Extending Medicare coverage for preventive and other services
| Otros Autores: | , , |
|---|---|
| Formato: | Libro electrónico |
| Idioma: | Inglés |
| Publicado: |
Washington, D.C. :
National Academy Press
c2000.
|
| Edición: | 1st ed |
| Colección: | Compass series (Washington, D.C.)
|
| Materias: | |
| Ver en Biblioteca Universitat Ramon Llull: | https://discovery.url.edu/permalink/34CSUC_URL/1im36ta/alma991009820327006719 |
Tabla de Contenidos:
- Extending Medicare Coverage for Preventive and Other Services
- Copyright
- Acknowledgments
- REVIEWERS
- Preface
- Contents
- Extending Medicare Coverage for Preventive and Other Services
- Summary
- EVIDENCE AND COST ESTIMATES FOR SELECTED SERVICES
- Skin Cancer Screening
- Current Coverage
- Evidence Review, Conclusions, and Cost Estimates
- Medically Necessary Dental Services
- Current Coverage
- Evidence Review, Conclusions, and Cost Estimates
- Eliminating the Time Limit on Coverage of Immunosuppressive Drugs for Transplant Recipients
- Current Coverage
- Evidence Review, Conclusions, and Cost Estimates
- DECIDING COVERAGE FOR PREVENTIVE AND OTHER SERVICES
- Linking Evidence to Medicare Coverage: The Case of Preventive Services
- The Infrastructure for Making Coverage Decisions
- BEYOND COVERAGE
- BEYOND EVIDENCE
- 1 Introduction
- THE MEDICARE PROGRAM
- Historical Background
- Enrollment and Expenditure Trends
- MEDICARE COVERAGE DECISIONS
- Congress
- Health Care Financing Administration
- Administrative Contractors
- COVERAGE, ACCESS TO CARE, AND OUTCOMES
- Rationales for Extending Medicare Coverage
- Insurance and the Use of Health Care Services
- OVERVIEW OF THE REPORT
- 2 Objectives, Principles, and Methods
- OBJECTIVES AND PRINCIPLES
- Criteria and Trade-Offs
- ANALYTIC STRATEGY
- Defining the Intervention, Population, and Outcomes
- Identifying and Assessing the Scientific Literature
- Linking Evidence to Conclusions
- ESTIMATING COSTS TO MEDICARE OF EXTENDING COVERAGE
- Considering Health Outcomes and Costs Together
- 3 Screening for Skin Cancer
- ASSESSMENT APPROACH: INTERVENTION, POPULATION, AND OUTCOMES
- POPULATION BURDEN OF DISEASE
- Melanoma
- Nonmelanoma Skin Cancers
- AVAILABILITY OF EFFECTIVE TREATMENT
- Melanoma
- Nonmelanoma Skin Cancers.
- SCREENING AND DIAGNOSTIC PROCEDURES
- Screening
- Diagnosis
- Accuracy of Screening Tests
- Accuracy of Diagnostic Tests
- BENEFITS AND HARMS OF SKIN CANCER SCREENING
- General Issues
- EVIDENCE OF BENEFITS FROM EARLY DETECTION OF SKIN CANCER THROUGH SCREENING
- ESTIMATED COSTS TO MEDICARE OF EXTENDING COVERAGE
- STATEMENTS OF OTHERS ABOUT SKIN CANCER SCREENING
- COMMITTEE FINDINGS AND CONCLUSIONS
- Findings
- Possible Directions for Future Research
- Conclusions
- 4 Medically Necessary Dental Services
- DEFINING MEDICALLY NECESSARY DENTAL SERVICES
- ASSESSMENT APPROACH: INTERVENTION, POPULATION, AND OUTCOMES
- HEAD AND NECK CANCER
- Burden of Disease
- Treatment of Cancers of the Head and Neck
- Oral Health Problems Associated with Radiation Treatment of Cancers of the Head and Neck
- Dental Care for Patients Undergoing Radiation Therapy for Cancer of the Head and Neck
- Effectiveness of Dental Care in Improving Health Outcomes for Head and Neck Cancer Patients Treated with Radiation
- LEUKEMIA AND LYMPHOMA
- Leukemia
- Burden of Disease
- Oral Health Problems and Leukemias
- Treatment for Leukemias
- Lymphoma
- Burden of Disease
- Oral Health Problems and Lymphomas
- Treatment for Lymphomas
- Oral Health Problems Related to Treatment for Leukemia and Lymphoma
- Dental Care for Patients with Leukemia or Lymphoma
- Effectiveness of Dental Care in Improving Health Outcomes for Leukemia and Lymphoma Patients
- SOLID ORGAN TRANSPLANTS
- Burden of Disease
- Oral Health Problems and Organ Transplantation
- Dental Care for Patients Before or After Organ Transplantation
- Effectiveness of Dental Care in Improving Health Outcomes for Organ Transplant Recipients
- HEART VALVE REPAIR OR REPLACEMENT
- Burden of Disease
- Oral Health Problems and Heart Valve Disease.
- Dental Care for Patients Undergoing Surgery for Heart Valve Disease
- Effectiveness of Dental Care in Promoting Better Health Outcomes for Patients with Heart Valve Disease
- ESTIMATED COSTS TO MEDICARE OF EXTENDING COVERAGE
- STATEMENTS OF OTHERS ON "MEDICALLY NECESSARY DENTAL SERVICES"
- COMMITTEE FINDINGS AND CONCLUSIONS
- Findings
- Cancers of the Head and Neck
- Leukemia
- Lymphoma
- Organ Transplantation
- Heart Valve Repair and Replacement
- Possible Directions for Future Research
- Conclusions
- 5 Immunosuppressive Drugs for Transplant Patients
- EVOLUTION OF IMMUNOSUPPRESSIVE DRUG COVERAGE BY MEDICARE
- ASSESSMENT APPROACH
- BURDEN OF DISEASE
- Need for Immunosuppression
- Waiting Lists for Transplantation
- AVAILABILITY OF EFFECTIVE TREATMENT
- BARRIERS TO ADEQUATE THERAPY
- Following Complex Drug Regimens: General Issues
- Cost of Immunosuppressive Drugs
- Expiration of Medicare Coverage and Alternative Funding
- Evidence About the Effects of Providing or Withdrawing Coverage13
- ESTIMATED COSTS TO MEDICARE OF EXTENDING COVERAGE
- STATEMENTS OF OTHERS ON COVERAGE FOR IMMUNOSUPPRESSANTS
- COMMITTEE FINDINGS AND CONCLUSIONS
- Findings
- Possible Directions for Further Research
- Conclusions
- 6 Future Directions
- LINKING EVIDENCE TO MEDICARE COVERAGE: THE CASE OF PREVENTIVE SERVICES
- STRENGTHENING THE INFRASTRUCTURE FOR COVERAGE DECISIONS
- Commitment to Technology Assessment
- Examples of Specific Infrastructure Weaknesses
- Role of Cost and Cost-Effectiveness Analyses
- Linking Evidence to Recommendations
- THE LIMITS OF COVERAGE
- THE LIMITS OF EVIDENCE
- References
- APPENDIX A Study Activities
- INSTITUTE OF MEDICINE COMMITTEE ON MEDICARE COVERAGE EXTENSIONS WORKSHOP ON MEDICALLY NECESSARY DENTAL CARE
- Agenda.
- INSTITUTE OF MEDICINE COMMITTEE ON MEDICARE COVERAGE EXTENSIONS WORKSHOP ON SKIN CANCER SCREENING
- Agenda
- INSTITUTE OF MEDICINE COMMITTEE ON MEDICARE COVERAGE EXTENSIONS WORKSHOP ON IMMUNOSUPPRESSIVE DRUG THERAPY
- Agenda
- APPENDIX B Screening for Skin Cancer
- INTRODUCTION
- EPIDEMIOLOGY AND BURDEN OF SUFFERING
- Melanoma
- Nonmelanoma Skin Cancer
- NATURAL HISTORY, DIAGNOSIS, AND STAGING OF SKIN CANCER
- Melanoma
- Nonmelanoma Skin Cancers
- RECOMMENDATIONS OF SECOND TASK FORCE AND OTHERS
- ANALYTIC FRAMEWORK AND KEY QUESTIONS
- METHODS
- Literature Review
- Data Extraction and Synthesis
- RESULTS
- Accuracy of Screening Tests
- Screening Studies
- Non-Screening Studies
- Risk Factors for Nonmelanoma Skin Cancer
- Risk Factors for Melanoma
- Reliability of Measures of Risk
- Use of Risk Assessment in Practice
- Consequences of Screening
- Type of Skin Examination
- Recruitment Strategy
- Procedure for Referring Patients for Follow-Up
- Effectiveness of Early Treatment
- Case-Control Study of Self-Examination
- Comparing Stages of Cancers and Mortality Found in Screening to Those Found in Usual Practice
- Retrospective Studies of the Consequences of Delay in Diagnosis
- Cost-Effectiveness Studies of Screening for Skin Cancer
- SUMMARY
- ADDENDUM B-1 STRATEGY FOR SKIN CANCER SEARCH
- ADDENDUM B-2 SCREENING FOR SKIN CANCER: INCLUSION CRITERIA FOR EVIDENCE TABLES
- REFERENCES
- APPENDIX C Medically Necessary Dental Services
- OVERVIEW
- What Are Medically Necessary Dental Services?
- Selected Clinical Conditions Under Consideration
- Currently Covered Dental Services Under Medicare
- Increasing Number of Persons 65 and Above Who Are Retaining Natural Teeth
- Decision Framework for Medically Necessary Dental Services
- Decision Analytical Framework
- General Analytic Approach.
- CONDITION 1: HEAD AND NECK CANCER
- Introduction
- Methods
- General Observations from the Literature Search
- Acute and Chronic Complications of Radiation Therapy to the Head and Neck Region
- Pretreatment Dental Assessment
- Prevalence of Dental Disease in the At-Risk Population
- Preventive Dental Treatment Needs
- Efficacy of Pretreatment Care: Aggressive Extraction-No Prevention Versus Dental Preservation Approach
- Influence of Paradigm Shift to Dental Preservation on Incidence of Osteoradionecrosis
- Is There a Role for Prophylactic Hyperbaric Oxygen Therapy in the Prevention of Osteoradionecrosis from Postradiation…
- What Treatment Is Required to Manage Osteoradionecrosis of the Jaws?
- What Is the Quality of Life Impact of Head and Neck Cancer Treatment?
- Summary
- CONDITIONS 2 AND 3: LEUKEMIA AND LYMPHOMA
- Introduction
- Methods
- Leukemia
- Leukemia Incidence and Burden
- Leukemia-Clinical Oral Aspects
- Lymphoma
- Lymphoma Incidence and Burden
- Lymphoma-Clinical Oral Aspects
- Oral Complications of Treatment for Leukemia and Lymphoma: Chemotherapy and Bone Marrow Transplantation
- Oral Sources of Septicemia in Patients with Hematologic or Lymphatic Malignancies
- Role of Prechemotherapy Dental Treatment in Reducing Septicemias
- Oral Mucositis Treatment
- CONDITION 4: ORGAN TRANSPLANTATION
- Introduction
- Methods
- Infections
- Immunosuppression Therapy
- Pre-Transplant Oral Considerations
- What Type of Dental Services Could Be Considered Medically Necessary?
- Early Detection of Dental Problems
- Posttransplant Considerations
- Other Oral Lesions in Transplant Recipients
- Summary
- CONDITION 5: HEART VALVE REPAIR OR REPLACEMENT
- Introduction
- Medicare Utilization and Reimbursement of Valvular Heart Disease
- Methods
- Results
- ACKNOWLEDGMENTS
- REFERENCES
- Overview.
- Head and Neck Cancer.
