Health affairs (Project Hope)最新文献_第9页

Arkansas Medical Marijuana Certifications: Higher-Volume Physicians Associated With Less Evidence Of Care Coordination. 阿肯色医用大麻认证：更多的医生与更少的护理协调证据相关。

Health affairs (Project Hope) Pub Date : 2025-03-01 DOI: 10.1377/hlthaff.2024.00380

Joseph W Thompson, Brad Martin, Anthony Goudie, Nichole Stanley, Katerina Noori, Teresa Hudson

{"title":"Arkansas Medical Marijuana Certifications: Higher-Volume Physicians Associated With Less Evidence Of Care Coordination.","authors":"Joseph W Thompson, Brad Martin, Anthony Goudie, Nichole Stanley, Katerina Noori, Teresa Hudson","doi":"10.1377/hlthaff.2024.00380","DOIUrl":"https://doi.org/10.1377/hlthaff.2024.00380","url":null,"abstract":"Patients' access to medical marijuana has dramatically increased despite the lack of Food and Drug Administration approval. In this study, we profiled individuals and the conditions for which they were certified for medical marijuana, and we examined the evidence of coordination with their physicians providing traditional care. Within two years of initiation, medical marijuana was approved for 3.4 percent of Arkansans ages eighteen and older by 12.5 percent of physicians who had an active license in the state. Posttraumatic stress disorder and four pain diagnoses were the most frequent qualifying conditions. We observed care coordination among low-volume certifying physicians, with a majority having both seen and diagnosed the adult with the qualifying conditions. Conversely, seven high-volume certifying physicians, each with more than 1,000 certifications, demonstrated limited contact with those they certified. The Department of Health and Human Services has recommended that marijuana be changed from Schedule I to Schedule III in the Controlled Substances Act, and the Justice Department has submitted a notice of proposed rulemaking to effect this change. Implications include the need to continue research and develop clinical guidelines, notify routine providers of care with potential incorporation of certifications into the health information exchanges, and consider screening for medical marijuana use in clinical settings.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 3","pages":"351-360"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Global Health Security Ensures Our Own Security. 全球卫生安全保障我们自身安全。

Health affairs (Project Hope) Pub Date : 2025-03-01 DOI: 10.1377/hlthaff.2025.00032

Rabih Torbay

引用次数: 0

Asian American, Native Hawaiian, And Pacific Islander Population Group Representation In The US Health Workforce. 亚裔美国人、夏威夷原住民和太平洋岛民群体在美国卫生人力中的代表性

Health affairs (Project Hope) Pub Date : 2025-03-01 DOI: 10.1377/hlthaff.2024.01069

Emmeline Ha, Finn Dobkin, Maria Portela Martinez, Jordan Herring, Edward Salsberg

{"title":"Asian American, Native Hawaiian, And Pacific Islander Population Group Representation In The US Health Workforce.","authors":"Emmeline Ha, Finn Dobkin, Maria Portela Martinez, Jordan Herring, Edward Salsberg","doi":"10.1377/hlthaff.2024.01069","DOIUrl":"10.1377/hlthaff.2024.01069","url":null,"abstract":"Although the Asian American, Native Hawaiian, and Pacific Islander (AANHPI) population encompasses more than 50 ethnicities and 100 languages, it is often treated as a monolith in research and policy. Despite substantial heterogeneity, policy makers and researchers do not usually focus on AANHPI subgroups when discussing underrepresentation and health disparities. We provide insights on the representation of AANHPI populations by disaggregating the AANHPI racial category among the health workforce and examining the representation of AANHPI subgroups in health occupations. These data indicate that although the AANHPI population is well represented as a collective population, there are population groups that are underrepresented, including the other Southeast Asian and NHPI populations in general. There is also considerable underrepresentation of AANHPI populations in the behavioral health workforce. Policy and research addressing underrepresentation and gaps in health care, which usually do not focus on the \"Asian\" racial population groups, should disaggregate AANHPI population groups.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 3","pages":"333-341"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

First-In-Class Drugs Experienced Different Regulatory Treatment In The US And Europe. 第一类药物在美国和欧洲的监管待遇不同

Health affairs (Project Hope) Pub Date : 2025-03-01 DOI: 10.1377/hlthaff.2024.01072

Jihye Han, Aaron S Kesselheim

{"title":"First-In-Class Drugs Experienced Different Regulatory Treatment In The US And Europe.","authors":"Jihye Han, Aaron S Kesselheim","doi":"10.1377/hlthaff.2024.01072","DOIUrl":"10.1377/hlthaff.2024.01072","url":null,"abstract":"First-in-class drugs can be highly innovative because of their novel mechanisms of action, but they also carry uncertainty in the absence of clinical experience. To understand how such drugs advance through development to enter the market, we investigated Food and Drug Administration (FDA) approval data for 186 first-in-class drugs (2013-23) and data for 121 drugs approved by both the FDA and the European Medicines Agency (EMA; 2013-22), focusing on review durations, expedited program use, and characteristics of pivotal efficacy trials. The FDA applied substantial regulatory flexibility to first-in-class drugs, with 50 percent lacking clinical endpoints and 30 percent lacking blinding and comparator drugs in the pivotal trials. This flexibility was particularly evident in cancer drugs, for which up to 90 percent lacked clinical endpoints and blinding. The FDA designated 81 percent of first-in-class drugs for expedited programs compared with 30 percent designated by the EMA. Review durations varied by therapeutic area, ranging from 7.7 months to 14.5 months at the FDA, and were slightly slower at the EMA. Regulators need to carefully balance flexibilities with rigorous assessments of evidence for first-in-class drugs.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 3","pages":"265-273"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dialysis Facility Participation In Medicare Advantage Networks Was Highest For Large Dialysis Organizations In 2021. 2021年，大型透析组织的透析设施参与医疗保险优势网络的比例最高。

Health affairs (Project Hope) Pub Date : 2025-03-01 DOI: 10.1377/hlthaff.2024.01142

Eunhae Grace Oh, Joan F Brazier, Emily A Gadbois, Denise A Tyler, Laura M Keohane, David J Meyers, Momotazur Rahman, Kevin H Nguyen, Amal N Trivedi

{"title":"Dialysis Facility Participation In Medicare Advantage Networks Was Highest For Large Dialysis Organizations In 2021.","authors":"Eunhae Grace Oh, Joan F Brazier, Emily A Gadbois, Denise A Tyler, Laura M Keohane, David J Meyers, Momotazur Rahman, Kevin H Nguyen, Amal N Trivedi","doi":"10.1377/hlthaff.2024.01142","DOIUrl":"10.1377/hlthaff.2024.01142","url":null,"abstract":"The share of patients with kidney failure enrolled in Medicare Advantage (MA) increased from 27 percent to 47 percent after the implementation of the 21st Century Cures Act, which expanded MA eligibility to all kidney failure patients. In this mixed-methods study, we examined the characteristics of dialysis facilities participating in MA contracts in 2021, and we supplemented the findings with data from qualitative interviews with representatives from MA plans and dialysis provider organizations. In 2021, dialysis facilities contracted with approximately 60 percent of MA plans offered in their and neighboring counties. In adjusted analyses, facilities affiliated with the two large dialysis organizations had 33-40 percentage points higher participation in MA networks compared with independent, not-for-profit facilities. Interviews suggest that large dialysis organizations had a unique advantage in their negotiations with MA plans. It is important for policy makers to understand how MA enrollment growth among people with kidney failure may be accelerating consolidation in the dialysis market.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 3","pages":"313-321"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Demographic Variation In US Outpatient Hydroxychloroquine And Ivermectin Use During The COVID-19 Pandemic. COVID-19大流行期间美国门诊羟氯喹和伊维菌素使用的人口统计学变化

Health affairs (Project Hope) Pub Date : 2025-03-01 Epub Date: 2025-02-19 DOI: 10.1377/hlthaff.2024.00452

Michelle S Rockwell, Sitaram Vangala, Michael Hadfield, Jonathan Cantor, Dale Skinner, Melody Craff, A Mark Fendrick, Cheryl L Damberg, Katherine Kahn, John N Mafi

{"title":"Demographic Variation In US Outpatient Hydroxychloroquine And Ivermectin Use During The COVID-19 Pandemic.","authors":"Michelle S Rockwell, Sitaram Vangala, Michael Hadfield, Jonathan Cantor, Dale Skinner, Melody Craff, A Mark Fendrick, Cheryl L Damberg, Katherine Kahn, John N Mafi","doi":"10.1377/hlthaff.2024.00452","DOIUrl":"10.1377/hlthaff.2024.00452","url":null,"abstract":"As COVID-19 surged across the US starting in 2020, so too did the use of repurposed medications such as hydroxychloroquine and ivermectin to treat COVID-19 infections. Use of these medications throughout the public health emergency and across demographic subgroups is not well understood. Using insurance claims from the MedInsight Emerging Experience Research Database for 8.1 million patients from all fifty US states, we evaluated COVID-19-associated outpatient hydroxychloroquine and ivermectin use and spending throughout the public health emergency (January 30, 2020-May 11, 2023) versus pre-public health emergency rates. Extrapolated to the US population, approximately three million prescriptions (totaling $272 million in spending) were used; 7 percent followed Food and Drug Administration authorization of outpatient COVID-19 medications ritonavir-boosted nirmatrelvir, molnupiravir, and remdesivir in December 2021 and January 2022. The combined overall hydroxychloroquine and ivermectin utilization rate was threefold higher in older versus younger adults. Ivermectin use was greater among patients with the highest versus the lowest degree of social vulnerability and in the southern US versus other regions. These findings can inform policy efforts to mitigate the harms of non-evidence-based care, particularly among vulnerable populations.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"246-255"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pharmaceuticals, Private Equity, Child Health, And More. 采购产品药品，私募股权，儿童健康等。

Health affairs (Project Hope) Pub Date : 2025-03-01 DOI: 10.1377/hlthaff.2025.00187

Donald E Metz, The Editorial Staff

引用次数: 0

Erratum. 勘误表。

Health affairs (Project Hope) Pub Date : 2025-03-01 DOI: 10.1377/hlthaff.2025.00186

引用次数: 0

When The Color Line Meets The Borderline: Health Insurance Coverage Among Black Immigrant Adults In The US. 当肤色线遇到边界：美国黑人成年移民的医疗保险覆盖。

Health affairs (Project Hope) Pub Date : 2025-03-01 DOI: 10.1377/hlthaff.2024.00672

Ezinne Nwankwo, Manuel Pastor

{"title":"When The Color Line Meets The Borderline: Health Insurance Coverage Among Black Immigrant Adults In The US.","authors":"Ezinne Nwankwo, Manuel Pastor","doi":"10.1377/hlthaff.2024.00672","DOIUrl":"10.1377/hlthaff.2024.00672","url":null,"abstract":"Black immigrants represent a growing share of the immigrant population in the United States and may face unique barriers to health insurance coverage. Using microdata from the 2017-21 American Community Survey five-year estimates, supplemented by an imputation of documentation status, we compared Black immigrants with their US-born Black and US-born and immigrant White, Latino, and Asian American and Pacific Islander (AAPI) counterparts. We found that Black immigrants had higher uninsurance rates than almost every other group except non-Black Latino immigrants. After covariates were controlled for in multivariable regression models, Black immigrants had 9 percent higher odds of being uninsured when compared with US-born White people. There were no significant differences in adjusted insurance rates between US-born White and Black people. Non-Black Latinos had notably high odds of being uninsured, with US-born Latinos experiencing a 31 percent higher likelihood of lacking coverage and Latino immigrants reporting more than double those odds. US-born people and AAPI immigrants reported significantly lower odds of being uninsured. We offer suggestions to community organizations and program planners to improve health insurance coverage among Black immigrants.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 3","pages":"296-303"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Socioeconomically Disadvantaged Groups May Have Underused The Emergency Department For Nonavoidable Visits, 2018-22. 2018-22年，社会经济弱势群体可能没有充分利用急诊室进行不可避免的访问。

Health affairs (Project Hope) Pub Date : 2025-03-01 DOI: 10.1377/hlthaff.2024.00815

Richard K Leuchter, Melody Craff, Sitaram Vangala, Chi-Hong Tseng, Julia Cave Arbanas, Cyrus Tabatabai-Yazdi, Michael Hadfield, Dale Skinner, Cheryl L Damberg, Catherine A Sarkisian, John N Mafi, Katherine L Kahn

{"title":"Socioeconomically Disadvantaged Groups May Have Underused The Emergency Department For Nonavoidable Visits, 2018-22.","authors":"Richard K Leuchter, Melody Craff, Sitaram Vangala, Chi-Hong Tseng, Julia Cave Arbanas, Cyrus Tabatabai-Yazdi, Michael Hadfield, Dale Skinner, Cheryl L Damberg, Catherine A Sarkisian, John N Mafi, Katherine L Kahn","doi":"10.1377/hlthaff.2024.00815","DOIUrl":"10.1377/hlthaff.2024.00815","url":null,"abstract":"In the decades preceding the COVID-19 pandemic, emergency department (ED) use increased more rapidly for socioeconomically disadvantaged patients than for advantaged patients, often because of barriers to accessing office-based care. However, it remains unknown whether the pandemic has had durable effects on socioeconomic disparities in ED use. We conducted a retrospective cohort study of ED visits in the US, using multipayer claims data. We used a difference-in-differences approach to compare ED visit rates between March 2020 and August 2022 with rates from the same months of 2018-19. Among 15.6 million ED visits, potentially avoidable visits persistently declined for all insured populations during the pandemic period. Potentially nonavoidable visits also declined early in the pandemic but rebounded to more than 95 percent of expected rates. However, stratifying by insurance revealed that this rebound occurred among commercially insured and Medicare fee-for-service patients; potentially nonavoidable visits only returned to about 75 percent of expected rates among Medicaid and dual-eligible patients. Although this suggests a beneficial reduction in potentially avoidable ED use, it also indicates the simultaneous emergence of a disparity wherein socioeconomically disadvantaged groups may be underusing the ED for potentially higher-acuity illness.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 3","pages":"322-332"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0