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Статті в журналах з теми "Insurance Claim Reporting – United States"
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Noone, Anne-Michelle, Clara J. K. Lam, Angela B. Smith, Matthew E. Nielsen, Eric Boyd, Angela B. Mariotto, and Mousumi Banerjee. "Machine Learning Methods to Identify Missed Cases of Bladder Cancer in Population-Based Registries." JCO Clinical Cancer Informatics, no. 5 (June 2021): 641–53. http://dx.doi.org/10.1200/cci.20.00170.
Повний текст джерелаАнотація:
PURPOSE Population-based cancer incidence rates of bladder cancer may be underestimated. Accurate estimates are needed for understanding the burden of bladder cancer in the United States. We developed and evaluated the feasibility of a machine learning–based classifier to identify bladder cancer cases missed by cancer registries, and estimated the rate of bladder cancer cases potentially missed. METHODS Data were from population-based cohort of 37,940 bladder cancer cases 65 years of age and older in the SEER cancer registries linked with Medicare claims (2007-2013). Cases with other urologic cancers, abdominal cancers, and unrelated cancers were included as control groups. A cohort of cancer-free controls was also selected using the Medicare 5% random sample. We used five supervised machine learning methods: classification and regression trees, random forest, logic regression, support vector machines, and logistic regression, for predicting bladder cancer. RESULTS Registry linkages yielded 37,940 bladder cancer cases and 766,303 cancer-free controls. Using health insurance claims, classification and regression trees distinguished bladder cancer cases from noncancer controls with very high accuracy (95%). Bacille Calmette-Guerin, cystectomy, and mitomycin were the most important predictors for identifying bladder cancer. From 2007 to 2013, we estimated that up to 3,300 bladder cancer cases in the United States may have been missed by the SEER registries. This would result in an average of 3.5% increase in the reported incidence rate. CONCLUSION SEER cancer registries may potentially miss bladder cancer cases during routine reporting. These missed cases can be identified leveraging Medicare claims and data analytics, leading to more accurate estimates of bladder cancer incidence.
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Noguchi, Yoshihiro, Shunsuke Yoshizawa, Tomoya Tachi, and Hitomi Teramachi. "Effect of Dipeptidyl Peptidase-4 Inhibitors vs. Metformin on Major Cardiovascular Events Using Spontaneous Reporting System and Real-World Database Study." Journal of Clinical Medicine 11, no. 17 (August 25, 2022): 4988. http://dx.doi.org/10.3390/jcm11174988.
Повний текст джерелаАнотація:
Background: Metformin had been recommended as the first-line treatment for type 2 diabetes since 2006 because of its low cost, high efficacy, and potential to reduce cardiovascular events, and thus death. However, dipeptidyl peptidase-4 (DPP-4) inhibitors are the most commonly prescribed first-line agents for patients with type 2 diabetes in Japan. Therefore, it is necessary to clarify the effect of DPP-4 inhibitors on preventing cardiovascular events, taking into consideration the actual prescription of antidiabetic drugs in Japan. Methods: This study examined the effect of DPP-4 inhibitors on preventing cardiovascular events. The Japanese Adverse Drug Event Report (JADER) database, a spontaneous reporting system in Japan, and the Japanese Medical Data Center (JMDC) Claims Database, a Japanese health insurance claims and medical checkup database, were used for the analysis. Metformin was used as the DPP-4 inhibitor comparator. Major cardiovascular events were set as the primary endpoint. Results: In the analysis using the JADER database, a signal of major cardiovascular events was detected with DPP-4 inhibitors (IC: 0.22, 95% confidence interval: 0.03–0.40) but not with metformin. In the analysis using the JMDC Claims Database, the hazard ratio of major cardiovascular events for DPP-4 inhibitors versus metformin was 1.01 (95% CI: 0.84–1.20). Conclusions: A comprehensive analysis using two different databases in Japan, the JADER and the JMDC Claims Database, showed that DPP-4 inhibitors, which are widely used in Japan, have a non-inferior risk of cardiovascular events compared to metformin, which is used as the first-line drug in the United States and Europe.
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Broder, Michael S., Qiufei Ma, Tingjian Yan, Eunice Chang, Lamis K. Eldjerou, Yanni Hao, David Kuzan, and Jie Zhang. "Economic Burden of Neurologic Toxicities Associated with Treating Relapsed Refractory Diffuse Large B-Cell Lymphoma in the United States." Blood 134, Supplement_1 (November 13, 2019): 4719. http://dx.doi.org/10.1182/blood-2019-122587.
Повний текст джерелаАнотація:
Introduction: Chimeric antigen receptor T (CAR-T) cell therapies targeting CD19 antigen can yield durable remissions in relapsed or refractory diffuse large B-cell lymphoma (r/r DLBCL). Yet the use of CAR-T can be limited by potentially severe toxicities, principally cytokine release syndrome (CRS) and neurologic toxicities. Management of neurologic toxicities requires vigilant monitoring, supportive treatment and resource allocation. We found no studies reporting healthcare costs associated with treatment-related neurologic adverse events (NEAEs) in r/r DLBCL patients. The objective of this study was to develop an evidence-based list of r/r DLBCL treatment-related NEAEs and to estimate the healthcare costs associated with these NEAEs in a real-world setting. Methods: Grade 3 or higher NEAEs that occurred in ≥2% of patients were identified by reviewing U.S. drug prescribing information (PI), European Medicines Agency summaries of product characteristics, and published clinical trials for treatments of r/r DLBCL. Then, adult patients ≥18 years old with r/r DLBCL were identified from a U.S. administrative claims database containing de-identified claims for over 150 million people across over 11 years. Patients were included if they had: 1) evidence of treatment beyond first-line (2L+) during the identification period (07/01/14 - 12/31/18); and 2) ≥1 inpatient or ≥2 outpatient claims for DLBCL (ICD-9-CM codes: 200.7X; ICD-10-CM codes: C83.3X) during the study period (01/01/14 - 12/31/18) with ≥1 having occurred prior to or on the date when the 2L+ treatment was received. 2L+ treatments were selected based on National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines and clinical expert input. To maximize the identification of patients treated with CAR-T, treatments were categorized hierarchically into 4 groups: CAR-T therapy (axicabtagene ciloleucel, or tisagenlecleucel), high-intensity cytotoxic therapy (carboplatin, cisplatin, cyclophosphamide, or ifosfamide), low-intensity cytotoxic therapy (bendamustine, lenalidomide, or gemcitabine), and targeted monotherapy (rituximab, ibrutinib, or brentuximab vedotin). The index date was defined as the start date of the 2L+ treatment. Patients in the cytotoxic and targeted therapy groups were also required to have evidence of an earlier line of cytotoxic or targeted therapy. All patients were required to have ≥6-months continuous enrollment before the index date. The outcomes of interest were the rates of NEAEs and total healthcare costs for patients with and without NEAEs during the 30-day post index period. Costs were inflated to 2018 US dollars. Descriptive statistics were reported. Results: Twenty-three NEAEs were identified based on the review: 17 for CAR-T, 10 for conventional immunochemotherapy regimens, and 4 for both. In the claims database, a total of 349 adult patients with r/r DLBCL were identified, including 27 CAR-T therapy, 262 high-intensity cytotoxic therapy, 50 low-intensity cytotoxic therapy, and 10 targeted therapy users. Mean (median, SD) patient age was 72.3 (73; 10.3) years, with 47.9% being female and 83.4% having Medicare insurance. Patients were mainly from the South (44.1%) and the Midwest (31.5%). The mean (SD) Charlson comorbidity index was 4.4 (3.6) and mean (SD) number of chronic conditions was 7.3 (2.2). Forty-five (12.9%) patients had ≥1 NEAE at some point during the 30-day post-index period. Of these, 14 (31.1%) were CAR-T users. Eleven (40.7%) of the CAR-T users had encephalopathy. Mean total healthcare costs were $99,611 higher for patients with NEAEs [mean (SD): $153,435 (227,771)] than those without any NEAEs [$53,824 (96,170)]. Among patients with NEAEs, 72% of the healthcare costs were accrued in the inpatient setting. Among patients without NEAEs, 63% of the healthcare costs were for outpatient medical services. The trend of higher costs in patients with NEAEs was consistent across treatment groups. Conclusion: This is the first study of the economic burden of NEAEs associated with treating r/r DLBCL in a real-world setting with data that reflects the current range of treatment options. Patients with r/r DLBCL who have NEAEs incur substantially higher costs than those without such events. In this analysis, CAR-T is overrepresented for NEAEs, although the sample size is small. We intend to repeat the analysis when more claims data becomes available in the near future. Disclosures Broder: Partnership for Health Analytic Research (PHAR), LLC: Other: I am an employee of the Partnership for Health Analytic Research (PHAR), LLC, which was paid by Novartis to conduct the research described in this abstract.. Ma:Novartis Pharmaceuticals Corporation: Employment. Yan:Partnership for Health Analytic Research (PHAR), LLC: Other: T. Yan is an employee of Partnership for Health Analytic Research (PHAR), LLC, a health services research company paid to conduct this research.. Chang:Partnership for Health Analytic Research (PHAR), LLC: Other: E. Chang is an employee of Partnership for Health Analytic Research (PHAR), LLC, a health services research company paid to conduct this research.. Eldjerou:Novartis Pharmaceuticals Corporation: Employment. Hao:Novartis Pharmaceuticals Corporation: Employment, Equity Ownership. Kuzan:Novartis Pharmaceuticals Corporation: Employment. Zhang:Novartis Pharmaceuticals Corporation: Employment, Equity Ownership.
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Muara Lysta Sirait, Muhammad Alfarisi, Zievan Ananta Pahlevi, and Maria Yus Trinity Irsan. "Claim Reserves Estimation Using Chain Ladder Method in Casualty Insurance for the Period 2010 - 2019." International Journal of Management and Business Economics 2, no. 3 (March 26, 2024): 35–40. http://dx.doi.org/10.58540/ijmebe.v2i3.515.
Повний текст джерелаАнотація:
In a work environment, the presence of risk or unforeseeable events is inevitable, as employees certainly seek to get a sense of security in doing work. Therefore, insurance is responsibility to provide sense of security to employees by providing protection in the form of claim payments to employees who get accidents. To meet the claim payment, insurance companies need to prepare funds. With the chain ladder method, insurance companies can estimate how much funds must be prepared to make claim payments. This study used the secondary data from general insurance companies in the United States published by the National Association of Insurance Commissioners under the title "Statistical Compilation of Annual Statement Information for Property/Casualty Insurance Companies in 2019". Data in the form of cumulative run-off triangle with accident period 2010-2019. Through this calculation, claim reserves that must be prepared by insurance companies for 2020 amounted to USD 1,553,906.
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Williams, PhD, MS, Rachel E., Timothy J. Sampson, BS, Linda Kalilani, MBBS, PhD, John I. Wurzelmann, MD, MPH, and Stephen W. Janning, PharmD. "Epidemiology of opioid pharmacy claims in the United States." Journal of Opioid Management 4, no. 3 (January 30, 2018): 145. http://dx.doi.org/10.5055/jom.2008.0019.
Повний текст джерелаАнотація:
Objective: To describe opioid pharmacy claims patterns in the United States among an insured population.Design: Information was obtained from the US insurance claims database, IMS Lifelink™, between 1997 and 2002. Descriptive statistics of opioid claims patterns were described with stratification by gender, age, and year of use.Results: The prevalence of insured people with opioid claims increased from 17.1 percent in 1997 to 18.4 percent in 2002. Among people with an opioid claim, 24 percent had ≥30 days and 10 percent had ≥90 days of days supplied based on the insurance claims. Prevalence varied by type of opioid; 56 percent of people with a claim received propoxyphene, 43 percent received codeine, 23 percent received oxycodone, and 17 percent received hydrocodone. Sustained-release opioids were found among 6 percent of those with a claim. With respect to the dose of opioids in the pharmacy claims (expressed as morphine equivalent total daily dose), 71 percent had claims for <50 mg, 55 percent had claims for 50-99 mg, and 24 percent had claims for ≥100 mg. Women, individuals with cancer, and older patients had significantly more pharmacy claims as well as claims for higher doses of opioids (p < 0.05). Internal medicine and family practice specialists were responsible for 22.4 percent and 20.9 percent of all opioid claims.Conclusions: Opioid pharmacy claims increased slightly over time. Older patients, women and patients with a cancer diagnosis had significantly more opioid claims and claims for higher doses than the younger patients, men, and those without cancer.
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Wen, Shiran. "Health insurance claim amount prediction using statistical methods." Applied and Computational Engineering 73, no. 1 (July 5, 2024): 94–99. http://dx.doi.org/10.54254/2755-2721/73/20240370.
Повний текст джерелаАнотація:
Healthcare can be costly in the United States. In 2021, the average cost of health insurance for a family of four was $22,221 per year. The average cost of health insurance for an individual was $7,739 per year (Keiser Family Foundation). With the aim of helping the public know more about what factors contribute the most to the expensive cost of their health insurance, this study conducted the analysis to identify the top contributing factors that increase health insurance claim amounts. Various statistical and machine learning tools were used to answer the proposed question: data conversion, correlation, partial correlation, k-means clustering, principal component analysis, multiple regression, lasso regression, support vector machine, and random forest. Consistent results that BMI (Body Mass Index), blood pressure, and smoking are the three variables that contribute the most to the increase in health insurance claim amount were found.
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Rejesus, Roderick M., Ashley C. Lovell, Bertis B. Little, and Mike H. Cross. "Determinants of Anomalous Prevented Planting Claims: Theory and Evidence from Crop Insurance." Agricultural and Resource Economics Review 32, no. 2 (October 2003): 244–58. http://dx.doi.org/10.1017/s1068280500006018.
Повний текст джерелаАнотація:
This study examines the factors that determine the likelihood of submitting a potentially fraudulent prevented planting claim. A theoretical model is developed and the theoretical predictions are empirically verified by utilizing a binary choice model and crop insurance data from the southern United States. The empirical results show that insured producers with higher prevented planting coverage, lower dollar value of expected yield, and a history of submitting prevented planting claims are more likely to submit an anomalous prevented planting claim. The empirical model also suggests revenue insurance plans may be more vulnerable to prevented planting fraud than the traditional yield-based insurance plan. Results of this study can be valuable to compliance offices in their efforts to find “indicators” of fraudulent behavior in crop insurance, especially with regard to prevented planting.
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Pascale, Joanne. "Measurement Error in Health Insurance Reporting." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 45, no. 4 (November 2008): 422–37. http://dx.doi.org/10.5034/inquiryjrnl_45.04.422.
Повний текст джерелаАнотація:
In the United States, surveys serve as the only source of data for the number of uninsured people; they also provide rich data for exploring the relationships between health insurance coverage and individuals' life circumstances, such as employment, income, and health status, enabling researchers to assess the effectiveness of various aspects of the health care system. The Current Population Survey (CPS) is one of the most influential surveys measuring health insurance, but it is not without critics. To address outstanding questions about the data quality of the CPS health insurance questions, qualitative testing was conducted to assess various aspects of the questionnaire from the respondent's perspective. A testing protocol was developed largely based on previous health survey methods literature, and test subjects were probed about their comprehension of the questions, particular terms and phrases, and their strategies for formulating an answer. Several design features were identified as problematic, including the overall questionnaire structure, the calendar year reference period, the household-level design, and the wording of questions on public coverage.
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Farrow, Freeman L. "The Anti-Patient Psychology of Health Courts: Prescriptions from a Lawyer-Physician." American Journal of Law & Medicine 36, no. 1 (March 2010): 188–220. http://dx.doi.org/10.1177/009885881003600104.
Повний текст джерелаАнотація:
Critics of the current medical malpractice tort system claim that adjudication of malpractice claims before generalist judges and lay juries contributes to rising costs of medical malpractice insurance premiums and medical care. They claim that properly deciding issues in this realm requires specialized knowledge of medicine and medical technology that juries, and even judges of general jurisdiction, do not possess. One lobbying group alleges there is a continuing medical malpractice litigation crisis in the United States, evidenced by increasing medical costs, deaths from needless medical errors, departure of physicians from the practice of medicine due to increasing medical malpractice insurance premiums, and random medical justice in medical malpractice cases. Whether there is a direct, causal correlation between the increasing cost of medical malpractice insurance premiums and medical malpractice litigation is debatable.
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Owusu-Edusei, Kwame, Carla A. Winston, Suzanne M. Marks, Adam J. Langer, and Roque Miramontes. "Tuberculosis Test Usage and Medical Expenditures from Outpatient Insurance Claims Data, 2013." Tuberculosis Research and Treatment 2017 (2017): 1–9. http://dx.doi.org/10.1155/2017/3816432.
Повний текст джерелаАнотація:
Objective. To evaluate TB test usage and associated direct medical expenditures from 2013 private insurance claims data in the United States (US). Methods. We extracted outpatient claims for TB-specific and nonspecific tests from the 2013 MarketScan® commercial database. We estimated average expenditures (adjusted for claim and patient characteristics) using semilog regression analyses and compared them to the Centers for Medicare and Medicaid Services (CMS) national reimbursement limits. Results. Among the TB-specific tests, 1.4% of the enrollees had at least one claim, of which the tuberculin skin test was most common (86%) and least expensive ($9). The T-SPOT® was the most expensive among the TB-specific tests ($106). Among nonspecific TB tests, the chest radiograph was the most used test (78%), while chest computerized tomography was the most expensive ($251). Adjusted average expenditures for the majority of tests (≈74%) were above CMS limits. We estimated that total United States medical expenditures for the employer-based privately insured population for TB-specific tests were $53.0 million in 2013, of which enrollees paid 17% ($9 million). Conclusions. We found substantial differences in TB test usage and expenditures. Additionally, employer-based private insurers and enrollees paid more than CMS limits for most TB tests.
Книги з теми "Insurance Claim Reporting – United States"
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Association, American Medical, ed. Fundamentals of coding, payment, and documentation: Understanding their role and impact in health care. Chicago: American Medical Association, 2012.
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Why are veterans waiting years on appeal?: A review of the post-decision process for appealed veterans' disability benefits claims : hearing before the Subcommittee on Disability Assistance and Memorial Affairs of the Committee on Veterans' Affairs, U.S. House of Representatives, One Hundred Thirteenth Congress, first session, Tuesday, June 18, 2013. Washington: U.S. Government Printing Office, 2014.
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Green, Michelle A. Understanding health insurance: A guide to billing and reimbursement. 9th ed. Clifton Park, NY: Delmar Cengage Learning, 2008.
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Rowell, Jo Ann C., 1934-, ed. Understanding health insurance: A guide to billing and reimbursement. 8th ed. Clifton Park, NY: Thomson Delmar Learning, 2006.
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Moynihan, James J. Implementation manual for the healthcare claim payment/advice: Guidelines for electronic payment of healthcare claims using the ANSI ASC X12 electronic data interchange (EDI) standard. Chicago: HFMA, 1996.
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Kate, Repa Barbara, ed. How to win your personal injury claim. Berkeley: Nolo Press, 1992.
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Kate, Repa Barbara, ed. How to win your personal injury claim. 2nd ed. Berkeley: Nolo Press, 1996.
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A, Foggan Laura, Zoogman Nicholas J, and Practising Law Institute, eds. Insurance coverage 2005: Claim trends & litigation. New York: Practising Law Institute, 2005.
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A, Foggan Laura, Paar Randy 1949-, and Practising Law Institute, eds. Insurance coverage, 2003: Claim trends & litigation. New York, N.Y: Practising Law Institute, 2003.
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Kate, Repa Barbara, and Gima Patricia, eds. How to win your personal injury claim. 3rd ed. Berkeley, CA: Nolo.com, 1999.
Знайти повний текст джерелаЧастини книг з теми "Insurance Claim Reporting – United States"
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Erikson, Robert S., Michael B. Mackuen,, and James A. Stimson. "Public Opinion and Policy: Causal Flow in a Macro System Model." In Navigating Public Opinio, 33–53. Oxford University PressNew York, NY, 2002. http://dx.doi.org/10.1093/oso/9780195149333.003.0003.
Повний текст джерелаАнотація:
Abstract In a democracy such as the United States, policy is supposed to flow from the preferences of the public. Of the many studies of a possible causal connection from public opinion to policy, almost all are cross-sectional, that is, involving a search for covariance between public opinion and policy across units measured for a constant time period. Although often reporting positive opinion-policy relationships, these studies invite the critique that reported cross-sectional correlations are subject to rival causal interpretations beyond the claim of representative democracy at work.
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Illingworth, Patricia, and Wendy E. Parmet. "Denying the Right to Health." In Health of Newcomers. NYU Press, 2017. http://dx.doi.org/10.18574/nyu/9780814789216.003.0006.
Повний текст джерелаАнотація:
Many nations claim to respect the right to health, which requires states to provide access to necessary health care without discrimination of any kind. Nevertheless, most states that purport to recognize the right to health discriminate against some classes of newcomers, especially unauthorized immigrants. This chapter reviews the status of immigrants’ right to health under international law and then turns to an examination of immigrants’ access to health insurance in Canada and the European Union. The chapter demonstrates that even in nations that are widely believed to have universal health care systems, many classes of immigrants are left without access to the means to pay for needed health care. As in the United States, these exclusions impact the health of newcomers and natives alike.
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Boutros, Andrew. "Investigations, Privacy and Data Security Issues." In From Baksheesh to Bribery, 593–604. Oxford University Press, 2019. http://dx.doi.org/10.1093/oso/9780190232399.003.0022.
Повний текст джерелаАнотація:
When conducting internal investigations, it is critical to understand and consider various U.S. and international privacy and data protection laws. Some of the key laws investigators must consider include the Electronic Communications Privacy Act, the Fair Credit Reporting Act, and the Health Insurance Portability and Accountability Act. In addition, Sarbanes-Oxley in the United States and privacy and data security regimes in other countries and regions, for example Australia and the European Union, contain critical data security provisions, of which internal investigators must be aware. This chapter also includes discussion of other laws pertaining to the subject, such as the Children’s Online Privacy Protection Act, the Communications Act, and the Driver’s Privacy Protection Act.
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Dewees, Don, David Duff, and Michael Trebilcock. "Introduction." In Exploring The Domain Of Accident Law, 3–14. Oxford University PressNew York, NY, 1996. http://dx.doi.org/10.1093/oso/9780195087970.003.0001.
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Abstract The crisis in the mid-1980s in the availability, affordability, and adequacy of liability insurance in the United States and to a lesser extent in Canada, and the widespread public attention that has been generated in the United States in a number of huge mass tort claims, such as the asbestos, DES, and Agent Orange litigations, have precipitated much anguished political, judicial, and academic soul-searching as to the goals and future of the tort system, especially with respect to personal injuries. While some scholars have questioned whether the perception of a so-called litigation explosion in recent years is empirically well grounded,. calls for a re examination of the tort system and its alternatives continue unabated.. In any event, the pervasiveness and cost of accidents underscore the immense importance of law and policy decisions in this area. One of every four Americans is injured each year. In 1985, million Americans were injured seriously enough to require medical attention or to restrict their activities, and 143,000 of these died from their injuries, making injuries the fourth leading cause of death in the United States.. One study estimated the cost of injuries in the United States in 1985 to be $182 billion (in 1988 dollars).. This book documents the ways in which the traditional tort regime has come underseige on a number of different fronts. While upward trends in frequency and size of claim have been less dramatic for automobile accidents than for other accidents, concerns over escalating costs of premiums-which most drivers must payhave led to questioning of various features of the tort system, as well as proposals for partial or total replacement of it by various forms of no-fault compensation schemes. Although medical misadventure is still ostensibly governed by a negligence regime, the frequency and size of both medical malpractice claims and insurance premiums have escalated dramatically in the last two decades. In turn, this escalation has led to criticisms that the tort system has induced enormously expensive forms of defensive medicine rather than cost-justified improvements in precautions. Again, as in automobile accidents, commentators have urged either major tort reforms or the replacement of tort with some form of no-fault compensation scheme.
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Marlin, Randal. "Media-Related Strategies and “War on Terrorism”." In Exchanging Terrorism Oxygen for Media Airwaves, 124–42. IGI Global, 2014. http://dx.doi.org/10.4018/978-1-4666-5776-2.ch009.
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Terrorist events are breaking news for the media whose ethical responsibility can be debatable. Tactics of terrorism vary from kidnapping, hostage-taking, hijackings, and others up to mass destruction, including the use of nuclear weapons. Media responses and coverage strategies of such tactics also vary, with some reluctant to provide terrorists with the “oxygen of publicity.” Some striking similarities have appeared recently between the build-up to the war on Iraq begun by U.S. President George W. Bush's administration in 2002, culminating with the start of war in 2003, and the 2012 push by current U.S. President Barack Obama for action to prevent Iran from acquiring a nuclear weapon. In the earlier case, the presumption was established in the public mind, without adequate evidence, that Iraq possessed or was about to possess weapons of mass destruction, and had the will to use them against the United States. In the latter case, the background presumption is that Iran is actively seeking to produce a nuclear weapon, with Israel as a potential target. This claim also lacks solid evidence at the time of writing, but has come to be accepted in some media as an uncontroversial fact. This chapter looks at aspects of how different English and French Canadian newspapers, as examples, covered the push for war on Iraq. It includes reflections on the use of language in reporting on the war itself. The central concern is with the media role in fear-mongering and propaganda for war.
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Saldanha, Ian J., Gaelen P. Adam, Ghid Kanaan, Michael L. Zahradnik, Dale W. Steele, Valery A. Danilack, Alex Friedman Peahl, Kenneth K. Chen, Alison M. Stuebe, and Ethan M. Balk. Postpartum Care up to 1 Year After Pregnancy: A Systematic Review and Meta-Analysis. Agency for Healthcare Research and Quality (AHRQ), June 2023. http://dx.doi.org/10.23970/ahrqepccer261.
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Objectives. This systematic review assesses postpartum care for individuals up to 1 year after pregnancy. We addressed two Key Questions (KQs) related to the comparative effectiveness and harms of: (1) alternative strategies for postpartum healthcare delivery and (2) extension of postpartum health insurance coverage. Data sources and review methods. We searched Medline®, Embase®, Cochrane CENTRAL, CINAHL®, and ClinicalTrials.gov from inception to November 16, 2022, to identify comparative studies in the United States and Canada (for KQ 1) and in the United States (for KQ 2). We extracted study data into the Systematic Review Data Repository Plus (SRDR+; https://srdrplus.ahrq.gov). We assessed the risk of bias and evaluated the strength of evidence (SoE) using standard methods. The protocol was registered in PROSPERO (registration number CRD42022309756). Results. We included 50 randomized controlled trials (RCTs) and 14 nonrandomized comparative studies (NRCSs) for KQ 1 and 28 NRCSs for KQ 2. Risk of bias was moderate to high for most RCTs and all NRCSs. KQ 1: Regarding where healthcare is provided, for general postpartum care (6 studies), whether the visit is at home/by telephone or at the clinic may not impact depression or anxiety symptoms (low SoE). For breastfeeding care (8 studies), whether the initial visit is at home or at the pediatric clinic may not impact depression symptoms up to 6 months postpartum, anxiety symptoms up to 2 months, hospital readmission up to 3 months (summary relative risk [RR] 1.38, 95% confidence interval [CI] 0.90 to 2.13; 4 studies), or other unplanned care utilization up to 2 months (low SoE, all outcomes). Regarding how care is provided, for general postpartum care (4 studies), integration of care (i.e., care provided by multiple types of providers) may not impact depression symptoms or substance use up to 1 year (low SoE). Regarding when care is provided, for contraceptive care (9 studies), compared with later contraception, earlier contraception start is probably associated with comparable continued IUD use at 3 and 6 months but greater implant use at 6 months (summary RR 1.36, 95% CI 1.13 to 1.64; 2 RCTs) (moderate SoE). Regarding who provides care, for breastfeeding care (19 studies), compared with no peer support, peer support is probably associated with higher rates of any breastfeeding at 1 month (summary effect size [ES] 1.13, 95% CI 1.03 to 1.24; 4 studies) and 3 to 6 months (summary ES 1.22, 95% CI 1.06 to 1.41; 4 studies) and of exclusive breastfeeding at 1 month (summary ES 1.10, 95% CI 1.02 to 1.19; 6 studies) but probably yields comparable rates of exclusive breastfeeding at 3 months and nonexclusive breastfeeding at 1 and 3 months (all moderate SoE). Compared with no lactation consultant, breastfeeding care by a lactation consultant is probably associated with higher rates of any breastfeeding at 6 months (summary ES 1.43, 95% CI 1.07 to 1.91; 3 studies) but not at 1 month or 3 months (all moderate SoE). Lactation consultant care may not be associated with rates of exclusive breastfeeding at 1 or 3 months (moderate SoE). Regarding coordination/management of care, provision of reminders for testing is probably associated with greater adherence to oral glucose tolerance testing up to 1 year postpartum but not random glucose testing or hemoglobin A1c testing (moderate SoE). Regarding use of information or communication technology (IT; 8 studies), IT use for breastfeeding care is probably associated with comparable rates of any breastfeeding at 3 months and 6 months and of exclusive breastfeeding at 3 months (all moderate SoE). Because of sparse evidence, inconsistent results, and/or the lack of reporting of prioritized outcomes, no conclusions related to interventions targeting healthcare providers are feasible (4 studies). KQ 2: Regarding health insurance (28 studies), more comprehensive health insurance is probably associated with greater attendance at postpartum visits (moderate SoE) and may be associated with fewer preventable readmissions and emergency room visits (low SoE). Conclusion. Most studies included in this systematic review enrolled predominantly healthy postpartum individuals. Researchers should therefore design studies that, either entirely or in part, enroll individuals at high risk of postpartum complications due to chronic conditions, pregnancy-related conditions, or incident or newly diagnosed conditions. New high-quality research is needed, especially for interventions targeting healthcare providers and the impact of more comprehensive or extended health insurance on postpartum health. Patient-reported outcomes, such as quality of life, should also be reported. Researchers should report separate data for various population subgroups, which could help close gaps in health outcomes among the races of postpartum individuals in the United States.