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https://www.readbyqxmd.com/read/29453528/longitudinal-analysis-of-racial-ethnic-trends-in-quality-outcomes-in-community-health-centers-2009-2014
#1
Megan B Cole, Brad Wright, Ira B Wilson, Omar Galárraga, Amal N Trivedi
BACKGROUND: To monitor progress towards eliminating health disparities, community health centers have reported on hypertension control, diabetes control, and birthweight by race and ethnicity since 2008. OBJECTIVE: To evaluate racial/ethnic time trends in quality outcomes in health centers and to assess both within- and between-center disparities in outcomes. DESIGN AND SAMPLE: Using 2009-2014 data from all US health centers (n = 1047 centers, serving 19...
February 16, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29453436/rural-urban-differences-in-access-to-hospital-obstetric-and-neonatal-care-how-far-is-the-closest-one
#2
Peiyin Hung, Michelle M Casey, Katy B Kozhimannil, Pinar Karaca-Mandic, Ira S Moscovice
OBJECTIVES: To quantify drive distances to hospital obstetric services and advanced neonatal care and to examine such disparities by residential rurality and insurance type. STUDY DESIGN: Data for all-payer maternal childbirth hospitalizations in 2002 (N = 661,240) and 2013 (N = 634,807) from nine geographically dispersed states were linked with the American Hospital Association annual surveys to identify maternal residence zip codes and the addresses of hospitals with obstetric services or advanced neonatal care...
February 16, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29452560/health-care-efficiencies-consolidation-and-alternative-models-vs-health-care-and-antitrust-regulation-irreconcilable-differences
#3
Michael W King
Despite the U.S. substantially outspending peer high income nations with almost 18% of GDP dedicated to health care, on any number of statistical measurements from life expectancy to birth rates to chronic disease, 1 the U.S. achieves inferior health outcomes. In short, Americans receive a very disappointing return on investment on their health care dollars, causing economic and social strain. 2 Accordingly, the debates rage on: what is the top driver of health care spending? Among the culprits: poor communication and coordination among disparate providers, paperwork required by payors and regulations, well-intentioned physicians overprescribing treatments, drugs and devices, outright fraud and abuse, and medical malpractice litigation...
November 2017: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29451859/harmonization-of-pcr-based-detection-of-intestinal-pathogens-experiences-from-the-dutch-external-quality-assessment-scheme-on-molecular-diagnosis-of-protozoa-in-stool-samples
#4
Theo A Schuurs, Rob Koelewijn, Eric A T Brienen, Titia Kortbeek, Theo G Mank, Bert Mulder, Foekje F Stelma, Lisette van Lieshout, Jaap J van Hellemond
BACKGROUND: Real-time PCR methods are increasingly used in routine patient care settings not only to determine the presence or absence of pathogens in patient materials, but also to obtain semiquantitative results to estimate the pathogen load. However, it is so far unknown how well these methods are harmonized among different laboratories. METHODS: Sets of stool samples were distributed three to four times per year to ca. 25-40 participating laboratories within the European Union as part of an external quality assessment scheme (EQAS) for the detection of gastrointestinal protozoa...
February 16, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29451839/correlates-of-postpartum-visits-among-medicaid-recipients-an-analysis-using-claims-data-from-a-managed-care-organization
#5
Saba W Masho, Susan Cha, Nicole Karjane, Elizabeth McGee, Rashel Charles, Linda Hines, Susan G Kornstein
BACKGROUND: The postpartum care visit (PPCV) plays an important role in ensuring the well-being of mother and infant. This study sought to assess correlates of PPCV attendance among women who are at high risk of nonattendance. MATERIALS AND METHODS: This study used deidentified medical claims data from Virginia Premier-a nonprofit Managed Care Organization that provides health insurance for Medicaid beneficiaries. The association between various correlates and PPCV attendance was examined using multiple logistic regression analyses...
February 16, 2018: Journal of Women's Health
https://www.readbyqxmd.com/read/29449443/sex-differences-in-ischemic-heart-disease-advances-obstacles-and-next-steps
#6
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
#7
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/29447091/obesity-in-pregnancy-a-comparison-of-four-national-guidelines
#8
Dana Vitner, Kristin Harris, Cynthia Maxwell, M D Farine
BACKGROUND: Obesity in pregnancy has become one of the most important challenges in obstetrical care given its prevalence and potential adverse impact on both mother and fetus. The primary objective of this descriptive review is to identify common themes and distinctions within the current recommendations for maternal obesity in the most updated version of four published national guidelines. METHODS: We reviewed the following guidelines for obesity in pregnancy: American College of Obstetricians and Gynecologists (ACOG) 2015, Royal Australian and New Zealand College of Obstetricians and Gynecologists (RANZCOG) 2013, Royal College of Obstetrics and Gynecology (RCOG) 2010, and Society of Obstetrics and Gynecologists of Canada (SOGC) 2010...
February 15, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29446808/private-public-partnership-a-solution-for-the-development-of-health-system-in-tunisia
#9
Jihen Jdidi, Yosra Mejdoub, Sourour Yaich, Houda Ben Ayed, Mondher Kassis, Habib Fki, Ines Ayadi, Jamel Damak
In a context of economic difficulties, the Tunisian government is required to find solutions to meet the expectations of the population. Health sector is one of the critical areas requiring radical reform. The objective of this paper is to find the place of public private partnership project in the harmonious development of both public and private sectors in Tunisia. Indeed, the Tunisian health system consists of two main sectors: the public sector, and the private sector, booming since the 90s. Tunisian infrastructure and staff resources distribution is characterised by a very significant regional disparity, to the detriment of the interior regions, which is more pronounced in the private sector...
March 2017: La Tunisie MĂ©dicale
https://www.readbyqxmd.com/read/29446331/the-case-for-severe-mental-illness-as-a-disparities-category
#10
Matthew L Goldman, Brigitta Spaeth-Rublee, Harold Alan Pincus
Extensive evidence documents that people with severe mental illness have higher rates of morbidity and mortality compared with the general population and receive lower-quality and higher-cost health care. These trends, at least in part, stem from discrimination, exclusion, widespread stigma, and criminalization of individuals with mental illness. As such, severe mental illness should receive formal, national recognition as a disparities category. Such a designation would have multiple important implications in health policy, services and quality research, and advocacy...
February 15, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29446064/roles-of-community-pharmacists-in-improving-oral-health-awareness-in-plateau-state-northern-nigeria
#11
Olaniyi Olufemi Taiwo, Raymond Panas
INTRODUCTION: There is poor oral health awareness in Nigeria because of limited access to correct information on oral health as well as a lack of oral health-care providers. The purpose of this study was to describe the roles of community pharmacists (CPs) in Plateau State, Northern Nigeria, as sources of oral health information in their communities. METHODS: A quantitative cross-sectional study on CPs spanning the entire State. Data collection was a survey method using a structured paper-based self-administered questionnaire...
February 15, 2018: International Dental Journal
https://www.readbyqxmd.com/read/29445979/hispanic-immigrant-father-involvement-with-young-children-in-the-united-states-a-comparison-with-us-born-hispanic-and-white-non-hispanic-fathers
#12
Sylvia Guendelman, Juliet Nussbaum, Ann Soliday, Maureen Lahiff
Objectives Fathering is known to foster child development and health, yet evidence on Hispanic immigrant fathers' involvement with their young children is sparse. This study assessed disparities in pregnancy intendedness and father involvement with children ages 0-4 among Hispanic immigrant co-resident fathers versus two reference groups: US-born Hispanic and US-born White fathers. We hypothesized that differentials in involvement were associated with socioeconomic and cultural factors. Methods Using 2011-2013 data from the National Survey of Family Growth (N = 598), we performed bivariate, logistic and linear regression analyses to assess disparities in pregnancy intendedness and five father involvement outcomes (physical care, warmth, outings, reading and discipline)...
February 14, 2018: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29444779/estimating-the-met-need-for-emergency-obstetric-care-emoc-services-in-three-payams-of-torit-county-south-sudan-a-facility-based-retrospective-cross-sectional-study
#13
Pontius Bayo, Imose Itua, Suzie Paul Francis, Kofi Boateng, Elijo Omoro Tahir, Abdulmumini Usman
OBJECTIVE: To determine the met need for emergency obstetric care (EmOC) services in three Payams of Torit County, South Sudan in 2015 and to determine the frequency of each major obstetric complication. DESIGN: This was a retrospective cross-sectional study. SETTING: Four primary healthcare centres (PHCCs) and one state hospital in three payams (administrative areas that form a county) in Torit County, South Sudan. PARTICIPANTS: All admissions in the obstetrics and gynaecology wards (a total of 2466 patient admission files) in 2015 in all the facilities designated to conduct deliveries in the study area were reviewed to identify obstetric complications...
February 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29444777/estimates-of-prevalence-demographic-characteristics-and-social-factors-among-people-with-disabilities-in-the-usa-a-cross-survey-comparison
#14
Eric Andrew Lauer, Andrew J Houtenville
OBJECTIVE: A national priority for disability research in the USA is the standardised identification of people with disabilities in surveillance efforts. Mandated by federal statute, six dichotomous difficulty-focused questions were implemented in national surveys to identify people with disabilities. The aim of this study was to assess the prevalence, demographic characteristics and social factors among people with disabilities based on these six questions using multiple national surveys in the USA...
February 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29444213/systematic-review-methodological-flaws-in-racial-ethnic-reporting-for-gastroesophageal-reflux-disease
#15
M R Craven, L Kia, L C O'Dwyer, E Stern, T H Taft, L Keefer
Health care disparities affecting the care of multiple disease groups are of growing concern internationally. Research guidelines, governmental institutions, and scientific journals have attempted to minimize disparities through policies regarding the collection and reporting of racial/ethnic data. One area where shortcomings remain is in gastroesophageal reflux disease (GERD). This systematic review, which adheres to the PRISMA statement, focuses on characterizing existing methodological weaknesses in research focusing on studies regarding the assessment, prevalence, treatment, and outcomes of GERD patients...
February 9, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29443649/use-of-charity-financial-assistance-for-novel-oral-anticancer-agents
#16
Adam J Olszewski, Andrew R Zullo, Christopher R Nering, Justin P Huynh
Novel oral targeted drugs are increasingly used for cancer therapy, but their extreme cost, often exceeding $10,000 per month, poses a significant barrier for patients and insurers alike, leading to the potential breakdown of traditional cost-sharing strategies. Insured patients' routine use of charity assistance to supplement their coverage would indicate a major deficiency in the current health care policies. By using data from a specialty pharmacy affiliated with an academic center (1,557 prescriptions dispensed between January 2014 and March 2017), we examined sources of payment for novel oral anticancer agents, distinguishing contributions from health insurance, patients, and from charitable assistance organizations...
February 13, 2018: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29443597/what-is-the-us-health-spending-problem
#17
David M Cutler
Is increased spending on medical care harmful to the US economy? The overall share of the gross domestic product spent on medical care is not a problem, provided that the services bought are worth more than their cost. However, high and rising costs expose two often-overlooked problems. First, spending is too high because many dollars are wasted. Estimates suggest that unnecessary medical spending costs the typical American family thousands of dollars each year. Second, high medical costs combined with stagnant incomes for a large share of the population and the inability of governments at all levels to raise tax dollars leads to increased health and economic disparities: fewer people covered by private insurance, the rationing of care in public health programs, and the lack of funds for other social programs...
February 14, 2018: Health Affairs
https://www.readbyqxmd.com/read/29440356/arterial-diameter-and-the-gender-disparity-in-stroke-thrombectomy-outcomes
#18
Mark A Davison, Bichun Ouyang, Kavantissa M Keppetipola, Michael Chen
BACKGROUND: Compared with males, females consistently fare worse following mechanical thrombectomy for large vessel ischemic strokes. Understanding why this gender disparity occurs may guide improvements in future treatment strategies. In this study, we aim to determine whether gender differences in cerebral arterial diameter correlate with clinical outcomes following stroke thrombectomy. METHODS: We performed an observational study of consecutive acute ischemic stroke patients undergoing mechanical thrombectomy at a single, urban tertiary care medical center...
February 12, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29439691/what-matters-most-protocol-for-a-randomized-controlled-trial-of-breast-cancer-surgery-encounter-decision-aids-across-socioeconomic-strata
#19
Marie-Anne Durand, Renata West Yen, A James O'Malley, Mary C Politi, Shubhada Dhage, Kari Rosenkranz, Katie Weichman, Julie Margenthaler, Anna N A Tosteson, Eloise Crayton, Sherrill Jackson, Ann Bradley, Robert J Volk, Karen Sepucha, Elissa Ozanne, Sanja Percac-Lima, Julia Song, Jocelyn Acosta, Nageen Mir, Glyn Elwyn
BACKGROUND: Breast cancer is the most commonly diagnosed malignancy in women. Mastectomy and breast-conserving surgery (BCS) have equivalent survival for early stage breast cancer. However, each surgery has different benefits and harms that women may value differently. Women of lower socioeconomic status (SES) diagnosed with early stage breast cancer are more likely to experience poorer doctor-patient communication, lower satisfaction with surgery and decision-making, and higher decision regret compared to women of higher SES...
February 13, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29439099/addressing-the-root-cause-rising-health-care-costs-and-social-determinants-of-health
#20
Melanie Bush
The United States is the only high-income country that does not have publicly-financed universal health care, yet it has one of the world's highest public health care expenditures. This financial outlay is not bringing the desired result in health outcomes because the root cause is not being addressed: solving the systematic disparities and social determinants that lead to poor health and health inequities. Targeting resources for the most vulnerable populations and linking health care plans with community-based organizations to address social determinants of health at the outset is a cost-effective means of preventing expensive chronic illnesses and health inequities...
January 2018: North Carolina Medical Journal
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