Journal of Health Politics Policy and Law最新文献_第8页

Hydroxychloroquine for COVID-19: Variation in Regional Political Preferences Predicted New Prescriptions after President Trump's Endorsement. 羟氯喹治疗COVID-19:地区政治偏好的变化预测了特朗普总统支持后的新处方。

IF 4.2 3区医学

Journal of Health Politics Policy and Law Pub Date : 2022-08-01 DOI: 10.1215/03616878-9716698

Farrah Madanay, Ryan C McDevitt, Peter A Ubel

{"title":"Hydroxychloroquine for COVID-19: Variation in Regional Political Preferences Predicted New Prescriptions after President Trump's Endorsement.","authors":"Farrah Madanay, Ryan C McDevitt, Peter A Ubel","doi":"10.1215/03616878-9716698","DOIUrl":"https://doi.org/10.1215/03616878-9716698","url":null,"abstract":"Context: On March 19, 2020, President Donald Trump endorsed using hydroxychloroquine for COVID-19 treatment despite inconclusive evidence of the drug's effectiveness. This study sought to understand the influence of political preferences on prescription uptake by quantifying the relationship between a geographic area's partisan leaning and hydroxychloroquine prescription rates following Trump's endorsement.Methods: We analyzed hydroxychloroquine prescriptions filled in 205 continental US designated market areas (DMAs) between March 1, 2018, and July 31, 2020, and the percentage of votes for Donald Trump in the 2016 presidential election in each DMA. We estimated associations by using an empirical strategy resembling a difference-in-differences estimation.Findings: Before President Trump's endorsement, mean weekly hydroxychloroquine prescription rates were similar across DMAs with the highest and lowest Trump vote percentages (0.56 and 0.49 scripts per 100,000). After Trump's endorsement, although both high- and low-Trump-supportive DMAs experienced sharp increases in weekly hydroxychloroquine prescription rates, results indicated a 1-percentage-point increase in share of Trump votes was associated with 0.013, or 2%, more weekly hydroxychloroquine prescriptions per 100,000 people (b = 0.013, t = 2.20, p = .028).Conclusion: President Trump's endorsement of an untested therapy influenced prescribing behavior, especially when that endorsement aligned with communities' political leanings.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39921911","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: 3

Centralization vs. Decentralization in COVID-19 Responses: Lessons from China. 应对COVID-19的集中与分散:来自中国的经验教训。

IF 4.2 3区医学

Journal of Health Politics Policy and Law Pub Date : 2022-06-01 DOI: 10.1215/03616878-9626908

Aofei Lv, Ting Luo, Jane Duckett

{"title":"Centralization vs. Decentralization in COVID-19 Responses: Lessons from China.","authors":"Aofei Lv, Ting Luo, Jane Duckett","doi":"10.1215/03616878-9626908","DOIUrl":"https://doi.org/10.1215/03616878-9626908","url":null,"abstract":"Researchers have begun to examine whether centralized or decentralized (or federal) political systems have better responded to the COVID-19 pandemic. In this article, we probe beneath the surface of China's political system to examine the balance between centralized and decentralized authority in China's handling of the pandemic. We focus not on the much-studied later response phase but on the detection and early response phases. We show that after the SARS epidemic of 2003, China sought to improve its systems by both centralizing early infectious disease reporting and decentralizing authority to respond to local health emergencies. But these adjustments in the central-local balance of authority after SARS did not change \"normal times\" authority relations and incentive structures in the political system-indeed they strengthened local authority. As a result, local leaders had both the enhanced authority and the incentives to prioritize tasks that determine their political advancement at the cost of containing the spread of COVID-19. China's efforts to balance central and local authority show just how difficult it is to get that balance right, especially in the early phases of a pandemic.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39768040","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: 3

Experiences of Health Insurance among American Indian Elders and Their Health Care Providers. 美国印第安老年人及其医疗保健提供者的健康保险经验。

IF 4.2 3区医学

Journal of Health Politics Policy and Law Pub Date : 2022-06-01 DOI: 10.1215/03616878-9626880

Elise Trott Jaramillo, Emily A Haozous, Cathleen E Willging

{"title":"Experiences of Health Insurance among American Indian Elders and Their Health Care Providers.","authors":"Elise Trott Jaramillo, Emily A Haozous, Cathleen E Willging","doi":"10.1215/03616878-9626880","DOIUrl":"https://doi.org/10.1215/03616878-9626880","url":null,"abstract":"Context: American Indian elders have a lower life expectancy than other aging populations in the United States because of inequities in health and in access to health care. To reduce such disparities, the 2010 Affordable Care Act included provisions to increase insurance enrollment among American Indians. Although the Indian Health Service remains underfunded, increases in insured rates have had significant impacts among American Indians and their health care providers.Methods: From June 2016 to March 2017, we conducted qualitative interviews with 96 American Indian elders (age 55+) and 47 professionals (including health care providers, outreach workers, public-sector administrators, and tribal leaders) in two southwestern states. Interviews focused on elders' experiences with health care and health insurance. We analyzed transcripts iteratively using open and focused coding techniques.Findings: Although tribal health programs have benefitted from insurance payments, the complexities of selecting, qualifying for, and maintaining health insurance are often profoundly alienating and destabilizing for American Indian elders and communities.Conclusions: Findings underscore the inadequacy of health-system reforms based on the expansion of private and individual insurance plans in ameliorating health disparities among American Indian elders. Policy makers must not neglect their responsibility to directly fund health care for American Indians.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9133029/pdf/nihms-1786886.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39678590","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: 1

The Line between Medicaid and Marketplace: Coverage Effects from Wisconsin's Partial Expansion. 医疗补助和市场之间的界限:威斯康星州部分扩张的覆盖效果。

IF 4.2 3区医学

Journal of Health Politics Policy and Law Pub Date : 2022-06-01 DOI: 10.1215/03616878-9626852

Laura Dague, Marguerite Burns, Donna Friedsam

{"title":"The Line between Medicaid and Marketplace: Coverage Effects from Wisconsin's Partial Expansion.","authors":"Laura Dague, Marguerite Burns, Donna Friedsam","doi":"10.1215/03616878-9626852","DOIUrl":"https://doi.org/10.1215/03616878-9626852","url":null,"abstract":"Context: States have experimented with the income eligibility threshold between Medicaid coverage and access to subsidized Marketplace plans in an effort to increase coverage for low-income adults while meeting other state priorities, particularly a balanced budget. In 2014, Wisconsin opted against adopting an ACA Medicaid expansion, instead setting the Medicaid eligibility threshold at 100% of the poverty level-a state-funded partial expansion. Childless adults gained new eligibility, while parents and caregivers with incomes between 101-200% of poverty lost existing eligibility.Methods: We used Wisconsin's all-payer claims database to assess health insurance gains, losses, and transitions among low-income adults affected by this partial expansion.Findings: We found that less than one third of adults who lost Medicaid eligibility definitely took up commercial coverage, and many returned to Medicaid. Among those newly eligible for Medicaid, there was little evidence of crowd-out. Both groups experienced limited continuity of coverage. Overall, new Medicaid enrollment of childless adults was offset by coverage losses among parents and caregivers, rendering Wisconsin's overall coverage gains similar to nonexpansion states.Conclusions: Wisconsin's experience demonstrates the difficulty in relying on the Marketplace to cover the near poor and suggests that full Medicaid expansion more effectively increases coverage.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39768042","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: 6

Potemkin Protections: Assessing Provider Directory Accuracy and Timely Access for Four Specialties in California. 波将金保护:评估提供者目录的准确性和及时访问在加利福尼亚州的四个专业。

IF 4.2 3区医学

Journal of Health Politics Policy and Law Pub Date : 2022-06-01 DOI: 10.1215/03616878-9626866

Abigail Burman, Simon F Haeder

{"title":"Potemkin Protections: Assessing Provider Directory Accuracy and Timely Access for Four Specialties in California.","authors":"Abigail Burman, Simon F Haeder","doi":"10.1215/03616878-9626866","DOIUrl":"https://doi.org/10.1215/03616878-9626866","url":null,"abstract":"Context: The accuracy of provider directories and whether consumers can schedule timely appointments are crucial determinants of health access and outcomes.Methods: We evaluated accuracy and timely access data obtained from the California Department of Managed Health Care, consisting of responses to large, random, representative surveys of primary care providers, cardiologists, endocrinologists, and gastroenterologists for 2018 and 2019 for all managed care plans in California.Findings: Surveys were able to verify provider directory entries for the four specialties for 59% to 76% of listings or 78% to 88% of providers reached. We found that consumers were able to schedule urgent care appointments for 28% to 54% of listings or 44% to 72% of accurately listed providers. For general care appointments, the percentages ranged from 35% to 64% of listed providers or 51% to 87% of accurately listed providers. Differences across markets related to accuracy were generally small. Medi-Cal plans outperformed other markets with regard to timely access. Primary care consistently outperformed all other specialties. Timely access rates were higher for general appointments than for urgent care appointments.Conclusions: Our finding raise questions about the regulatory regime as well as consumer access and health outcomes.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39678595","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: 3

Authoritarian Regime Legitimacy and Health Care Provision: Survey Evidence from Contemporary China. 专制政权合法性与医疗服务:来自当代中国的调查证据。

IF 4.2 3区医学

Journal of Health Politics Policy and Law Pub Date : 2022-06-01 DOI: 10.1215/03616878-9626894

Jane Duckett, Neil Munro

{"title":"Authoritarian Regime Legitimacy and Health Care Provision: Survey Evidence from Contemporary China.","authors":"Jane Duckett, Neil Munro","doi":"10.1215/03616878-9626894","DOIUrl":"https://doi.org/10.1215/03616878-9626894","url":null,"abstract":"Context: Over the last two decades a growing body of research has shown that authoritarian regimes are trying to increase their legitimacy by providing public goods. But there has so far been very little research on whether or not these regimes are successful.Methods: This article analyzes data from a 2012-2013 nationally representative survey in China to examine whether health care provision bolsters the Communist regime's legitimacy. Using multivariate ordinal logistic regression, we test whether having public health insurance and being satisfied with the health care system are associated with separate measures of the People's Republic of China's regime legitimacy: support for \"our form of government\" (which we call \"system support\") and political trust.Findings: Having public health insurance is positively associated with trust in the Chinese central government. Health care system satisfaction is positively associated with system support and trust in local government.Conclusions: Health care provision may bolster the legitimacy of authoritarian regimes, with the clearest evidence showing that concrete benefits may translate into trust in the central government. Further research is needed to understand the relationship between trends in health care provision and legitimacy over time and in other types of authoritarian regime.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39768041","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: 5

State Policies and Health Disparities between Transgender and Cisgender Adults: Considerations and Challenges Using Population-Based Survey Data. 跨性别和顺性成年人之间的国家政策和健康差异:使用基于人口的调查数据的考虑和挑战。

IF 4.2 3区医学

Journal of Health Politics Policy and Law Pub Date : 2022-05-06 DOI: 10.1215/03616878-9978117

G. Gonzales, Nathaniel M. Tran, Marcus A Bennett

{"title":"State Policies and Health Disparities between Transgender and Cisgender Adults: Considerations and Challenges Using Population-Based Survey Data.","authors":"G. Gonzales, Nathaniel M. Tran, Marcus A Bennett","doi":"10.1215/03616878-9978117","DOIUrl":"https://doi.org/10.1215/03616878-9978117","url":null,"abstract":"CONTEXT\u0000This study examined the association between state-level policy protections (e.g., inclusive of hate crimes, employment, housing, education, and/or public accommodations) and self-rated health disparities between transgender and cisgender adults.\u0000\u0000\u0000METHODS\u0000We used data on transgender (n=4,982) and cisgender (n=1,168,859) adults from the 2014-2019 Behavioral Risk Factor Surveillance System. We estimated state-specific health disparities between transgender and cisgender adults. Multivariable logistic regression models were used to compare adjusted odds ratios (aOR) between transgender and cisgender adults by state-level policy environments.\u0000\u0000\u0000FINDINGS\u0000Overall, transgender adults were significantly (p<0.05) more likely to report poor/fair health (aOR=1.26; 95% CI=1.18-1.36), frequent mental distress (aOR=1.79; 95% CI=1.67-1.93), and frequent poor physical health days (aOR=1.26; 1.16-1.36) than cisgender adults. Disparities between transgender and cisgender adults were found in states with strengthened protections and in states with limited protections. Compared to transgender adults in states with limited protections, transgender adults in states with strengthened protections were marginally (p<0.10) less likely to report frequent mental distress (aOR=0.33; 95% CI=0.11-1.05).\u0000\u0000\u0000CONCLUSIONS\u0000Transgender adults in most states reported worse self-rated health than their cisgender peers. Much more research and robust data collection on gender identity are critically needed to study the associations between state policies and transgender health and to identify best practices for achieving health equity for transgender Americans.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2022-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86438503","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: 5

Counting: How We Use Numbers to Decide What Matters 计数:我们如何用数字来决定什么是重要的

IF 4.2 3区医学

Journal of Health Politics Policy and Law Pub Date : 2022-05-06 DOI: 10.1215/03616878-9978145

Herschel Nachlis

引用次数: 0

Challenges with Defining Pharmaceutical Markets and Potential Remedies to Screen for Industry Consolidation. 定义药品市场的挑战和筛选行业整合的潜在补救措施。

IF 4.2 3区医学

Journal of Health Politics Policy and Law Pub Date : 2022-05-06 DOI: 10.1215/03616878-9978131

Robin C. Feldman, Brent D. Fulton, Jamie R. Godwin, R. Scheffler

{"title":"Challenges with Defining Pharmaceutical Markets and Potential Remedies to Screen for Industry Consolidation.","authors":"Robin C. Feldman, Brent D. Fulton, Jamie R. Godwin, R. Scheffler","doi":"10.1215/03616878-9978131","DOIUrl":"https://doi.org/10.1215/03616878-9978131","url":null,"abstract":"CONTEXT\u0000Dramatic increases in pharmaceutical merger and acquisition activity since 2010 suggest we are currently in the midst of a third wave of industry consolidation.\u0000\u0000\u0000METHODS\u0000Reviewing 168 economic, legal, medical, industry, and government sources, we examine the effects of consolidation on competition and innovation and explore how industry attributes complicate M&A regulation in a pharmaceutical context.\u0000\u0000\u0000FINDINGS\u0000We find that, in spite of certain metrics that might argue otherwise, consolidation consistently reduces innovation and harms the public good. We also find that several factors within the pharmaceutical industry impede proper evaluation of proposed mergers. Because consumer choice across substitutes is limited, pharmaceutical markets frustrate conventional methods of defining markets. Volume bargaining in the pharmaceutical supply chain and common ownership of pharmaceutical firms by asset managers further complicate the definitional process. Hence, the Herfindahl-Hirschman Index (HHI), one measure used by the Federal Trade Commission and Department of Justice to screen for concerning M&A activity, sometimes depends on faulty market definitions but also fails to capture the implications of consolidation on future market share.\u0000\u0000\u0000CONCLUSIONS\u0000We describe ways to improve how pharmaceutical markets are defined, highlight quantitative alterations to HHI to account for common ownership, and propose areas requiring further research.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2022-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89199310","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

The Link between Democratic Institutions and Population Health in the American States. 美洲各州民主制度与人口健康之间的联系。

IF 4.2 3区医学

Journal of Health Politics Policy and Law Pub Date : 2022-05-06 DOI: 10.1215/03616878-9978103

Julianna Pacheco, Scott J. LaCombe

{"title":"The Link between Democratic Institutions and Population Health in the American States.","authors":"Julianna Pacheco, Scott J. LaCombe","doi":"10.1215/03616878-9978103","DOIUrl":"https://doi.org/10.1215/03616878-9978103","url":null,"abstract":"CONTEXT\u0000This project investigates the role of state-level institutions in explaining variation in population health in the American states. Although cross-national research has established the positive effects of democracy on population health, little attention has been given to subnational units. We leverage a new dataset to understand how political accountability and a system of checks and balances are associated with state population health.\u0000\u0000\u0000METHOD\u0000We estimate error correction models and two-way fixed effects models to estimate how the strength of state-level democratic institutions are associated with infant mortality rates, life expectancy, and midlife mortality.\u0000\u0000\u0000FINDINGS\u0000We find that institutions that promote political accountability are related to lower infant mortality across the states, while those that promote checks and balances are associated with longer life expectancy. We also find that policy liberalism is associated with better health outcomes.\u0000\u0000\u0000CONCLUSIONS\u0000Subnational institutions play an important role in population health outcomes and more research is needed to understand the linkage between democracy and health. We are the first to explore the link between democratic institutions and population health within the United States contributing to both the social science literature on the positive effects of democracy and the epidemiological literature on subnational health outcomes.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2022-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81074775","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: 1