JAMA Health Forum最新文献

{"title":"Harms of Framing Obesity as a Disease of Individuals.","authors":"Luc Louis Hagenaars, Grant Ennis, Yogi Hale Hendlin","doi":"10.1001/jamahealthforum.2026.0968","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2026.0968","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"7 5","pages":"e260968"},"PeriodicalIF":11.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823506","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}

{"title":"Vaccine Litigation-Weighing the Consequences for the Public's Health.","authors":"Lawrence O Gostin, Richard Hughes","doi":"10.1001/jamahealthforum.2026.1986","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2026.1986","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"7 5","pages":"e261986"},"PeriodicalIF":11.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846033","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}

{"title":"Private Equity Acquisition in Primary Care and Avoidable Hospitalizations.","authors":"Meehir N Dixit, Alexander P Philips, Amal N Trivedi, Christopher Whaley, Yashaswini Singh","doi":"10.1001/jamahealthforum.2026.1045","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2026.1045","url":null,"abstract":"<p><strong>Importance: </strong>Private equity (PE) is one form of corporate investment that has rapidly expanded into primary care, with more than 2400 primary care physicians becoming PE-affiliated since 2019. There are concerns that profit incentives associated with PE investment might be detrimental to care quality and patient outcomes.</p><p><strong>Objective: </strong>To examine changes in patient outcomes for the traditional Medicare (TM) population after primary care practices are acquired by PE firms and to identify any changes in patient composition.</p><p><strong>Design, setting, and participants: </strong>This economic evaluation used a stacked difference-in-differences analysis with a 20% Medicare Part B sample from 2016 to 2022. Medicare beneficiaries with PE-acquired primary care physicians were matched to control patients based on age, risk score, sex, race and ethnicity, state of residence, and dual-eligibility status. Statistical analysis was performed from November 2024 to February 2026.</p><p><strong>Exposure: </strong>Primary care practice acquisition by a PE firm, identified using PitchBook data.</p><p><strong>Main outcomes and measures: </strong>Primary outcomes at the patient-quarter level include number of all-cause hospitalizations, number of potentially avoidable hospitalizations for ambulatory-sensitive conditions, and number of emergency department (ED) visits. Secondary outcomes include measures of patient composition, including patient age, sex, race and ethnicity, and hierarchical condition category score.</p><p><strong>Results: </strong>The analysis included 24 397 beneficiaries with PE-acquired primary care physicians, matched to 121 939 control patients. The mean (SD) age was 74 (10) years, and 56% of patients were female. After PE acquisition, the number of all-cause ED visits decreased by 1.36% (95% CI, -2.72% to -0.14%) per patient-quarter relative to baseline. Considering various sensitivity tests, there were no significant changes to the probability of or number of potentially preventable hospitalizations or all-cause hospitalizations. Patient composition remained unchanged.</p><p><strong>Conclusions and relevance: </strong>In this national study of traditional Medicare beneficiaries, PE acquisitions of primary care practices were not associated with meaningful short-term changes in acute care outcomes. Overall, findings contribute to policy discourse on understanding the role of PE investments in shaping care quality, suggesting heterogeneity in outcomes across health care settings.</p>","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"7 5","pages":"e261045"},"PeriodicalIF":11.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846046","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}

{"title":"JAMA Health Forum.","authors":"","doi":"10.1001/jamahealthforum.2025.6023","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2025.6023","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"7 5","pages":"e256023"},"PeriodicalIF":11.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823428","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}

{"title":"Potential for Bias in Social Needs Data Collection and Screening Activities in Health Care Settings.","authors":"Joshua R Vest, Christopher A Harle, Cassidy McNamee, Nicole C Hammer, Megan E Gregory","doi":"10.1001/jamahealthforum.2026.0971","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2026.0971","url":null,"abstract":"<p><strong>Importance: </strong>Health-related social needs (HRSN) data are used in referral and treatment decisions, in population health management strategies, and in health services research. However, evidence suggests HRSN data are at risk for bias.</p><p><strong>Objective: </strong>To identify and classify sources of bias in HRSN data and the implications for usage for patient care and population health.</p><p><strong>Design, setting, and participants: </strong>In this qualitative study, key informant interviews with patients and health care professionals in Indiana and Florida (recruited using multiple recruitment methods and snowball sampling) were conducted from January to May 2025. Key informants in Indiana were primarily associated with a public safety-net system including federally qualified health centers, or a multihospital system with services statewide. In Florida, key informants were associated with a large academic medical center, with some dual-affiliated with a US Department of Veterans Affairs hospital. Health care professionals had the titles such as physician, social worker, and community health worker.</p><p><strong>Main outcomes and measures: </strong>Data collection occurred via video or telephone call. Interviews followed a semistructured interview guide grounded in a framework describing sources of potential bias in health data. Participants were asked about HRSN data collection practices and experiences, documentation practices, responses to HRSN data collection, and how, in their own words, they defined food insecurity, housing instability, financial strain, and transportation barriers. Thematic analysis followed a consensus coding approach.</p><p><strong>Results: </strong>A total of 20 patients and 20 health care professionals were recruited (40 informants total; 22 aged 40-64 years [42.5%]; 27 female [67.5%]). Participants described variation in HRSN data collection and differing availability of organizational resources that contributed to sampling bias. Patients and professionals reported detection bias was possible because HRSNs could be intentionally sought during visits or not collected at all. Concerns about stigma or embarrassment, power distance, and privacy could result in nonresponse bias. Health care professionals and patients could all offer slightly different, or nuanced, definitions of different HRSNs. These more expansive or restrictive definitions could lead to misclassification bias.</p><p><strong>Conclusions and relevance: </strong>In this qualitative study, both patients and health care professionals described opportunities for bias in HRSN data collection and documentation. These findings suggest that, while HRSN data are potentially valuable to patient care, their fitness for use in organizational decision-making, research, and health policy may need improvement.</p>","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"7 5","pages":"e260971"},"PeriodicalIF":11.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823532","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}

{"title":"Error in the Author Affiliations.","authors":"","doi":"10.1001/jamahealthforum.2026.1225","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2026.1225","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"7 5","pages":"e261225"},"PeriodicalIF":11.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823495","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}

{"title":"Promises, Pitfalls, and Paths Forward for the Pediatric Research Equity Act.","authors":"Alexa Pagano, Danielle J Green, Jennifer L Goldman, Anjali Deshmukh","doi":"10.1001/jamahealthforum.2026.0993","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2026.0993","url":null,"abstract":"<p><strong>Importance: </strong>Since its enactment in 2003, the Pediatric Research Equity Act (PREA) has significantly increased the number of pediatric drug studies performed and expanded pediatric drug labeling. Despite these advancements, many drugs used in children still lack pediatric-specific US Food and Drug Administration (FDA) labeling, even when pediatric studies are required by law. Recent legislative changes strengthened the FDA's enforcement authority over PREA. As these changes are implemented, persistent gaps in pediatric drug development warrant examination. Addressing these gaps may help ensure that children are systematically included in clinical research and that medications used in children are supported by rigorous evidence on safety, dosing, and efficacy.</p><p><strong>Observations: </strong>Legislation to ensure pediatric drug safety and efficacy has a long history, yet pediatric-specific labeling frequently lags behind initial drug approval, with many studies required under PREA remaining incomplete for years after initial FDA approval. Consequently, off-label prescribing can be necessary for pediatric health care, leaving children exposed to medications lacking adequate pediatric evidence. Barriers to the timely completion of clinical trials are often attributed to challenges inherent to smaller, disease-specific pediatric populations; however, the FDA's limited enforcement authority and insufficient resources to address delayed pediatric trial completion play an underappreciated role. In addition, limited ability to track required studies and insufficient public transparency undermine the regulatory goals intended to protect children. With new legislative authority strengthening enforcement of PREA, understanding these barriers is essential to ensure this authority is effectively deployed to improve children's health.</p><p><strong>Conclusions and relevance: </strong>To ensure children have access to safe, effective, evidence-based medications, effective policy changes are necessary. The FDA should use its new authority to ensure the timely completion of required pediatric studies and enhance public transparency by improving mechanisms to track PREA-mandated research.</p>","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"7 5","pages":"e260993"},"PeriodicalIF":11.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845989","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}

{"title":"Implications of Medicare Negotiation and Most-Favored-Nation Pricing for Cancer Medicine Costs.","authors":"Thomas J Hwang, Ariadna Tibau, Aaron S Kesselheim, Kerstin Noelle Vokinger","doi":"10.1001/jamahealthforum.2026.0509","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2026.0509","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"7 5","pages":"e260509"},"PeriodicalIF":11.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823455","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}

{"title":"Health-Related Social Needs Screening Bias as a Health Equity Measurement Problem.","authors":"Ninez A Ponce, Sugy Choi","doi":"10.1001/jamahealthforum.2026.0967","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2026.0967","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"7 5","pages":"e260967"},"PeriodicalIF":11.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823501","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}

{"title":"Primary Care Access and the Role of Telemedicine for Traditional Medicare Beneficiaries.","authors":"Ishani Ganguli, Nicholas E Daley, Andrew Hicks, Katherine M Morgan, Ateev Mehrotra, David M Cutler, Meredith B Rosenthal","doi":"10.1001/jamahealthforum.2026.0979","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2026.0979","url":null,"abstract":"<p><strong>Importance: </strong>Primary care improves population health, yet access is a challenge in the US. It is unclear how primary care use, access, and access disparities have changed since widespread adoption of telemedicine during the pandemic.</p><p><strong>Objective: </strong>To quantify trends in primary care use and determine the role of telemedicine in primary care access and access disparities for traditional Medicare beneficiaries.</p><p><strong>Design, setting, and participants: </strong>Serial cross-sectional study using 2017-2023 100% claims and administrative data for traditional Medicare beneficiaries continuously enrolled and alive for the given year. Data were analyzed from October 2024 to July 2025.</p><p><strong>Main outcomes and measures: </strong>Primary care visits per beneficiary, primary care access (defined as ≥1 virtual or in-person primary care visit in the year), and primary care continuity (Bice-Boxerman Index).</p><p><strong>Results: </strong>Among 258 324 127 person-years from 2017 to 2023, primary care visit rates decreased from 2.54 per person-year in 2017 to 2.27 per person-year in 2023, and access dropped from 61.9% to 59.8%. In 2023, virtual visits comprised 7% of primary care visits and 14% of beneficiaries who accessed primary care used telemedicine to do so. Disparities in access by race, geography, and income increased slightly from 2019 to 2023, and beneficiaries in historically underserved groups by race, geography, and income who accessed primary care were more likely than others to use telemedicine to do so. Primary care continuity decreased from 0.72 in 2019 to 0.65 in 2023; in 2023, continuity was slightly higher for those using telemedicine for primary care than for those who were not.</p><p><strong>Conclusions and relevance: </strong>This serial cross-sectional study found that across all traditional Medicare beneficiaries, primary care visit rates and access decreased, with virtual visits comprising a small share of previously in-person visits. Access disparities widened while those in underserved groups were more likely than others to use telemedicine for this access. Results suggest that telemedicine plays a small but potentially important role in primary care access.</p>","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"7 5","pages":"e260979"},"PeriodicalIF":11.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823576","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}