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Disparities in care

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https://www.readbyqxmd.com/read/28938046/the-value-that-infectious-diseases-physicians-bring-to-the-healthcare-system
#1
Daniel P McQuillen, Ann T MacIntyre
While a career in infectious diseases (ID) has always been challenging and exciting, recognition of the value that ID physicians provide to the healthcare system as a whole, over and above the value they provide to individual patients, has been poor in this system. In response to this disparity, the Infectious Diseases Society of America Clinical Affairs Committee has long endeavored to quantify the value of ID physicians to the system, which is challenging in part because of the many avenues through which they influence healthcare...
September 15, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28936391/evaluation-of-a-multi-year-policy-focused-intervention-to-increase-physical-activity-and-related-behaviors-in-lower-resourced-early-care-and-education-settings-active-early-2-0
#2
Emily J Tomayko, Ronald J Prince, Jill Hoiting, Abbe Braun, Tara L LaRowe, Alexandra K Adams
Physical activity is a critical component of obesity prevention, but few interventions targeting early childhood have been described. The Active Early guide was designed to increase physical activity in early care and education (ECE) settings. The purpose of Active Early 2.0 was to evaluate the effectiveness of Active Early along with provider training, microgrant support, and technical assistance over 2 years (2012-2014) to increase physical activity and related behaviors (e.g., nutrition) in settings serving a high proportion of children from underserved groups in recognition of significant disparities in obesity and challenges meeting physical activity recommendations in low-resource settings...
December 2017: Preventive Medicine Reports
https://www.readbyqxmd.com/read/28936272/hereditary-gynaecologic-cancers-in-nepal-a-proposed-model-of-care-to-serve-high-risk-populations-in-developing-countries
#3
Hanoon P Pokharel, Neville F Hacker, Lesley Andrews
BACKGROUND: Endometrial, ovarian and breast cancers are paradigms for global health disparity. Women living in the developing world continue to present in later stages of disease and have fewer options for treatment than those in developed countries. Risk reducing surgery is of proven benefit for women at high risk of gynaecological cancer. There is no specific model for identification and management of such women in the developing world. METHODS: We have integrated data from our published audit of a major gynaecological oncology centre at Royal Hospital for Women in Australia, with data from our survey and a focus group discussion of Nepalese gynaecological health care professionals regarding genetic testing, and findings from the literature...
2017: Hereditary Cancer in Clinical Practice
https://www.readbyqxmd.com/read/28935442/what-are-patient-navigators-doing-for-whom-and-where-a-national-survey-evaluating-the-types-of-services-provided-by-patient-navigators
#4
Kristen J Wells, Patricia Valverde, Amy E Ustjanauskas, Elizabeth A Calhoun, Betsy C Risendal
OBJECTIVE: A nationwide cross-sectional study was conducted to assess patient navigator, patient population, and work setting characteristics associated with performance of various patient navigation (PN) tasks. METHODS: Using respondent-driven sampling, 819 navigators completed a survey assessing frequency of providing 83 PN services, along with information about themselves, populations they serve, and setting in which they worked. Analyses of variance and Pearson correlations were conducted to determine differences and associations in frequency of PN services provided by various patient, navigator, and work setting characteristics...
August 31, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28935359/disparities-by-sex-tracked-in-the-2015-national-healthcare-quality-and-disparities-report-trends-across-national-quality-strategy-priorities-health-conditions-and-access-measures
#5
Jennifer E Moore, Atlang Mompe, Ernest Moy
INTRODUCTION: Established by the Affordable Care Act, the National Quality Strategy (NQS) is the national policy goals aimed at improving the quality of health care for all Americans. The NQS established six priorities to provide better, more affordable care for individuals and communities. This is the first analysis of data on the NQS and access measures that focus on sex differences, health conditions, trends, and disparities. METHODS: Measures from the 2015 National Healthcare Quality and Disparities Report (QDR) for the four National Quality Strategy priorities (Patient Safety, Person Centered Care, Effective Treatment and Healthy Living), access to care, and health conditions for women were compared to measures for men...
September 19, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28934554/improvements-in-clinical-practice-for-fertility-preservation-among-young-cancer-patients-results-from-bundled-interventions
#6
Natalie K Bradford, Roderick Walker, Roslyn Henney, Po Inglis, Raymond J Chan
AIMS: The consequences of cancer and treatment on fertility can be a continuing source of distress for adolescents and young adults. The study aims were to assess the effects of bundled interventions on clinical practice concerning fertility in young people aged 14-25 years with cancer. METHODS: Bundled interventions, including development of quality indicators, resources, and targeted education, were introduced during 2015 across five cancer centers. Data before interventions (2012-2014) were compared with data prospectively collected during 2015-2016...
September 21, 2017: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/28934183/trends-in-cervical-cancer-screening-in-title-x-funded-health-centers-united-states-2005-2015
#7
Christina I Fowler, Mona Saraiya, Susan B Moskosky, Jacqueline W Miller, Julia Gable, Nancy Mautone-Smith
Cervical cancer screening is critical to early detection and treatment of precancerous cells and cervical cancer. In 2015, 83% of U.S. women reported being screened per current recommendations, which is below the Healthy People 2020 target of 93% (1,2). Disparities in screening persist for women who are younger (aged 21-30 years), have lower income, are less educated, are uninsured, lack a source of health care, or who self-identify as Asian or American Indian/Alaska Native (2). Women who are never screened or rarely screened are more likely to develop cancer and receive a cancer diagnosis at later stages than women who are screened regularly (3)...
September 22, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28933932/enrollment-in-california-s-medicaid-program-after-the-affordable-care-act-expansion
#8
Jing Wang, Amal N Trivedi
OBJECTIVES: To determine enrollment rates and predictors of enrollment for newly eligible low-income adults in California following the Affordable Care Act's (ACA's) Medicaid expansion. METHODS: We used data from the 2014 to 2015 California Health Interview Survey to examine post-ACA Medicaid enrollment rates and multivariable logistic regression to assess the association of demographic factors, income, and health with enrollment. RESULTS: We found a 78...
September 21, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28933619/african-american-adults-and-seasonal-influenza-vaccination-changing-our-approach-can-move-the-needle
#9
Sandra Crouse Quinn
Consistent disparities in influenza (flu) vaccine uptake among African Americans, coupled with a disproportionate burden of chronic diseases, places too many African Americans at high risk for complications, hospitalizations and premature mortality. This disparity is the result of individual attitudes and beliefs, social norms, and health care practices. Recent research identifies critical factors affecting vaccine uptake among African American adults including perceived risk of vaccine side effects, social norms that do not support for vaccination, and lower knowledge of the flu and the vaccine...
September 21, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/28931306/feeling-heard-and-not-judged-perspectives-on-substance-use-services-among-youth-formerly-in-foster-care
#10
Jordan M Braciszewski, Tanya B Tran, Roland S Moore, Beth C Bock, Golfo K Tzilos Wernette, Patricia Chamberlain, Robert L Stout, Adam Vose-O'Neal
Youth in foster care have limited access to substance use services for a variety of reasons. Attempts to unpack this health disparity have focused on foster care systems, administrators, providers, and foster parents. This study seeks to understand the perspectives of youth themselves, with the hope of understanding their experiences with and preferences for such services. Analyses of focus groups with youth who had recently left foster care suggested concrete and perceptual facilitators/barriers to treatment...
January 1, 2017: Child Maltreatment
https://www.readbyqxmd.com/read/28931117/migrant-tuberculosis-patient-needs-and-health-system-response-along-the-thailand-myanmar-border
#11
Naomi Tschirhart, Francois Nosten, Angel M Foster
This article aims to identify how the health system in Tak province, Thailand has responded to migrants' barriers to tuberculosis (TB) treatment. Our qualitatively driven multi-methods project utilized focus group discussions, key informant interviews, and a survey of community health volunteers to collect data in 2014 from multiple perspectives. Migrants identified legal status and transportation difficulties as the primary barriers to seeking TB treatment. Lack of financial resources and difficulties locating appropriate and affordable health services in other Thai provinces or across the border in Myanmar further contributed to migrants' challenges...
October 1, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28930888/what-matters-most-to-whom-racial-ethnic-and-language-differences-in-the-health-care-experiences-most-important-to-patients
#12
Rebecca L Collins, Ann Haas, Amelia M Haviland, Marc N Elliott
BACKGROUND: Some aspects of patient experience are more strongly related to overall ratings of care than others, reflecting their importance to patients. However, little is known about whether the importance of different aspects of this experience differs across subgroups. OBJECTIVES: To determine whether the aspects of health care most important to patients differ according to patient race, ethnicity, and language preference. RESEARCH DESIGN: In response to the 2013 Medicare Consumer Assessment of Health Plans Study (CAHPS) survey, patients rated their overall health care and completed items measuring five patient experience domains...
September 19, 2017: Medical Care
https://www.readbyqxmd.com/read/28929424/aphasia-as-a-predictor-of-stroke-outcome
#13
REVIEW
Ronald M Lazar, Amelia K Boehme
PURPOSE OF REVIEW: Aphasia is a common feature of stroke, affecting 21-38% of acute stroke patients and an estimated 1 million stroke survivors. Although stroke, as a syndrome, is the leading cause of disability in the USA, less is known about the independent impact of aphasia on stroke outcomes. RECENT FINDINGS: During the acute stroke period, aphasia has been found to increase length of stay, inpatient complications, overall neurological disability, mortality, and to alter discharge disposition...
September 19, 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28929097/integrated-clinical-decision-support-systems-promote-absolute-cardiovascular-risk-assessment-an-important-primary-prevention-measure-in-aboriginal-and-torres-strait-islander-primary-health-care
#14
Veronica Matthews, Christopher P Burgess, Christine Connors, Elizabeth Moore, David Peiris, David Scrimgeour, Sandra C Thompson, Sarah Larkins, Ross Bailie
BACKGROUND: Aboriginal and Torres Strait Islander Australians experience a greater burden of disease compared to non-Indigenous Australians. Around one-fifth of the health disparity is caused by cardiovascular disease (CVD). Despite the importance of absolute cardiovascular risk assessment (CVRA) as a screening and early intervention tool, few studies have reported its use within the Australian Indigenous primary health care (PHC) sector. This study utilizes data from a large-scale quality improvement program to examine variation in documented CVRA as a primary prevention strategy for individuals without prior CVD across four Australian jurisdictions...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28929012/current-practice-in-the-management-of-new-onset-atrial-fibrillation-in-critically-ill-patients-a-uk-wide-survey
#15
Chung Shen Chean, Daniel McAuley, Anthony Gordon, Ingeborg Dorothea Welters
BACKGROUND: New-onset atrial fibrillation (AF) is the most common arrhythmia in critically ill patients. Although evidence base and expert consensus opinion for management have been summarised in several international guidelines, no specific considerations for critically ill patients have been included. We aimed to establish current practice of management of critically ill patients with new-onset AF. METHODS: We designed a short user-friendly online questionnaire...
2017: PeerJ
https://www.readbyqxmd.com/read/28927396/socioeconomic-disparities-in-orthodontic-treatment-outcomes-and-expenditure-on-orthodontics-in-england-s-state-funded-national-health-service-a-retrospective-observational-study
#16
Juliet Price, William Whittaker, Stephen Birch, Paul Brocklehurst, Martin Tickle
BACKGROUND: This study aimed to assess whether there are potential areas for efficiency improvements in the National Health Service (NHS) orthodontic service in North West England and to assess the socioeconomic status (SES)-related equity of the outcomes achieved by the NHS. METHODS: The study involved a retrospective analysis of 2008-2012 administrative data, and the study population comprised patients aged ≥10 who started NHS primary care orthodontic treatment in North West England in 2008...
September 19, 2017: BMC Oral Health
https://www.readbyqxmd.com/read/28926778/korean-immigrants-don-t-buy-health-insurance-the-influences-of-culture-on-self-employed-korean-immigrants-focusing-on-structure-and-functions-of-social-networks
#17
Hyunsung Oh, Chung Hyeon Jeong
Culture has been pinpointed as a culprit of disparities in health insurance coverage between Korean immigrants and other ethnic groups. This study explored specific mechanisms by which culture influences a decision to buy health insurance among self-employed Korean immigrants living in ethnic enclaves by focusing on the structure and functions of social networks. Between March and June 2015, we recruited 24 Korean immigrant adults (aged 18 or older) who identified as self-employed and being uninsured for substantial periods before 2014 in Southern California...
September 12, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28926481/disparities-in-health-care-utilization-of-adults-with-traumatic-brain-injuries-are-related-to-insurance-race-and-ethnicity-a-systematic-review
#18
Shiyao Gao, Raj G Kumar, Stephen R Wisniewski, Anthony Fabio
OBJECTIVE: To characterize racial/ethnic and insurance disparities in the utilization of healthcare services among US adults with traumatic brain injury (TBI). METHODS: The PubMed database was used to search for articles that directly examined the association between race/ethnicity and insurance disparities and healthcare utilization among patients with TBI. Eleven articles that met the criteria and were published between June 2011 and June 2016 were finally included in the review...
September 18, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28924919/use-of-accessible-examination-tables-in-the-primary-care-setting-a-survey-of-physical-evaluations-and-patient-attitudes
#19
Megan A Morris, Allysha C Maragh-Bass, Joan M Griffin, Lila J Finney Rutten, Tara Lagu, Sean Phelan
BACKGROUND: Accessible diagnostic equipment, including height-adjustable examination tables, is necessary to accommodate patients with disabilities. Studies demonstrate that only a minority of clinics provide accessible equipment. For clinics with this equipment, no studies have examined the use of such equipment in routine clinical care. OBJECTIVE: In primary care clinics with and without height-adjustable examination tables, we compared the frequency and variation in physical evaluations on examination tables and patients' perceptions of quality care...
September 18, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28923816/-finding-the-right-fit-rural-patient-preferences-for-fecal-immunochemical-test-fit-characteristics
#20
Robyn Pham, Suzanne Cross, Bianca Fernandez, Kathryn Corson, Kristen Dillon, Coco Yackley, Melinda M Davis
PURPOSE: Colorectal cancer (CRC) is the third leading cause of cancer death in the United States, yet 1 in 3 Americans have never been screened for CRC. Annual screening using fecal immunochemical tests (FITs) is often a preferred modality in populations experiencing CRC screening disparities. Although multiple studies evaluate the clinical effectiveness of FITs, few studies assess patient preferences toward kit characteristics. We conducted this community-led study to assess patient preferences for FIT characteristics and to use study findings in concert with clinical effectiveness data to inform regional FIT selection...
September 2017: Journal of the American Board of Family Medicine: JABFM
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