Inquiry-The Journal of Health Care Organization Provision and Financing最新文献

{"title":"Association of Hospital Consolidation with Cancer Outcomes.","authors":"Justin Graff, Mahnoor Ayub, Prashanth Prabakaran, Brendan Keelan, John D Cramer","doi":"10.1177/00469580251314954","DOIUrl":"10.1177/00469580251314954","url":null,"abstract":"<p><p>Hospital mergers have increased significantly since 2010, driven by factors such as healthcare policy changes, reimbursement, economies of scale, and quality improvement goals. However, limited evidence exists about how these mergers affect the quality of care and cancer outcomes. We conducted a difference-in-differences analysis to assess the impact of hospital consolidation on cancer outcomes. Using data from the Surveillance, Epidemiology, and End Results (SEER) program, we identified cancer patients diagnosed between 2008 and 2016, then used the Health Cost Institute's Healthy Marketplace Index to assess hospital consolidation as measured by the Herfindahl-Hirschman Index (HHI). The HHI is a measure of market concentration and competition between firms in a given industry. We found that increases in hospital consolidation were associated with a higher likelihood of early-stage cancer diagnosis compared to control areas (-1.1%, 95% confidence interval (CI) -2.3 to 0.0%), and improved overall survival (hazard ratio 0.94, CI 0.90-0.98). These improvements were restricted to cancers with screening recommendations. Our study suggests that hospital consolidation may have some benefits for cancer patients. However, these benefits may not be evenly distributed across all cancer types. Further research is needed to confirm these findings and to understand the mechanisms by which hospital consolidation affects cancer outcomes.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251314954"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054381","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}

{"title":"Re-Engagement in Physical Activity Slows the Decline in Older Adults' Well-Being - A Longitudinal Study.","authors":"Hon Lon Tam, Kai Chow Choi, Ying Lau, Leona Yuen Ling Leung, Alex Siu Wing Chan, Lilin Zhou, Eliza Mi Ling Wong, Jonathan Ka Ming Ho","doi":"10.1177/00469580251314776","DOIUrl":"10.1177/00469580251314776","url":null,"abstract":"<p><p>Physical activity is recommended for older adults; however, the benefits of previous active engagement in physical activity that can be sustained after one becomes inactive remain to be determined. This study investigated the longitudinal associations between physical activity engagement patterns and older adults' well-being. This population-based cohort study used data from the China Health and Retirement Longitudinal Study between 2015 and 2020. People aged 60 years and above were included, and they were categorized as active engagers if they reported engaging in at least 10 min of moderate and/or vigorous exercise consecutively per week in each survey year. Older adults' well-being was evaluated using the healthy aging score, and geographical variations were visualized. The generalized estimating equations model was adopted to examine the differences between various physical activity engagement patterns and older adults' well-being. Among the 3300 older adults (50.5% men; age 66.9 ± 5.7 years) during the five years of follow-up, engagement in physical activity increased from 31.7% to 59.6%. However, their well-being decreased gradually, especially among those who were inactive engagers (beta = -0.20 to -0.21). Physical activity engagement patterns appeared to slow decline in well-being. Geographical variations were noted, with more favorable healthy aging scores observed in northern China than in southern China. As older adults age, well-being deteriorates, and disengagement of physical activity accelerates the rate of decline. Re-engagement in physical activity can slow the rate of decline in well-being. Early identification of and intervention in inactive engagement in physical activity reduce the detrimental effects on older adult's well-being. A national health initiative is an effective strategy to create a supportive environment for older adults to continue and engage in physical activity. The participation of healthcare professionals and community parties is important to encourage and engage older adults in physical activity.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251314776"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015648","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}

{"title":"The Predictors of Dietary Supplement Use Among Women With Musculoskeletal Disease: A Population-Based Complex Sample Designed Study.","authors":"Myoungjin Kwon, Sun Ae Kim, Youngshin Song","doi":"10.1177/00469580251314770","DOIUrl":"10.1177/00469580251314770","url":null,"abstract":"<p><p>Supplement use is influenced by personal factors such as sex, knowledge, health status, and sociocultural factors. Korean women with musculoskeletal disease commonly use dietary supplements for purposes such as symptom relief. This study aimed to identify the differences in demographics, health status, and functional health literacy depending on the use of dietary supplements in Korean women with musculoskeletal disease. A cross-sectional study and secondary data analysis were designed using a representative, multilevel stratified cluster sample from the 8th wave (2019) of the National Health and Nutrition Examination Survey, a national statistical survey encompassing health status, health behaviors, and food and nutrient consumption. Data on 804 women aged 20 years or older with musculoskeletal disease were included. A complex samples χ²-test was conducted to compare all variables such as demographics, health status, and functional health literacy. As results, significant differences were found between the dietary supplement user and non-user groups in terms of age (χ² = 12.21, <i>P</i> = .009), type of health insurance (χ² = 4.01, <i>P</i> = .049), education level (χ² = 42.86, <i>P</i> < .001), and presence of diabetes mellitus (χ² = 9.16, <i>P</i> = .005). Functional health literacy was higher in the user group than in the non-user group (χ² = 5.48, <i>P</i> = .050). We found that younger individuals with health insurance, higher educational levels, and functional health literacy, and who do not have diabetes are likely to use dietary supplements. Healthcare providers should continue to monitor the use of dietary supplements among women with musculoskeletal diseases to ensure their safe and effective use.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251314770"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016033","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}

{"title":"Examples from US Policies to Reduce Oversupply and Overutilization: Lessons for the Japanese Health Care System.","authors":"Jared Lane K Maeda","doi":"10.1177/00469580241310757","DOIUrl":"10.1177/00469580241310757","url":null,"abstract":"<p><p>The Japanese health care system provides universal coverage with relatively low cost sharing and patients have a free choice of providers. Although Japan's government price controls have helped to restrain the growth in health care spending, the country's rapidly growing elderly population and adoption of new drugs and technologies have placed increased fiscal pressures on its health care system. Additionally, the Japanese health care system does not have the infrastructure in place to restrain utilization, which may be a key driver of increases in health care spending. Although the US health care system has many shortcomings, such as the highest health care prices among developed countries and a significant uninsured population, it has been able to manage utilization by using various tools, such as prior authorization and gatekeeping. The US health care system might be able to offer Japan some lessons on ways to reduce unnecessary utilization and supply to create greater value in its health care system.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580241310757"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933333","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}

{"title":"Exploring Barriers, Facilitators, and Needs Related to Mental Health Promotion for Police Officers: A Qualitative Approach.","authors":"Gi Wook Ryu, Ji Yeon Lee","doi":"10.1177/00469580251317931","DOIUrl":"10.1177/00469580251317931","url":null,"abstract":"<p><p>Police officers are vulnerable to psychological distress and trauma since they are constantly exposed to significant physical and mental violence. Poor mental health can lead to increased healthcare costs for individuals, organizations, and nations and negatively impacts public safety. Mental health interventions tailored to the nature of police work are needed; however, a research gap exists regarding understanding the mental health of police officers. This study aimed to explore the barriers, facilitators, and needs for mental health promotion among police officers. This study adopted a qualitative approach in South Korea. Twelve police officers working in a metropolitan city were recruited using purposive sampling methods. One-on-one interviews were conducted with open-ended questions regarding barriers, facilitators, and needs for improving mental health. Content analysis was used to derive relevant themes. The participants included 3 women and 9 men, with an average age of 37.8 years and working experience of 12.6 years. Three themes and 9 subcategories emerged. The theme related to barriers was \"difficulty accessing resources\"; the theme related to facilitators was \"supportive environment for mental health prevention and management\"; and the theme related to needs was \"education and policies to promote mental health.\" Considering the occupational and organizational characteristics of the police profession, individual and organizational interventions and policies are needed to adequately manage the mental health of police officers.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251317931"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082315","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}

{"title":"High Medication Non-Adherence Rates and its Drivers in the General Population: A Cross-sectional Study Using the OMAS-37 Adherence Survey Tool.","authors":"Rønnaug Eline Larsen, Ala Karimi, Tonje Krogstad, Cecilie Johannessen Landmark, Lene Berge Holm","doi":"10.1177/00469580251321596","DOIUrl":"10.1177/00469580251321596","url":null,"abstract":"<p><p>Substantial variability in patients' medication adherence underscores the key significance of pharmacists and other healthcare providers proactively aiding individuals in achieving optimal medication outcomes. Medication-taking behaviours, barriers, and beliefs varies significantly among medication users. It is crucial to ascertain these factors when designing adherence interventions. The OsloMet Adherence-to-medication Survey tool (OMAS-37) is designed to quantify the degree of adherence, and to assess 37 unique causes for non-adherence. The aim of this study was to assess non-adherence among medication users in the general population utilising the OMAS-37 tool. A cross sectional study among medication users in Norway was conducted in 2021. The features of the general population and three patient subgroups-cardiovascular, pain, and mental health disorders-were characterized and compared using Kruskal-Wallis tests. Of the 812 participants, with a median age of 50 (IQR 37-59) and 91% (n = 736) identifying as female, 64% (n = 517) exhibited high non-adherence scores indicating poor medication. Main reasons included forgetfulness (42%, n = 343), perceived improvement in health (40%, n = 326), and fear of adverse drug reactions (39%, n = 320). Statistically significant positive adherence factors encompassed increasing age, higher education, medication decision involvement, and pill organiser usage. The cardiovascular subgroup exhibited significantly better adherence than the pain and mental health disorders subgroups. The total sample and all three subgroups demonstrated some variation in the main causes for non-adherence. This first study employing OMAS-37 reveals high non-adherence levels and varying causes of non-adherence among different patient groups, emphasizing the need for targeted adherence interventions.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251321596"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494556","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}

{"title":"Acceptability and Efficacy of an Adapted School-Based Dialectical Behavioral Therapy Skills Group for Adolescents: A Qualitative Perspective.","authors":"MacKenzie Whitener, Shirin Khazvand, Ian Carson, Anna Martin, Michelle Salyers, Melissa Cyders, Matthew Aalsma, Tamika Zapolski","doi":"10.1177/00469580251314279","DOIUrl":"10.1177/00469580251314279","url":null,"abstract":"<p><p>Adolescence is characterized by heightened emotion dysregulation, impulsivity, and engagement in high-risk behaviors, such as substance use, violence, and unprotected sexual activity. Dialectical Behavioral Therapy for Adolescents (DBT-A) is an evidence-based intervention that targets emotion regulation and impulsivity among adolescents, proven effective at decreasing high-risk behaviors. However, limited research exists on adolescents' perceptions of DBT-A, particularly in schools. The current study aimed to understand adolescents' perspectives on a DBT-A skills group delivered within urban high schools in a midwestern state. The study sample of 18 youth (mean age 14.7; 66.7% male; 38.9% Black) completed individual semi-structured qualitative interviews assessing their perspectives on the DBT-A skills group. Interview topics included the program's impact on youths' daily lives, risk-taking behaviors, skill acquisition, and general feedback about the group. Fifteen of the eighteen participants (86%) reported acceptability of the program, expressing that they enjoyed the content and would recommend the group to peers. Participants observed positive impacts on their daily lives, including self-reported enhanced ability to regulate their emotions, communicate with teachers, effectively adapt their mindsets and motivations, and make healthy relationship decisions. Additionally, some noted an increased feeling of connection to their peers following the group. Delivering the DBT-A skills group in schools was shown to have high rates of acceptability among youth and resulted in improved emotion regulation and reduced impulsivity. Further research is needed to assess long-term effects of this program and to identify best training practices for school staff to implement and sustain the program long-term.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251314279"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030407","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}

{"title":"Acceptability and Future Considerations for Telegenetic Counseling After the COVID Pandemic: Interviews with Genetic Counselors, Clinicians, and Patients.","authors":"Meghan C Martinez, Nina Szwerinski, Su-Ying Liang, Sharon Chan, Monique de Bruin, Cheryl D Stults","doi":"10.1177/00469580251314747","DOIUrl":"10.1177/00469580251314747","url":null,"abstract":"<p><p>While telegenetic counseling has increased substantially since the start of the COVID-19 pandemic, previous studies reported concerns around building rapport, nonverbal communication, and the patient-counselor relationship. This qualitative evaluation elicited feedback from genetic counselors, referring clinicians, and patients from a single healthcare organization to understand the user-driven reasons for overall satisfaction and experience. We conducted 22 in-depth, semi-structured interviews with participants from all 3 groups between February 2022 and February 2023. Interview recordings were transcribed and analyzed using a pragmatic thematic approach. Participants across all groups felt the style and content of the genetic counseling visit lent itself perfectly to telegenetics specifically because of no physical exam component. Most patient and counselor participants expressed having the genetic counseling over phone or video had no impact on the patient-counselor relationship or the amount of trust and emotional connection they were able to achieve remotely. Preference for visit type can be influenced by in-person masking requirements impeding full facial expressions or expressing strong emotions over phone. All respondents expressed strong support for all modalities going forward. Counselors with broad experience across platforms should be the focus of future recruitment as should patient education around the nature of the genetic counseling visit and the accuracy of various testing options. Telegenetic programs should consider perspectives from all 3 groups to ensure that specific needs of each are addressed.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251314747"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030410","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}

{"title":"How Individuals Seeking Help for Substance Use Disorder Adjusted to Virtual 12-Step Meetings During the COVID-19 Pandemic.","authors":"Connie Hassett-Walker","doi":"10.1177/00469580251320767","DOIUrl":"10.1177/00469580251320767","url":null,"abstract":"<p><p>Technology-based online support services are emerging as a resource for people recovering from substance abuse. This study presents findings on how individuals seeking help for a substance use disorder through 12-step fellowship meetings (Alcoholics Anonymous, Narcotics Anonymous) adjusted to virtual rather than in-person meetings during the COVID-19 pandemic. Fifty individuals (50) were interviewed, recruited primarily from 12-step meetings in 3 locations in a rural New England state in the United States. Subjects were asked about whether they had attended virtual meetings during the pandemic, how online meetings compare to in-person meetings, and if they encountered any obstacles when attending virtual meetings (eg, Internet connectivity). More individuals preferred in-person meetings for a variety of reasons, although many participants were willing to give virtual meetings a try. Some participants continued to attend virtual meetings, even after in-person meetings returned. Positives of virtual recovery meetings included convenience and the fact that they could be accessed from anywhere. Internet connectivity and technical difficulties presented a challenge for some. Some individuals were unable to focus in virtual meetings and got easily distracted. Digital recovery support services should continue to be offered as some recovering individuals find them helpful. Virtual meetings are a resource, particularly for those individuals living in rural areas without many in-person resources readily available, or access to adequate transportation. Treatment providers working in rural states may consider advocating to policymakers for quality Internet services (eg, high-speed broadband access), to sufficiently meet residents' treatment and other healthcare needs.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251320767"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525267","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}

{"title":"Professional Identity and Self-efficacy Among Occupational Therapy Students Engaged in Objective Structured Clinical Examination Utilizing Simulation Learning.","authors":"Hassan Izzeddin Sarsak","doi":"10.1177/00469580251315351","DOIUrl":"10.1177/00469580251315351","url":null,"abstract":"<p><p>Objective structured clinical examination (OSCE) is widely used in health programs and has been applied in medical education to enhance clinical knowledge and help build clinical competence and confidence. It is carried out in different clinical stations that simulate real clinical situations and scenarios and helps prepare students for clinical training and practical applications. The purpose of this study was to investigate the change in professional identity and self-efficacy of occupational therapy students after applying OSCE utilizing simulated learning. A pre-post study design was used. The participants were 48 occupational therapy university students at 1 university in Saudi Arabia. Total scores and subscale scores for professional identity and self-efficacy were compared before and after OSCE using the Wilcoxon signed- rank test. Spearman's rank correlation coefficient was calculated to examine the relationship between professional identity and self-efficacy. There were significant increases in both professional identity and self-efficacy total scores after OSCE (<i>P</i> < .05). Most items in the professional identity, such as choosing occupational therapy again (<i>P</i> < .01) and improving occupational therapy skills (<i>P</i> < .01) and the self-efficacy, such as doing very well in class (<i>P</i> < .01) and ability to learn the material for class (<i>P</i> < .01) increased significantly. OSCE utilizing simulated-based learning plays a supportive role in forming occupational therapy students' identities as clinicians and can potentially enhance their overall self-efficacy, professional identity and growth. It is a beneficial teaching and learning strategy for occupational therapy educators and considered important steppingstones for students transitioning to real life occupational therapy practice.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251315351"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048894","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}