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Factors Associated With Intent to Leave the Profession for the Allied Health Workforce: A Rapid Review. 与联合卫生工作者离职意向相关的因素：快速审查。
IF 2.5 3区 医学
Medical Care Research and Review Pub Date : 2024-02-01 Epub Date: 2023-10-21 DOI: 10.1177/10775587231204105
Leonard Roth, Clara Le Saux, Ingrid Gilles, Isabelle Peytremann-Bridevaux
{"title":"Factors Associated With Intent to Leave the Profession for the Allied Health Workforce: A Rapid Review.","authors":"Leonard Roth, Clara Le Saux, Ingrid Gilles, Isabelle Peytremann-Bridevaux","doi":"10.1177/10775587231204105","DOIUrl":"10.1177/10775587231204105","url":null,"abstract":"<p><p>Shortages of satisfied and well-trained health care professionals are an urgent threat for health systems worldwide. Although numerous studies have focused on retention issues for nurses and physicians, the situation for the allied health workforce remains understudied. We conducted a rapid review of the literature on allied health workers to investigate the main reasons for leaving their profession. 1,305 original research articles were retrieved from databases MEDLINE, CINAHL, PsycInfo, and Epistemonikos, of which 29 were eligible for data extraction. Reviewed studies featured mainly pharmacists, psychologists, dietitians, physical therapists, emergency medical professionals, and occupational therapists. We categorized 17 typical factors of the intent to leave as organizational, psychological, team and management, and job characteristics. The relative importance of each factor was assessed by measuring its prevalence in the selected literature. By revealing common themes across allied health professions, our work suggests actionable insights to improve retention in these vital services.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"3-18"},"PeriodicalIF":2.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10757398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49684756","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
Impact of the COVID-19 Pandemic on the Community Pharmacy Workforce. 新冠肺炎大流行对社区药房劳动力的影响。
IF 2.5 3区 医学
Medical Care Research and Review Pub Date : 2024-02-01 Epub Date: 2023-10-13 DOI: 10.1177/10775587231204101
Jennifer L Bacci, Samantha W Pollack, Susan M Skillman, Peggy Soule Odegard, Jennifer Hookstra Danielson, Bianca K Frogner
{"title":"Impact of the COVID-19 Pandemic on the Community Pharmacy Workforce.","authors":"Jennifer L Bacci, Samantha W Pollack, Susan M Skillman, Peggy Soule Odegard, Jennifer Hookstra Danielson, Bianca K Frogner","doi":"10.1177/10775587231204101","DOIUrl":"10.1177/10775587231204101","url":null,"abstract":"<p><p>This study sought to describe the impact of the COVID-19 pandemic on community pharmacy practice and its workforce. Interviews were conducted with 18 key informants from pharmacy associations and community pharmacists representing chain and independent pharmacy organizations across the United States from January to May 2022. Interview notes were analyzed using a rapid content analysis approach. Four themes resulted: (a) patient care at community pharmacies focused on fulfilling COVID-19 response needs; (b) pharmacists' history as immunizers and scope of practice expansions facilitated COVID-19 response efforts; (c) workforce supply shortages impeded COVID-19 response efforts and contributed to burnout; and (d) maintaining community pharmacy workforce's readiness will be critical to future emergency preparedness and response efforts. Formalizing scope of practice expansion policies and reimbursement pathways deployed during the COVID-19 pandemic could facilitate the community pharmacy workforce's ability to address ongoing public health needs and respond to future public health emergencies.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"39-48"},"PeriodicalIF":2.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41219534","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
Hospital and Patient Factors Affecting Veterans' Hospital Choice. 影响退伍军人医院选择的医院和病人因素。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2024-02-01 Epub Date: 2023-09-07 DOI: 10.1177/10775587231194681
Jean Yoon, Michael K Ong, Megan E Vanneman, Yue Zhang, Matthew P Dizon, Ciaran S Phibbs
{"title":"Hospital and Patient Factors Affecting Veterans' Hospital Choice.","authors":"Jean Yoon, Michael K Ong, Megan E Vanneman, Yue Zhang, Matthew P Dizon, Ciaran S Phibbs","doi":"10.1177/10775587231194681","DOIUrl":"10.1177/10775587231194681","url":null,"abstract":"<p><p>Veterans enrolled in the Veterans Affairs (VA) health care system gained greater access to non-VA care beginning in 2014. We examined hospital and Veteran characteristics associated with hospital choice. We conducted a longitudinal study of elective hospitalizations 2011 to 2017 in 11 states and modeled patients' choice of VA hospital, large non-VA hospital, or small non-VA hospital in conditional logit models. Patients had higher odds of choosing a hospital with an academic affiliation, better patient experience rating, location closer to them, and a more common hospital type. Patients who were male, racial/ethnic minorities, had higher VA enrollment priority, and had a mental health comorbidity were more likely than other patients to choose a VA hospital than a non-VA hospital. Our findings suggest that patients respond to certain hospital attributes. VA hospitals may need to maintain or achieve high levels of quality and patient experience to attract or retain patients in the future.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"58-67"},"PeriodicalIF":2.4,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10842609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10553336","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
Interruptions in Insurance Coverage and Prescription Drug Utilization: Evidence from Kentucky 保险中断与处方药使用：肯塔基州的证据
IF 2.5 3区 医学
Medical Care Research and Review Pub Date : 2023-12-07 DOI: 10.1177/10775587231213691
Giacomo Meille
{"title":"Interruptions in Insurance Coverage and Prescription Drug Utilization: Evidence from Kentucky","authors":"Giacomo Meille","doi":"10.1177/10775587231213691","DOIUrl":"https://doi.org/10.1177/10775587231213691","url":null,"abstract":"This study examined how interruptions in insurance coverage affect purchases of prescription drugs for young adults. It used data spanning 2014 to 2018 from Kentucky’s prescription drug monitoring program, which tracked the universe of federally-regulated (Schedule II–V) prescription drugs dispensed in the state. The study employed a regression discontinuity design based on the age limit at 26 for dependent insurance coverage for children. At age 26, the probability of purchasing a prescription decreased by 5%, with all subcategories of prescriptions affected. The share of generic prescriptions increased for stimulants (the only category observed with substantial branded prescriptions). By age 27, prescription purchases returned to levels observed at 25, but the share purchased with public insurance and the generic share for stimulants remained higher. The findings suggest that interruptions in insurance coverage decrease prescription drug utilization by young adults and that public insurance programs such as Medicaid are important for resuming treatment.","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":"50 10","pages":""},"PeriodicalIF":2.5,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138592313","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
Comprehensive Caregiver Supports and Ascertainment and Treatment of Veteran Pain 对护理人员的全面支持以及退伍军人疼痛的确定和治疗
IF 2.5 3区 医学
Medical Care Research and Review Pub Date : 2023-12-07 DOI: 10.1177/10775587231210026
Courtney H. Van Houtven, Valerie A. Smith, Katherine E M Miller, T. Berkowitz, M. Shepherd-Banigan, Tyler Hein, Lauren S. Penney, Kelli D. Allen, Margaret Kabat, Timothy Jobin, S. N. Hastings
{"title":"Comprehensive Caregiver Supports and Ascertainment and Treatment of Veteran Pain","authors":"Courtney H. Van Houtven, Valerie A. Smith, Katherine E M Miller, T. Berkowitz, M. Shepherd-Banigan, Tyler Hein, Lauren S. Penney, Kelli D. Allen, Margaret Kabat, Timothy Jobin, S. N. Hastings","doi":"10.1177/10775587231210026","DOIUrl":"https://doi.org/10.1177/10775587231210026","url":null,"abstract":"Disabled Veterans commonly experience pain. The Program of Comprehensive Assistance for Family Caregivers (PCAFC) provides training, a stipend, and services to family caregivers of eligible Veterans to support their caregiving role. We compared ascertainment of veteran pain and pain treatment through health care encounters and medications (pain indicators) of participants (treated group) and non-participants (comparison group) using inverse probability treatment weights. Modeled results show that the proportion of Veterans with a pain indicator in the first year post-application was higher than that pre-application for both groups. However, the proportion of Veterans with a pain indicator was substantially higher in the treatment group: 76.1% versus 63.9% in the comparison group ( p < .001). Over time, the proportion of Veterans with any pain indicator fell and group differences lessened. However, differences persisted through 8 years post-application ( p < .001). PCAFC caregivers appear to help Veterans engage in pain treatment at higher rates than caregivers not in PCAFC.","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":"52 19","pages":""},"PeriodicalIF":2.5,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138593248","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
Beyond Nursing Staff Levels: The Association of Nursing Home Quality and the Five-Star Quality Rating System's New Staffing Measures. 超越护理人员水平:养老院质量协会和五星级质量评级系统的新人员配备措施。
IF 2.5 3区 医学
Medical Care Research and Review Pub Date : 2023-12-01 Epub Date: 2023-07-18 DOI: 10.1177/10775587231187782
Christopher S Brunt, John R Bowblis
{"title":"Beyond Nursing Staff Levels: The Association of Nursing Home Quality and the Five-Star Quality Rating System's New Staffing Measures.","authors":"Christopher S Brunt, John R Bowblis","doi":"10.1177/10775587231187782","DOIUrl":"10.1177/10775587231187782","url":null,"abstract":"<p><p>Recently, the Centers for Medicare & Medicaid Services (CMS) introduced staffing measures related to staffing variability and turnover in the Nursing Home (NH) <i>Care Compare</i> Five-Star Quality Rating System. While the consensus within the literature is that reduced variability and turnover are associated with higher NH quality of care and life, no existing studies have evaluated the relationship between CMS's newly introduced staffing measures and quality. This study uses regression analysis to estimate the relationship between 13 quality measures (used in <i>Care Compare</i>) and CMS's new staffing measures (i.e., weekend nursing staff levels, total nursing and registered nurse staff turnover, and administrator turnover) as well as a measure of daily staffing variation recently introduced in the literature called the coefficient of variation. Regressions analysis finds strong evidence of an association between quality and these staffing measures, though some measures (e.g., nursing staff turnover) are highly correlated and may be duplicative.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"631-640"},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10185836","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
A Systematic Review of Outcomes Related to Nurse Practitioner-Delivered Primary Care for Multiple Chronic Conditions. 对多种慢性疾病由执业护士提供的初级保健相关结果的系统回顾。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2023-12-01 Epub Date: 2023-07-12 DOI: 10.1177/10775587231186720
Amy McMenamin, Eleanor Turi, Amelia Schlak, Lusine Poghosyan
{"title":"A Systematic Review of Outcomes Related to Nurse Practitioner-Delivered Primary Care for Multiple Chronic Conditions.","authors":"Amy McMenamin, Eleanor Turi, Amelia Schlak, Lusine Poghosyan","doi":"10.1177/10775587231186720","DOIUrl":"10.1177/10775587231186720","url":null,"abstract":"<p><p>Multiple chronic conditions (MCCs) are more common and costly than any individual health condition in the United States. The growing workforce of nurse practitioners (NPs) plays an active role in providing primary care to this patient population. This study identifies the effect of NP primary care models, compared with models without NP involvement, on cost, quality, and service utilization by patients with MCCs. We conducted a literature search of six databases and performed critical appraisal. Fifteen studies met inclusion criteria (years: 2003-2021). Overall, most studies showed reduced or similar costs, equivalent or better quality, and similar or lower rates of emergency department use and hospitalization associated with NP primary care models for patients with MCCs, compared with models without NP involvement. No studies found them associated with worse outcomes. Thus, NP primary care models, compared with models without NP involvement, have similar or positive impacts on MCC patient outcomes.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"563-581"},"PeriodicalIF":2.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10784406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10132258","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
Emerging Health Technologies in Long-Term Care and Suppliers' Views on Their Potential to Assist and Support the Workforce. 长期护理中的新兴卫生技术和供应商对其协助和支持劳动力潜力的看法。
IF 2.5 3区 医学
Medical Care Research and Review Pub Date : 2023-12-01 Epub Date: 2023-08-03 DOI: 10.1177/10775587231190127
Susan A Chapman, Jacqueline R Miller, Joanne Spetz
{"title":"Emerging Health Technologies in Long-Term Care and Suppliers' Views on Their Potential to Assist and Support the Workforce.","authors":"Susan A Chapman, Jacqueline R Miller, Joanne Spetz","doi":"10.1177/10775587231190127","DOIUrl":"10.1177/10775587231190127","url":null,"abstract":"<p><p>Emerging technological advances hold potential to assist the long-term care (LTC) workforce in caring for an aging population in the home and LTC settings. Technology may alter workforce needs and mitigate rising workforce demand. This study identified and assessed emerging technologies that may assist, replace, and/or support recruitment and retention of the LTC workforce and identified barriers and facilitators to their implementation. We identified a variety of technologies with applications for LTC, created a taxonomy of technology types and functions across LTC settings, and conducted semi-structured interviews with a sample of company leaders to assess perceived impact of their products and services on the LTC workforce. Thematic analysis of those interviews found that technology is not currently positioned to replace the LTC workforce but may facilitate work and support worker recruitment and retention. More rigorous evaluation of technologies in LTC and financing mechanisms are needed to support widespread adoption.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"619-630"},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10637095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9918178","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
Health Insurance Coverage Gaps Among Children With a History of Adversity. 有逆境史的儿童的健康保险覆盖差距。
IF 2.5 3区 医学
Medical Care Research and Review Pub Date : 2023-12-01 Epub Date: 2023-06-17 DOI: 10.1177/10775587231180673
Chidiogo Anyigbo, Emmalee Todd, Dmitry Tumin, Jennifer Kusma
{"title":"Health Insurance Coverage Gaps Among Children With a History of Adversity.","authors":"Chidiogo Anyigbo, Emmalee Todd, Dmitry Tumin, Jennifer Kusma","doi":"10.1177/10775587231180673","DOIUrl":"10.1177/10775587231180673","url":null,"abstract":"<p><p>Health insurance stability among children with adverse childhood experiences (ACEs) is essential for accessing health care services. This cross-sectional study used an extensive, multi-year, nationally representative database of children aged 0 to 17 to examine the association between ACE scores and continuous or intermittent lack of health insurance over a 12-month period. Secondary outcomes were reported reasons for coverage gaps. Compared with children having 0 ACEs, those with 4+ ACEs had a higher likelihood of being part-year uninsured rather than year-round private insured (relative risk ratio [RRR]: 4.20; 95% CI: 3.25, 5.43), year-round public insured (RRR: 1.37; 95% CI: 1.06, 1.76), or year-round uninsured (RRR: 2.28; 95% confidence interval [CI]: 1.63, 3.21). Among children who experienced part-year or year-round uninsurance, a higher ACE score was associated with a greater likelihood of coverage gap due to difficulties with the application or renewal process. Policy changes to reduce administrative burdens may improve health insurance stability and access to health care among children who endure ACEs.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"648-658"},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9648249","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
Permanent Supportive Housing Receipt and Health Care Use Among Adults With Disabilities. 永久性支持性住房收据和残疾成年人的医疗保健使用。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2023-12-01 Epub Date: 2023-06-27 DOI: 10.1177/10775587231183192
Lexie R Grove, Seth A Berkowitz, Gary Cuddeback, George H Pink, Sally Clark Stearns, Til Stürmer, Marisa Elena Domino
{"title":"Permanent Supportive Housing Receipt and Health Care Use Among Adults With Disabilities.","authors":"Lexie R Grove, Seth A Berkowitz, Gary Cuddeback, George H Pink, Sally Clark Stearns, Til Stürmer, Marisa Elena Domino","doi":"10.1177/10775587231183192","DOIUrl":"10.1177/10775587231183192","url":null,"abstract":"<p><p>This study assessed whether permanent supportive housing (PSH) participation is associated with health service use among a population of adults with disabilities, including people transitioning into PSH from community and institutional settings. Our primary data sources were 2014 to 2018 secondary data from a PSH program in North Carolina linked to Medicaid claims. We used propensity score weighting to estimate the average treatment effect on the treated of PSH participation. All models were stratified by whether individuals were in institutional or community settings prior to PSH. In weighted analyses, among individuals who were institutionalized prior to PSH, PSH participation was associated with greater hospitalizations and emergency department (ED) visits and fewer primary care visits during the follow-up period, compared with similar individuals who largely remained institutionalized. Individuals who entered PSH from community settings did not have significantly different health service use from similar comparison group members during the 12-month follow-up period.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"596-607"},"PeriodicalIF":2.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10637096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10045887","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
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