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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...
November 22, 2016: 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
Leigh Harper
No abstract text is available yet for this article.
January 2016: Australian Veterinary Journal
Cathy Schoen, Claudia Solís-Román, Nick Huober, Zachary Kelchner
Medicare provides essential health coverage for older and disabled adults, yet it does not limit out-of-pocket costs for covered benefits and excludes dental, hearing, and longer-term care. The resulting out-of-pocket costs can add up to a substantial share of income. Based on U.S. Census surveys, nearly a quarter of Medicare beneficiaries (11.5 million) were underinsured in 2013–14, meaning they spent a high share of their income on health care. Adding premiums to medical care expenses, we find that 16 percent of beneficiaries (8 million) spent 20 percent or more of their income on insurance plus care...
May 2016: Issue Brief of the Commonwealth Fund
Anne L Kinderman, Heather A Harris, Ruth T Brousseau, Pamelyn Close, Steven Z Pantilat
BACKGROUND: Compared with private, not-for-profit hospitals, significantly fewer public hospitals report that they provide palliative care services for their patients. Because uninsured and underinsured patients largely depend on public hospitals for acute medical care, they therefore experience disparities in access to inpatient palliative care services. To address this disparity, the statewide Spreading Palliative Care in Public Hospitals Initiative (SPCPHI) was established to help implement or expand inpatient palliative care services in all 17 of California's public acute care hospitals...
September 2016: Journal of Palliative Medicine
Marco D Huesch, Michael K Ong
Uninsured and underinsured near-elderly may not have timely investigation, diagnosis, or care of cancer. Prior studies suggest Medicare eligibility confers significant and substantial reductions in mortality and increases in health service utilization. We compared 2245 patients diagnosed with lung cancer at ages 64.5 to 65 years and 2512 patients aged 65 to 65.5 years, with 2492 patients aged 65.5 to 66 years (controls) in 2000 to 2005. Compared with controls, patients diagnosed with lung cancer before Medicare eligibility had no statistically significant differences in cancer stage, time to treatment, type of treatment, and survival...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
Christine M Blue, Mary Beth Kaylor
OBJECTIVES: A chronic shortage of dentists, the importance of oral health, and the lack of access to care led to the introduction of a new oral health practitioner in Minnesota, the dental therapist. Dental therapy graduates from the University of Minnesota have been in practice since 2012. To date, there has been no formal study of how they have been incorporated into dental practice. The purpose of this study was to obtain baseline knowledge of dental therapists' practice patterns in Minnesota and determine if dentists' patterns of work changed after a dental therapist was employed...
October 2016: Community Dentistry and Oral Epidemiology
George M Martin
The US pays about twice as much per capita for health care than any other developed country, yet its health metrics rank among the lowest among peer nations - for example, the US has 12.2 maternal mortality deaths per 100,000 compared to 4.8 in Canada which, like other developed nations, has a single payer health care program. The leading cause of bankruptcies in the US is attributable to medical expenses. Despite recently introduced legislation (the Affordable Care Act) many millions of Americans remain uninsured or underinsured...
April 19, 2016: Experimental Gerontology
Della L Hughes-Carter, Roberta E Hoebeke
PURPOSE: Screening rates for DKD in primary care are low, even though diabetes accounts for 44% of all new kidney disease cases. The purpose of this project was to determine if a primary care team for the underinsured improved screening and diagnosis of diabetic kidney disease (DKD) after initiating a quality improvement (QI) process. METHODS: A chart audit with feedback, provider education of clinical practice guidelines, and strategies from TeamSTEPPS™ were implemented with the inter-professional primary care team...
May 2016: Applied Nursing Research: ANR
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