RAND Research Topic: Gastrointestinal Disorders 2021-01-22T17:03:39Z Copyright (c) 2021, The RAND Corporation RAND Corporation https://www.rand.org/topics/gastrointestinal-disorders.html Health Shocks and Their Long-Lasting Impact on Health Behaviors Trinidad Beleche https://www.rand.org/pubs/external_publications/EP67139.html 2017-05-19T10:00:00Z 2017-05-19T10:00:00Z Hospitalizations of young children in Mexico continued to decline three years after the 2009 H1N1 flu pandemic, showing that disease outbreaks can act as "natural nudges" that spur long-lasting effects on behavior and health outcomes. Anesthesia Service Use During Outpatient Gastroenterology Procedures Continued to Increase from 2010 to 2013 and Potentially Discretionary Spending Remained High Zachary Predmore; Xiaoyu Nie; Regan Main; Soeren Mattke; Harry H. Liu https://www.rand.org/pubs/external_publications/EP66550.html 2016-07-19T12:45:00Z 2016-07-19T12:45:00Z Previous studies have identified an increasing number of gastroenterology (GI) procedures using anesthesia services to provide sedation, with a majority of these services delivered to low-risk patients. The aim of this study was to update these trends with the most recent years of data. Screening for Colorectal Cancer Jennifer S. Lin; Margaret A. Piper; Leslie A. Perdue; Carolyn M. Rutter; Elizabeth M. Webber; Elizabeth O'Connor; Yang Liu; Evelyn P. Whitlock https://www.rand.org/pubs/external_publications/EP66517.html 2016-06-27T10:00:00Z 2016-06-27T10:00:00Z This study systematically reviewed the evidence on the effectiveness, diagnostic accuracy, and harms of colonoscopy, flexible sigmoidoscopy, computed tomographic colonography, and stool tests for colorectal cancer screening. Association Between Primary Care Visits and Colorectal Cancer Screening Outcomes in the Era of Population Health Outreach Ethan A. Halm; Elisabeth F. Beaber; Dale McLerran; Jessica Chubak; Douglas A. Corley; Carolyn M. Rutter; Chyke A. Doubeni; Jennifer S. Haas; Bijal A. Balasubramanian https://www.rand.org/pubs/external_publications/EP66509.html 2016-06-24T13:15:00Z 2016-06-24T13:15:00Z Patients who visited their primary care provider one or more times were almost twice as likely to be screened for colorectal cancer and about 30 percent more likely receive a follow-up colonoscopy after a positive screening result. Estimation of Benefits, Burden, and Harms of Colorectal Cancer Screening Strategies Amy B. Knudsen; Ann G. Zauber; Carolyn M. Rutter; Steffie K. Naber; V. Paul Doria-Rose; Chester Pabiniak; Colden Johanson; Sara E. Fischer; Iris Lansdorp-Vogelaar; Karen M. Kuntz https://www.rand.org/pubs/external_publications/EP66508.html 2016-06-21T10:00:00Z 2016-06-21T10:00:00Z Comparative modeling of colorectal cancer screening methods for previously unscreened adults found that the use of four strategies over different intervals between the ages of 50 and 75 years yielded a comparable balance of benefit and burden. Upcoding and Anesthesia Risk in Outpatient Gastrointestinal Endoscopy Procedures Xiaoyu Nie; Soeren Mattke; Zachary Predmore; Harry H. Liu https://www.rand.org/pubs/external_publications/EP66470.html 2016-05-09T12:00:00Z 2016-05-09T12:00:00Z Claims data analysis suggests that physicians may be identifying more patients in the coding system as being at high risk of complications from some outpatient procedures in order to ensure payment for anesthesia services. Risks Associated with Anesthesia Services During Colonoscopy Karen J. Wernli; Alison T. Brenner; Carolyn M. Rutter; John M. Inadomi https://www.rand.org/pubs/external_publications/EP66437.html 2016-04-22T13:00:00Z 2016-04-22T13:00:00Z Risk of complications within 30 days of a colonoscopy increases with the use of anesthesia services. Cost Effectiveness of Nonoperative Management Versus Laparoscopic Appendectomy for Acute Uncomplicated Appendicitis James X. Wu; Aaron J. Dawes; Greg D. Sacks; F. Charles Brunicardi; Emmett B. Keeler https://www.rand.org/pubs/external_publications/EP51908.html 2015-07-28T10:15:00Z 2015-07-28T10:15:00Z Appendectomy remains the gold standard in the treatment of acute, uncomplicated appendicitis in the United States. Outcomes and Costs of Surgical Treatments of Necrotizing Enterocolitis Anne M. Stey; Elizabeth S. Barnert; Chi-Hong Tseng; Emmett B. Keeler; Jack Needleman; Mei Leng; Lorraine I. Kelley-Quon; Stephen B. Shew https://www.rand.org/pubs/external_publications/EP50841.html 2015-04-24T16:15:00Z 2015-04-24T16:15:00Z Despite previous studies demonstrating no difference in mortality or morbidity, the various surgical approaches for necrotizing enterocolitis (NEC) in infants have not been evaluated economically. Specialty Payment Model Opportunities and Assessment Andrew W. Mulcahy; Chris Chan; Samuel Hirshman; Peter J. Huckfeldt; Aaron Kofner; Jodi L. Liu; Susan L. Lovejoy; Ioana Popescu; Justin W. Timbie; Peter S. Hussey https://www.rand.org/pubs/research_reports/RR831.html 2015-03-17T00:01:00Z 2015-03-17T00:01:00Z Describes research related to the design of episode-based payment models for ambulatory gastroenterology and cardiology services for possible testing by the Centers for Medicare and Medicaid Services' Center for Medicare and Medicaid Innovation. Hospital Costs by Cost Center of Inpatient Hospitalization for Medicare Patients Undergoing Major Abdominal Surgery Anne M. Stey; Robert H. Brook; Jack Needleman; Bruce L. Hall; David Zingmond; Elise H. Lawson; Clifford Y. Ko https://www.rand.org/pubs/external_publications/EP50578.html 2015-01-19T14:45:00Z 2015-01-19T14:45:00Z This study aims to describe the magnitude of hospital costs among patients undergoing abdominal surgery, and determine whether hospital costs estimates are consistent with clinical expectations of hospital resource use. The Health Risks of Bathing in Recreational Waters Sarah King; Josephine Exley; Eleanor Winpenny; Lottie Alves; Marie-Louise Henham; Jody Larkin https://www.rand.org/pubs/research_reports/RR698.html 2014-08-14T15:04:11Z 2014-08-14T15:04:11Z A rapid evidence assessment confirms an association between the quality of recreational bathing waters and the risk of gastrointestinal illness, particularly in fresh water, but there is insufficient evidence to determine whether a revision to the European Bathing Directive is needed. Comparative Effectiveness of Fidaxomicin for Treatment of Clostridium Difficile Infection Courtney A. Gidengil; John P. Caloyeras; Mark Alan Hanson; Richard Hillestad; Soeren Mattke https://www.rand.org/pubs/external_publications/EP66179.html 2014-07-01T12:00:00Z 2014-07-01T12:00:00Z The authors assess the differential clinical and economic value of fidaxomicin compared with metronidazole and vancomycin in the treatment of Clostridium difficile infection (CDI). Probiotics for Diarrhoea Susanne Hempel https://www.rand.org/pubs/external_publications/EP66143.html 2014-03-01T12:00:00Z 2014-03-01T12:00:00Z In order to be of informational value, the effectiveness of probiotics needs to be demonstrated in strong research designs, such as randomized controlled trials, that hold up to scientific scrutiny. Small Ideas for Saving Big Health Care Dollars (No. 1-3) RAND Corporation https://www.rand.org/blog/2014/01/small-ideas-for-saving-big-health-care-dollars-1.html 2014-01-08T08:00:00Z 2014-01-08T08:00:00Z Focusing on smaller, more focused approaches can identify less controversial opportunities for modest health care savings. Probiotics Can Reduce Risk of Diarrhea Caused by Antibiotics RAND Corporation https://www.rand.org/news/press/2012/05/08.html 2012-05-08T16:00:00Z 2012-05-08T16:00:00Z Probiotics are believed to improve health by maintaining a normal balance of microorganisms in the human intestines. Evidence shows that they can reduce the risk of developing diarrhea, which is a common side effect of taking antibiotics. Probiotics Can Reduce Risk of Diarrhea Caused by Antibiotics Susanne Hempel; Sydne Newberry; Alicia Ruelaz Maher; Zhen Wang; Jeremy N. V. Miles; Roberta M. Shanman; Breanne Johnsen; Paul G. Shekelle https://www.rand.org/pubs/external_publications/EP201200103.html 2012-05-08T16:00:00Z 2012-05-08T16:00:00Z Probiotics are believed to improve health by maintaining a normal balance of microorganisms in the human intestines. Evidence shows that they can reduce the risk of developing diarrhea, which is a common side effect of taking antibiotics. Use of Anesthesia Providers During Gastroenterology Procedures Has Increased Rapidly, but May Be Unneeded RAND Corporation https://www.rand.org/news/press/2012/03/20.html 2012-03-20T16:00:00Z 2012-03-20T16:00:00Z Use of anesthesia providers to monitor sedation during screening colonoscopies and other outpatient gastroenterology procedures more than doubled from 2003 to 2009 in the United States, with most of the increase among low-risk patients who may not need this service. Use of Anesthesia Providers During Gastroenterology Procedures Has Increased Rapidly, but May Be Unneeded Harry H. Liu; Daniel A. Waxman; Regan Main; Soeren Mattke https://www.rand.org/pubs/external_publications/EP20120073.html 2012-03-20T16:00:00Z 2012-03-20T16:00:00Z The use of dedicated anesthesia providers for routine gastroenterology (GI) procedures is seen as medically justifiable only for high-risk patients. Eliminating these services for low-risk patients could generate $1.1 billion in savings per year. Eliminating Discretionary Use of Anesthesia Providers During Gastroenterology Procedures Could Generate $1.1 Billion in Savings per Year Harry H. Liu; Daniel A. Waxman; Regan Main; Soeren Mattke https://www.rand.org/pubs/research_briefs/RB9648.html 2012-03-20T16:00:00Z 2012-03-20T16:00:00Z The use of dedicated anesthesia providers for routine gastroenterology (GI) procedures is seen as medically justifiable only for high-risk patients. Eliminating these services for low-risk patients could generate $1.1 billion in savings per year.