JAMA Health Forum最新文献

{"title":"JAMA Health Forum-The Year in Review, 2024.","authors":"Sandro Galea","doi":"10.1001/jamahealthforum.2025.0187","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2025.0187","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 3","pages":"e250187"},"PeriodicalIF":9.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674704","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":"Medicaid Eligibility Gaps and Pandemic-Era Postpartum Insurance Rates.","authors":"Ellerie Weber, Heeun Kim, Annabelle Ng, Frances M Howell, Ashley Fox, Teresa Janevic","doi":"10.1001/jamahealthforum.2025.0109","DOIUrl":"10.1001/jamahealthforum.2025.0109","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 3","pages":"e250109"},"PeriodicalIF":9.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674706","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":"Population-Based Payments to Deliver Health Care to Unhoused Individuals.","authors":"Sudhakar V Nuti, Amanda K Johnson, Theodore Long","doi":"10.1001/jamahealthforum.2025.0004","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2025.0004","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 3","pages":"e250004"},"PeriodicalIF":9.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574669","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":"Prospects for Artificial Intelligence in Health Policy and Practice.","authors":"John Z Ayanian, Zirui Song","doi":"10.1001/jamahealthforum.2025.0080","DOIUrl":"10.1001/jamahealthforum.2025.0080","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 3","pages":"e250080"},"PeriodicalIF":9.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626823","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":"Enhanced COVID-19 Provider Relief, Hospital Finances, and Care for Medicare Inpatients.","authors":"Jason D Buxbaum","doi":"10.1001/jamahealthforum.2025.0046","DOIUrl":"10.1001/jamahealthforum.2025.0046","url":null,"abstract":"<p><strong>Importance: </strong>Congress appropriated $178 billion in emergency relief for health care providers (hospitals, physicians, and other health care professionals) in 2020 to stabilize finances and support the COVID-19 pandemic response. The US Department of Health and Human Services directed $35 billion of these funds to safety-net hospitals and high-impact hospitals using strict criteria. However, the importance of enhanced funding is inadequately understood.</p><p><strong>Objective: </strong>To evaluate the association between enhanced COVID-19 relief funding and hospital finances and clinical care for Medicare inpatients.</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study used a differences-in-discontinuities study design with overlap weighting. Nonrural hospitals with data on costs and fee-for-service Medicare inpatient care for 2018 to 2021. Hospitals near a threshold for receiving high-impact and/or safety-net hospital funding were analyzed. Data were analyzed from July 2022 to January 2025.</p><p><strong>Exposures: </strong>Receipt of high-impact and/or safety-net hospital relief funds.</p><p><strong>Main outcomes and measures: </strong>Financial outcomes related to revenues, costs, margin, and liquidity and clinical outcomes related to volume, care processes, and mortality.</p><p><strong>Results: </strong>A total of 555 hospitals were included, with 311 receiving high-impact and/or safety-net hospital funds. Hospitals not receiving enhanced relief averaged $7.0 million in total relief (about $45 000 per bed), while hospitals receiving enhanced relief averaged $15.4 million in total relief (about $100 000 per bed). Operating revenues in 2020 increased by 4.5% (95% CI, 3.0-5.9) among basic relief hospitals and 6.1% (95% CI, 4.6-7.6) among enhanced relief hospitals. However, total costs grew similarly (basic relief: 4.6%; 95% CI, 3.6-5.6; enhanced relief: 4.5%; 95% CI, 3.4-5.7). This resulted in a significant differential increase of 1.4 points (95% CI, 0.3-2.5) in operating margin in association with enhanced relief. Enhanced relief was also associated with limited deterioration in liquidity (differential increase in net asset ratio of 0.03 points; 95% CI, 0-0.05). There was not a significant association between receipt of enhanced relief and fee-for-service Medicare inpatient admissions (-19.6 stays; 95% CI, -281.0 to 241.8), use of a sentinel deferrable procedure among fee-for-service Medicare inpatients (-3.9 admissions for lower joint replacement; 95% CI, -29.6 to 21.7), or use of 2 resource-intensive services among fee-for-service Medicare inpatients (-0.3 admissions with ventilation; 95% CI, -20.8 to 20.2; 0.9 admissions with dialysis; 95% CI, -15.4 to 17.1). Enhanced relief was not detectibly associated with change in the complexity (change in Charlson Comorbidity Index score, 0 points; 95% CI, 0-0) or inpatient mortality (-2.9 deaths; 95% CI, -11.3 to 5.5) for fee-for-service Medicar","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 3","pages":"e250046"},"PeriodicalIF":9.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574666","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":"JAMA Health Forum Peer Reviewers in 2024.","authors":"","doi":"10.1001/jamahealthforum.2025.0269","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2025.0269","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 3","pages":"e250269"},"PeriodicalIF":9.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674728","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":"High-Deductible Health Plan Enrollment and Prostate Cancer Screening Rates.","authors":"Vanessa N Peña, Daisy Obiora, Chris Kypriotis, Kathryn A Marchetti, Danielle La Selva, Michael G Stencel, Bruce L Jacobs, Benjamin J Davies","doi":"10.1001/jamahealthforum.2025.0180","DOIUrl":"10.1001/jamahealthforum.2025.0180","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 3","pages":"e250180"},"PeriodicalIF":9.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732932","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":"Diabetes and Hypertension Risk Across Acculturation and Education Levels in Hispanic/Latino Adults: The Hispanic Community Health Study/Study of Latinos.","authors":"Eliseo J Pérez-Stable, Asmi Panigrahi, Saida I Coreas, Erik J Rodriquez, Aimee Afable, Tali Elfassy, Carmen R Isasi, Jeffrey S Gonzalez, Martha L Daviglus, Amanda Hinerman, Aida Giachello, Krista M Perreira, Linda C Gallo","doi":"10.1001/jamahealthforum.2025.0273","DOIUrl":"10.1001/jamahealthforum.2025.0273","url":null,"abstract":"<p><strong>Importance: </strong>Acculturation among Hispanic/Latino populations, defined as adaptation to US lifestyle and culture, is often assumed to lead to adverse health outcomes that will reduce the immigrant health advantage.</p><p><strong>Objective: </strong>To evaluate the risks for incident diabetes and hypertension by levels of acculturation and educational attainment.</p><p><strong>Design, setting, and participants: </strong>This study used data from the Hispanic Community Health Study/Study of Latinos, a population-based cohort study of men and women aged 18 to 74 years who identified as Central American, Cuban, Dominican, Mexican, Puerto Rican, or South American living in 4 urban locales in the US. Visit 1 spanned March 2008 to June 2011; visit 2 spanned October 2014 to December 2017.</p><p><strong>Main outcomes and measures: </strong>Multivariable logistic regression was used to evaluate the association between language acculturation level defined by the Short Acculturation Scale for Hispanics (SASH) and educational attainment (less than high school graduate vs more than high school) and incident diabetes and hypertension by heritage group.</p><p><strong>Results: </strong>Of 11 623 adult participants, 1207 (10.4%) were of Central American heritage, 1645 (14.2%) of Cuban heritage, 1021 (8.8%) of Dominican heritage, 11 623 (41.3%) of Mexican heritage, 1801 (15.5%) of Puerto Rican heritage, and 795 (6.8%) of South American heritage. The mean (SE) age of all participants was 43.1 (0.3) years, and 7345 (56.3%) were female. A total of 8697 (71.4%) were born outside the US, 4358 (32.5%) had less than a high school education, and 7475 (58.3%) were less acculturated (SASH score less than 2). Incident rates of diabetes (total cohort, 14.6% [95% CI, 13.6%-15.6%]) and hypertension (total cohort, 20.4% [95% CI, 19.0%-21.9%]) varied across heritages; Mexican individuals (17.2% [95% CI, 15.5%-19.0%]) had the highest diabetes incidence and Dominican individuals the highest hypertension incidence (27.1% [95% CI, 22.7%-31.4%]). Persons with more educational attainment were at lower risk for diabetes and hypertension independent of acculturation, and more acculturated participants had a lower risk for incident diabetes. Less acculturated with lower socioeconomic status (SES) were more likely to have incident diabetes (weighted predicted probability [WPP], 0.17 [95% CI, 0.14-0.19]), and more acculturated with lower SES had the highest predicted probability of hypertension (WPP, 0.19 [95% CI, 0.15-0.23]). More acculturated with higher SES were at lower risk of diabetes (WPP, 0.11 [95% CI, 0.09-0.13]) and had a lower predicted probability of hypertension (WPP, 0.10 [95% CI, 0.08-0.12]).</p><p><strong>Conclusions and relevance: </strong>In this cohort study, the association of acculturation with health outcomes is not unidirectional and interacts with educational attainment in determining incident diabetes and hypertension. The Hispanic and Latino parado","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 3","pages":"e250273"},"PeriodicalIF":9.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732929","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":"Characteristics and Benefit Design of Veteran Medicare Advantage Affinity Plans.","authors":"Allison Dorneo, Yanlei Ma, Melissa M Garrido, Steven D Pizer, Paul R Shafer, Thomas C Tsai, Austin B Frakt, Jose F Figueroa","doi":"10.1001/jamahealthforum.2025.0159","DOIUrl":"10.1001/jamahealthforum.2025.0159","url":null,"abstract":"<p><strong>Importance: </strong>Recently, there has been an emergence of veteran Medicare Advantage affinity plans (VMAPs) marketing to veterans, including those dually covered by the Veterans Health Administration (VHA). To date, limited evidence exists characterizing what benefits VMAPs offer and their veteran enrollees.</p><p><strong>Objective: </strong>To examine plan-level differences between VMAPs and other Medicare Advantage (MA) plans and characteristics of their veteran enrollees.</p><p><strong>Design, setting, and participants: </strong>This cross-sectional study compared the plan benefit design, supplemental benefit offerings, and veteran enrollee characteristics of all VMAP and other MA plan enrollees in 2022 using standardized mean differences (SMDs). VMAPs were identified based on military-associated words in their plan name and further validated through a web-based search. Data were analyzed from April 2023 to August 2024.</p><p><strong>Exposure: </strong>VMAP designation.</p><p><strong>Main outcomes and measures: </strong>Plan-level characteristics, supplemental benefits, and veteran enrollee characteristics.</p><p><strong>Results: </strong>The sample included 188 VMAPs with 179 449 veteran enrollees and 3442 other MA plans with 954 581 veteran enrollees. A total of 1 088 938 (96.0%) were male, 3558 (0.3%) were American Indian or Alaska Native, 8845 (0.8%) were Asian or Pacific Islander, 162 934 (14.4%) were Black, 61 264 (5.4%) were Hispanic, and 876 234 (77.3%) were White; the mean (SD) age was 75.9 (8.6) years. Most VMAPs were administered by for-profit insurers (173 [92.0%]; SMD, 0.42), including Aetna (46 [24.9%]), Humana (36 [19.5%]), and United HealthCare (49 [26.5%]). Compared with veterans in other MA plans, veterans in VMAPs were slightly younger (mean [SD] age, 73.7 [8.0] years vs 76.3 [8.7] years; SMD, 0.31), more likely to be Black (34 837 [19.4%] vs 128 097 [13.4%]; SMD, 0.18), and more likely to have zero cost sharing for VHA services (ie, priority group 1) (62 056 [34.6%] vs 195 688 [20.5%]; SMD, 0.40). VMAPs were more likely than other MA plans to offer $0 plan premiums (186 [98.9%] vs 2064 [60.0%]; SMD, 1.10), and Medicare Part B premium reductions (140 [74.5%] vs 298 [8.7%]; SMD, 1.80), averaging $33 more in cash back benefits. Only 1 VMAP offered Medicare Part D coverage compared with most other MA plans (1 [0.5%] vs 3293 [95.7%]; SMD, 6.23). VMAPs were more likely than other MA plans to provide comprehensive dental coverage (179 [95.2%] vs 3006 [87.3%]; SMD, 0.28), hearing aids (184 [97.9%] vs 3012 [87.5%]; SMD, 0.40), eyewear (188 [100%] vs 3620 [94.7%]; SMD, 0.33), over-the-counter drug coverage (179 [95.2%] vs 2831 [82.2%]; SMD, 0.42), and meal benefits (151 [80.3%] vs 2348 [68.2%]; SMD, 0.28).</p><p><strong>Conclusions and relevance: </strong>This study found that MA insurers-specifically VMAPs-engaged in targeted marketing to veterans, offering $0 premiums, cash back benefits, and supplemental benefits. H","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 3","pages":"e250159"},"PeriodicalIF":9.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732919","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":"A Backlash Against Health Insurers, Redux.","authors":"Larry Levitt","doi":"10.1001/jamahealthforum.2025.0954","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2025.0954","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 3","pages":"e250954"},"PeriodicalIF":9.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626803","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}