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Patricia Moyle Wright
BACKGROUND: Healthcare services can be difficult to access, particularly for low-income or underinsured women. One way of overcoming the barriers to quality, patient-centered care is through the use of the Medical Home Model (MHM). The MHM is a cost-effective approach to care that improves patient outcomes and improves access. In this article, the benefits of extending the MHM into the area of women's health will be discussed. AIM: The purpose of this article is to discuss barriers to healthcare, with an emphasis on reducing healthcare disparities for women...
January 11, 2017: Contemporary Nurse
Laura A Hatfield, Melissa M Favreault, Thomas G McGuire, Michael E Chernew
OBJECTIVE: To forecast out-of-pocket health care spending among older adults. Long-term forecasts allow policy makers to explore potential impacts of policy scenarios, but existing microsimulations do not incorporate details of supplemental insurance coverage and income effects on health care spending. DATA SOURCES: Dynamic microsimulation calibrated to survey and administrative data. STUDY DESIGN: We augment Urban Institute's Dynamic Simulation of Income Model (DYNASIM) with modules that incorporate demand responses and economic equilibria, with dynamics driven by exogenous technological change...
December 26, 2016: Health Services Research
Jing Fang, Guixiang Zhao, Guijing Wang, Carma Ayala, Fleetwood Loustalot
BACKGROUND: Hypertension is a major risk factor for heart disease and stroke. Health insurance coverage affects hypertension treatment and control, but limited information is available for US adults with hypertension who are classified as underinsured. METHODS AND RESULTS: Using Behavioral Risk Factor Surveillance System 2013 data, we identified adults with self-reported hypertension. On the basis of self-reported health insurance status and health care-related financial burdens, participants were categorized as uninsured, underinsured, or adequately insured...
December 21, 2016: Journal of the American Heart Association
Dora M Dumont, Junhie Oh, Tara Cooper
BACKGROUND: The Affordable Care Act (ACA) has reduced uninsurance, but underinsurance, health care-related financial burden, and dental uninsurance may not follow suit. Underinsurance is associated with reduced access to care, household debt, and bankruptcy but has been difficult to track without economic data. METHODS: We used readily available state-level survey data to build a model that states can adopt to implement surveillance over underinsurance and health care-related financial burden, as well as assess related disparities and health profiles...
December 16, 2016: Journal of Public Health Management and Practice: JPHMP
Solomon J Sager, Chris Healy, Archana Ramireddy, Harold Rivner, Juan F Viles Gonzalez, James O Coffey, Natalia Rossin, Ka M Lo, Jeffrey J Goldberger, Robert J Myerburg, Raul D Mitrani
Differences in implantable cardioverter defibrillator (ICD) utilization based on insurance status have been described, but little is known about postimplant follow-up patterns associated with insurance status and outcomes. We collected demographic, clinical, and device data from 119 consecutive patients presenting with ICD shocks. Insurance status was classified as uninsured/Medicaid (uninsured) or private/Health Maintenance Organization /Medicare (insured). Shock frequencies were analyzed before and after a uniform follow-up pattern was implemented regardless of insurance profile...
November 16, 2016: American Journal of Cardiology
Linda Larkey, Laura Szalacha, Patricia Herman, Julie Gonzalez, Usha Menon
INTRODUCTION: Regular screening facilitates early diagnosis of colorectal cancer (CRC) and reduction of CRC morbidity and mortality. Screening rates for minorities and low-income populations remain suboptimal. Provider referral for CRC screening is one of the strongest predictors of adherence, but referrals are unlikely among those who have no clinic home (common among poor and minority populations). METHODS/STUDY DESIGN: This group randomized controlled study will test the effectiveness of an evidence based tailored messaging intervention in a community-to-clinic navigation context compared to no navigation...
December 7, 2016: Contemporary Clinical Trials
Barbarajean Magnani, Beth Harubin, Judith F Katz, Andrea L Zuckerman, William C Strohsnitter
CONTEXT: - See, Test & Treat is a pathologist-driven program to provide cervical and breast cancer screening to underserved and underinsured patient populations. This program is largely funded by the CAP Foundation (College of American Pathologists, Northfield, Illinois) and is a collaborative effort among several medical specialties united to address gaps in the current health care system. OBJECTIVE: - To provide an outline for administering a See, Test & Treat program, using an academic medical center as a model for providing care and collating the results of 5 years of data on the See, Test & Treat program's findings...
December 2016: Archives of Pathology & Laboratory Medicine
Joanna Buscemi, Yazmin San Miguel, Lisa Tussing-Humphreys, Elizabeth A Watts, Marian L Fitzgibbon, Karriem Watson, Robert A Winn, Kameron L Matthews, Yamile Molina
Although colorectal cancer (CRC) is largely preventable through identification of pre-cancerous polyps through various screening modalities, morbidity and mortality rates remain a challenge, especially in African-American, Latino, low-income and uninsured/underinsured patients. Barriers to screening include cost, access to health care facilities, lack of recommendation to screen, and psychosocial factors such as embarrassment, fear of the test, anxiety about testing preparation and fear of a cancer diagnosis...
January 2017: Contemporary Clinical Trials
Laura A Cooley, Brooke Hoots, Cyprian Wejnert, Rashunda Lewis, Gabriela Paz-Bailey
Recent policy changes have improved the ability of gay, bisexual, and other men who have sex with men (MSM) to secure health insurance. We wanted to assess changes over time in self-reported health insurance status among MSM participating in CDC's National HIV Behavioral Surveillance (NHBS) in 2008, 2011, and 2014. We analyzed NHBS data from sexually active MSM interviewed at venues in 20 U.S. cities. To determine if interview year was associated with health insurance status, we used a Poisson model with robust standard errors...
October 22, 2016: AIDS and Behavior
Ajaratu Keshinro, Ioannis Hatzaras, Kenneth Rifkind, Shubhada Dhage, Kathie-Ann Joseph
INTRODUCTION: Cancer screening is a key component of primary care, and access to regular screening mammography (SMG) is highly dependent on recommendation and referral by a primary care provider (PCP). Women with no health insurance or who are underinsured often lack access to a regular PCP and thus access to routine screening. METHODS: We retrospectively reviewed the charts of 173 surgical patients diagnosed between January 2012 and December 2013. The main outcome variables were PCP status, method of cancer detection, and breast cancer stage at diagnosis...
October 20, 2016: Annals of Surgical Oncology
Eric M Nordstrom, Angela Keniston, Fafa Baouchi, Alvaro Martinez-Camacho
AIMS: This study assesses the efficacy, accessibility, and safety of hepatitis C virus (HCV) treatment in a safety net hospital population. METHODS: Patients at Denver Health receiving pegylated interferon for HCV infection between 2008 and 2012 were included in this retrospective study. Sociodemographic, biochemical, and virologic data were collected on each patient. The primary outcomes were the rate of sustained virologic response and early treatment discontinuation, with reason for discontinuation documented...
January 2017: European Journal of Gastroenterology & Hepatology
Howard Waitzkin, Ida Hellander
The Colombian reform of 1994, through a strange historical sequence, became a model for health reform in Latin America, Europe, and the United States. Officially, the reform aimed to improve access for the uninsured and underinsured, in collaboration with the private, for-profit insurance industry. After several historical attempts at health reform adhering to the neoliberal pattern, favored by international financial institutions and multinational insurance corporations, the Affordable Care Act (ACA) similarly enhanced access by corporations to public-sector trust funds...
October 2016: International Journal of Health Services: Planning, Administration, Evaluation
Ketan Sharma, David Grant, Rajiv Parikh, Terence Myckatyn
BACKGROUND: Racial disparity continues to be a well-documented problem afflicting contemporary health care. Because the breast is a symbol of femininity, breast reconstruction is critical to mitigating the psychosocial stigma of a breast cancer diagnosis. Whether different races have equitable access to breast reconstruction remains unknown. METHODS: Two thousand five hundred thirty-three women underwent first-time autologous versus implant-based reconstruction following mastectomy...
August 2016: Plastic and Reconstructive Surgery
Sharon M Grisanti, Linda D Boyd, Lori Rainchuso
PURPOSE: The purpose of this report was to establish baseline data on 10 oral health performance indicators over 5 fiscal years (2007 to 2008 through 2011 to 2012) for an Iowa health center. The baseline data provides an assessment model and reports outcomes based on the use of the model. Performance indicators show evidence of provider performance, accountability to stakeholders and provide the benchmarks required for dental management to develop future goals to improve oral health outcomes for atrisk populations...
June 2016: Journal of Dental Hygiene: JDH
Christian King
Children with insurance have better access to care and health outcomes if their parents also have insurance. However, little is known about whether the type of parental insurance matters. This study attempts to determine whether the type of parental insurance affects the access to health care services of children.I used data from the 2009-2013 Medical Expenditure Panel Survey and estimated multivariate logistic regressions (N = 26,152). I estimated how family insurance coverage affects the probability that children have a usual source of care, well-child visits in the past year, unmet medical and prescription needs, less than 1 dental visit per year, and unmet dental needs...
July 2016: Medicine (Baltimore)
Simon J Craddock Lee, Robin T Higashi, Stephen J Inrig, Joanne M Sanders, Hong Zhu, Keith E Argenbright, Jasmin A Tiro
Rural mammography screening remains suboptimal despite reimbursement programs for uninsured women. Networks linking non-clinical community organizations and clinical providers may overcome limited delivery infrastructure in rural areas. Little is known about how networks expand their service area. To evaluate a hub-and-spoke model to expand mammography services to 17 rural counties by assessing county-level delivery and local stakeholder conduct of outreach activities. We conducted a mixed-method evaluation using EMR data, systematic site visits (73 interviews, 51 organizations), 92 patient surveys, and 30 patient interviews...
July 11, 2016: Translational Behavioral Medicine
Amanda E Staiano, Madeline Morrell, Daniel S Hsia, Gang Hu, Peter T Katzmarzyk
BACKGROUND: Obesity, elevated blood pressure (BP), and diabetes mellitus are rising among the general U.S. adolescent population, but prevalence estimates are not available for uninsured or Medicaid populations. METHODS: This retrospective epidemiological study extracted 155,139 electronic medical records collected between 1998 and 2012 on patients aged 10-19 years, from a clinical population predominantly uninsured or insured by Medicaid. Age, sex, race, height, weight, BP, and insurance type were captured at first clinic visit...
November 2016: Metabolic Syndrome and related Disorders
Kathleen O Hodges, Ellen J Rogo, Allison C Cahoon, Karen Neill
PURPOSE: This descriptive, comparative study was conducted to examine characteristics, services, models and opinions among collaborative dental hygiene practitioners in New Mexico and Minnesota. METHODS: A self-designed online questionnaire, distributed via SurveyMonkey®, was utilized to collect data from 73 subjects who met the inclusion criteria. A multi-phase administration process was followed. Content validity and reliability was established. Descriptive statistics were used for analysis of 6 research questions...
June 2016: Journal of Dental Hygiene: JDH
Katherine Sharpe, Beverly Shaw, Mandi Battaglia Seiler
The American Cancer Society (ACS) has been a leading voice for healthcare reform and an informed advocate for effective health insurance reforms. Since the implementation of the Affordable Care Act (ACA), the ACS has observed a shift in inquiries to its Health Insurance Assistance Service (HIAS) from individuals seeking coverage, to a growing problem of individuals presenting issues from being underinsured. Underinsured patients with cancer face serious financial challenges due to large co-pays and coinsurance costs...
March 2016: American Journal of Managed Care
Kathleen A McManus, Keanan M McGonigle, Carolyn L Engelhard, Rebecca Dillingham
People living with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) often are uninsured or underinsured, and they may benefit from the Patient Protection and Affordable Care Act (PL 111-148) and its improved access to medical care. Safety net programs, such as AIDS Drug Assistance Programs (ADAP) funded through the Ryan White HIV/AIDS Program, which serve low-income people living with HIV, are incorporating Patient Protection and Affordable Care Act Marketplace-qualified health plans (QHPs) and helping to fund patients' participation...
June 2016: Southern Medical Journal
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