Health affairs scholar最新文献_第2页

Growing divergence between Medicare Advantage plan bids and payments to plans. 医疗保险优势计划的出价与支付给计划的费用之间的差异越来越大。

Health affairs scholar Pub Date : 2024-08-05 eCollection Date: 2024-08-01 DOI: 10.1093/haschl/qxae093

Grace McCormack, Erin Trish

引用次数: 0

Development and validation of a community risk score for sexual and reproductive health in the United States. 美国性健康和生殖健康社区风险评分的开发和验证。

Health affairs scholar Pub Date : 2024-07-27 eCollection Date: 2024-07-01 DOI: 10.1093/haschl/qxae048

Lisa M Lines, Christina I Fowler, Yevgeniya Kaganova, Karen Peacock

{"title":"Development and validation of a community risk score for sexual and reproductive health in the United States.","authors":"Lisa M Lines, Christina I Fowler, Yevgeniya Kaganova, Karen Peacock","doi":"10.1093/haschl/qxae048","DOIUrl":"10.1093/haschl/qxae048","url":null,"abstract":"Equitable access to sexual and reproductive health (SRH) care is key to reducing inequities in SRH outcomes. Publicly funded family-planning services are an important source of SRH care for people with social risk factors that impede their access. This study aimed to create a new index (Local Social Inequity in SRH [LSI-SRH]) to measure community-level risk of adverse SRH outcomes based on social determinants of health (SDoH). We evaluated the validity of the LSI-SRH scores in predicting adverse SRH outcomes and the need for publicly funded services. The data were drawn from more than 200 publicly available SDoH and SRH measures, including availability and potential need for publicly supported family planning from the Guttmacher Institute. The sample included 72 999 Census tracts (99.9%) in the 50 states and the District of Columbia. We used random forest regression to predict the LSI-SRH scores; 42 indicators were retained in the final model. The LSI-SRH model explained 81% of variance in the composite SRH outcome, outperforming 3 general SDoH indices. LSI-SRH scores could be a useful for measuring community-level SRH risk and guiding site placement and resource allocation.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11282459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790627","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}

引用次数: 0

How structural racism, neighborhood deprivation and maternal characteristics contribute to inequities in birth outcomes 结构性种族主义、邻里贫困和孕产妇特征如何导致分娩结果的不平等

Health affairs scholar Pub Date : 2024-07-23 DOI: 10.1093/haschl/qxae092

A. Gangopadhyaya, Lisa Dubay, Emily Johnston, Vincent Pancini

引用次数: 0

Psychological Safety Associated With Better Work Environment And Lower Levels Of Clinician Burnout 心理安全与更好的工作环境和更低的临床医生职业倦怠水平有关

Health affairs scholar Pub Date : 2024-07-17 DOI: 10.1093/haschl/qxae091

Rosalind de Lisser, Mary S. Dietrich, J. Spetz, Rangaraj Ramanujam, Jana Lauderdale, D. Stolldorf

{"title":"Psychological Safety Associated With Better Work Environment And Lower Levels Of Clinician Burnout","authors":"Rosalind de Lisser, Mary S. Dietrich, J. Spetz, Rangaraj Ramanujam, Jana Lauderdale, D. Stolldorf","doi":"10.1093/haschl/qxae091","DOIUrl":"https://doi.org/10.1093/haschl/qxae091","url":null,"abstract":"\u0000 Burnout is attributed to negative work environments and threatens patient and clinician safety. Psychological safety is the perception that the work environment is safe for interpersonal risk taking and may offer insight into the relationship between the work environment and burnout. In this cross-sectional analysis of survey data from 621 nurse practitioners in California, we found that one-third (34%) experienced high burnout. Four factors in the work environment were negatively associated with burnout and positively associated with psychological safety. Significant mediation effects of psychological safety were observed on the relationships between each work environment factor and both emotional exhaustion and depersonalization. The largest mediation effects were observed on the total effects of Nurse Practitioner- Physician Relations and Practice Visibility on Emotional Exhaustion (37% and 32% respectively) and Independent Practice and Support and NP-Administration Relations on Depersonalization (32% and 29% respectively). We found overall that psychological safety decreased the strength of the negative relationship between work environment and burnout. We argue that research, practice, and policy efforts to mitigate burnout and improve the work environment should consider psychological safety as a metric for system level wellbeing.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141828529","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}

引用次数: 0

"Do not inject our babies": a social listening analysis of public opinion about authorizing pediatric COVID-19 vaccines. "不要给我们的婴儿注射"：关于授权小儿 COVID-19 疫苗的公众意见社会倾听分析。

Health affairs scholar Pub Date : 2024-07-08 eCollection Date: 2024-07-01 DOI: 10.1093/haschl/qxae082

Aleksandra M Golos, Sharath-Chandra Guntuku, Alison M Buttenheim

{"title":"\"Do not inject our babies\": a social listening analysis of public opinion about authorizing pediatric COVID-19 vaccines.","authors":"Aleksandra M Golos, Sharath-Chandra Guntuku, Alison M Buttenheim","doi":"10.1093/haschl/qxae082","DOIUrl":"10.1093/haschl/qxae082","url":null,"abstract":"Designing effective childhood vaccination counseling guidelines, public health campaigns, and school-entry mandates requires a nuanced understanding of the information ecology in which parents make vaccination decisions. However, evidence is lacking on how best to \"catch the signal\" about the public's attitudes, beliefs, and misperceptions. In this study, we characterize public sentiment and discourse about vaccinating children against SARS-CoV-2 with mRNA vaccines to identify prevalent concerns about the vaccine and to understand anti-vaccine rhetorical strategies. We applied computational topic modeling to 149 897 comments submitted to regulations.gov in October 2021 and February 2022 regarding the Food and Drug Administration's Vaccines and Related Biological Products Advisory Committee's emergency use authorization of the COVID-19 vaccines for children. We used a latent Dirichlet allocation topic modeling algorithm to generate topics and then used iterative thematic and discursive analysis to identify relevant domains, themes, and rhetorical strategies. Three domains emerged: (1) specific concerns about the COVID-19 vaccines; (2) foundational beliefs shaping vaccine attitudes; and (3) rhetorical strategies deployed in anti-vaccine arguments. Computational social listening approaches can contribute to misinformation surveillance and evidence-based guidelines for vaccine counseling and public health promotion campaigns.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11229700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560571","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}

引用次数: 0

One year of publishing: onward and upward. 出版一年：勇往直前。

Health affairs scholar Pub Date : 2024-06-28 eCollection Date: 2024-07-01 DOI: 10.1093/haschl/qxae085

Kathryn A Phillips

引用次数: 0

Physicians working with physician assistants and nurse practitioners: perceived effects on clinical practice. 医生与医生助理和护士合作：对临床实践的影响。

Health affairs scholar Pub Date : 2024-06-25 eCollection Date: 2024-06-01 DOI: 10.1093/haschl/qxae070

Xiaochu Hu, Bettie Coplan, Hilary Barnes, Noël Smith, Alison Essary, Michael Dill

{"title":"Physicians working with physician assistants and nurse practitioners: perceived effects on clinical practice.","authors":"Xiaochu Hu, Bettie Coplan, Hilary Barnes, Noël Smith, Alison Essary, Michael Dill","doi":"10.1093/haschl/qxae070","DOIUrl":"10.1093/haschl/qxae070","url":null,"abstract":"Physicians in the United States are increasingly working with physician assistants (PAs) and nurse practitioners (NPs), but little is known about how they perceive working with PAs and NPs affects their clinical practice. We used a new national survey to examine physicians' perceptions of working with PAs and/or NPs on their patient volume, care quality, time use, and workload. Among our analytical sample of 5823 physicians, 59% reported working with PAs and/or NPs. Most reported that PAs and NPs positively affected their clinical practice. Among several findings, physicians working in medical schools and with higher incomes were more likely to indicate that PAs improve their clinical practices in all 4 aspects, while being in specialties with higher women's representation was associated with lower ratings for working with PAs. Native Hawaiian and Pacific Islander physicians and those with higher incomes were more likely to signify that NPs improved their clinical practices in all 4 aspects. These findings provide valuable insights, from the physicians' perspective, on care delivery reform.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11196955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452462","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}

引用次数: 0

Acquisitions of safety-net hospitals from 2016-2021: a case series. 2016-2021 年收购安全网医院：案例系列。

Health affairs scholar Pub Date : 2024-06-24 eCollection Date: 2024-06-01 DOI: 10.1093/haschl/qxae056

Christian Wood, Xinwei Chen, William Schpero, Paula Chatterjee

{"title":"Acquisitions of safety-net hospitals from 2016-2021: a case series.","authors":"Christian Wood, Xinwei Chen, William Schpero, Paula Chatterjee","doi":"10.1093/haschl/qxae056","DOIUrl":"10.1093/haschl/qxae056","url":null,"abstract":"Safety-net hospitals have recently become targets of acquisition by health systems with the stated purpose of improving their financial solvency and preserving access to safety-net services. Whether acquisition achieves these goals is unknown. In this descriptive case series, we sought to determine the factors that contribute to safety-net hospital acquisition, and identify whether safety-net services are preserved after acquisition. We examined 22 acquisitions of safety-net hospitals from 2016 to 2021 and described characteristics of the acquired safety-net hospitals, their acquiring systems, and the operational fate of acquired hospitals. Relative to other hospitals in the same Hospital Referral Region in the year prior to acquisition, acquired safety-net hospitals tended to be smaller and have lower occupancy rates. Acquiring systems were geographically concentrated, with only 6 of 20 systems operating in more than 1 state. Safety-net hospitals frequently offered typical safety-net services prior to acquisition. However, after acquisition, 2 of the 22 acquired safety-net hospitals lost safety-net services, 3 hospitals ceased inpatient services, and 1 hospital closed entirely. These findings suggest that acquisition of safety-net hospitals may be associated with trade-offs related to the provision of safety-net services for the communities that stand to benefit from them most.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447876","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}

引用次数: 0

The medical competence of health care providers in sub-Saharan Africa: Evidence from 16 127 providers across 11 countries. 撒哈拉以南非洲医疗服务提供者的医疗能力：来自 11 个国家 16 127 名医疗服务提供者的证据。

Health affairs scholar Pub Date : 2024-06-07 eCollection Date: 2024-06-01 DOI: 10.1093/haschl/qxae066

Benjamin Daniels, Andres Yi Chang, Roberta Gatti, Jishnu Das

{"title":"The medical competence of health care providers in sub-Saharan Africa: Evidence from 16 127 providers across 11 countries.","authors":"Benjamin Daniels, Andres Yi Chang, Roberta Gatti, Jishnu Das","doi":"10.1093/haschl/qxae066","DOIUrl":"10.1093/haschl/qxae066","url":null,"abstract":"Despite a consensus that quality of care is critically deficient in low-income countries, few nationally representative studies provide comparable measures of quality of care across countries. To address this gap, we used nationally representative data from in-person administrations of clinical vignettes to measure the competence of 16 127 health care providers across 11 sub-Saharan African countries. Rather than large variations across countries, we found that 81% of the variation in competence is within countries and the characteristics of health care providers do not explain most of this variation. Professional qualifications-including cadre and education-are only weakly associated with competence: across our sample, one-third of nurses are more competent than the average doctor in the same country and one-quarter of doctors are less competent than the average nurse. Finally, while younger cohorts do tend to be more competent, perhaps reflecting improvements in medical education, it would take 25 decades of turnover to improve care by 10 percentage points, on average, if we were to rely on such improvements alone. These patterns necessitate a fundamentally different approach to health care human resource management, calling into question typical staffing policies based on qualifications and seniority rather than directly measured quality.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11157171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297616","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}

引用次数: 0

Quantifying public and private investment in European biopharmaceutical research and development. 量化欧洲生物制药研发领域的公共和私人投资。

Health affairs scholar Pub Date : 2024-05-31 eCollection Date: 2024-06-01 DOI: 10.1093/haschl/qxae060

Annabelle Fowler, Kathleen Grieve, Andreas Maos, Tim Wilsdon

{"title":"Quantifying public and private investment in European biopharmaceutical research and development.","authors":"Annabelle Fowler, Kathleen Grieve, Andreas Maos, Tim Wilsdon","doi":"10.1093/haschl/qxae060","DOIUrl":"10.1093/haschl/qxae060","url":null,"abstract":"Robust biopharmaceutical research and development (R&D) ecosystems require investment from both the public and private sectors. In Europe, there is an interest in growing biopharmaceutical R&D given its contribution to public health and the economy, which requires an understanding of current public and private investment. In addition, recent European draft legislation has focused on the public sector's contributions to biopharmaceutical R&D to inform pharmaceutical prices. However, there is little empirical evidence on the specifics of public and private funding for medicine R&D in Europe. This paper performs aggregative data collection to quantify 2019 investment in biopharmaceutical R&D by the public and private sectors in 6 countries: Belgium, France, Germany, Norway, Poland, and the United Kingdom. We find that, across these countries, the private sector accounts for just under two-thirds of investment. We contrast results to those obtained using high-level R&D indicators from the Organization for Economic Co-operation and Development (OECD) and contextualize differences. We then provide 2013-2019 estimates for Belgium, France, Germany, and the United Kingdom (countries with data to support such analysis), and show that total spending grew over those years, although proportions attributable to each sector remained stable. These findings should provide further evidence for debates on policies to effectively grow the biopharmaceutical R&D sector.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11141779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201626","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}

引用次数: 0