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https://www.readbyqxmd.com/read/28708447/coverage-for-gender-affirming-care-making-health-insurance-work-for-transgender-americans
#1
William V Padula, Kellan Baker
Many transgender Americans continue to remain uninsured or are underinsured because of payers' refusal to cover medically necessary, gender-affirming healthcare services-such as hormone therapy, mental health counseling, and reconstructive surgeries. Coverage refusal results in higher costs and poor health outcomes among transgender people who cannot access gender-affirming care. Research into the value of health insurance coverage for gender-affirming care for transgender individuals shows that the health benefits far outweigh the costs of insuring transition procedures...
July 14, 2017: LGBT Health
https://www.readbyqxmd.com/read/28550905/socioeconomic-factors-and-mortality-in-emergency-general-surgery-trends-over-a-20-year-period
#2
Sarah J Armenia, Sri Ram Pentakota, Aziz M Merchant
BACKGROUND: Socioeconomic factors such as race, insurance, and income quartiles have been identified as independent risk factors in emergency general surgery (EGS), but this impact has not been studied over time. We sought to identify trends in disparities in EGS-related operative mortality over a 20-y period. METHODS: The National Inpatient Sample was used to identify patient encounters coded for EGS in 1993, 2003, and 2013. Logistic regression models were used to examine the adjusted relationship between race, primary payer status, and median income quartiles and in-hospital mortality after adjusting for patients' age, gender, Elixhauser comorbidity score, and hospital region, size, and location-cum-teaching status...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28534189/national-trends-in-bariatric-surgery-2012-2015-demographics-procedure-selection-readmissions-and-cost
#3
Scott Kizy, Cyrus Jahansouz, Michael C Downey, Nathanael Hevelone, Sayeed Ikramuddin, Daniel Leslie
BACKGROUND: Bariatric surgery is widely accepted as the best treatment for obesity and type 2 diabetes mellitus (T2DM). The Roux-en-Y gastric bypass (RYGB) and the sleeve gastrectomy (SG) have become the predominant bariatric procedures in the USA over the last several years, although the most recent trends in selection are unknown. OBJECTIVE: The objective of this study is to assess selection trends, readmission rates, and cost of bariatric procedures in the USA from 2012 to 2015...
May 22, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28511946/national-incidence-of-patient-safety-indicators-in-the-total-hip-arthroplasty-population
#4
Joseph E Tanenbaum, Derrick M Knapik, Glenn D Wera, Steven J Fitzgerald
BACKGROUND: The Centers for Medicare & Medicaid Services use the incidence of patient safety indicators (PSIs) to determine health care value and hospital reimbursement. The national incidence of PSI has not been quantified in the total hip arthroplasty (THA) population, and it is unknown if patient insurance status is associated with PSI incidence after THA. METHODS: All patients in the Nationwide Inpatient Sample (NIS) who underwent THA in 2013 were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification codes...
April 12, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28346590/implementation-and-evaluation-of-a-large-scale-teleretinal-diabetic-retinopathy-screening-program-in-the-los-angeles-county-department-of-health-services
#5
Lauren P Daskivich, Carolina Vasquez, Carlos Martinez, Chi-Hong Tseng, Carol M Mangione
Importance: Diabetic retinopathy (DR) is the leading cause of blindness in adults of working age in the United States. In the Los Angeles County safety net, a nonvertically integrated system serving underinsured and uninsured patients, the prevalence of DR is approximately 50%, and owing to limited specialty care resources, the average wait times for screening for DR have been 8 months or more. Objective: To determine whether a primary care-based teleretinal DR screening (TDRS) program reduces wait times for screening and improves timeliness of needed care in the Los Angeles County safety net...
May 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28241907/physicians-perceptions-of-volunteer-service-at-safety-net-clinics
#6
Laura Mcgeehan, Michael A Takehara, Ellen Daroszewski
BACKGROUND: Volunteer physicians are crucial for the operation of safety-net clinics, which provide medical care for uninsured and underinsured populations. Thus, identifying ways to maximize the number of physicians volunteering at such clinics is an important goal. OBJECTIVE: To investigate the perceptions, motivations, functions, and barriers associated with physician volunteering in four safety-net clinics in San Bernardino County, Southern California, a location of great medical need with many barriers to care...
2017: Permanente Journal
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
#7
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/28209637/the-impact-of-payer-source-on-trauma-outcomes-in-a-pediatric-population
#8
Felecia A Lee, Ashley M Hervey, Arash Sattarin, Aaron Deeds, Gina M Berg, Kimberly Molik
OBJECTIVES: Determine if there were differences in conclusions drawn regarding disparities in trauma outcomes based on literature-derived payer source definitions in a pediatric population. PATIENTS AND METHODS: Retrospective registry review of admitted pediatric trauma patients (‚ȧ17 years of age) at a level II pediatric trauma facility. Eligible patients were categorized into 3 payer source definitions: definition 1: commercially insured, Medicaid, uninsured; definition 2: insured, uninsured; definition 3: commercially insured, underinsured...
February 16, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28166671/the-unintended-consequences-of-the-centers-for-medicare-and-medicaid-services-pay-for-performance-structures-on-safety-net-hospitals-and-the-low-income-medically-vulnerable-population
#9
Elmer B Fos
Safety-net hospitals are hospitals with patient mix that is substantially composed of the uninsured, underinsured, and low-income, medically vulnerable patient populations. They are the hospitals of last resort for poor patients. This article examined the impact of The Centers for Medicare and Medicaid Services pay-for-performance reimbursement policies on the financial viability of safety-net hospitals. Studies showed that these policies, which are based on the principle of reward and punishment, might have unintentionally placed safety-net hospitals on financial disadvantage compared to other hospital organizations...
February 2017: Health Services Management Research
https://www.readbyqxmd.com/read/28109783/the-affordable-care-act-medicaid-expansion-correlated-with-increased-heart-transplant-listings-in-african-americans-but-not-hispanics-or%C3%A2-caucasians
#10
Khadijah Breathett, Larry A Allen, Laura Helmkamp, Kathryn Colborn, Stacie L Daugherty, Prateeti Khazanie, Richard Lindrooth, Pamela N Peterson
OBJECTIVES: The aim of this study was to determine if the Affordable Care Act (ACA) Medicaid Expansion was associated with increased census-adjusted heart transplant listing rates for racial/ethnic minorities. BACKGROUND: Underinsurance limits access to transplants, especially among racial/ethnic minorities. Changes in racial/ethnic listing rates post-ACA Medicaid Expansion are unknown. METHODS: Using the Scientific Registry of Transplant Recipients, we analyzed 5,651 patients from early adopter states (implemented the ACA Medicaid Expansion by January 2014) and 4,769 patients from non-adopter states (no implementation during the study period) from 2012 to 2015...
February 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28077044/reducing-health-disparities-for-women-through-use-of-the-medical-home-model
#11
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. AIM: The purpose of this article is to discuss barriers to healthcare, with an emphasis on reducing healthcare disparities for women. METHOD: Extant, contemporary literature has been reviewed and synthesized to develop this theoretical paper on the benefits of using the MHM to reduce disparities in the provision of healthcare for women...
February 2017: Contemporary Nurse
https://www.readbyqxmd.com/read/28024314/modeling-health-care-spending-growth-of-older-adults
#12
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
https://www.readbyqxmd.com/read/28003253/insurance-status-among-adults-with-hypertension-the-impact-of-underinsurance
#13
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
https://www.readbyqxmd.com/read/27997481/state-level-surveillance-of-underinsurance-and-health-care-related-financial-burden
#14
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
https://www.readbyqxmd.com/read/27956005/differences-between-access-to-follow-up-care-and-inappropriate-shocks-based-on-insurance-status-of-implantable-cardioverter-defibrillator-recipients
#15
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...
February 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/27940183/randomized-controlled-dissemination-study-of-community-to-clinic-navigation-to-promote-crc-screening-study-design-and-implications
#16
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
https://www.readbyqxmd.com/read/27922769/see-test-treat-a-5-year-experience-of-pathologists-driving-cervical-and-breast-cancer-screening-to-underserved-and-underinsured-populations
#17
REVIEW
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
https://www.readbyqxmd.com/read/27888090/rationale-and-design-of-mi-care-the-mile-square-colorectal-cancer-screening-awareness-and-referral-and-education-project
#18
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
https://www.readbyqxmd.com/read/27771817/policy-changes-and-improvements-in-health-insurance-coverage-among-msm-20-u-s-cities-2008-2014
#19
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
https://www.readbyqxmd.com/read/27766557/the-impact-of-primary-care-providers-on-patient-screening-mammography-and-initial-presentation-in-an-underserved-clinical-setting
#20
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...
March 2017: Annals of Surgical Oncology
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