Revision Of Fees Research Articles

Summary of Revision of Medical Fees in 2024 and Introduction of Topics

Summary of Revision of Medical Fees in 2024 and Introduction of Topics

Empowering Brazil's Energy Cooperatives: Creating a Federation and Fostering SDGs

Objective: This study examines the potential of establishing an energy cooperative federation in Brazil. Initially, challenges faced by cooperatives are identified, such as cultural resistance, lack of understanding about distributed generation, and financial difficulties. Theoretical Framework: Accelerating the global energy transition is necessary due to the effects of climate change, which presents a challenge for governments as they must balance conflicting agendas. Energy cooperatives have the potential to promote renewable energies and sustainable urban development and are increasingly growing in Brazil. By promoting unity, knowledge sharing, and collective advocacy, the federation can enhance the cooperatives' efficiency, influence, and resilience. This initiative aligns with multiple Sustainable Development Goals (SDGs). Method: Online interviews with management teams of Brazilian energy cooperatives and relevant organizations were conducted in 2023 to gather data on the sector's opportunities, challenges, and barriers. Data triangulation with literature provided a comprehensive view, leading to an analysis of key issues and a proposal to strengthen the sector.Results and Discussion: The main difficulties and solutions include: imbalances in relationships with utilities (discussion of legislation and regulation), disputes over taxation (revision of fees), difficulty obtaining resources (facilitated access to financing), high bureaucracy (simplification of processes), and public unfamiliarity (educational programs). Originality/Value: The proposed federation could act as a transformative force, promoting positive changes and shaping a more sustainable and democratic energy landscape in Brazil. Through robust governance structures, transparent practices, and active member engagement, this federation can catalyze innovation, promote equitable access to renewable energy, foster inclusive economic development, and position cooperatives as critical players in achieving sustainable development goals.

Enhancing Dietary Guidance for Children with Food Allergy: A Survey to Support Medical Fee Revision in 2024

Enhancing Dietary Guidance for Children with Food Allergy: A Survey to Support Medical Fee Revision in 2024

Effectiveness of medical fee revisions for psychotropic polypharmacy in patients with mood disorders in Japan: An interrupted time-series analysis using a nationwide inpatient database.

This study aimed to evaluate the effects of medical fee revisions aimed to reduce psychotropic polypharmacy in Japan on the proportion of psychotropic polypharmacy in discharge prescriptions for patients with major depressive disorder (MDD) or bipolar disorder (BD) using a nationwide inpatient database. In this retrospective cohort study, we used the Diagnosis Procedure Combination database to identify patients with MDD or BD discharged between April 2012 and March 2021. We targeted medical fee revisions in October 2014, April 2016, and April 2018. The major outcome was the monthly proportion of psychotropic polypharmacy in prescription at discharge using the criteria following the April 2018 revision (antidepressants ≥3, antipsychotics ≥3, anxiolytics ≥3, hypnotics ≥3, or sum of anxiolytics and hypnotics ≥4). We performed interrupted time series analyses to evaluate the changes in level and trend between pre- and post-revisions. We identified 63,289 and 33,780 patients with MDD and BD respectively in the entire study period. In both the patient groups, there were significant decreases in the proportion of psychotropic polypharmacy at revision in October 2014, and no significant trend and level change at revision were observed in April 2016 and April 2018, with a few exceptions. The medical fee revisions aimed to reduce psychotropic polypharmacy in Japan might have had a limited impact on discharge prescriptions for patients with MDD and BD.

Patient Safety Management Practiced by Pharmacy Pharmacists Using Their Training at Oncology Hospital

Recent changes in the environment surrounding community pharmacists include "follow-up after dispensing" becoming mandatory, initiation of "certified pharmacy system with specific functions," with the discussions on post-graduate training, lifelong training and specialization, refill of prescriptions, as well as pros and cons of hospital pharmacies in preparation for the 2022 dispensing fee revision. In this regard, since 2019, I have been receiving training at The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR). In addition, to implementing community pharmacists' perspectives into collaboration between community pharmacists and hospital pharmacists, a tracing report model incorporating the Common Terminology Criteria for Adverse Events (CTCAE) ver. 5.0 has been created. And, a regimen of drugs and operation describing necessary supportive care has been published in The Cancer Institute Hospital of JFCR website. As a practice of patient safety management at pharmacies, we are working on the standardization of questionnaire criteria to assess the severity of adverse medication reactions in cancer patients and the measurement of health-related quality of life using EuroQol 5 dimensions 5-level (EQ-5D-5L), introduced with cooperation of universities, hospitals, and pharmacies. As medical care is advancing day by day, especially in cancer medication therapy, patient safety management by pharmacists becomes essential, when dealing with the complexity of administration schedule and the wide variety of side effects. For patient safety management, community pharmacists need to practice with pharmaceutical and medical knowledge, and have skills to acquire and convey information, with a researcher's perspective.

Effects of Japanese policies and novel hypnotics on long-term prescriptions of hypnotics.

The current study aimed to examine the effect of Japanese policies for appropriate hypnotics use and novel hypnotics (e.g. melatonin receptor agonist and orexin receptor antagonist [ORA]) on long-term prescriptions of hypnotics. This retrospective study was conducted using a large-scale health insurance claims database. Among subscribers prescribed hypnotics at least once between April 2005 and March 2021, those prescribed hypnotics for the first time after being included in the database in three periods (period 1: April 2012-March 2013; period 2: April 2016-March 2017; and period 3: April 2018-March 2019) were eligible. These were set considering the timing of the 2014 and 2018 medical fee revisions (2014 for polypharmacy of three or more hypnotics, 2018 for long-term prescription of benzodiazepine receptor agonists for >12months). The duration of consecutive prescriptions of hypnotics over 12months was evaluated. Factors associated with short-term prescriptions of hypnotics were also investigated. In total, 186 535 participants were newly prescribed hypnotics. The mean duration of prescriptions was 2.9 months, and 9.3% of participants were prescribed hypnotics for 12months. Prescription periods were not associated with short-term prescriptions of hypnotics. ORA use was associated with short-term prescriptions of hypnotics (adjusted hazard ratio, 1.077 [95% confidence interval, 1.035-1.120]; P < 0.001), but melatonin receptor agonist use was not. Japanese policies had no statistically significant effect on long-term prescriptions of hypnotics. Although this study suggests initiating ORA for insomniacs as a candidate strategy to prevent long-term prescriptions of hypnotics, further research is necessary to draw conclusions.

Summary of Revision of Medical Fees in 2022 and Introduction of Topics

Summary of Revision of Medical Fees in 2022 and Introduction of Topics

Assessment of the Effects of Medical Fee Revisions on Acute Rehabilitation Therapy after Total Knee Arthroplasty

Assessment of the Effects of Medical Fee Revisions on Acute Rehabilitation Therapy after Total Knee Arthroplasty

Laser Treatments in the Current Medical Fee Revision 2022

Laser Treatments in the Current Medical Fee Revision 2022

Characteristics of Home-Visit Nursing Agencies That Closed after the 2012 Fee Revision for Home-Visit Nursing Services: A Nationwide Panel Data Analysis in Japan.

Despite the 2012 fee revision raising fees for home-visit nursing services to increase their supply in Japan, 300 to 500 home-visit nursing agencies (VNA) are still being closed annually. This study aims to identify the regional and organizational characteristics of the VNAs that closed after the 2012 fee revision. A longitudinal observational study was conducted using nationwide panel data of VNAs from 2014 to 2017 (N = 6496). Multiple logistic regression models stratified by years of operation were used for the analysis. We identified 821 closed agencies (12.6%). In this study, many important factors related to VNA closures were found. In the less than three years group, there were regional factors (lower aging rate and larger number of clinics) and an organizational factor (higher proportion of users under 40 years of age). In the 3–14 years group, there was a regional factor (larger number of clinics) and organizational factors (smaller number of FTE nurses, smaller number of users per FTE nurse, and smaller number of medical care types that can be provided). In the over 15 years group, there was an organizational factor (smaller number of FTE nurses). The findings provide valuable insights for policymakers in avoiding VNA closures.

Effects of medical service fee revision on reducing irrational psychotropic polypharmacy in Japan: an interrupted time-series analysis

PurposeAccording to the revised Japanese medical service fees aimed at reducing irrational psychotropic polypharmacy, medical service fees are reduced if the number of simultaneously prescribed psychotropic drugs exceeds the standard. This study primarily aims to examine the effect of the 2018 revision.MethodsUsing a large Japanese administrative claims database, we retrospectively identified five groups (April 2013–September 2018) prescribed at least one drug from the following drug groups: anxiolytics, hypnotics, sum of anxiolytics and hypnotics, antipsychotics, and antidepressants (study population in each group: 547,511, 406,524, 759,137, 112,929, and 201,046, respectively). We used an interrupted time-series design to evaluate changes in the proportion of patients prescribed more than the standard number of drugs.ResultsAfter the 2018 revision, the proportion of patients prescribed more than the standard number of drugs significantly decreased only for the sum of anxiolytics and hypnotics; estimated changes in level and trend were − 0.60% [− 0.69%, − 0.52%] and − 0.04% [− 0.06%, − 0.02%] per month, respectively. The proportion of patients exhibiting a decrease in the number of prescribed drugs from more than the standard to within the standard increased when the revision was enforced (April 2018); this proportion in April 2018 was 36.3%, while all other proportions were in the range of 12.1–22.3%.ConclusionThe 2018 revision promoted a reduction in the number of prescribed drugs, which served as an important factor in the decrease in the proportion of patients prescribed more than the standard number of drugs for the sum of anxiolytics and hypnotics.

Summary of Revision of Medical Fees in 2020 and Introduction of Activities of JIRA Medical Fees Committee

Summary of Revision of Medical Fees in 2020 and Introduction of Activities of JIRA Medical Fees Committee

Laser Treatments in the Current Medical Fee Revision 2020

Laser Treatments in the Current Medical Fee Revision 2020

October 2019 GPI membership fee revision (E)

October 2019 GPI membership fee revision (E)

An Evaluation of the Effects of the Medical Fee Revision on the Multi-Drug Use of Psychotropic Medicines Using Interrupted Time Series Analysis

An Evaluation of the Effects of the Medical Fee Revision on the Multi-Drug Use of Psychotropic Medicines Using Interrupted Time Series Analysis

October 2019 GPI membership fee revision (J)

October 2019 GPI membership fee revision (J)

2473. Trends in Methicillin Resistance Rate of Staphylococcus aureus among Medical Facilities Participating in Japan Nosocomial Infections Surveillance (JANIS)

BackgroundThe medical fee revision in 2014 economically motivated hospitals to join surveillance programs, such as Japan Nosocomial Infections Surveillance (JANIS), and rapidly increased JANIS member hospitals. The characteristics of the newly joined hospitals might have affected the reported resistance rate trends regardless of the effect of the policy itself. We examined the effect of the hospitals joining JANIS after 2014 on the trends in methicillin resistance rate of S. aureus.MethodsWe analyzed annual trends in methicillin resistance rate of S. aureus among inpatients, using JANIS datasets of 2007 to 2016, and defined oxacillin- or cefoxitin-resistant S. aureus as methicillin resistant. The dataset consisted of a total of 7,105 hospitals and 2,740,750 S. aureus test results. Hospitals were divided into two groups; joining JANIS A) before 2014 (751 hospitals), B) in and after 2014 (781 hospitals). A probit model examined their characteristics, and a panel data analysis calculated the resistance rate trends adjusted for age and sex, including interaction terms of hospitals group and year. Finally, we divided patients into quintile age groups, and conducted the same analysis by sex.ResultsThe methicillin resistance rate of S. aureus decreased from 59.4% (2007) to 48.6% (2016), and the decreasing trend kept significant through the study period but 2009 (mean annual decrease: 1.2%, P < 0.05). Inpatients of hospital B had higher age (β = 0.01, P < 0.001), and more male (β = 0.005, P < 0.05), but their resistance rate was not significantly higher (β = 0.05, p = 0.12) compared with hospital A. Age stratified analysis for all hospitals found the youngest group (younger than 35 years old) of both sex had steadily low resistance rates through the period, while the older groups had higher rates, but their rates decreased continuously.ConclusionThe methicillin resistance rates of S. aureus decreased throughout 2007 to 2016 except 2009. The patients of the hospitals newly joining JANIS were higher in age, but the resistance rate of S. aureus was not statistically different from the hospitals having joined JANIS before 2014. Also, among JANIS member hospitals, older patients had higher resistance rates than younger patients, but their rates were continuously decreasing.Disclosures All authors: No reported disclosures.

The Simultaneous Revision of Medical Fees and Long Term Care Fees in FY 2018, and Future Researches for the Next Revision

The Simultaneous Revision of Medical Fees and Long Term Care Fees in FY 2018, and Future Researches for the Next Revision

Current Status and Issues of Nursing for People with both Mental Illness and Diabetes:Toward Future Medical Fee Evaluation in the Revision of Medical Fees

Current Status and Issues of Nursing for People with both Mental Illness and Diabetes:Toward Future Medical Fee Evaluation in the Revision of Medical Fees

A comparison of correction methods for medical fee revisions in health expenditure analyses using claims data

A comparison of correction methods for medical fee revisions in health expenditure analyses using claims data