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Laura Pizzi

Publications and source records attributed to Laura Pizzi.

4 recordsLinked to original sources
PubMed2005

Pharmacy utilization and the Medicare Modernization Act.

To control expenditures and use medications appropriately, the Medicare drug coverage program has established pharmacy utilization management (PUM) measures. This article assesses the effects of these strategies on the care of seniors. The literature suggests that although caps on drug benefits lower pharmaceutical costs, they may also increase the use of other health care services and hurt health outcomes. Our review raises concerns regarding the potential unintended effects of the Medicare drug program's PUM policies for beneficiaries. Therefore, the economic and clinical impact of PUM measures on seniors should be studied further to help policymakers design better drug benefit plans.

Aged↗
PubMed2005

Minimally invasive: minimally reimbursed? An examination of six laparoscopic surgical procedures.

It is generally believed that minimally invasive surgery (MIS) results in less postoperative pain, fewer complications, and shorter recovery periods compared with open procedures. Yet despite these benefits, the level of reimbursement assigned to the surgeon by United States health-care payers is often lower than that for open procedures. Furthermore, the cost of performing a MIS may be higher vs an open procedure because specialized equipment, increased surgical time, or both may be required. In this report, we examine the issue by comparing reimbursements for MIS with open procedures, summarizing the medical literature on MIS vs open surgical procedures, and offering recommendations for payers who establish reimbursement policies. The review is focused on six MIS procedures where outcomes data exist: laparoscopic cholecystectomy (lap chole), laparoscopic colectomy (LC), laparoscopic fundoplication (LF), laparoscopic hysterectomy (LH), laparoscopic ventral hernia repair (LVHR), and laparoscopic appendectomy (LA). Outcomes summarized were length of hospital stay (LOS), operating room time, operating room costs, complications, and return to work or normal activities. The level of scientific evidence was assigned to each study using predetermined criteria. A total of 112 articles were reviewed: 14 for lap chole, 26 for LC, 7 for LF, 19 for LH, 9 for LVHR, and 37 for LA. The data demonstrate that these procedures result in reduced hospital stay, reduced hospital costs, and faster return to work or normal activities. Yet, the operating room time and costs are frequently higher for MIS. These findings suggest that as both the outcomes value and level of operating room resources are greater, MIS warrants reimbursement that meets or exceeds that of open procedures.

Appendectomy↗
PubMed2004

A review of health-related workplace productivity loss instruments.

The objective of this review was to identify health-related workplace productivity loss survey instruments, with particular emphasis on those that capture a metric suitable for direct translation into a monetary figure. A literature search using Medline, HealthSTAR, PsycINFO and Econlit databases between 1966 and 2002, and a telephone-administered survey of business leaders and researchers, were conducted to identify health-related workplace productivity measurement survey instruments. This review was conducted from the societal perspective. Each identified instrument was reviewed for the following: (i). reliability; (ii). content validity; (iii). construct validity; (iv). criterion validity; (v). productivity metric(s); (vi). instrument scoring technique; (vii). suitability for direct translation into a monetary figure; (viii). number of items; (ix). mode(s) of administration; and (x). disease state(s) in which it had been tested. Reliability and validity testing have been performed for 8 of the 11 identified surveys. Of the 11 instruments identified, six captured metrics that are suitable for direct translation into a monetary figure. Of those six, one instrument measured absenteeism, while the other five measured both absenteeism and presenteeism. All of the identified instruments except for one were available as paper, self-administered questionnaires and many were available in languages other than English. This review provides a comprehensive overview of the published, peer-reviewed survey instruments available to measure health-related workplace productivity loss. As the field of productivity measurement matures, tools may be developed that will allow researchers to accurately calculate lost productivity costs when performing cost-effectiveness and cost-benefit analyses. Using data captured by these instruments, society and healthcare decision makers will be able to make better informed decisions concerning the value of the medications, disease management and health promotion programmes that individuals receive.

Absenteeism↗