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Health care disparity

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https://www.readbyqxmd.com/read/29783031/a-unique-all-payer-rate-setting-system-controls-the-cost-but-not-the-racial-disparity-in-lower-extremity-revascularization-procedures
#1
Besma Nejim, Robert J Beaulieu, Husain Alshaikh, Mohammed Hamouda, Joseph Canner, Mahmoud B Malas
BACKGROUND: Patients with peripheral arterial disease (PAD) often have high comorbidity burden that may complicate post-interventional course and drive increased healthcare expenditures. Racial disparity had been observed in lower extremity revascularization (LER) patterns and outcomes. In 2014, Maryland adopted an all-payer rate setting system to limit the rising hospitalization costs. This resulted in an aggregate payment system in which hospital compensation takes place as an overall per capita expenditure for hospital services...
May 18, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29782511/prevalence-and-factors-associated-with-underutilization-of-antenatal-care-services-in-nigeria-a-comparative-study-of-rural-and-urban-residences-based-on-the-2013-nigeria-demographic-and-health-survey
#2
Emmanuel Olorunleke Adewuyi, Asa Auta, Vishnu Khanal, Olasunkanmi David Bamidele, Cynthia Pomaa Akuoko, Kazeem Adefemi, Samson Joseph Tapshak, Yun Zhao
INTRODUCTION: Antenatal care (ANC) is a major public health intervention aimed at ensuring safe pregnancy outcomes. In Nigeria, the recommended minimum of four times ANC attendance is underutilized. This study investigates the prevalence and factors associated with underutilization of ANC services with a focus on the differences between rural and urban residences in Nigeria. METHODS: We analyzed the 2013 Nigeria Demographic and Health Survey dataset with adjustment for the sampling weight and the cluster design of the survey...
2018: PloS One
https://www.readbyqxmd.com/read/29781915/childhood-asthma-disparities-in-chicago-developing-approaches-to-health-inequities
#3
Molly A Martin, Melissa Gutierrez Kapheim, Kim Erwin, Stacy Ignoffo, Kate McMahon, Amy OʼRourke, Lynn B Gerald, Meredith Barrett, Valerie G Press, Houshang Darabi, Jerry A Krishnan
We conducted a needs assessment to develop an evidence-based, locally tailored asthma care implementation plan for high-risk children with asthma in Chicago. Our team of health policy experts, clinicians, researchers, and designers included extensive stakeholder engagement (N = 162) in a mixed-methods community needs assessment. Results showed the lines of communication and collaboration across sectors were weak; caregivers were the only consistent force and could not always manage this burden. A series of recommendations for interventions and how to implement and measure them were generated...
July 2018: Family & Community Health
https://www.readbyqxmd.com/read/29781691/enabling-factors-for-specialist-outreach-in-western-kwazulu-natal
#4
Robert I Caldwell, Merridy Grant, Bernard Gaede, Colleen Aldous
BACKGROUND: There exists a major disparity in access to specialist care between patients in urban and rural areas. Specialists are a scarce resource and are concentrated in urban areas. Specialist outreach attempts to fill the gap in service provision for patients situated remotely. While there is international evidence that multifaceted specialist outreach has achieved varying levels of success, factors that influence the effectiveness of outreach have not yet been fully elucidated in South Africa...
May 17, 2018: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/29781683/tuberculosis-non-communicable-disease-comorbidity-and-multimorbidity-in-public-primary-care-patients-in-south-africa
#5
Karl Peltzer
BACKGROUND:  Little is known about the prevalence of non-communicable disease (NCD) multimorbidity among tuberculosis (TB) patients in Africa.Aim and setting: The aim of this study was to assess the prevalence of NCD multimorbidity, its pattern and impact on adverse health outcomes among patients with TB in public primary care in three selected districts of South Africa. METHODS:  In a cross-sectional survey, new TB and TB retreatment patients were interviewed, and medical records assessed in consecutive sampling within 1 month of anti-TB treatment...
April 11, 2018: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/29780822/epidemiology-characteristics-and-outcomes-of-icu-managed-homeless-patients-a-population-based-study
#6
Lavi Oud
Background: The population-level demand for critical care services among the homeless (H) remains unknown, with only sparse data on the characteristics and outcomes of those managed in the ICU. Methods: The Texas Inpatient Public Use Data File and annual federal reports were used to identify H hospitalizations and annual estimates of the H population between 2007 and 2014. The incidence of ICU admissions in the H population, the characteristics of ICU-managed H, and factors associated with their short-term mortality were examined...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29780766/racial-ethnic-differences-in-health-insurance-adequacy-and-consistency-among-children-evidence-from-the-2011-12-national-survey-of-children-s-health
#7
Tulay G Soylu, Eman Elashkar, Fatemah Aloudah, Munir Ahmed, Panagiota Kitsantas
Background: Surveillance of disparities in healthcare insurance, services and quality of care among children are critical for properly serving the medical/healthcare needs of underserved populations. The purpose of this study was to assess racial/ethnic differences in children's (0 to 17 years old) health insurance adequacy and consistency (child has insurance coverage for the last 12 months). Design and methods: We used data from the 2011/2012 National Survey of Children's Health (n=79,474)...
February 5, 2018: Journal of Public Health Research
https://www.readbyqxmd.com/read/29779883/gender-gap-and-risk-factors-for-poor-stroke-outcomes-a-single-hospital-based-prospective-cohort-study
#8
Kuo-Hua Hung, Jerry Cheng-Yen Lai, Kuang-Nan Hsu, Chihmin Hu, Hung-Chang Chang, Cheng-Neng Chen, He-Shu Ku, Ming-Shiang Yang, Pei-Hao Chen
BACKGROUND: This study intended to investigate whether etiological stroke subtypes and their corresponding major risk factors have differential effects on outcomes between genders. PATIENTS AND METHODS: We enrolled 403 consecutive patients with first-ever acute ischemic stroke (170 women, 233 men), from a referral hospital in Taiwan over a 2-year period. Gender differences in demographics, vascular risk factors, access to health care, etiological stroke subtypes, stroke severity, and outcomes were examined...
May 17, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29779546/state-legislative-approach-to-enumerating-behavioral-health-workforce-shortages-lessons-learned-in-new-mexico
#9
Deborah B Altschul, Caroline A Bonham, Martha J Faulkner, Amy W Farnbach Pearson, Jessica Reno, Wayne Lindstrom, Shelley M Alonso-Marsden, Annette Crisanti, Julie G Salvador, Richard Larson
Nationally, the behavioral health workforce is in crisis because of a lack of resources, culturally responsive services, quality clinical supervision, sufficient training in evidence-based practices, and targeted recruitment and retention. Disparities in access to behavioral health care are particularly significant in New Mexico, where 25% of the population live in rural areas, and behavioral health shortages are among the highest in the nation. Additionally, as a Medicaid expansion state, New Mexico providers experience increased demand for services at a time when the state is challenged with limited workforce capacity...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29779543/geographic-variation-in-the-supply-of-selected-behavioral-health-providers
#10
C Holly A Andrilla, Davis G Patterson, Lisa A Garberson, Cynthia Coulthard, Eric H Larson
INTRODUCTION: In 2015, an estimated 43.4 million Americans aged 18 and older suffered from a behavioral health issue. Accurate estimates of the number of psychiatrists, psychologists, and psychiatric nurse practitioners are needed as demand for behavioral health care grows. METHODS: The National Plan and Provider Enumeration System National Provider Identifier data (October 2015) was used to examine the supply of psychiatrists, psychologists, and psychiatric nurse practitioners...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29779426/community-efforts-to-reduce-racial-and-ethnic-health-disparities-challenges-and-facilitators-identified-by-16-multistakeholder-alliances
#11
Jaime Hamil, Juliet Yonek, Yasmin Mahmud, Raymond Kang, Ariane Garrett, Philethea Duckett, Muriel Jean-Jacques
The Robert Wood Johnson Foundation's Aligning Forces for Quality (AF4Q) program aimed to improve health care quality and reduce racial and ethnic disparities in 16 diverse communities in the United States from 2006 to 2015; yet most communities failed to make substantive progress toward advancing health care equity by the program's end. This qualitative analysis of key stakeholder interviews aims to identify the major contributors to success versus failure in addressing local health disparities during AF4Q and identified five major themes...
May 1, 2018: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29778934/spatial-accessibility-of-primary-health-care-in-china-a-case-study-in-sichuan-province
#12
Xiuli Wang, Huazhen Yang, Zhanqi Duan, Jay Pan
Access to primary health care is considered a fundamental right and an important facilitator of overall population health. Township health centers (THCs) and Community health centers (CHCs) serve as central hubs of China's primary health care system and have been emphasized during recent health care reforms. Accessibility of these hubs is poorly understood and a better understanding of the current situation is essential for proper decision making. This study assesses spatial access to health care provided by primary health care institutions (THCs/CHCs) in Sichuan Province as a microcosm in China...
May 10, 2018: Social Science & Medicine
https://www.readbyqxmd.com/read/29778396/how-effective-are-approaches-to-migrant-screening-for-infectious-diseases-in-europe-a-systematic-review
#13
REVIEW
Farah Seedat, Sally Hargreaves, Laura B Nellums, Jing Ouyang, Michael Brown, Jon S Friedland
Rates of migration to Europe, and within Europe, have increased in recent years, with considerable implications for health systems. Migrants in Europe face a disproportionate burden of tuberculosis, HIV, and hepatitis B and C, yet experience a large number of barriers to accessing statutory health care on arrival. A better understanding of how to deliver effective and cost-effective screening, vaccination, and health services to this group is now crucial. We did a systematic review to document and assess the effectiveness and cost-effectiveness of approaches used for infectious diseases screening, and to explore facilitators and barriers experienced by migrants to accessing screening programmes...
May 16, 2018: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29775173/healthcare-barriers-and-supports-for-american-indian-women-with-cancer
#14
Jessica L Liddell, Catherine E Burnette, Soonhee Roh, Yeon-Shim Lee
Although American Indian (AI) women continue to experience cancer at higher rates and have not seen the same decline in cancer prevalence as the general U.S. population, little research examines how interactions with health care providers may influence and exacerbate these health disparities. The purpose of the study was to understand the experiences of AI women who receive cancer treatment, which is integral for eradication of AI cancer disparities among women. A qualitative descriptive methodology was used with a sample of 43 AI women with breast, cervical, colon, and other types of cancer from the Northern Plains region of South Dakota...
May 18, 2018: Social Work in Health Care
https://www.readbyqxmd.com/read/29773125/regional-overview-of-specific-populations-workforce-considerations-training-and-diseases-in-latin-america
#15
REVIEW
Jose Pablo Stolovitzky, Jacqueline Alvarado
Latin America has significant disparities that make the region vulnerable in the delivery of health care. There is a need to plan comprehensive health care strategies that result in a more robust trained health care workforce, while improving the quality and efficiencies of tertiary public hospitals. This article introduces a survey conducted among otorhinolaryngology leaders in the region that identified the need to strengthen postgraduate programs. Although all countries in Latin America have at least one residency program, more otorhinolaryngology-trained specialists are necessary to address the workforce shortages that are present in about 50% of Latin American countries...
June 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29771619/affordable-care-act-impact-in-kentucky-increasing-access-reducing-disparities
#16
Lynn A Blewett, Colin Planalp, Giovann Alarcon
OBJECTIVES: To examine health insurance disparities since Kentucky's implementation of the Affordable Care Act (ACA). METHODS: Using the American Community Survey, we estimated coverage rates by race/ethnicity before and after implementation of the ACA (2013 and 2015), and we estimated whether groups were over- or underrepresented among the uninsured, compared with their share of the state population. RESULTS: Kentucky's uninsurance rate declined from 14...
May 17, 2018: American Journal of Public Health
https://www.readbyqxmd.com/read/29771101/-evidence-of-lack-of-concordance-between-hemodialysis-patients-and-nurses-on-the-presence-and-severity-of-symptoms
#17
Christine Cohen, Matteo Antonini, Philippe Delmas
Hemodialysis patients represent a fragile population experiencing many symptoms (e.g., pain, fatigue) that impact their quality of life. The presence and severity of these symptoms are significantly underestimated by health professionals. The purpose of this study is to describe and compare the symptoms perceived by hemodialysis patients versus those detected by nurses and to discuss the possible causes of the disparity observed. A total of 123 patients and 70 nurses working in six hemodialysis centers were included in this study...
March 2018: Recherche en Soins Infirmiers
https://www.readbyqxmd.com/read/29770102/rolling-out-hiv-antiretroviral-therapy-in-sub-saharan-africa-2003-2017
#18
G Taylor
Multiple issues need to be addressed in order to control the HIV pandemic in sub-Saharan Africa. Combination antiretroviral therapy (cART) is key to reducing morbidity and mortality among people living with HIV and has a role in preventing HIV transmission. However, access to cART is very unevenly distributed globally, especially in sub-Saharan Africa. Although cost of cART is no longer a major barrier as effective treatment can be had for under US$100 per year, HIV management is compromised by the inadequate number of trained clinicians, the lack of clinical and laboratory infrastructure and the increased prevalence of co-morbidities (e...
February 1, 2018: Canada Communicable Disease Report, Relevé des Maladies Transmissibles Au Canada
https://www.readbyqxmd.com/read/29769080/a-complex-culturally-targeted-intervention-to-reduce-hispanic-disparities-in-living-kidney-donor-transplantation-an-effectiveness-implementation-hybrid-study-protocol
#19
Elisa J Gordon, Jungwha Lee, Raymond H Kang, Juan Carlos Caicedo, Jane L Holl, Daniela P Ladner, Michelle D Shumate
BACKGROUND: The shortage of organs for kidney transplantation for patients with end-stage renal disease (ESRD) is magnified in Hispanics/Latin Americans in the United States. Living donor kidney transplantation (LDKT) is the treatment of choice for ESRD. However, compared to their representation on the transplant waitlist, fewer Hispanics receive a LDKT than non-Hispanic whites. Barriers to LDKT for Hispanics include: lack of knowledge, cultural concerns, and language barriers. Few interventions have been designed to reduce LDKT disparities...
May 16, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29766438/sexual-orientation-differences-in-outpatient-psychiatric-treatment-and-antidepressant-usage-evidence-from-a-population-based-study-of-siblings
#20
Richard Bränström, Mark L Hatzenbuehler, Petter Tinghög, John E Pachankis
In the past two decades, population-based health surveys have begun including measures of sexual orientation, permitting estimates of sexual orientation disparities in psychiatric morbidity and differences in treatment utilization. The present study takes advantage of the high-quality, comprehensive nationwide health registry data available in Sweden to examine whether psychiatric outpatient treatment for various diagnoses and antidepressant medication usage are greater in sexual minority individuals compared to their siblings...
May 15, 2018: European Journal of Epidemiology
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