CONTEXT Since varicella vaccine was first recommended for routine immunization in the United States in 1995, the incidence of disease has dropped substantially. However, national surveillance data are incomplete, and comprehensive data regarding outpatient as well as hospital utilization have not been reported. OBJECTIVE To examine the impact of the varicella vaccination program on medical vi...

Background From an equity perspective, a health system needs to address social, political and economic inequalities that prevent people to achieve higher standards of living and exert their right to health [1,2]. The 2008 Ecuadorian Constitution guarantees the right to health, an important contributing factor to good living or Sumak Kawsay [3]. The purpose of this study was to analyze socioecon...

PURPOSE The purpose of this systematic review is to identify clinical outcomes, health care utilization and costs associated with teledentistry. Relevant databases were searched for articles on teledentistry published until March 2012, reference lists examined and key journals hand searched. Of a possible 58 articles, 19 studies met the inclusion criteria. Clinical outcomes were generally impro...

BACKGROUND We assessed change in household catastrophic health care expenditures (CHE) and inequality in facing such expenditures in south-west Tehran. METHODS A cluster-sampled survey was conducted in 2003 using the World Health Survey questionnaire. We repeated the survey on the same sample in 2008 (635 and 603 households, respectively). We estimated the proportion of households facing CHE ...

IMPORTANCE In 2009, Washington State enacted legislation outlining the medical care of children and adolescents with concussion (ie, the Lystedt Law), with all other states and Washington, DC passing legislation by January 2014. OBJECTIVE To evaluate the effect of concussion laws on health care utilization rates from January 1, 2006, through June 30, 2012, in states with and without legislati...

A good understanding of the health heterogeneity of elderly people, their characteristics, patterns of health care utilization and subsequent expenditures is necessary to adequately evaluate the policy options and interventions aimed at improving quality and efficiency of care for older people. This article reviews studies that used Latent Class Analysis to identify four health profiles among e...

10.1056/nejmp0907172 nejm.org 1 since doing so would require taxes to be raised beyond the level the public can sustain. Others believe that we can slow spending growth only by rationing needed care. Neither option is attractive. Evidence regarding regional variations in spending and growth, however, points to a more hopeful alternative: we should be able to reorganize and improve care to elimi...

Among Veterans, heart failure (HF) contributes to frequent emergency department visits and hospitalization. Dual health care system use (dual use) occurs when Veterans Health Administration (VA) enrollees also receive care from non-VA sources. Mounting evidence suggests that dual use decreases efficiency and patient safety. This qualitative study used constructivist grounded theory and content ...

Family members are important to the well-being of their relatives with substance use disorders or co-occurring substance use and mental disorders. Many caregivers experience high levels of burden, negatively impacting their capacity to provide support to their ill family member. The Andersen health care utilization model (Andersen & Newman, 1973, 2005) was used to identify the impact of predisp...

In a recent paper, John Nyman (Nyman, 1999b) revisits an issue that has been central to much of the literature in health economics in recent years, namely the trade-off between the gains from insurance, on the one hand, and the efficiency losses from the moral hazard effect that arises as a result of the implicit subsidy to health services utilization under conventional insurance plans, on the ...