Medical Care Research and Review最新文献

Hospital Bypass Among Rural Obstetric Patients With Commercial Health Insurance. 商业健康保险农村产科患者的医院分流

IF 2.7 3区医学

Medical Care Research and Review Pub Date : 2026-10-15 DOI: 10.1177/10775587261484427

Caitlin E Carroll, Jessica Y Chang, Emily C Sheffield, Julia D Interrante, Katy B Kozhimannil

{"title":"Hospital Bypass Among Rural Obstetric Patients With Commercial Health Insurance.","authors":"Caitlin E Carroll, Jessica Y Chang, Emily C Sheffield, Julia D Interrante, Katy B Kozhimannil","doi":"10.1177/10775587261484427","DOIUrl":"https://doi.org/10.1177/10775587261484427","url":null,"abstract":"Hospital bypass by rural obstetric patients contributes to low patient volumes at rural hospitals, limiting revenues and eroding the viability of the obstetric service line. Bypass by commercially insured patients is particularly concerning for hospital finances because commercial insurers reimburse hospitals at higher rates than public insurers for obstetric services. Using commercial claims, we characterized bypass among rural obstetric patients with commercial insurance and calculated hospital payments generated by bypass admissions. Half of rural obstetric patients bypassed their nearest obstetric hospital between 2016 and 2021. Bypass rates were higher when the nearest obstetric hospital was in a noncore or urban-adjacent county, had low birth volumes, or lacked higher-level neonatal services. Bypass rates increased when patients had another nearby hospital option or higher clinical risk. However, bypass by low-risk patients was common and generated $536 million in payments to admitting hospitals, suggesting a meaningful role for obstetric bypass in influencing rural hospital finances.","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"10775587261484427"},"PeriodicalIF":2.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multiple Jobholding and Earnings Differences Among Direct Care Workers. 直接护理人员的多重工作和收入差异。

IF 2.7 3区医学

Medical Care Research and Review Pub Date : 2026-10-10 DOI: 10.1177/10775587261486596

Jiyeon Kim, Lina Stepick

引用次数: 0

Health Care Expenditures and Cost-Sharing Before and After Long COVID: Three-Year Evidence From a Statewide Multi-Payer Cohort. 长期COVID前后的医疗保健支出和成本分担：来自全州多付款人队列的三年证据。

IF 2.7 3区医学

Medical Care Research and Review Pub Date : 2026-10-08 DOI: 10.1177/10775587261486590

Rick DeVoss, Elizabeth J Carlton, Marcelo C Perraillon

{"title":"Health Care Expenditures and Cost-Sharing Before and After Long COVID: Three-Year Evidence From a Statewide Multi-Payer Cohort.","authors":"Rick DeVoss, Elizabeth J Carlton, Marcelo C Perraillon","doi":"10.1177/10775587261486590","DOIUrl":"https://doi.org/10.1177/10775587261486590","url":null,"abstract":"The objective of this study was to quantify expenditures for long COVID (LC) before/after diagnosis and compare 3-year trajectories with similar patients without LC in claims. A retrospective cohort study was conducted using Colorado All Payer Claims Database multi-payer claims (October 1, 2020-August 1, 2024). Adults with ≥1 U09.9 code and 1-year continuous enrollment pre-index were followed 1 year pre- and 2 years post-index. Multipart models addressed right-censoring; clustered bootstraps produced confidence intervals overall and by age, sex, and payer. Sample: 25,229 LC and 126,089 comparison patients across commercial, Medicare, Medicaid, and dual coverage. LC patients averaged $79,777 total expenditures over 3 years and $5,158 in cost-sharing. Spending rose about 6 months before the index date, peaked just before the index date, and returned to baseline within 6 months; excess spending totaled $21,597 per patient. Dual-eligible patients had the highest absolute expenditures but lowest relative increase, whereas Medicaid had the lowest absolute expenditures and highest relative increase. LC patients had a substantial financial burden concentrated around diagnosis, highlighting broader, system-level implications for health care spending.","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"10775587261486590"},"PeriodicalIF":2.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Analysis of Hospital Trauma Center Charges for Commercially Insured Patients in the United States. 美国商业保险患者医院创伤中心收费分析。

IF 2.7 3区医学

Medical Care Research and Review Pub Date : 2026-10-01 Epub Date: 2026-04-14 DOI: 10.1177/10775587261439676

Elena Andreyeva, Ayae Yamamoto, Oluwayomi Akintola, Glenn Melnick

引用次数: 0

Including Nurse Practitioners in the Calculation of Primary Care Health Professional Shortage Areas. 包括护士从业人员在内的初级保健卫生专业人员短缺地区的计算。

IF 2.7 3区医学

Medical Care Research and Review Pub Date : 2026-10-01 Epub Date: 2026-05-29 DOI: 10.1177/10775587261442035

L David Wittkower, Katharine W V Bradley, Alicia Plemmons

引用次数: 0

Nurse and Social Worker Perceptions of Early Adoption of VA's Nationally Scaled Care Coordination Initiative. 护士和社会工作者对早期采用VA全国规模护理协调倡议的看法。

IF 2.7 3区医学

Medical Care Research and Review Pub Date : 2026-10-01 Epub Date: 2026-05-30 DOI: 10.1177/10775587261442277

Summer Newell, Dylan Waller, Anaïs Tuepker, Diana Govier, Sara J Singer, Kathryn M McDonald, Lisa Perla, Christopher G Slatore, Denise M Hynes

{"title":"Nurse and Social Worker Perceptions of Early Adoption of VA's Nationally Scaled Care Coordination Initiative.","authors":"Summer Newell, Dylan Waller, Anaïs Tuepker, Diana Govier, Sara J Singer, Kathryn M McDonald, Lisa Perla, Christopher G Slatore, Denise M Hynes","doi":"10.1177/10775587261442277","DOIUrl":"10.1177/10775587261442277","url":null,"abstract":"Care coordination is increasingly evidenced to improve outcomes for patients with complex conditions. Accordingly, the Veterans Health Administration (VA) is expanding care coordination for ~1.5 million Veterans nationally at the highest risk for hospitalization and mortality. One large nationally mandated initiative, Care Coordination & Integrated Case Management (CCICM), provides a practice framework and structure for local facilities to adopt and accelerate care coordination efforts. We sought to characterize the experiences of lead coordinators (LCs) at VA sites during early adoption of CCICM. LCs expressed a common understanding and believed in the goals of CCICM, with wide agreement that Veterans benefit. The level of buy-in to the framework varied. When local CCICM leaders facilitated a collaborative approach, LCs more often embraced the role. Enthusiasm waned when a directive, top-down approach was taken. Providers often lacked awareness or understanding of CCICM, hindering coordination efforts. System-wide education about goals and potential gains of CCICM needs to be expanded.","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"353-361"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148058151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Defining the Social Needs Service Cascade: Evidence From A Multistakeholder Qualitative Study. 定义社会需求服务级联：来自多利益相关者定性研究的证据。

IF 2.7 3区医学

Medical Care Research and Review Pub Date : 2026-10-01 Epub Date: 2026-04-29 DOI: 10.1177/10775587261439173

Daniel Gilmore, Alicia Bunger, Katharine Garrity, Seuli Bose-Brill, Ann Scheck McAlearney, Jennifer L Hefner, Eric Seiber, Jennifer A Garner, Amy Headings, Joshua J Joseph, Daniel M Walker

{"title":"Defining the Social Needs Service Cascade: Evidence From A Multistakeholder Qualitative Study.","authors":"Daniel Gilmore, Alicia Bunger, Katharine Garrity, Seuli Bose-Brill, Ann Scheck McAlearney, Jennifer L Hefner, Eric Seiber, Jennifer A Garner, Amy Headings, Joshua J Joseph, Daniel M Walker","doi":"10.1177/10775587261439173","DOIUrl":"10.1177/10775587261439173","url":null,"abstract":"A service cascade refers conceptually to a multi-step process that occurs during the delivery of care as individuals proceed from one part of care to the next. Health care systems increasingly screen patients for unmet social needs and refer them to community-based organizations to address them, requiring a multi-step interaction between the health and social care systems, which we refer to as the social needs service cascade. This cascade is poorly understood beyond screening and referral. As part of an ongoing trial, we interviewed clinicians (n = 38), representatives from community-based organizations (n = 14), and patients with both uncontrolled type 2 diabetes and food insecurity (n = 39), to improve our understanding of the cascade. Qualitative data were analyzed thematically, and highlight key cascade steps including: (a) screening, (b) referral, (c) lag time, (d) linkage and engagement experience, and (e) resolution. These findings can inform future studies and policy approaches supporting integration between health and social care.Trial Registration: ClinicalTrials.gov NCT05472441.","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"329-341"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13156916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Estimating True Patient Cost-Sharing Burden: Multi-Payer Claim Reconciliation in an All-Payer Claims Database. 估计真正的病人费用分摊负担：多付款人索赔协调在一个全付款人索赔数据库。

IF 2.7 3区医学

Medical Care Research and Review Pub Date : 2026-10-01 Epub Date: 2026-04-14 DOI: 10.1177/10775587261437729

Rick DeVoss, Cathy J Bradley, Richard C Lindrooth, Lindsay Sabik, Marcelo Perraillon

{"title":"Estimating True Patient Cost-Sharing Burden: Multi-Payer Claim Reconciliation in an All-Payer Claims Database.","authors":"Rick DeVoss, Cathy J Bradley, Richard C Lindrooth, Lindsay Sabik, Marcelo Perraillon","doi":"10.1177/10775587261437729","DOIUrl":"10.1177/10775587261437729","url":null,"abstract":"All-payer claims databases (APCDs) comprise claims from multiple payers that can be traced to a single patient. To correctly estimate cost-sharing for an individual patient, we developed an algorithm to reconcile payments from secondary and tertiary payers to claims that are not fully covered by primary insurance. In a Colorado APCD cancer cohort (n = 70,100), reconciliation of claims across multiple payers markedly lowered estimated cost-sharing for patients with more than one source of coverage ($5,544 (no reconciliation); $5,013 (primary payer only) to $1,580). The largest reductions in cost-sharing after reconciliation were for individuals with Traditional Medicare with Medigap ($6,449→$1,123; Δ = -$5,326), dual Medicare-Medicaid ($4,439→$2,340; Δ = -$2,099), and Medicaid-commercial ($2,708→$2,009; Δ = -$699). Excluding secondary payments from estimates of cost-sharing systematically inflates cost-sharing estimates. A transparent reconciliation algorithm is necessary to correctly estimate cost-sharing and is recommended for researchers and policymakers who use the APCD for estimating costs across payers and to the patient.","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"379-386"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13383803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Workplace Outcomes and Experiences of Internationally Educated Nurses: A Scoping Review. 国际教育护士的工作场所结果和经验：一项范围审查。

IF 2.7 3区医学

Medical Care Research and Review Pub Date : 2026-10-01 Epub Date: 2026-08-06 DOI: 10.1177/10775587261468704

Nayeon Lee, Marianne Baernholdt, Jennifer Leeman, Joanne Spetz, Naae Lee, Mark Toles

{"title":"Workplace Outcomes and Experiences of Internationally Educated Nurses: A Scoping Review.","authors":"Nayeon Lee, Marianne Baernholdt, Jennifer Leeman, Joanne Spetz, Naae Lee, Mark Toles","doi":"10.1177/10775587261468704","DOIUrl":"10.1177/10775587261468704","url":null,"abstract":"Nursing shortages in the United States (U.S.) have increased reliance on internationally educated nurses (IENs), yet their workplace outcomes remain poorly understood. This scoping review synthesized peer-reviewed empirical studies examining IEN workplace outcomes and associated individual characteristics and work conditions. Findings from 34 studies published between 2004 and 2025 showed that IENs generally reported moderate to high job satisfaction, while burnout findings suggested moderate to high occupational strain. Evidence on intention to leave was limited by inconsistent measurement and insufficient reporting. Workplace outcomes were most consistently associated with organizational conditions, particularly workload, discrimination, leadership support, orientation, and organizational commitment. Individual characteristics, including age, host-country tenure, and sociocultural adaptation, showed less consistent associations. Interpretation was limited by heterogeneity in study designs, outcome measures, and international settings. Future research using standardized measures and longitudinal or mixed-methods designs is needed to inform organizational practice and workforce policy supporting IEN well-being and retention.","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"303-328"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Insurance Coverage Disruptions and Associated Access and Utilization, 2008 to 2022. 保险覆盖中断和相关的访问和利用，2008 - 2022。

IF 2.7 3区医学

Medical Care Research and Review Pub Date : 2026-10-01 DOI: 10.1177/10775587261484437

Natalie Schwehr Mac Arthur, Jean M Abraham, Julia A Rivera Drew, Lynn A Blewett

{"title":"Insurance Coverage Disruptions and Associated Access and Utilization, 2008 to 2022.","authors":"Natalie Schwehr Mac Arthur, Jean M Abraham, Julia A Rivera Drew, Lynn A Blewett","doi":"10.1177/10775587261484437","DOIUrl":"https://doi.org/10.1177/10775587261484437","url":null,"abstract":"U.S. nonelderly adults rely on a patchwork of private and public sources for health insurance. Without universal coverage, changes in employment, income, and public policy can increase individuals' risk of coverage disruptions. Using data from the Medical Expenditure Panel Survey-Household Component, we examine changes in patterns of coverage, including transitions between sources and discontinuities (temporary or prolonged uninsurance), during three policy-relevant time periods: pre-Affordable Care Act (ACA), 2008 to 2009; post-ACA, 2015 to 2016; and the COVID-19 public health emergency, 2021 to 2022. We also examine associations of coverage patterns with health care access and utilization. Despite coverage gains, relatively high rates of coverage discontinuities persisted across the study periods, affecting 25.3% of adults in 2021 to 2022. Relative to those with continuous private coverage, individuals with coverage discontinuities were less likely to receive any office visits or prescriptions. Rates of delayed or forgone care due to cost among those with coverage discontinuities also grew significantly over time.","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"10775587261484437"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0