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"Access to care"

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https://www.readbyqxmd.com/read/29471480/family-medicine-clinic-a-case-study-of-a-hospital-family-medicine-practice-redesign-to-improve-chronic-disease-care-in-the-community-in-singapore
#1
Yee Wei Lim, Joanna Ling, Zoe Lim, Audrey Chia
Background: Singapore's health care system is strained by the health care needs of a rapidly aging population. The unprecedented collaboration between a public hospital and a private family practice to set up the Family Medicine Clinic (FMC) to co-manage patients with chronic disease is an example of efforts to shift care to the community. Objective: To explore patients' initial experience of shared chronic disease care in a private family practice setting. Methods: In this exploratory case study, we surveyed 330 patients with stable chronic diseases and interviewed 10 complex care patients and their caregivers...
February 17, 2018: Family Practice
https://www.readbyqxmd.com/read/29470120/racial-ethnic-variation-in-the-impact-of-the-affordable-care-act-on-insurance-coverage-and-access-among-young-adults
#2
Aurora VanGarde, Jangho Yoon, Jeff Luck, Carolyn A Mendez-Luck
OBJECTIVES: To examine the impact of the Affordable Care Act's (ACA's) 2010 parental insurance coverage extension to young adults aged 19 to 25 years on health insurance coverage and access to care, including racial/ethnic disparities. METHODS: We pooled data from the Behavioral Risk Factor Surveillance System for the periods 2007 to 2009 and 2011 to 2013 (n = 402 777). We constructed quasiexperimental difference-in-differences models in which adults aged 26 to 35 years served as a control group...
February 22, 2018: American Journal of Public Health
https://www.readbyqxmd.com/read/29470098/large-datasets-logistics-sharing-and-workflow-in-screening
#3
Tessa S Cook
Cancer screening initiatives exist around the world for different malignancies, most frequently breast, colorectal, and cervical cancer. A number of cancer registries exist to collect relevant data, but while these data may include imaging findings, they rarely, if ever, include actual images. Additionally, the data submitted to the registry are usually correlated with eventual cancer diagnoses and patient outcomes, rather than used with the individual's future screenings. Developing screening programs that allow for images to be submitted to a central location in addition to patient meta-data and used for comparison to future screening exams would be very valuable in increasing access to care and ensuring that individuals are effectively screened from year to year...
February 22, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29469712/future-growth-of-physicians-and-non-physician-providers-within-the-u-s-dermatology-workforce
#4
Michael R Sargen, Lucy Shi, Roderick S Hooker, Suephy C Chen
Trends in the training, supply, availability, career decisions, and retirement of US dermatology physicians are not well delineated. The current study evaluates whether growth in the dermatology workforce will keep pace with population expansion in the United States. A dermatologist supply model was projected to 2030 drawing on data from the American Academy of Dermatology, American Medical Association, Bureau of Labor Statistics, American Association of Medical Colleges, and other associations. The clinically active dermatologist workforce in 2015 was 36 per capita (1,000,000); entry following postgraduate training was age 30 with career separation at age 65 on average...
September 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29468493/facilitators-and-barriers-to-pre-exposure-prophylaxis-prep-use-among-black-individuals-in-the-united-states-results-from-the-national-survey-on-hiv-in-the-black-community-nshbc
#5
Bisola O Ojikutu, Laura M Bogart, Molly Higgins-Biddle, Sannisha K Dale, Wanda Allen, Tiffany Dominique, Kenneth H Mayer
This study explores willingness to use PrEP among Black individuals in the US. From February to April 2016, an online survey was administered to a nationally representative sample of Black individuals. 855 individuals who were HIV negative by self-report participated [mean age: 33.6 (SD 9.2); 45.5% male]. Among all respondents, 14.5% were aware of, and 26.0% would be willing to use PrEP. Among high-risk individuals (N = 327), 19.8% knew about and 35.1% would be willing to use PrEP. The most common reason for lack of willingness among high-risk individuals was low self-perceived risk (65...
February 21, 2018: AIDS and Behavior
https://www.readbyqxmd.com/read/29466389/mapping-integration-of-midwives-across-the-united-states-impact-on-access-equity-and-outcomes
#6
Saraswathi Vedam, Kathrin Stoll, Marian MacDorman, Eugene Declercq, Renee Cramer, Melissa Cheyney, Timothy Fisher, Emma Butt, Y Tony Yang, Holly Powell Kennedy
METHODS: Our multidisciplinary team examined published regulatory data to inform a 50-state database describing the environment for midwifery practice and interprofessional collaboration. Items (110) detailed differences across jurisdictions in scope of practice, autonomy, governance, and prescriptive authority; as well as restrictions that can affect patient safety, quality, and access to maternity providers across birth settings. A nationwide survey of state regulatory experts (n = 92) verified the 'on the ground' relevance, importance, and realities of local interpretation of these state laws...
2018: PloS One
https://www.readbyqxmd.com/read/29462359/privatization-in-the-irish-hospital-sector-since-1980
#7
Julien Mercille
Background: Privatization has transformed health care systems over the last several decades. This article examines trends in bed supply in Ireland between 1980 and 2015 within the context of government policy on bed provision in a system of inequitable access to care. Ireland has not published bed data on private hospitals since the 1980s, even if they comprise about one-quarter of all hospitals. However, this article presents, for the first time, annual bed data since the 1980s collected from private hospitals and used to trace the evolution of bed supply over time...
February 16, 2018: Journal of Public Health
https://www.readbyqxmd.com/read/29462292/state-and-non-state-mental-health-service-collaboration-in-a-south-african-district-a-mixed-methods-study
#8
André Janse van Rensburg, Inge Petersen, Edwin Wouters, Michelle Engelbrecht, Gladys Kigozi, Pieter Fourie, Dingie van Rensburg, Piet Bracke
The Life Esidimeni tragedy in South Africa showed that, despite significant global gains in recognizing the salience of integrated public mental health care during the past decade, crucial gaps remain. State and non-state mental health service collaboration is a recognized strategy to increase access to care and optimal use of community resources, but little evidence exist about how it unfolds in low- to middle-income countries. South Africa's Mental Health Policy Framework and Strategic Plan 2013-20 (MHPF) underlines the importance of collaborative public mental health care, though it is unclear how and to what extent this happens...
February 15, 2018: Health Policy and Planning
https://www.readbyqxmd.com/read/29462077/maryland-multipayor-patient-centered-medical-home-program-a-4-year-quasiexperimental-evaluation-of-quality-utilization-patient-satisfaction-and-provider-perceptions
#9
Jill A Marsteller, Yea-Jen Hsu, Christine Gill, Zippora Kiptanui, Oludolapo A Fakeye, Lilly D Engineer, Donna Perlmutter, Niharika Khanna, Gail B Rattinger, Donald Nichols, Ilene Harris
OBJECTIVE: To evaluate impact of the Maryland Multipayor Patient-centered Medical Home Program (MMPP) on: (1) quality, utilization, and costs of care; (2) beneficiaries' experiences and satisfaction with care; and (3) perceptions of providers. DESIGN: 4-year quasiexperimental design with a difference-in-differences analytic approach to compare changes in outcomes between MMPP practices and propensity score-matched comparisons; pre-post design for patient-reported outcomes among MMPP beneficiaries...
February 16, 2018: Medical Care
https://www.readbyqxmd.com/read/29462030/refining-risk-adjustment-for-the-proposed-cms-surgical-hip-and-femur-fracture-treatment-bundled-payment-program
#10
Mark A Cairns, Robert F Ostrum, R Carter Clement
BACKGROUND: The U.S. Centers for Medicare & Medicaid Services (CMS) has been considering the implementation of a mandatory bundled payment program, the Surgical Hip and Femur Fracture Treatment (SHFFT) model. However, bundled payments without appropriate risk adjustment may be inequitable to providers and may restrict access to care for certain patients. The SHFFT proposal includes adjustment using the Diagnosis-Related Group (DRG) and geographic location. The goal of the current study was to identify and quantify patient factors that could improve risk adjustment for SHFFT bundled payments...
February 21, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29461991/technology-s-role-in-quality-improvement-and-operational-efficiency
#11
Judy Blauwet, Mandy Bell
Technology for technology's sake is never a good idea. There must be a purpose behind it. It must help us do our jobs better. Technology allows healthcare to remain affordable and, as such, accessible. Technology must increase access to care, improve safety, make test results more reliable, and help teams communicate better for a seamless care experience.Avera Health, a health system based in Sioux Falls, South Dakota, comprises 330 facilities in 100 communities in five states. Sponsored by the Benedictine and Presentation Sisters, Avera is a healthcare ministry whose employees deliver high-quality care with compassion...
April 2018: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/29461725/many-cds-members-go-above-beyond-for-access-to-care
#12
Joseph Derosier
No abstract text is available yet for this article.
May 2017: CDS Review
https://www.readbyqxmd.com/read/29460689/exploring-characteristics-and-health-care-utilization-trends-among-individuals-who-fall-in-the-health-insurance-assistance-gap-in-a-medicaid-nonexpansion-state
#13
Jean Edward, Nageen Mir, Denise Monti, Enbal Shacham, Mary C Politi
States that did not expand Medicaid under the Affordable Care Act (ACA) in the United States have seen a growth in the number of individuals who fall in the assistance gap, defined as having incomes above the Medicaid eligibility limit (≥44% of the federal poverty level) but below the lower limit (<100%) to be eligible for tax credits for premium subsidies or cost-sharing reductions in the marketplace. The purpose of this article is to present findings from a secondary data analysis examining the characteristics of those who fell in the assistance gap ( n = 166) in Missouri, a Medicaid nonexpansion state, by comparing them with those who did not fall in the assistance gap ( n = 157)...
January 1, 2018: Policy, Politics & Nursing Practice
https://www.readbyqxmd.com/read/29455158/american-heart-association-s-life-s-simple-7-at-middle-age-and-prognosis-after-myocardial-infarction-in-later-life
#14
Yejin Mok, Yingying Sang, Shoshana H Ballew, Casey M Rebholz, Wayne D Rosamond, Gerardo Heiss, Aaron R Folsom, Josef Coresh, Kunihiro Matsushita
BACKGROUND: The American Heart Association recommends focusing on 7 health factors (Life's Simple 7) for primordial prevention of cardiovascular health. However, whether greater adherence to Life's Simple 7 in midlife improves prognosis after myocardial infarction (MI) in later life is unknown. METHODS AND RESULTS: In 1277 participants who developed MI during the ARIC (Atherosclerosis Risk in Communities) Study follow-up, a 14-point score of Life's Simple 7 was constructed according to the status (2 points for ideal, 1 point for intermediate, and 0 points for poor) of each of 7 factors (smoking, adiposity, physical activity, diet, total cholesterol, blood pressure, and fasting glucose) at baseline (1987-1989)...
February 17, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29449443/sex-differences-in-ischemic-heart-disease-advances-obstacles-and-next-steps
#15
Niti R Aggarwal, Hena N Patel, Laxmi S Mehta, Rupa M Sanghani, Gina P Lundberg, Sandra J Lewis, Marla A Mendelson, Malissa J Wood, Annabelle S Volgman, Jennifer H Mieres
Evolving knowledge of sex-specific presentations, improved recognition of conventional and novel risk factors, and expanded understanding of the sex-specific pathophysiology of ischemic heart disease have resulted in improved clinical outcomes in women. Yet, ischemic heart disease continues to be the leading cause of morbidity and mortality in women in the United States. The important publication by the Institute of Medicine titled "Women's Health Research-Progress, Pitfalls, and Promise," highlights the persistent disparities in cardiovascular disease burden among subgroups of women, particularly women who are socially disadvantaged because of race, ethnicity, income level, and educational attainment...
February 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29449090/clinical-and-molecular-characteristics-and-burden-of-kidney-cancer-among-hispanics-and-native-americans-steps-toward-precision-medicine
#16
Ken Batai, Andrew Bergersen, Elinora Price, Kieran Hynes, Nathan A Ellis, Benjamin R Lee
Cancer disparities in Native Americans (NAs) and Hispanic Americans (HAs) vary significantly in terms of cancer incidence and mortality rates across geographic regions. This review reports that kidney and renal pelvis cancers are unevenly affecting HAs and NAs compared to European Americans of non-Hispanic origin, and that currently there is significant need for improved data and reporting to be able to advance toward genomic-based precision medicine for the assessment of such cancers in these medically underserved populations...
February 12, 2018: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/29448900/provision-of-surgical-care-in-ethiopia-challenges-and-solutions
#17
Caitrin M Kelly, Nichole Starr, Nakul P Raykar, Rachel R Yorlets, Charles Liu, Miliard Derbew
With the lowest measured rate of surgery in the world, Ethiopia is faced with a number of challenges in providing surgical care. The aim of this study was to elucidate challenges in providing safe surgical care in Ethiopia, and solutions providers have created to overcome them. Semi-structured interviews were conducted with 10 practicing surgeons in Ethiopia. Following de-identification and immersion into field notes, topical coding was completed with an existing coding manual. Codes were adapted and expanded as necessary, and the primary data analyst confirmed reproducibility with a secondary analyst...
February 15, 2018: Global Public Health
https://www.readbyqxmd.com/read/29448885/-recognize-our-humanity-immigrant-youth-voices-on-health-care-in-arizona-s-restrictive-political-environment
#18
Sofía Gómez, Heide Castañeda
The "DACAmented Voices in Healthcare" project examined the intersection of restrictive immigration policies and health care via photovoice, a participatory action research approach, with immigrant youth living in Arizona, who were recipients of the Deferred Action for Childhood Arrivals (DACA) program. These "DACAmented" youth took part in nine photovoice sessions exploring their health care experiences and accessibility to care using documentary photography and narratives. They poignantly illustrated their experiences through images identifying their main health concerns and strengths, facilitating the development of health policy recommendations...
February 1, 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29448879/extending-access-to-care-accross-the-rural-us-south-preliminary-results-from-the-alabama-ehealth-programme
#19
Kriti M Jain, Prashanth Bhat, Cathy Maulsby, Alexandria Andersen, Tomas Soto, Ashley Tarrant, David R Holtgrave, Erin Nortrup, Melissa Werner, Laurie Dill
Purpose Using a mixed-methods formative evaluation, the purpose of this study was to provide a broad overview of the Alabama eHealth programme set-up and initial patient outcomes. The Alabama eHealth programme uses telemedicine to provide medical care to people living with HIV in rural Alabama. It was led by a community-based organisation, Medical Advocacy and Outreach (MAO), and supported by AIDS United and the Corporation for National Community Service's Social Innovation Fund with matching support from non-federal donors...
January 1, 2018: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/29447257/access-to-health-insurance-coverage-among-sub-saharan-african-migrants-living-in-france-results-of-the-anrs-parcours-study
#20
Nicolas Vignier, Annabel Desgrées du Loû, Julie Pannetier, Andrainolo Ravalihasy, Anne Gosselin, France Lert, Nathalie Lydié, Olivier Bouchaud, Rosemary Dray Spira
BACKGROUND: Migrants' access to care depends on their health insurance coverage in the host country. We aimed to evaluate in France the dynamic and the determinants of health insurance coverage acquisition among sub-Saharan migrants. METHODS: In the PARCOURS life-event retrospective survey conducted in 2012-2013 in health-care facilities in the Paris region, data on health insurance coverage (HIC) each year since arrival in France has been collected among three groups of sub-Saharan migrants recruited in primary care centres (N = 763), centres for HIV care (N = 923) and for chronic hepatitis B care (N = 778)...
2018: PloS One
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