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Disparities in care

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https://www.readbyqxmd.com/read/28231631/commentary-response-frailty-not-just-about-old-people-reply-to-smith-gd-kydd-a-2017-getting-care-of-older-people-right-the-need-for-appropriate-frailty-assessment
#1
Sunita R Jha, Julee Mcdonagh, Caleb Ferguson, Peter S Macdonald, Phillip J Newton
As highlighted in a recent editorial, the ageing population and burden of frailty amongst those aged 60 years and older represents an impending challenge for individuals and health care systems globally (Smith & Kydd 2017). As frailty is largely considered a geriatric syndrome, research has primarily occurred within elderly community dwelling populations (Fried et al. 2001). However, it is important to highlight that not all older people are frail; and conversely not all younger people are non-frail. With frailty research expanding its scope beyond geriatrics over the last 2 decades, our understanding of this syndrome and its complexities has progressed...
February 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28231416/feasibility-of-combining-common-data-elements-across-studies-to-test-a-hypothesis
#2
Elizabeth J Corwin, Shirley M Moore, Andrea Plotsky, Margaret M Heitkemper, Susan G Dorsey, Drenna Waldrop-Valverde, Donald E Bailey, Sharron L Docherty, Joanne D Whitney, Carol M Musil, Cynthia M Dougherty, Donna J McCloskey, Joan K Austin, Patricia A Grady
PURPOSE: The purpose of this article is to describe the outcomes of a collaborative initiative to share data across five schools of nursing in order to evaluate the feasibility of collecting common data elements (CDEs) and developing a common data repository to test hypotheses of interest to nursing scientists. This initiative extended work already completed by the National Institute of Nursing Research CDE Working Group that successfully identified CDEs related to symptoms and self-management, with the goal of supporting more complex, reproducible, and patient-focused research...
February 23, 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/28231239/surveillance-for-health-care-access-and-health-services-use-adults-aged-18-64-years-behavioral-risk-factor-surveillance-system-united-states-2014
#3
Catherine A Okoro, Guixiang Zhao, Jared B Fox, Paul I Eke, Kurt J Greenlund, Machell Town
PROBLEM/CONDITION: As a result of the 2010 Patient Protection and Affordable Care Act, millions of U.S. adults attained health insurance coverage. However, millions of adults remain uninsured or underinsured. Compared with adults without barriers to health care, adults who lack health insurance coverage, have coverage gaps, or skip or delay care because of limited personal finances might face increased risk for poor physical and mental health and premature mortality. PERIOD COVERED: 2014...
February 24, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/28230243/global-disparities-in-cancer-pain-management-and-palliative-care
#4
Madhuri Are, Amanda McIntyre, Suresh Reddy
Palliative care and pain management constitute an integral part of the multi-disciplinary approach to treating patients with cancer. There are major disparities in the global presence of sustainable palliative care models and universal availability of effective pain medications, especially in low and middle income countries with the highest predicted future burden of cancer. Active intervention is needed to improve the availability of palliative care and effective pain control worldwide.
February 23, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28228449/neighborhood-differences-in-post-stroke-mortality
#5
Theresa L Osypuk, Amy Ehntholt, J Robin Moon, Paola Gilsanz, M Maria Glymour
BACKGROUND: Post-stroke mortality is higher among residents of disadvantaged neighborhoods, but it is not known whether neighborhood inequalities are specific to stroke survival or similar to mortality patterns in the general population. We hypothesized that neighborhood disadvantage would predict higher poststroke mortality, and neighborhood effects would be relatively larger for stroke patients than for individuals with no history of stroke. METHODS AND RESULTS: Health and Retirement Study participants aged ≥50 years without stroke at baseline (n=15 560) were followed ≤12 years for incident stroke (1715 events over 159 286 person-years) and mortality (5325 deaths)...
February 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28228140/should-co-payments-for-financially-deprived-patients-be-lowered-primary-care-physicians-perspectives-using-a-mixed-methods-approach-in-a-survey-study-in-tokyo
#6
Machiko Inoue, Yuko Kachi
BACKGROUND: Japan's stagnant economy has produced increasing income disparities, and the effect of poverty on health and health-care utilization is a significant issue. Co-payments could be a trade-off for patients when seeking medical care and limit health-care utilization. We sought primary care physicians' experiences in dealing with financially deprived patients and their perspectives about reducing co-payments by low-income patients. METHODS: We used a convergent mixed-methods approach in a mail survey; it was distributed to 1989 primary care physicians practicing in areas with the highest proportions of socially disadvantaged individuals in Tokyo...
February 22, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28225661/lgbtq-youth-part-1
#7
Tracy Perron, Connie Kartoz, Chaya Himelfarb
In order to provide holistic care, school nurses must be culturally competent by being sensitive to health disparities experienced by students in at-risk populations. Despite the growing acceptance toward gender and sexual minorities, LGBTQ youth remain an at-risk population in our communities and our schools. School nurses as well as school counselors, social workers, and psychologists can increase their cultural competence in caring for this group of students by increasing their understanding of appropriate terminology and risks associated with this vulnerable group...
March 2017: NASN School Nurse
https://www.readbyqxmd.com/read/28225658/lgbtq-part-2
#8
Tracy Perron, Connie Kartoz, Chaya Himelfarb
In addition to dealing with the normal challenges of being a teenager, many times LGBTQ youth have to deal with harassment, intimidation, and bullying on a daily basis as they disproportionately experience verbal and physical harassment while in school as a result of their sexual orientation and/or gender identity. This violence adversely affects these students' health and well-being as reflected in the depression and suicide rate among LGBTQ youth. As Part 2 of a series in articles on caring for LGBTQ youth in a school setting, this article reviews specific health risks in this group of students...
March 2017: NASN School Nurse
https://www.readbyqxmd.com/read/28225427/race-differences-in-initial-presentation-early-treatment-and-1-year-outcomes-of-pediatric-crohn-s-disease-results-from-the-improvecarenow-network
#9
Jennifer L Dotson, Michele Cho, Josh Bricker, Michael D Kappelman, Deena J Chisolm, Gitit Tomer, Wallace V Crandall
BACKGROUND: Racially disparate care has been shown to contribute to suboptimal health care outcomes for minorities. Using the ImproveCareNow network, we investigated differences in management and outcomes of pediatric patients with Crohn's disease at diagnosis and 1-year postdiagnosis. METHODS: ImproveCareNow is a learning health network for pediatric inflammatory bowel disease. It contains prospective, longitudinal data from outpatient encounters. This retrospective study included all patients with Crohn's disease ≤21 years, September 2006 to October 2014, with the first recorded encounter ≤90 days from date of diagnosis and an encounter 1 year ±60 days...
February 20, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28225376/a-qualitative-analysis-of-general-emergency-medicine-providers-perceptions-on-pediatric-emergency-telemedicine
#10
Ji Won Kim, Gunjan Tiyyagura, Melissa Langhan
OBJECTIVE: Most children in the United States are evaluated in general emergency departments (ED), which are staffed by practitioners who care for both adults and children and may have limited pediatric resources. The application of telemedicine in pediatrics is growing and has been shown to be effective in outpatient as well as critical care settings. Telemedicine has the potential to address disparities in access to pediatric emergency care. The objective of this study was to explore experiences of general ED providers with telemedicine and their perception about a potential video telemedicine program with pediatric ED providers...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28224941/telehealth-applications-to-enhance-ckd-knowledge-and-awareness-among-patients-and-providers
#11
REVIEW
Delphine S Tuot, L Ebony Boulware
CKD affects 13% of the US adult population, causes excess mortality, and is associated with significant sociodemographic disparities. Optimal CKD management slows progression of disease and reduces cardiovascular-related outcomes. Resources for patients and primary care providers, major stakeholders in preventive CKD care, are critically needed to enhance understanding of the disease and to optimize CKD health, particularly because of the asymptomatic nature of kidney disease. Telehealth is defined as the use of electronic communication and telecommunications technology to support long-distance clinical health care, patient and professional health-related education, and public health and health administration...
January 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28224441/does-medicaid-insurance-confer-adequate-access-to-adult-orthopaedic-care-in-the-era-of-the-patient-protection-and-affordable-care-act
#12
Joseph T Labrum, Taylor Paziuk, Theresa C Rihn, Alan S Hilibrand, Alexander R Vaccaro, Mitchell G Maltenfort, Jeffrey A Rihn
BACKGROUND: A current appraisal of access to orthopaedic care for the adult patient receiving Medicaid is important, since Medicaid expansion was written into law by the Patient Protection and Affordable Care Act (PPACA). QUESTIONS/PURPOSES: (1) Do orthopaedic practices provide varying access to orthopaedic care for simulated patients with Medicaid insurance versus private insurance in a blinded survey? (2) What are the surveyed state-by-state Medicaid acceptance rates for adult orthopaedic practices in the current era of Medicaid expansion set forth by the PPACA? (3) Do surveyed rates of access to orthopaedic care in the adult patient population vary across practice setting (private vs academic) or vary with different Medicaid physician reimbursement rates? (4) Are there differences in the surveyed Medicaid acceptance rates for adult orthopaedic practices in states that have expanded Medicaid coverage versus states that have foregone expansion? METHODS: Simulated Patient Survey: We performed a telephone survey study of orthopaedic offices in four states with Medicaid expansion...
February 21, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28224349/mapping-the-health-information-landscape-in-a-rural-culturally-diverse-region-implications-for-interventions-to-reduce-information-inequality
#13
A Susana Ramírez, Erendira Estrada, Ariana Ruiz
The media is an important source of health information, especially critical in rural communities with geographically-dispersed populations that are harder to reach through other channels. Yet health information is unequally distributed; these information disparities are compounded in rural areas, which may contribute to health disparities. We identify and describe health-related news in a culturally-diverse rural California county characterized by high levels of poverty, unemployment, low educational attainment, and over half of Mexican-origin...
February 21, 2017: Journal of Primary Prevention
https://www.readbyqxmd.com/read/28222724/financial-barriers-and-coping-strategies-a-qualitative-study-of-accessing-multidrug-resistant-tuberculosis-and-tuberculosis-care-in-yunnan-china
#14
C Hutchison, M S Khan, J Yoong, X Lin, R J Coker
BACKGROUND: Tuberculosis (TB) and multidrug-resistance tuberculosis (MDR-TB) pose serious challenges to global health, particularly in China, which has the second highest case burden in the world. Disparities in access to care for the poorest, rural TB patients may be exacerbated for MDR-TB patients, although this has not been investigated widely. We examine whether certain patient groups experience different barriers to accessing TB services, whether there are added challenges for patients with MDR-TB, and how patients and health providers cope in Yunnan, a mountainous province in China with a largely rural population and high TB burden...
February 22, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28222715/the-characteristics-of-stroke-units-in-ontario-a-pan-provincial-survey
#15
Valeria E Rac, Yeva Sahakyan, Iris Fan, Luciano Ieraci, Ruth Hall, Linda Kelloway, Gabrielle van der Velde, Moira K Kapral, Mark Bayley, Murray Krahn
BACKGROUND: Previous studies have demonstrated that organized, multidisciplinary care is the cornerstone of current strategies to reduce the death and disability caused by stroke. Identification of stroke units and an understanding of their composition and operation would provide insight for the further actions required to improve stroke care. The objective of this study was to identify and survey stroke units in Canada's largest province, Ontario (population of 13 million) in order to describe availability, structure, staffing, processes of care, and type of population stroke units serve...
February 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28221820/risks-benefits-and-importance-of-collecting-sexual-orientation-and-gender-identity-data-in-healthcare-settings-a-multi-method-analysis-of-patient-and-provider-perspectives
#16
Allysha C Maragh-Bass, Maya Torain, Rachel Adler, Eric Schneider, Anju Ranjit, Lisa M Kodadek, Ryan Shields, Danielle German, Claire Snyder, Susan Peterson, Jeremiah Schuur, Brandyn Lau, Adil H Haider
PURPOSE: Research suggests that LGBT populations experience barriers to healthcare. Organizations such as the Institute of Medicine recommend routine documentation of sexual orientation (SO) and gender identity (GI) in healthcare, to reduce LGBT disparities. We explore patient views regarding the importance of SO/GI collection, and patient and provider views on risks and benefits of routine SO/GI collection in various settings. METHODS: We surveyed LGBT/non-LGBT patients and providers on their views on SO/GI collection...
February 21, 2017: LGBT Health
https://www.readbyqxmd.com/read/28221273/the-association-between-immigration-status-and-office-based-medical-provider-visits-for-cancer-patients-in-the-united-states
#17
Yang Wang, Fernando A Wilson, Li-Wu Chen
OBJECTIVES: We examined differences in cancer-related office-based provider visits associated with immigration status in the United States. METHODS: Data from the 2007-2012 Medical Expenditure Panel Survey and National Health Interview Survey included adult patients diagnosed with cancer. Univariate analyses described distributions of cancer-related office-based provider visits received, expenditures, visit characteristics, as well as demographic, socioeconomic, and health covariates, across immigration groups...
February 17, 2017: Medical Care
https://www.readbyqxmd.com/read/28221214/an-integrative-review-of-psychosocial-concerns-among-young-african-american-breast-cancer-survivors
#18
Timiya S Nolan, Jennifer Frank, Silvia Gisiger-Camata, Karen Meneses
BACKGROUND: African American (AA) women are more likely to be given a diagnosis of breast cancer at an early age, experience morbidity after treatment, and exhibit disparities in survivorship. Although psychosocial well-being is largely studied among breast cancer survivors, data are sparse regarding young AA survivors. OBJECTIVE: This integrative review examined psychosocial concerns in survivorship among young AA survivors using a quality-of-life framework. METHODS: PubMed, CINHAL, EMBASE, PsychINFO, and Scopus were searched for articles exploring psychosocial well-being in young AA survivors...
February 17, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28219027/do-u-s-states-socioeconomic-and-policy-contexts-shape-adult-disability
#19
Jennifer Karas Montez, Mark D Hayward, Douglas A Wolf
Growing disparities in adult mortality across U.S. states point to the importance of assessing disparities in other domains of health. Here, we estimate state-level differences in disability, and draw on the WHO socio-ecological framework to assess the role of ecological factors in explaining these differences. Our study is based on data from 5.5 million adults aged 25-94 years in the 2010-2014 waves of the American Community Survey. Disability is defined as difficulty with mobility, independent living, self-care, vision, hearing, or cognition...
February 13, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28217575/working-as-a-family-physician-in-canada-and-portugal-how-different-is-it
#20
Ana Nunes Barata
BACKGROUND: The work of a family physician is quite different in each country, and if we consider different continents, differences are even more remarkable. Social and cultural contexts justify a particular organization, not only of the health-care system but also its providers as well. OBJECTIVES: By analyzing different health-care systems, new ideas may come about which may trigger positive changes in a health-care service to diminish healthcare disparities. METHODS: Description and comparison of the Primary Healthcare Service in Canada and Portugal...
July 2016: Journal of Family Medicine and Primary Care
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