Archive for March, 2007
March 31st, 2007 12:03:11
The programme for the evaluation of patient care with acupuncture (PEP-Ac) - a project sponsored by ten German social health insurance funds.
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The programme for the evaluation of patient care with acupuncture (PEP-Ac) - a project sponsored by ten German social health insurance funds.
Acupunct Med. 2006 Dec;24 Suppl:S25-32
Authors: Linde K, Streng A, Hoppe A, Jürgens S, Weidenhammer W, Melchart D
OBJECTIVE: The aim of the Programme for the Evaluation of Patient care with Acupuncture (PEP-Ac) was to investigate the efficacy, effectiveness and safety of acupuncture in patients with the following three indications: chronic headache, chronic low back pain and chronic osteoarthritic pain. This article provides an overview of the results of the whole programme. METHODS: The programme included five randomised trials, a large observational study, a survey of physicians providing acupuncture, and three systematic reviews. RESULTS: The results show that, for all three indications, acupuncture, when compared to no treatment, produces a clear benefit that lasts for at least several months. However the effects of point-specific acupuncture only offered a significant advantage over minimal acupuncture in the treatment of OA knee. CONCLUSIONS: The evidence from these trials - on the one hand, a clear overall effect of acupuncture and on the other hand, the lack of evidence supporting its superiority over sham acupuncture for all indications except osteoarthritis of the knee - leaves a considerable amount of room for interpretation.
PMID: 17308506 [PubMed - in process]
March 30th, 2007 14:03:54
Improved asthma care after enrollment in the State Children’s Health Insurance Program in New York.
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Improved asthma care after enrollment in the State Children’s Health Insurance Program in New York.
Pediatrics. 2006 Feb;117(2):486-96
Authors: Szilagyi PG, Dick AW, Klein JD, Shone LP, Zwanziger J, Bajorska A, Yoos HL
BACKGROUND: Uninsured children with asthma are known to face barriers to asthma care, but little is known about the impact of health insurance on asthma care. OBJECTIVES: We sought to assess the impact of New York’s State Children’s Health Insurance Program (SCHIP) on health care for children with asthma. DESIGN: Parents of a stratified random sample of new enrollees in New York’s SCHIP were interviewed by telephone shortly after enrollment (baseline, n = 2644 [74% of eligible children]) and 1 year later (follow-up, n = 2310 [87%]). Asthma was defined by parent report using questions based on National Heart, Lung, and Blood Institute criteria. A comparison group (n = 401) who enrolled in SCHIP 1 year later was interviewed as a test for secular trends. MAIN OUTCOME MEASURES: Access (having a usual source of care [USC], unmet health needs, problems receiving acute asthma care), asthma-related medical visits, quality (continuity of care at the USC, problems receiving chronic asthma care, use of antiinflammatory medications), and asthma outcomes (change in asthma care or severity) were the main outcome measures used. Bivariate and multivariate analyses compared measures at baseline (year before SCHIP) versus follow-up (year during SCHIP). RESULTS: Three-hundred eighty-three children (14%) had asthma at baseline, and 364 had asthma at follow-up (16%). No secular trends were detected between the baseline study group and the comparison group. After enrollment in SCHIP, improvements were noted in access: lacking a USC (decrease from 5% to 1%), unmet health needs (48% to 21%), and problems getting to the USC for asthma (13 to 4%). Children had fewer asthma-related attacks and medical visits after SCHIP (mean number of attacks: 9.5 to 3.8: mean number of asthma visits: 3.0 to 1.5; hospitalizations: 11% to 3%). Quality of asthma care improved for general measures (most/all visits to USC: 53% to 94%; mean rating of provider: 7.9 to 8.8 of 10) and asthma-specific measures (problems getting to the USC for asthma care when child was well: 13% to 1%). More than two thirds of the parents at follow-up reported that both quality of asthma care and asthma severity were “better or much better” than at baseline, generally because of insurance coverage or lower costs of medications and medical care. CONCLUSIONS: Enrollment in New York’s SCHIP was associated with improvements in access to asthma care, quality of asthma care, and asthma-specific outcomes. These findings suggest that health insurance improves the health of children with asthma.
PMID: 16452369 [PubMed - indexed for MEDLINE]
March 30th, 2007 12:03:38
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