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https://www.readbyqxmd.com/read/28080012/medicaid-s-future-what-might-aca-repeal-mean
#1
Sara Rosenbaum, Sara Rothenberg, Rachel Gunsalus, Sara Schmucker
Issue: Republicans in Congress are expected to repeal portions of the Affordable Care Act (ACA) using a fast-track process known as budget reconciliation. Goals: This issue brief examines how repeal legislation could affect Medicaid, the nation’s health care safety net, which insured 70 million people in 2016. Findings and Conclusions: Partial-repeal legislation that passed Congress but was vetoed by President Obama in 2016 offers some insight but new legislation could go further. It could repeal the ACA’s Medicaid eligibility expansions for adults and children but also roll back other provisions, such as simplified enrollment and improvements in long-term services and supports for beneficiaries with disabilities...
2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28075363/maternal-and-child-health-of-internally-displaced-persons-in-ukraine-a-qualitative-study
#2
Svitlana Nidzvetska, Jose M Rodriguez-Llanes, Isabelle Aujoulat, Julita Gil Cuesta, Hannah Tappis, Joris A F van Loenhout, Debarati Guha-Sapir
Due to the conflict that started in spring 2014 in Eastern Ukraine, a total of 1.75 million internally displaced persons (IDPs) fled the area and have been registered in government-controlled areas of the country. This paper explores perceived health, barriers to access to healthcare, caring practices, food security, and overall financial situation of mothers and young children displaced by the conflict in Ukraine. This is a qualitative study, which collected data through semi-structured in-depth interviews with nine IDP mothers via Skype and Viber with a convenience sample of participants selected through snowball technique...
January 9, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28069561/cancer-survivors-experience-with-telehealth-a-systematic-review-and-thematic-synthesis
#3
REVIEW
Anna Cox, Grace Lucas, Afrodita Marcu, Marianne Piano, Wendy Grosvenor, Freda Mold, Roma Maguire, Emma Ream
BACKGROUND: Net survival rates of cancer are increasing worldwide, placing a strain on health service provision. There is a drive to transfer the care of cancer survivors-individuals living with and beyond cancer-to the community and encourage them to play an active role in their own care. Telehealth, the use of technology in remote exchange of data and communication between patients and health care professionals (HCPs), is an important contributor to this evolving model of care. Telehealth interventions are "complex," and understanding patient experiences of them is important in evaluating their impact...
January 9, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28069526/opportunities-to-improve-care-of-hepatocellular-carcinoma-in-vulnerable-patient-populations
#4
Richard S Hoehn, Dennis J Hanseman, Vikrom Dhar, Derek E Go, Michael J Edwards, Shimul A Shah
BACKGROUND: Hepatocellular carcinoma (HCC) patients with Medicaid or no health insurance have inferior survival compared to privately-insured patients. Safety-net hospitals that care for these patients are often criticized for their inferior outcomes. We hypothesized that HCC survival was related to appropriate surgical management. STUDY DESIGN: The American College of Surgeons National Cancer Data Base was queried for patients diagnosed with HCC (n=111,481) from 1998-2010...
January 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28065558/the-availability-of-community-health-center-services-and-access-to-medical-care
#5
James B Kirby, Ravi Sharma
BACKGROUND: Community Health Centers (CHCs) funded by Section 330 of the Public Health Service Act are an essential part of the health care safety net in the US. The Patient Protection and Affordable Care Act expanded the program significantly, but the extent to which the availability of CHCs improve access to care in general is not clear. In this paper, we examine the associations between the availability of CHC services in communities and two key measures of ambulatory care access - having a usual source of care and having any office-based medical visits over a one year period...
January 5, 2017: Healthcare
https://www.readbyqxmd.com/read/28060053/safety-net-hospitals-face-more-barriers-yet-use-fewer-strategies-to-reduce-readmissions
#6
Jose F Figueroa, Karen E Joynt, Xiner Zhou, Endel J Orav, Ashish K Jha
OBJECTIVE: US hospitals that care for vulnerable populations, "safety-net hospitals" (SNHs), are more likely to incur penalties under the Hospital Readmissions Reduction Program, which penalizes hospitals with higher-than-expected readmissions. Understanding whether SNHs face unique barriers to reducing readmissions or whether they underuse readmission-prevention strategies is important. DESIGN: We surveyed leadership at 1600 US acute care hospitals, of whom 980 participated, between June 2013 and January 2014...
January 3, 2017: Medical Care
https://www.readbyqxmd.com/read/28041570/a-collaborative-care-team-to-integrate-behavioral-health-care-and-treatment-of-poorly-controlled-type-2-diabetes-in-an-urban-safety-net-primary-care-clinic
#7
Lydia A Chwastiak, Sara L Jackson, Joan Russo, Pamela DeKeyser, Meghan Kiefer, Brittaney Belyeu, Kathleen Mertens, Lisa Chew, Elizabeth Lin
OBJECTIVE: Demonstrate the feasibility of implementing a collaborative care program for poorly-controlled type 2 diabetes and complex behavioral health disorders in an urban academically-affiliated safety net primary care clinic. METHODS: This retrospective cohort study evaluates multidisciplinary team care approach to diabetes in a safety net clinic, and included 634 primary care clinic patients with hemoglobin A1c (HbA1c)>9%. HbA1c, blood pressure, and depression severity were assessed at the initial visit and at the end of treatment, and compared to those of patients who were not referred to the team...
January 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28040840/black-patients-with-colorectal-cancer-have-more-advanced-cancer-stage-at-time-of-diagnosis-a-community-based-safety-net-hospital-experience
#8
Chuck Chan, Aristeo Lopez, Garland Castaneda, Taft Bhuket, Benny Liu, Stephen Yee, David Irwin, Robert J Wong
Colorectal cancer (CRC) remains a leading cause of morbidity and mortality in the U.S. Disparities in access to care contribute to advanced CRC stage at diagnosis, and these disparities are most pronounced among underserved populations and ethnic minorities. We aim to evaluate race/ethnicity-specific disparities in CRC stage at diagnosis among an ethnically diverse, urban safety-net hospital. We retrospectively evaluated all adult CRC patients diagnosed from January 1, 2009 to October 1, 2015. CRC cases were confirmed by histopathology specimens from biopsies and/or surgical resection...
December 31, 2016: Journal of Community Health
https://www.readbyqxmd.com/read/28028130/does-tax-based-health-financing-offer-protection-from-financial-catastrophe-findings-from-a-household-economic-impact-survey-of-ischaemic-heart-disease-in-malaysia
#9
Surianti Sukeri, Masoud Mirzaei, Stephen Jan
BACKGROUND: Malaysia is an upper-middle income country with a tax-based health financing system. Health care is relatively affordable, and safety nets are provided for the needy. The objectives of this study were to determine the out-of-pocket health spending, proportion of catastrophic health spending (out-of-pocket spending >40% of non-food expenditure), economic hardship and financial coping strategies among patients with ischaemic heart disease (IHD) in Malaysia under the present health financing system...
December 26, 2016: International Health
https://www.readbyqxmd.com/read/28025830/the-hispanic-and-latino-dentist-workforce-in-the-united-states
#10
Elizabeth Mertz, Cynthia Wides, Jean Calvo, Paul Gates
OBJECTIVES: The purpose of this paper is to describe the Hispanic/Latino (H/L) dentist workforce, their general practice patterns, and their contributions to oral health care for H/L and underserved patients. METHODS: A national sample survey of underrepresented minority dentists was conducted in 2012 and received a 35.4 percent response rate for self-reported H/L dentists. Data were weighted for selection and response bias to be nationally representative. A workforce profile of H/L dentists was created using descriptive and multivariable statistics and published data...
December 26, 2016: Journal of Public Health Dentistry
https://www.readbyqxmd.com/read/28019015/factors-associated-with-oral-health-related-quality-of-life-among-safety-net-clinic-patients
#11
Akiko Kamimura, Bethany Gull, Shannon Weaver, Lindsey Wright, Alysa Edwards, Kimiya Nourian, Jeanie Ashby, Lea E Erickson
OBJECTIVES: Oral health-related quality of life (OHRQoL) is an important health indicator not only for individuals but also for oral health care providers to treat a person holistically. Previous studies focused on OHRQoL do not provide comprehensive knowledge regarding low-income patients in the United States, many of whom have chronic health conditions that can affect their oral health. The purpose of this study is to examine factors associated with OHRQoL among low-income, uninsured patients of safety-net providers, which provide free or reduced fee medical and/or dental care to underserved populations...
December 26, 2016: Journal of Public Health Dentistry
https://www.readbyqxmd.com/read/28005532/designing-a-text-messaging-intervention-to-improve-physical-activity-behavior-among-low-income-latino-patients-with-diabetes-a-discrete-choice-experiment-los-angeles-2014-2015
#12
Magaly Ramirez, Shinyi Wu, Elizabeth Beale
INTRODUCTION: Automated text messaging can deliver self-management education to activate self-care behaviors among people with diabetes. We demonstrated how a discrete-choice experiment was used to determine the features of a text-messaging intervention that are important to urban, low-income Latino patients with diabetes and that could support improvement in their physical activity behavior. METHODS: In a discrete-choice experiment from December 2014 through August 2015 we conducted a survey to elicit information on patient preferences for 5 features of a text-messaging intervention...
December 22, 2016: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28002134/neuroplasticity-and-amblyopia-vision-at-the-balance-point
#13
Vijay K Tailor, D Samuel Schwarzkopf, Annegret H Dahlmann-Noor
PURPOSE OF REVIEW: New insights into triggers and brakes of plasticity in the visual system are being translated into new treatment approaches which may improve outcomes not only in children, but also in adults. RECENT FINDINGS: Visual experience-driven plasticity is greatest in early childhood, triggered by maturation of inhibitory interneurons which facilitate strengthening of synchronous synaptic connections, and inactivation of others. Normal binocular development leads to progressive refinement of monocular visual acuity, stereoacuity and fusion of images from both eyes...
December 20, 2016: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28002122/neuroplasticity-and-amblyopia-vision-at-the-balance-point
#14
Vijay K Tailor, D Samuel Schwarzkopf, Annegret H Dahlmann-Noor
PURPOSE OF REVIEW: New insights into triggers and brakes of plasticity in the visual system are being translated into new treatment approaches which may improve outcomes not only in children, but also in adults. RECENT FINDINGS: Visual experience-driven plasticity is greatest in early childhood, triggered by maturation of inhibitory interneurons which facilitate strengthening of synchronous synaptic connections, and inactivation of others. Normal binocular development leads to progressive refinement of monocular visual acuity, stereoacuity and fusion of images from both eyes...
February 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/27997478/establishing-a-baseline-community-benefit-spending-by-not-for-profit-hospitals-prior-to-implementation-of-the-affordable-care-act
#15
Jonathon P Leider, Greg J Tung, Richard C Lindrooth, Emily K Johnson, Rose Hardy, Brian C Castrucci
CONTEXT: Community Benefit spending by not-for-profit hospitals has served as a critical, formalized part of the nation's safety net for almost 50 years. This has occurred mostly through charity care. This article examines how not-for-profit hospitals spent Community Benefit dollars prior to full implementation of the Affordable Care Act (ACA). METHODS: Using data from 2009 to 2012 hospital tax and other governmental filings, we constructed national, hospital-referral-region, and facility-level estimates of Community Benefit spending...
December 16, 2016: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/27995458/a-community-based-outreach-navigator-approach-to-establishing-partnerships-for-a-safety-net-mammography-screening-center
#16
Sherrie Wallington, Bridget Oppong, Chiranjeev Dash, Tesha Coleman, Holly Greenwald, Tanya Torres, Marquita Iddirisu, Lucile Lauren Adams-Campbell
Washington, DC, has one of the highest incidence and mortality rates for breast cancer in the USA. Patient navigation coupled with informational and community resources are important strategies that assist patients' access and help them understand the complex world of cancer care. The Georgetown Lombardi Comprehensive Cancer Center's Capital Breast Care Center (CBCC) is a safety net mammography screening center that utilizes a community-based navigation program. In addition to providing assistance with coordination of clinical services, navigators at CBCC are integral in establishing intra-community partnerships to educate members of the community about breast cancer screening...
December 19, 2016: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/27992491/survivorship-care-plan-information-needs-perspectives-of-safety-net-breast-cancer-patients
#17
Nancy J Burke, Tessa M Napoles, Priscilla J Banks, Fern S Orenstein, Judith A Luce, Galen Joseph
PURPOSE: Despite the Institute of Medicine's (IOM) 2005 recommendation, few care organizations have instituted standard survivorship care plans (SCPs). Low health literacy and low English proficiency are important factors to consider in SCP development. Our study aimed to identify information needs and survivorship care plan preferences of low literacy, multi-lingual patients to support the transition from oncology to primary care and ongoing learning in survivorship. METHODS: We conducted focus groups in five languages with African American, Latina, Russian, Filipina, White, and Chinese medically underserved breast cancer patients...
2016: PloS One
https://www.readbyqxmd.com/read/27956375/an-ecological-momentary-intervention-for-smoking-cessation-evaluation-of-feasibility-and-effectiveness
#18
Michael S Businelle, Ping Ma, Darla E Kendzor, Summer G Frank, Damon J Vidrine, David W Wetter
BACKGROUND: Despite substantial public health progress in reducing the prevalence of smoking in the United States overall, smoking among socioeconomically disadvantaged adults remains high. OBJECTIVE: To determine the feasibility and preliminary effectiveness of a novel smartphone-based smoking cessation app designed for socioeconomically disadvantaged smokers. METHODS: Participants were recruited from a safety-net hospital smoking cessation clinic in Dallas, Texas, and were followed for 13 weeks...
December 12, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27940751/achieving-high-adolescent-hpv-vaccination-coverage
#19
Anna-Lisa M Farmar, Kathryn Love-Osborne, Katherine Chichester, Kristin Breslin, Kristi Bronkan, Simon J Hambidge
BACKGROUND AND OBJECTIVE: Despite national recommendations for adolescent human papillomavirus (HPV) vaccination, rates have lagged behind those of other adolescent vaccines. We implemented interventions and examined rates of vaccination coverage in a large, urban, safety net health care system to understand whether our tactics for achieving high rates of adolescent vaccination were successful. METHODS: Denver Health is an integrated urban safety net health system serving >17 000 adolescents annually...
November 2016: Pediatrics
https://www.readbyqxmd.com/read/27931463/guideline-for-monitoring-and-management-of-pediatric-patients-before-during-and-after-sedation-for-diagnostic-and-therapeutic-procedures-update-2016
#20
(no author information available yet)
The safe sedation of children for procedures requires a systematic approach that includes the following: no administration of sedating medication without the safety net of medical/dental supervision, careful presedation evaluation for underlying medical or surgical conditions that would place the child at increased risk from sedating medications, appropriate fasting for elective procedures and a balance between the depth of sedation and risk for those who are unable to fast because of the urgent nature of the procedure, a focused airway examination for large (kissing) tonsils or anatomic airway abnormalities that might increase thepotential for airway obstruction, a clear understanding of the medication's pharmacokinetic and pharmacodynamic effects and drug interactions, appropriate training and skills in airway management to allow rescue of the patient, age- and size-appropriate equipment for airway management and venous access, appropriate medications and reversal agents, sufficient numbers of staff to both carry out the procedure and monitor the patient, appropriate physiologic monitoring during and after the procedure, a properly equipped and staffed recovery area, recovery to the presedation level of consciousness before discharge from medical/dental supervision, and appropriate discharge instructions...
October 2016: Pediatric Dentistry
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