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Disparities in care

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https://www.readbyqxmd.com/read/29155639/when-machines-think-radiology-s-next-frontier
#1
Keith J Dreyer, J Raymond Geis
Artificial intelligence (AI), machine learning, and deep learning are terms now seen frequently, all of which refer to computer algorithms that change as they are exposed to more data. Many of these algorithms are surprisingly good at recognizing objects in images. The combination of large amounts of machine-consumable digital data, increased and cheaper computing power, and increasingly sophisticated statistical models combine to enable machines to find patterns in data in ways that are not only cost-effective but also potentially beyond humans' abilities...
December 2017: Radiology
https://www.readbyqxmd.com/read/29155612/health-reform-and-utilization-of-high-volume-hospitals-for-complex-cancer-operations
#2
Andrew P Loehrer, David C Chang, Zirui Song, George J Chang
PURPOSE: Underinsured patients are less likely to receive complex cancer operations at hospitals with high surgical volumes (high-volume hospitals, or HVHs), which contributes to disparities in care. To date, the impact of insurance coverage expansion on site of complex cancer surgery remains unknown. METHODS: Using the 2006 Massachusetts coverage expansion as a natural experiment, we searched the Hospital Cost and Utilization Project state inpatient databases for Massachusetts and control states (New York, New Jersey, and Florida) between 2001 and 2011 to evaluate changes in the utilization of HVHs for resections of bladder, esophageal, stomach, pancreatic, rectal, or lung cancer after the expansion of insurance coverage...
November 20, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29154611/individual-and-systemic-barriers-to-health-care-perspectives-of-lesbian-gay-bisexual-and-transgender-adults
#3
Meghan Romanelli, Kimberly D Hudson
Access to effective services is imperative to address the many health and mental health disparities that lesbian, gay, bisexual, and transgender (LGBT) people face. This population, however, remains underserved and often ill-served in health care environments. Furthermore, interactions between system- and individual-level dimensions of access create barriers to service engagement. Within much of the extant literature surrounding health care barriers among LGBT people, the rich narratives and varied experiences of LGBT community members from diverse backgrounds have often been excluded...
2017: American Journal of Orthopsychiatry
https://www.readbyqxmd.com/read/29153870/factors-associated-with-use-of-disease-modifying-agents-for-rheumatoid-arthritis-in-the-national-hospital-and-ambulatory-medical-care-survey
#4
Priyanka Gaitonde, Laura M Bozzi, Fadia T Shaya
OBJECTIVE: We examined the treatment patterns among adults with rheumatoid arthritis (RA) and identified factors influencing access to traditional and biological disease modifying antirheumatic drugs (DMARDs). METHODS: We analyzed visits recorded in the National Ambulatory Medical Care Survey from 2005 to 2014 with a RA diagnosis. The primary outcome was DMARD use (traditional and/or biological). We included prescriptions of all RA-related treatments such as traditional and biological DMARDs, glucocorticoids, gold preparations, immunosuppressants, and non-steroidal anti-inflammatory drugs...
October 18, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/29153296/use-of-self-management-interventions-for-chronic-pain-management-a-comparison-between-rural-and-nonrural-residents
#5
Linda H Eaton, Dale J Langford, Alexa R Meins, Tessa Rue, David J Tauben, Ardith Z Doorenbos
Individuals with chronic pain who live in rural communities often lack access to pain specialists and rely on primary care providers who may be less prepared. Research has indicated that rural residents with chronic pain are more likely to receive an opioid prescription than nonrural residents. Although self-management approaches are available for chronic pain management, it is unclear to what extent rural residents use these interventions. This study compares usage of self-management interventions and opioid-based analgesics for chronic pain management between rural and nonrural residents...
November 15, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29152751/healthcare-disparities-in-pediatric-otolaryngology-a-systematic-review
#6
Jad Jabbour, Thomas Robey, Michael J Cunningham
OBJECTIVES: Multiple studies have reported healthcare disparities in particular settings and conditions within pediatric otolaryngology, but a systematic examination of the breadth of the problem within the field is lacking. This study's objectives are to synthesize the available evidence regarding healthcare disparities in pediatric otolaryngology, highlight recurrent themes with respect to etiologies and manifestations, and demonstrate potential impacts from patient and provider standpoints...
November 20, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29152607/use-of-post-acute-care-after-hospital-discharge-in-urban-and-rural-hospitals
#7
Robert E Burke, Christine D Jones, Eric A Coleman, Jason R Falvey, Jennifer E Stevens-Lapsley, Adit A Ginde
Objectives: Geographic variation in the use of post-acute care (PAC - skilled nursing facility and home health care) after hospital discharge is substantial, but reasons for this remain largely unexplored. PAC use in urban hospitals compared to rural hospitals may be one key contributor. We aimed to describe PAC use, explore substitution of one type of PAC for another, and identify how PAC use varies by diagnosis in urban and rural settings. Study Design: Secondary analysis of the 2012 National Inpatient Sample including adult discharges to PAC after a hospitalization...
March 2017: Am J Accountable Care
https://www.readbyqxmd.com/read/29152588/the-delivery-science-rapid-analysis-program-a-research-and-operational-partnership-at-kaiser-permanente-northern-california
#8
Julie A Schmittdiel, Rick Dlott, Joseph D Young, Michael B Rothmann, Wendy Dyer, Alyce S Adams
Introduction: Health care researchers and delivery system leaders share a common mission to improve health care quality and outcomes. However, differing timelines, incentives, and priorities are often a barrier to research and operational partnerships. In addition, few funding mechanisms exist to generate and solicit analytic questions that are of interest to both research and to operations within health care settings, and provide rapid results that can be used to improve practice and outcomes...
October 2017: Learn Health Syst
https://www.readbyqxmd.com/read/29152476/early-recovery-pathway-for-hepatectomy-data-driven-liver-resection-care-and-recovery
#9
REVIEW
Susanne G Warner, Zeljka Jutric, Liana Nisimova, Yuman Fong
In recent years, great progress has been made toward safer hepatobiliary surgical interventions. This has resulted in more widely available treatments for patients who in the past were ineligible for curative resection of primary liver tumors, liver metastases, and advanced biliary tumors. However, the rise in procedures has seen increasingly heterogeneous perioperative management, yielding strikingly disparate outcomes. A number of groups have attempted to standardize perioperative care in an effort to create enhanced recovery pathways (ERPs) and provide clinicians with a dependable roadmap to success following hepatectomy...
October 2017: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/29150888/systematic-review-of-disparities-in-surgical-care-for-m%C3%A4-ori-in-new-zealand
#10
REVIEW
Jamie-Lee Rahiri, Zanazir Alexander, Matire Harwood, Jonathan Koea, Andrew G Hill
BACKGROUND: Health equity for Indigenous peoples in the context of surgery has recently become topical amongst surgeons in Australasia. Health inequities are amongst the most consistent and compelling disparities between Māori and New Zealand Europeans (NZE) in New Zealand (NZ). We aimed to investigate where ethnic disparities in surgical care may occur and highlight some of the potential contributing factors, over all surgical specialties, between Māori and NZE adults in NZ. METHODS: A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement...
November 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29150535/disparities-in-management-of-cardiovascular-disease-in-rural-south-africa-data-from-the-haalsi-study-health-and-aging-in-africa-longitudinal-studies-of-international-network-for-the-demographic-evaluation-of-populations-and-their-health-communities
#11
Thiago Veiga Jardim, Sheridan Reiger, Shafika Abrahams-Gessel, Nigel J Crowther, Alisha Wade, F Xavier Gómez-Olivé, Joshua Salomon, Stephen Tollman, Thomas A Gaziano
BACKGROUND: Optimal secondary prevention is critical for the reduction of repeated cardiovascular events, and the control of cardiovascular risk factors in this context is essential. Data on secondary prevention of cardiovascular disease (CVD) in sub-Saharan Africa are needed to inform intervention strategies with a particular focus on local disparities. The aim of this study was to assess CVD management in a rural community in northeast South Africa. METHODS AND RESULTS: We recruited adults aged ≥40 years residing in the Agincourt subdistrict of Mpumalanga province...
November 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29149914/testing-the-effectiveness-of-a-motivational-interviewing-based-brief-intervention-for-substance-use-as-an-adjunct-to-usual-care-in-community-based-aids-service-organizations-study-protocol-for-a-multisite-randomized-controlled-trial
#12
Bryan R Garner, Heather J Gotham, Stephen J Tueller, Elizabeth L Ball, David Kaiser, Patricia Stilen, Kathryn Speck, Denna Vandersloot, Traci R Rieckmann, Michael Chaple, Erika G Martin, Steve Martino
BACKGROUND: In 2010, the first comprehensive National HIV/AIDS Strategy for the United States was released and included three goals: (1) reducing the number of people who become infected with HIV, (2) increasing access to care and improving health outcomes for people living with HIV, and (3) reducing HIV-related health disparities and health inequities. In 2013, as part of its effort to help address the National HIV/AIDS Strategy, the National Institute on Drug Abuse (NIDA) funded a type 2 effectiveness-implementation hybrid trial titled the Substance Abuse Treatment to HIV Care (SAT2HIV) Project...
November 17, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/29149459/the-economic-impact-of-nursing
#13
EDITORIAL
Sharon M Brownie
Economics includes 'the condition of a region or group as regards material prosperity' (Oxford Dictionaries, 2017). The links between material prosperity versus poverty, health status and quality of life are well documented as are the devastating impacts of population disparities on the aforementioned indicators (Association of State and Territorial Health Officials, 2012). Poor health affects the ability of people to work, generate income and care for their families- a widely understood conundrum. In short, economic position impacts health status and health status impacts economic prosperity...
November 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29149222/personalized-medicine-and-hispanic-health-improving-health-outcomes-and-reducing-health-disparities-a-national-heart-lung-and-blood-institute-workshop-report
#14
M Larissa Avilés-Santa, John Heintzman, Nangel M Lindberg, Rafael Guerrero-Preston, Kenneth Ramos, Ana L Abraído-Lanza, Jonca Bull, Adolph Falcón, Mary Ann McBurnie, Ernest Moy, George Papanicolaou, Ileana L Piña, Jennifer Popovic, Shakira F Suglia, Miguel A Vázquez
Persons of Hispanic/Latino descent may represent different ancestries, ethnic and cultural groups and countries of birth. In the U.S., the Hispanic/Latino population is projected to constitute 29% of the population by 2060. A personalized approach focusing on individual variability in genetics, environment, lifestyle and socioeconomic determinants of health may advance the understanding of some of the major factors contributing to the health disparities experienced by Hispanics/Latinos and other groups in the U...
2017: BMC Proceedings
https://www.readbyqxmd.com/read/29149182/comparison-between-public-and-private-sectors-of-care-and-disparities-in-adverse-neonatal-outcomes-following-emergency-intrapartum-cesarean-at-term-a-retrospective-cohort-study
#15
Woonji Jang, Christopher Flatley, Ristan M Greer, Sailesh Kumar
BACKGROUND: Perinatal outcomes may be influenced by a variety of factors including maternal demographics and medical condition as well as socio-economic status. The evidence for disparities in health outcomes stratified by type of care (public or private) is lacking. The aim of this study was to investigate short term neonatal outcomes following category 1 and 2 emergency cesareans at term between publicly and privately funded women at a single major tertiary centre in Australia. Category 1-immediate threat to life (maternal or fetal); Category 2-maternal or fetal compromise that is not immediately life-threatening...
2017: PloS One
https://www.readbyqxmd.com/read/29148344/moderating-effects-of-patient-characteristics-on-the-impact-of-financial-incentives
#16
Meredith B Rosenthal, Andrea B Troxel, Kevin G Volpp, Walter F Stewart, Thomas D Sequist, James B Jones, AnneMarie G Hirsch, Karen Hoffer, Jingsan Zhu, Wenli Wang, Amanda Hodlofski, Darra Finnerty, Jack J Huang, David A Asch
While financial incentives to providers or patients are increasingly common as a quality improvement strategy, their impact on patient subgroups and health care disparities is unclear. To examine these patterns, we analyzed data from a randomized clinical trial of financial incentives to lower low-density lipoprotein (LDL) cholesterol levels in patients at risk for cardiovascular disease. Patients with higher baseline LDL experienced greater cholesterol reductions in the shared incentive arm (0.23 mg/dL per unit change in baseline LDL, 95% CI [-0...
May 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148341/the-affordable-care-act-appears-to-have-narrowed-racial-and-ethnic-disparities-in-insurance-coverage-and-access-to-care-among-young-adults
#17
Brandy J Lipton, Sandra L Decker, Benjamin D Sommers
Prior to the Affordable Care Act, one in three young adults aged 19 to 25 years were uninsured, with substantial racial/ethnic disparities in coverage. We analyzed the separate and cumulative changes in racial/ethnic disparities in coverage and access to care among young adults after implementation of the Affordable Care Act's 2010 dependent coverage provision and 2014 Medicaid and Marketplace expansions. We find that the dependent coverage provision was associated with similar gains across racial/ethnic groups, but the 2014 expansion was associated with larger gains in coverage among Hispanics and Blacks relative to Whites...
April 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29147853/biospecimen-donation-among-black-and-white-breast-cancer-survivors-opportunities-to-promote-precision-medicine
#18
Vanessa B Sheppard, Alejandra Hurtado-de-Mendoza, Yun-Ling Zheng, Ying Wang, Kristi D Graves, Tania Lobo, Hanfei Xu, Yvonne Jennings, Dennis Tolsma, Martha Trout, Brandi E Robinson, Brittany McKinnon, Mahlet Tadesse
PURPOSE: Advances in precision medicine (PM) have potential to reduce and/or eliminate breast cancer disparities in both treatment and survivorship. However, compared to white Americans, black Americans are often underrepresented in genetic research. This report assessed factors that influence receipt of buccal cells via saliva kits. METHODS: This prospective study recruited women with confirmed hormonal-positive (HR+) breast cancer (BC). A standardized telephone survey collected sociodemographic, socio-cultural (e...
November 16, 2017: Journal of Cancer Survivorship: Research and Practice
https://www.readbyqxmd.com/read/29147063/nativity-race-ethnicity-and-dual-diagnosis-among-us-adults
#19
Magdalena Szaflarski, Shawn Bauldry, Lisa A Cubbins, Karthikeyan Meganathan
Purpose: This study investigated disparities in dual diagnosis (comorbid substance-use and depressive/anxiety disorders) among US adults by nativity and racial-ethnic origin and socioeconomic, cultural, and psychosocial factors that may account for the observed disparities. Design/methodology: The study drew on data from two waves of the National Epidemiological Survey on Alcohol and Related Conditions. Racial-ethnic categories included African, Asian/Pacific Islander, European, Mexican, Puerto Rican, and other Hispanic/Latino...
2017: Research in the Sociology of Health Care
https://www.readbyqxmd.com/read/29146613/racial-and-ethnic-differences-in-trajectories-of-hospitalization-in-us-men-and-women-with-heart-failure
#20
Matthew E Dupre, Danan Gu, Hanzhang Xu, Janese Willis, Lesley H Curtis, Eric D Peterson
BACKGROUND: Prior studies have documented racial and ethnic disparities in hospitalization among patients with heart failure (HF). However, racial/ethnic differences in trajectories of hospitalization following the diagnosis of HF have not been well characterized. This study examined racial/ethnic differences in individual-level trajectories of hospitalization in older adults with diagnosed HF. METHODS AND RESULTS: Data from a nationally representative prospective cohort of US men and women aged 45 years and older were used to examine the number of hospitalizations reported every 24 months...
November 16, 2017: Journal of the American Heart Association
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