International Journal of Health Services最新文献

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Climate Change and Human Well-Being in the 2020s: Lessons From 2020. 21世纪20年代的气候变化与人类福祉:从2020年开始的教训。
IF 3.4 4区 医学
International Journal of Health Services Pub Date : 2021-07-01 Epub Date: 2021-04-28 DOI: 10.1177/00207314211012155
Mary C Sheehan
{"title":"Climate Change and Human Well-Being in the 2020s: Lessons From 2020.","authors":"Mary C Sheehan","doi":"10.1177/00207314211012155","DOIUrl":"https://doi.org/10.1177/00207314211012155","url":null,"abstract":"<p><p>Behind the coronavirus headlines the year 2020 set multiple extreme weather records, including unprecedented wildfires in Australia and California, massive flooding in China, and back-to-back hurricanes in Central America. The impacts on the well-being of local populations have been devastating. We reviewed these extreme weather events, together with the year's newly published climate and health science reports, and identified three important themes for building health resilience in the decade ahead: (1) preparing for greater magnitude and intensity of climate hazards, extreme events, and population health impacts; (2) better anticipating cascading and compound impacts on population well-being, particularly for the most vulnerable; and (3) identifying appropriate, effective preparedness tools and strategies. While decarbonizing the economy is the urgent goal to protect both human and planetary health from a changing climate, 2020 demonstrates that recognizing the likely magnitude and complexity of future extreme weather events, and preparing local public health agencies and communities with the knowledge and tools to respond to them, will be essential in this critical decade.</p>","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00207314211012155","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38849719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 4
Health Inequalities in the Time of COVID-19: The Globally Reinforcing Need to Strengthen Health Inequalities Research Capacities. 新冠肺炎时期的健康不平等:全球加强健康不平等研究能力的必要性。
IF 3.4 4区 医学
International Journal of Health Services Pub Date : 2021-07-01 Epub Date: 2021-03-08 DOI: 10.1177/0020731421993939
Lucinda Cash-Gibson, Juan M Pericàs, Eliana Martinez-Herrera, Joan Benach
{"title":"Health Inequalities in the Time of COVID-19: The Globally Reinforcing Need to Strengthen Health Inequalities Research Capacities.","authors":"Lucinda Cash-Gibson,&nbsp;Juan M Pericàs,&nbsp;Eliana Martinez-Herrera,&nbsp;Joan Benach","doi":"10.1177/0020731421993939","DOIUrl":"10.1177/0020731421993939","url":null,"abstract":"<p><p>The full impact of coronavirus disease 2019 (COVID-19) is yet to be well established; however, as the pandemic spreads, and early results emerge, unmet needs are being revealed, and pressing questions are being asked about who is most affected, how, where, and in what ways government responses might be exacerbating inequalities. A number of scholars have called for more in-depth critical research on COVID-19 and health inequalities to produce a strong empirical evidence based on these issues. There are also justifiable concerns about the scarcity of health-equity actions oriented analyses of the situation and calls for more empirical evidence on COVID-19 and health inequalities. A preliminary condition to establish this type of information is strong capacity to conduct health inequalities research. Worldwide, however, this type of capacity is limited, which, alongside other challenges, will likely hinder capacities of many countries to develop comprehensive equity-oriented COVID-19 analyses, and adequate responses to present and future crises. The current pandemic reinforces the pending need to invest in and strengthen these research capacities. These capacities must be supported by widespread recognition and concern, cognitive social capital, and greater commitment to coordinated, transparent action, and responsibility. Otherwise, we will remain inadequately prepared to respond and meet our society's unmet needs.</p>","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0020731421993939","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25459549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 16
Assessing the Impact of Individual Characteristics and Neighborhood Socioeconomic Status During the COVID-19 Pandemic in the Provinces of Milan and Lodi. 评估米兰和洛迪省COVID-19大流行期间个人特征和社区社会经济地位的影响
IF 3.4 4区 医学
International Journal of Health Services Pub Date : 2021-07-01 Epub Date: 2021-03-02 DOI: 10.1177/0020731421994842
David Consolazio, Rossella Murtas, Sara Tunesi, Federico Gervasi, David Benassi, Antonio Giampiero Russo
{"title":"Assessing the Impact of Individual Characteristics and Neighborhood Socioeconomic Status During the COVID-19 Pandemic in the Provinces of Milan and Lodi.","authors":"David Consolazio,&nbsp;Rossella Murtas,&nbsp;Sara Tunesi,&nbsp;Federico Gervasi,&nbsp;David Benassi,&nbsp;Antonio Giampiero Russo","doi":"10.1177/0020731421994842","DOIUrl":"https://doi.org/10.1177/0020731421994842","url":null,"abstract":"<p><p>Social inequalities in health are known to be influenced by the socioeconomic status of the territory in which people live. In the context of the ongoing coronavirus disease 2019 (COVID-19) pandemic, this study is aimed at assessing the role of 5 area-level indicators in shaping the risk of contagion in the provinces of Milan and Lodi (Lombardy, Italy), namely: educational disadvantage, unemployment, housing crowding, mobility, and population density. The study area includes the municipalities at the origin of the first Italian epidemic outbreak. Data on COVID-19 patients from the <i>Integrated Datawarehouse for COVID Analysis</i> in Milan were used and matched with aggregate-level data from the National Institute of Statistics Italy (Istat). Multilevel logistic regression models were used to estimate the association between the census block-level predictors and COVID-19 infection, independently of age, sex, country of birth, and preexisting health conditions. All the variables were significantly associated with the outcome, with different effects before and after the lockdown and according to the province of residence. This suggests a pattern of socioeconomic inequalities in the outbreak, which should be taken into account in the eventuality of future epidemics to contain their spread and its related disparities.</p>","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0020731421994842","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25426928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 29
Classism and Everyday Racism as Experienced by Racialized Health Care Users: A Concept Mapping Study. 种族化的医疗保健使用者所经历的阶级主义和日常种族主义:一项概念映射研究。
IF 3.4 4区 医学
International Journal of Health Services Pub Date : 2021-07-01 Epub Date: 2021-05-05 DOI: 10.1177/00207314211014782
Deb F Mahabir, Patricia O'Campo, Aisha Lofters, Ketan Shankardass, Christina Salmon, Carles Muntaner
{"title":"Classism and Everyday Racism as Experienced by Racialized Health Care Users: A Concept Mapping Study.","authors":"Deb F Mahabir,&nbsp;Patricia O'Campo,&nbsp;Aisha Lofters,&nbsp;Ketan Shankardass,&nbsp;Christina Salmon,&nbsp;Carles Muntaner","doi":"10.1177/00207314211014782","DOIUrl":"https://doi.org/10.1177/00207314211014782","url":null,"abstract":"<p><p>In Toronto, Canada, 51.5 % of the population are members of racialized groups. Systemic labor market racism has resulted in an overrepresentation of racialized groups in low-income and precarious jobs, a racialization of poverty, and poor health. Yet, the health care system is structured around a model of service delivery and policies that fail to consider unequal power social relations or racism. This study examines how racialized health care users experience classism and everyday racism in the health care setting and whether these experiences differ within stratifications such as social class, gender, and immigration status. A concept mapping design was used to identify mechanisms of classism and everyday racism. For the rating activity, 41 participants identified as racialized health care users. The data analysis was completed using concept systems software. Racialized health care users reported \"race\"/ethnic-based discrimination as moderate to high and socioeconomic position-/social class-based discrimination as moderate in importance for the challenges experienced when receiving health care; differences within stratifications were also identified. To improve access to services and quality of care, antiracist policies that focus on unequal power social relations and a broader systems thinking are needed to address institutional racism within the health care system.</p>","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00207314211014782","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38950985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 12
Why Asian Countries are Controlling the Pandemic Better Than the United States and Western Europe. 为什么亚洲国家比美国和西欧控制得更好?
IF 3.4 4区 医学
International Journal of Health Services Pub Date : 2021-04-01 Epub Date: 2021-03-11 DOI: 10.1177/0020731421999930
Vicente Navarro
{"title":"Why Asian Countries are Controlling the Pandemic Better Than the United States and Western Europe.","authors":"Vicente Navarro","doi":"10.1177/0020731421999930","DOIUrl":"https://doi.org/10.1177/0020731421999930","url":null,"abstract":"<p><p>The coronavirus pandemic has shed light on the detrimental impact of neoliberal policies on public health and well-being and as a result, there have been calls for increases in public spending to rectify the lack of public health services. However, neoliberal right-wing parties have dismissed such calls, pointing instead to Asian countries as examples in successfully controlling the pandemic without high public health spending, attributing this to the entrepreneurial orientation of their governments, as opposed to their public services. This article refutes this idea, instead charting the reasons that Asian countries have better controlled the pandemic including prior experience of pandemics, cultural factors, and various successful public health policies. The article concludes by looking at the example of Trump and demonstrating the inadequacies of the business model for dealing with the coronavirus pandemic.</p>","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0020731421999930","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25461124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 12
The Promise of Science, Knowledge Mobilization, and Rapid Learning Systems for COVID-19 Recovery. 科学、知识动员和快速学习系统对COVID-19恢复的承诺。
IF 3.4 4区 医学
International Journal of Health Services Pub Date : 2021-04-01 Epub Date: 2021-03-18 DOI: 10.1177/0020731421997089
Meghan McMahon, Marisa I Creatore, Erin Thompson, Andrea Morgan Lay, Steven J Hoffman, Diane T Finegood, Richard H Glazier
{"title":"The Promise of Science, Knowledge Mobilization, and Rapid Learning Systems for COVID-19 Recovery.","authors":"Meghan McMahon,&nbsp;Marisa I Creatore,&nbsp;Erin Thompson,&nbsp;Andrea Morgan Lay,&nbsp;Steven J Hoffman,&nbsp;Diane T Finegood,&nbsp;Richard H Glazier","doi":"10.1177/0020731421997089","DOIUrl":"https://doi.org/10.1177/0020731421997089","url":null,"abstract":"<p><p>The health, economic, and social crises created by the coronavirus disease 2019 (COVID-19) pandemic have been global in scope and inequitable in impact. The global road to recovery can be enhanced with robust, relevant, and timely scientific evidence. This commentary seeks to illustrate the power of science, scientific collaboration, and innovative research funding programs to inform pandemic recovery and inspire transformational changes for a more equitable, resilient, and sustainable future. Specifically, this commentary provides an introduction to the United Nations (UN) Research Roadmap for the COVID-19 Recovery that was published in November 2020. It introduces 5 scoping reviews that helped inform the UN Research Roadmap and that are now available open access within this series of special papers, and it provides an overview of an innovative research funding program that facilitated rapid mobilization and collaboration to produce the scoping reviews. The publication of the scoping reviews in this journal series will help complement and amplify the UN Research Roadmap by furthering knowledge mobilization efforts and informing COVID-19 recovery around the world, to ensure a more equitable, resilient, and sustainable postpandemic future.</p>","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0020731421997089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25502645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Health Care Crisis Unabated: A Review of Recent Data on Health Care in the United States. 卫生保健危机有增无减:对美国卫生保健最新数据的回顾。
IF 3.4 4区 医学
International Journal of Health Services Pub Date : 2021-04-01 Epub Date: 2020-12-17 DOI: 10.1177/0020731420981497
David U Himmelstein, Steffie Woolhandler
{"title":"Health Care Crisis Unabated: A Review of Recent Data on Health Care in the United States.","authors":"David U Himmelstein,&nbsp;Steffie Woolhandler","doi":"10.1177/0020731420981497","DOIUrl":"https://doi.org/10.1177/0020731420981497","url":null,"abstract":"<p><p>We review recently published studies of US health policy and the nation's health care system. Even prior to the COVID-19 pandemic, health inequalities were widening and care was inequitably distributed. Although the Affordable Care Act's coverage expansion improved access to care and timely cancer diagnoses, a large proportion of US residents continued to avoid medical care due to concerns about costs, and access to mental health services remains particularly inadequate. Yet more evidence of private insurers' profit-driven misbehaviors and of corruption among medical leaders continues to emerge. Misguided incentives and lax regulation encourages nominally nonprofit health care providers to mimic for-profits' misconduct, and rapacious investors own and control an increasing share of physicians' practices. Pharmaceutical firms wield outsize political influence and devote far more funds to rewarding investors than to research and development effort. Yet despite vigorous efforts by pharma and other commercial interests to denigrate national health insurance, polls indicate that the COVID-19 pandemic has led to increasing support for such reform.</p>","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0020731420981497","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38723466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 2
COVID-19 and Precarious Employment: Consequences of the Evolving Crisis. 2019冠状病毒病与不稳定就业:危机演变的后果。
IF 3.4 4区 医学
International Journal of Health Services Pub Date : 2021-04-01 Epub Date: 2021-01-11 DOI: 10.1177/0020731420986694
Nuria Matilla-Santander, Emily Ahonen, Maria Albin, Sherry Baron, Mireia Bolíbar, Kim Bosmans, Bo Burström, Isabel Cuervo, Letitia Davis, Virginia Gunn, Carin Håkansta, Tomas Hemmingsson, Christer Hogstedt, Johanna Jonsson, Mireia Julià, Katarina Kjellberg, Bertina Kreshpaj, Wayne Lewchuk, Carles Muntaner, Patricia O'Campo, Cecilia Orellana, Per-Olof Östergren, Eva Padrosa, Marisol E Ruiz, Christophe Vanroelen, Emilia Vignola, Alejandra Vives, David H Wegman, Theo Bodin
{"title":"COVID-19 and Precarious Employment: Consequences of the Evolving Crisis.","authors":"Nuria Matilla-Santander,&nbsp;Emily Ahonen,&nbsp;Maria Albin,&nbsp;Sherry Baron,&nbsp;Mireia Bolíbar,&nbsp;Kim Bosmans,&nbsp;Bo Burström,&nbsp;Isabel Cuervo,&nbsp;Letitia Davis,&nbsp;Virginia Gunn,&nbsp;Carin Håkansta,&nbsp;Tomas Hemmingsson,&nbsp;Christer Hogstedt,&nbsp;Johanna Jonsson,&nbsp;Mireia Julià,&nbsp;Katarina Kjellberg,&nbsp;Bertina Kreshpaj,&nbsp;Wayne Lewchuk,&nbsp;Carles Muntaner,&nbsp;Patricia O'Campo,&nbsp;Cecilia Orellana,&nbsp;Per-Olof Östergren,&nbsp;Eva Padrosa,&nbsp;Marisol E Ruiz,&nbsp;Christophe Vanroelen,&nbsp;Emilia Vignola,&nbsp;Alejandra Vives,&nbsp;David H Wegman,&nbsp;Theo Bodin","doi":"10.1177/0020731420986694","DOIUrl":"https://doi.org/10.1177/0020731420986694","url":null,"abstract":"<p><p>The world of work is facing an ongoing pandemic and an economic downturn with severe effects worldwide. Workers trapped in precarious employment (PE), both formal and informal, are among those most affected by the COVID-19 pandemic. Here we call attention to at least 5 critical ways that the consequences of the crisis among workers in PE will be felt globally: (<i>a</i>) PE will increase, (<i>b</i>) workers in PE will become more precarious, (<i>c</i>) workers in PE will face unemployment without being officially laid off, (<i>d</i>) workers in PE will be exposed to serious stressors and dramatic life changes that may lead to a rise in diseases of despair, and (<i>e</i>) PE might be a factor in deterring the control of or in generating new COVID-19 outbreaks. We conclude that what we really need is a new social contract, where the work of all workers is recognized and protected with adequate job contracts, employment security, and social protection in a new economy, both during and after the COVID-19 crisis.</p>","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0020731420986694","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38808066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 51
COVID-19 Economic Response and Recovery: A Rapid Scoping Review. 2019冠状病毒病经济应对与复苏:快速评估。
IF 3.4 4区 医学
International Journal of Health Services Pub Date : 2021-04-01 Epub Date: 2021-03-18 DOI: 10.1177/00207314211002785
Farah N Mawani, Virginia Gunn, Patricia O'Campo, Michelle Anagnostou, Carles Muntaner, Susitha Wanigaratne, Melissa Perri, Carolyn Ziegler, Angie An
{"title":"COVID-19 Economic Response and Recovery: A Rapid Scoping Review.","authors":"Farah N Mawani,&nbsp;Virginia Gunn,&nbsp;Patricia O'Campo,&nbsp;Michelle Anagnostou,&nbsp;Carles Muntaner,&nbsp;Susitha Wanigaratne,&nbsp;Melissa Perri,&nbsp;Carolyn Ziegler,&nbsp;Angie An","doi":"10.1177/00207314211002785","DOIUrl":"https://doi.org/10.1177/00207314211002785","url":null,"abstract":"This rapid scoping review of existing evidence and research gaps addressed the following question: what research evidence exists and what are the research gaps at global, regional, and national levels on interventions to protect jobs, small- and medium-sized enterprises, and formal/informal sector workers in socioeconomic response to the coronavirus disease 2019 (COVID-19) pandemic? The results are based on 79 publications deemed eligible for inclusion after the screening and prioritizing of 1,658 records. The findings are organized according to the 3 main categories of socioeconomic interventions—protecting jobs, enterprises, and workers—although the 3 are intertwined. Most results were derived from global-level gray literature with recommendations for interventions and implicit links to the sustainable development goals. Based on research gaps uncovered in the review, future implementation science research needs to focus on designing, implementing, evaluating, and scaling: effective evidence-based socioeconomic interventions; equity-focused, redistributive, and transformative interventions; comprehensive packages of complementary interventions; interventions to upend root causes of systemic social inequities; collaborative and participatory approaches; interventions that integrate environmental sustainability; and city-level interventions. Failing to consider the environmental dimensions of economic recovery is shortsighted and will ultimately exacerbate social inequities and poverty and undermine economic stability in the long term.","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00207314211002785","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25491429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 15
Will For-Profits Keep Up the Pace in the United States? The Future of the Program of All-Inclusive Care for the Elderly and Implications for Other Programs Serving Medically Vulnerable Populations. 非营利组织在美国能跟上步伐吗?老年人全包护理计划的未来及其对其他医疗弱势群体服务计划的影响。
IF 3.4 4区 医学
International Journal of Health Services Pub Date : 2021-04-01 Epub Date: 2020-10-05 DOI: 10.1177/0020731420963946
Lori Gonzalez
{"title":"Will For-Profits Keep Up the Pace in the United States? The Future of the Program of All-Inclusive Care for the Elderly and Implications for Other Programs Serving Medically Vulnerable Populations.","authors":"Lori Gonzalez","doi":"10.1177/0020731420963946","DOIUrl":"https://doi.org/10.1177/0020731420963946","url":null,"abstract":"<p><p>The Program of All-Inclusive Care for the Elderly (PACE) has provided, for more than 4 decades, high-quality, cost-effective medical and social care to older people in the United States under nonprofit ownership. Recent rulings by the Centers for Medicare & Medicaid Services (CMS), however, will fundamentally change the initial intent and operation of the program. CMS's final rule (4168-F) removes the provision that PACE operators be nonprofit. This article provides the legislative background for the final ruling and critiques the study that was used to justify the removal of the nonprofit provision. Although the Balanced Budget Act of 1997 listed a number of requirements for evaluating for-profit PACE programs, the secretary of the Department of Health and Human Services did not follow them before establishing for-profit PACE sites as permanent providers. It also argues that the ruling was made without much evidence that for-profit compared to nonprofit operators can provide a similar level of quality of care, access, and cost-effectiveness and urges policymakers to increase regulatory accountability, given what we know about other shifts in profit status and health care.</p>","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0020731420963946","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38558540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 4
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