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https://www.readbyqxmd.com/read/28445806/patient-engagement-at-the-margins-health-care-providers-assessments-of-engagement-and-the-structural-determinants-of-health-in-the-safety-net
#1
Mark D Fleming, Janet K Shim, Irene Yen, Ariana Thompson-Lastad, Sara Rubin, Meredith Van Natta, Nancy J Burke
Increasing "patient engagement" has become a priority for health care organizations and policy-makers seeking to reduce cost and improve the quality of care. While concepts of patient engagement have proliferated rapidly across health care settings, little is known about how health care providers make use of these concepts in clinical practice. This paper uses 20 months of ethnographic and interview research carried out from 2015 to 2016 to explore how health care providers working at two public, urban, safety-net hospitals in the United States define, discuss, and assess patient engagement...
April 20, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28445557/us-adult-illicit-cannabis-use-cannabis-use-disorder-and-medical-marijuana-laws-1991-1992-to-2012-2013
#2
Deborah S Hasin, Aaron L Sarvet, Magdalena Cerdá, Katherine M Keyes, Malka Stohl, Sandro Galea, Melanie M Wall
Importance: Over the last 25 years, illicit cannabis use and cannabis use disorders have increased among US adults, and 28 states have passed medical marijuana laws (MML). Little is known about MML and adult illicit cannabis use or cannabis use disorders considered over time. Objective: To present national data on state MML and degree of change in the prevalence of cannabis use and disorders. Design, Participants, and Setting: Differences in the degree of change between those living in MML states and other states were examined using 3 cross-sectional US adult surveys: the National Longitudinal Alcohol Epidemiologic Survey (NLAES; 1991-1992), the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; 2001-2002), and the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III; 2012-2013)...
April 26, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28445217/why-health-insurance-matters-and-why-research-evidence-should-too
#3
Benjamin D Sommers
In the current debate over the future of the Affordable Care Act (ACA), research evidence on the impact of the law and the effects of health insurance coverage in general is critical. Studies of health insurance expansion over the past decade have demonstrated that coverage expansions can produce significant reductions in mortality-particularly among minorities, those living in poorer areas, and those with chronic conditions potentially treatable with timely medical care. More recent studies of the ACA in particular demonstrate that the law has produced historically large reductions in the uninsured rate, with resulting improvements in access to care, perceived quality of care, and self-reported health...
April 25, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28445216/opposition-to-obamacare-a-closer-look
#4
Paul R Gordon, Laurel Gray, Alex Hollingsworth, Eve C Shapiro, James E Dalen
Prior telephone surveys have reported two main reasons for opposition to the Affordable Care Act (ACA): distrust of government and opposition to the universal coverage mandate. The authors set out to elucidate the reasons for this opposition. This article describes how the authors used qualitative methods with semistructured interviewing as a principal investigative method to gather information from people they met while bicycling across the United States from April through July 2016. During this time, the authors conducted open-ended, semistructured conversations with people they met as they rode their bicycles from Washington, DC, to Seattle, Washington...
April 25, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28444056/care-for-young-victims-of-assault-in-public-emergency-services-in-2011-sex-differences
#5
Alice Cristina Medeiros Melo, Leila Posenato Garcia
This article aims to describe the characteristics of assaults among youth victims of violence treated in Public Emergency Departments, according to sex. This is a descriptive study using data from the Brazilian Violence and Accidents Surveillance System based on a multicenter survey conducted by the Ministry of Health in 71 public emergency departments, located in 24 state capitals and the Federal District in 2011. Male subjects predominated among the victims (75.1%) and also among aggressors (83.1% and 69...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28444043/challenges-for-ensuring-availability-and-accessibility-toin-health-care-services-under-brazil-s-unified-health-system-sus
#6
Ana Paula Cavalcante de Oliveira, Mariana Gabriel, Mario Roberto Dal Poz, Gilles Dussault
Shortages and imbalances in the distribution of the health workforce, are social and political problems that, along with the socio-economic inequality, reduce the access of the population to the health services. This study aims to understand the challenges of SUS policy-makers and managers to ensure the availability and geographical accessibility to health service providers. The analysis was guided by a framework of the health labour market and health policy interventions. Two main problems have been identified: shortage of doctors and maldistribution of professionals between levels of health care and between geographical areas...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28444031/health-policies-and-federative-gaps-in-brazil-an-analysis-of-regional-capacity-of-services-delivery
#7
José Mendes Ribeiro, Marcelo Rasga Moreira, Assis Mafort Ouverney, Cosme Marcelo Furtado Passos da Silva
This paper analyzes Brazilian health regions according to their service delivery capacity from the debate on the crisis of cooperative federalism in the SUS that resulted from decentralizing process established in the 1988 Constitution. Service delivery capacity tracer indicators were selected by regions and statistical analyses evidenced greater regional capacity in hospital care and large asymmetries with regard to the availability of physicians, high complexity equipment and private insurance coverage. In conclusion,we argue that further solutions are required to strengthen governmental capacity to reduce regional inequalities throughincreased central coordination...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28444005/promoting-and-regulating-generic-medicines-brazil-in-comparative-perspective
#8
Elize Massard da Fonseca, Kenneth C Shadlen
Promoting the use of generic drugs can constitute a core instrument for countries' national pharmaceutical policies, one that reduces drug expenditure while expanding health care access. Despite the potential importance of such policy measures and the differences among national practices, scholars embarking on comparative analysis lack a roadmap for determining which dimensions of generic drug policy to assess and compare. This report fills that gap by considering national rules and regulations across four dimensions deemed crucial to any evaluation: demonstrated therapeutic equivalence; pharmaceutical packaging and labeling; drug prescription; and drug substitution...
April 20, 2017: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28443132/disease-resistance-and-the-definition-of-genetic-enhancement
#9
Derek So, Erika Kleiderman, Seydina B Touré, Yann Joly
Recent gene editing experiments carried out in human embryos have raised the question of whether interventions like the introduction of a CCR5-Δ32 deletion, which could provide heritable resistance to HIV infection, ought to be considered enhancements. Many authors have used the term "enhancement" in different ways, some based on patients' biomedical outcomes and others on their social context. These classifications are often considered overly imprecise. Nevertheless, the concept of "enhancement" could affect the ways in which these applications are regulated in different jurisdictions, the availability of coverage by insurers or public health care, and the force of public opinion in shaping future policy on gene editing...
2017: Frontiers in Genetics
https://www.readbyqxmd.com/read/28442033/out-of-pocket-healthcare-expenditure-and-chronic-disease-do-australians-forgo-care-because-of-the-cost
#10
Emily J Callander, Lisa Corscadden, Jean-Frederic Levesque
Although we do know that out-of-pocket healthcare expenditure is relatively high in Australia, little is known about what health conditions are associated with the highest out-of-pocket expenditure, and whether the cost of healthcare acts as a barrier to care for people with different chronic conditions. Cross-sectional analysis using linear and logistic regression models applied to the Commonwealth Fund international health policy survey of adults aged 18 years and over was conducted in 2013. Adults with asthma, emphysema and chronic obstructive pulmonary disease (COPD) had 109% higher household out-of-pocket healthcare expenditure than did those with no health condition (95% CI: 50-193%); and adults with depression, anxiety and other mental health conditions had 95% higher household out-of-pocket expenditure (95% CI: 33-187%)...
April 2017: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/28442028/revisiting-the-ability-of-australian-primary-healthcare-services-to-respond-to-health-inequity
#11
Toby Freeman, Fran Baum, Angela Lawless, Sara Javanparast, Gwyn Jolley, Ronald Labonté, Michael Bentley, John Boffa, David Sanders
Equity of access and reducing health inequities are key objectives of comprehensive primary health care. However, the supports required to target equity are fragile and vulnerable to changes in the fiscal and political environment. Six Australian primary healthcare services, five in South Australia and one in the Northern Territory, were followed over 5 years (2009-2013) of considerable change. Fifty-five interviews were conducted with service managers, staff, regional health executives and health department representatives in 2013 to examine how the changes had affected their practice regarding equity of access and responding to health inequity...
September 2016: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/28441926/timing-and-utilisation-of-antenatal-care-service-in-nigeria-and-malawi
#12
Vincent Z Kuuire, Joseph Kangmennaang, Kilian N Atuoye, Roger Antabe, Sheila A Boamah, Siera Vercillo, Jonathan A Amoyaw, Isaac Luginaah
As the world draws curtains on the implementation of Millennium Development Goals (MDGs), there is increasing interest in evaluating the performance of countries on the goals and assessing related challenges and opportunities to inform the upcoming Sustainable Development Goals (SDGs). This study examined changes in the timing and utilisation of maternal health care services in Nigeria and Malawi; using multivariate negative log-log and logistic regression models fitted to demographic and health survey data sets...
June 2017: Global Public Health
https://www.readbyqxmd.com/read/28441324/designing-fit-for-purpose-health-and-social-services-for-ageing-populations
#13
Jean Woo
Population ageing is occurring in all countries, regardless of the level of economic development. While the rising burden of chronic diseases and disabilities as a consequence of this demographic transition is well recognized, the increasing prevalence of geriatric syndromes as a public health issue is not as well recognized. Recently the World Health Organization's World Health and Ageing Report emphasized functional ability as an important outcome for aging populations, highlighting the concept of raising intrinsic capacity throughout the life course...
April 25, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28441153/discharge-criteria-for-the-late-preterm-infant-a-review-of-the-literature
#14
Jenny M Quinn, Marteen Sparks, Sheila M Gephart
BACKGROUND: Standardized late preterm infant (LPI) discharge criteria ensure best practice and help guide the neonatal provider to determine the appropriate level of care following birth. However, the location can vary from the well newborn setting to the neonatal intensive care unit (NICU). PURPOSE: The purpose of this review is to examine differences in LPI discharge criteria between the well newborn setting and the NICU by answering the clinical questions, "What are the recommended discharge criteria for the LPI and do they differ if admitted to the well newborn setting versus the NICU?" SEARCH STRATEGY: Databases searched include CINAHL, TRIP, PubMed, and the Cochrane Library...
April 24, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28440543/registered-nurses-perceptions-regarding-nurse-led-antiretroviral-therapy-initiation-in-hhohho-region-swaziland
#15
A H Mavhandu-Mudzusi, P T Sandy, A Hettema
BACKGROUND: Swaziland has the highest HIV prevalence globally. It faces a critical shortage of health workers for addressing the HIV pandemic. To curb this human resource challenge, Swaziland adopted a nurse-driven model for antiretroviral therapy delivery in line with the recommendations of the World Health Organization on task shifting. OBJECTIVE: The study explored the perceptions of registered nurses on the nurse-led antiretroviral therapy initiation programme in the Hhohho region of Swaziland (NARTIS)...
April 25, 2017: International Nursing Review
https://www.readbyqxmd.com/read/28439716/antipsychotic-prescribing-to-patients-diagnosed-with-dementia-without-a-diagnosis-of-psychosis-in-the-context-of-national-guidance-and-drug-safety-warnings-longitudinal-study-in-uk-general-practice
#16
S Jill Stocks, Evangelos Kontopantelis, Roger T Webb, Anthony J Avery, Alistair Burns, Darren M Ashcroft
INTRODUCTION: Policy interventions to address inappropriate prescribing of antipsychotic drugs to older people diagnosed with dementia are commonplace. In the UK, warnings were issued by the Medicines Healthcare products Regulatory Agency in 2004, 2009 and 2012 and the National Institute for Health and Care Excellence guidance was published in 2006. It is important to evaluate the impact of such interventions. METHODS: We analysed routinely collected primary-care data from 111,346 patients attending one of 689 general practices contributing to the Clinical Practice Research Datalink to describe the temporal changes in the prescribing of antipsychotic drugs to patients aged 65 years or over diagnosed with dementia without a concomitant psychosis diagnosis from 2001 to 2014 using an interrupted time series and a before-and-after design...
April 24, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28439403/policy-entrepreneurship-and-policy-networks-in-healthcare-systems-the-case-of-israel-s-pediatric-dentistry-reform
#17
Nissim Cohen, Tuvia Horev
BACKGROUND: Can the entry of a policy entrepreneur challenge the equilibrium of a policy network and promote changes that might clash with the goals of powerful civil-servants and/or interest groups and, if so, why and how? Our goal is to examine two sides of the same coin: how does an in-depth analysis of Israel's dental care reform enrich our understanding of policy networks and policy entrepreneurship? Second, how does the literature on policy networks and policy entrepreneurship help us understand this reform? Based on a theoretical framework that appears in the literature of policy entrepreneurship and policy networks, we analyze the motivations, goals and strategies of the main actors involved in the process of reforming pediatric dental care in Israel...
2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28439378/oman-vision-2050-for-health-research-a-strategic-plan-for-the-future-based-on-the-past-and-present-experience
#18
REVIEW
Adhra Hilal Nasser Al Mawali, Ahmed Mohamed Al Qasmi, Sultana Mohamed Saif Al Sabahi, John Idikula, Mahmoud Attia Abd Elaty, Magdi Morsi, Ali Talib Al Hinai
Health care delivery in Oman has attained great heights since the modern renaissance in 1970. Although the health service had the main impetus all these years, the importance of health research began to take place by mid 1990's and is now gaining momentum as an important responsibility and activity of the Ministry of Health (MoH). Although there has been progressively increasing investment and commitment to research activities in the recent Five Year Plan for Health Development, it still lags behind in the quality and quantity of research output...
March 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28439178/hispanic-residential-isolation-adhd-diagnosis-and-stimulant-treatment-among-medicaid-insured-youth
#19
Dinci Pennap, Mehmet Burcu, Daniel J Safer, Julie M Zito
OBJECTIVE: This study aimed to evaluate a conceptual framework that assessed the effect of Hispanic residential isolation on Attention Deficit Hyperactivity Disorder (ADHD) health service utilization among 2.2 million publicly insured youth. DESIGN: Cross-sectional. SETTING: Medicaid administrative claims data for ambulatory care services from a US Pacific state linked with US census data. PARTICIPANTS: Youth, aged 2-17 years, continuously enrolled in 2009...
2017: Ethnicity & Disease
https://www.readbyqxmd.com/read/28438917/disease-ecology-health-and-the-environment-a-framework-to-account-for-ecological-and-socio-economic-drivers-in-the-control-of-neglected-tropical-diseases
#20
A Garchitorena, S H Sokolow, B Roche, C N Ngonghala, M Jocque, A Lund, M Barry, E A Mordecai, G C Daily, J H Jones, J R Andrews, E Bendavid, S P Luby, A D LaBeaud, K Seetah, J F Guégan, M H Bonds, G A De Leo
Reducing the burden of neglected tropical diseases (NTDs) is one of the key strategic targets advanced by the Sustainable Development Goals. Despite the unprecedented effort deployed for NTD elimination in the past decade, their control, mainly through drug administration, remains particularly challenging: persistent poverty and repeated exposure to pathogens embedded in the environment limit the efficacy of strategies focused exclusively on human treatment or medical care. Here, we present a simple modelling framework to illustrate the relative role of ecological and socio-economic drivers of environmentally transmitted parasites and pathogens...
June 5, 2017: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
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