps for safe and efficacious agents that can provide relief and better management for patients. Access to appropriate care based on clinical guidelines is associated with favorable outcomes. Managed care organizations should consider treatment guidelines, patient factors, and emerging pharmacologic as well as nonpharmacologic treatment options to create a streamlined approach to managing chronic cough treatment in an evidence-based and cost-effective manner.
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Parkinson disease affects nearly 1 million people in the United States, and the prevalence is expected to increase to at least 1.2 million people by 2030. Parkinson disease is a chronic, incurable disease. ⋯ People with Parkinson disease who experience OFF periods and their caregivers have reported more work days with low productivity and more missed work days compared with those who do not experience OFF periods. More caregivers of people with Parkinson disease who experience OFF episodes reported that due to the disease, they had reduced or changed working hours, lost opportunities, or had reduced work productivity, and these caregivers reported an average of more than twice the amount of employment income lost compared with caregivers of people with Parkinson disease who do not experience OFF periods.