Health affairs scholar最新文献_第4页

Perceptions of multi-cancer early detection tests among communities facing barriers to health care. 面临医疗保健障碍的社区对多种癌症早期检测试验的看法。

Health affairs scholar Pub Date : 2024-08-16 eCollection Date: 2024-09-01 DOI: 10.1093/haschl/qxae102

Kristi L Roybal, Robyn A Husa, Maria Connolly, Catherine Dinh, Kara M K Bensley, Staci J Wendt

{"title":"Perceptions of multi-cancer early detection tests among communities facing barriers to health care.","authors":"Kristi L Roybal, Robyn A Husa, Maria Connolly, Catherine Dinh, Kara M K Bensley, Staci J Wendt","doi":"10.1093/haschl/qxae102","DOIUrl":"10.1093/haschl/qxae102","url":null,"abstract":"Marginalized racial and ethnic groups and rural and lower income communities experience significant cancer inequities. Blood-based multi-cancer early detection tests (MCEDs) provide a simple and less invasive method to screen for multiple cancers at a single access point and may be an important strategy to reduce cancer inequities. In this qualitative study, we explored barriers and facilitators to MCED adoption among communities facing health care access barriers in Alaska, California, and Oregon. We used reflexive thematic analysis to analyze general barriers to cancer screening, MCED-specific barriers, facilitators of MCED adoption, and MCED communication strategies. We found barriers and facilitators to MCED adoption across 4 levels of the social-ecological model: (1) individual, (2) interpersonal, (3) health care system, and (4) societal. These included adverse psychological impacts, positive perceptions of MCEDs, information and knowledge about cancer screening, the quality of the patient-provider relationship, a lack of health care system trustworthiness, logistical accessibility, patient supports, and financial accessibility. Optimal MCED communication strategies included information spread through the medical environment and the community. These findings underscore the importance of understanding and addressing the multilevel factors that may influence MCED adoption among communities facing health care access barriers to advance health equity.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116465","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

Lessons for cannabinoid regulation from electronic nicotine delivery system product regulation. 电子尼古丁给药系统产品监管对大麻素监管的启示。

Health affairs scholar Pub Date : 2024-08-16 eCollection Date: 2024-08-01 DOI: 10.1093/haschl/qxae101

Brian Yagi, Stan Veuger, Brian J Miller, Paul Larkin

引用次数: 0

Predictors of telehealth use after the Minnesota Telehealth Act: analysis using the Minnesota All Payer Claims Database. 明尼苏达州远程医疗法案》颁布后远程医疗使用的预测因素：使用明尼苏达州所有支付方索赔数据库进行分析。

Health affairs scholar Pub Date : 2024-08-16 eCollection Date: 2024-08-01 DOI: 10.1093/haschl/qxae100

Arkadipta Ghosh, Ethan Jacobs, Elizabeth Greener, Alyssa Evans, Mark Lee, Rui Wang, Pamela Mink, Michael Burian

引用次数: 0

Advancing the Future of Equitable Access to Health Care: Recommendations from International Health Care Leaders 推进公平获得医疗服务的未来：国际医疗保健领导人的建议

Health affairs scholar Pub Date : 2024-08-09 DOI: 10.1093/haschl/qxae094

Beth Boyer, Katie Huber, Eyal Zimlichman, Robert S Saunders, Mark McClellan, Charles N. Kahn, Ryan Noach, Claudia Salzberg

{"title":"Advancing the Future of Equitable Access to Health Care: Recommendations from International Health Care Leaders","authors":"Beth Boyer, Katie Huber, Eyal Zimlichman, Robert S Saunders, Mark McClellan, Charles N. Kahn, Ryan Noach, Claudia Salzberg","doi":"10.1093/haschl/qxae094","DOIUrl":"https://doi.org/10.1093/haschl/qxae094","url":null,"abstract":"\u0000 Disparities in access to health care are persistent and contribute to poor health outcomes for many populations around the world. Barriers to access are often similar across countries, despite differences in how health systems are structured. Health care leaders can work to address these barriers through bold, evidence-based actions. The Future of Health (FOH), an international community of senior health leaders, collaborated with the Duke-Margolis Institute for Health Policy to identify priority organizational and policy actions needed to improve equitable access to health care through a consensus-building exercise, a targeted literature review, and an expert discussion group. This paper describes four key action areas for health care leaders that FOH members identified as critical to enabling the future of equitable access to health care: ensuring prioritization of and accountability for equitable access to care; establishing comprehensive, organization-wide strategies to address barriers to access; clearly defining and incentivizing improvement on key measures related to reducing disparities in access; and establishing cross-sector partnerships to improve equitable access.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141925326","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

Putting Meat on the Bone: How to Fast-Track Innovative Medicines to Those Who Need Them and Generate Data to Justify Continued Use 有的放矢：如何将创新药物快速提供给需要者，并生成数据证明继续使用的合理性

Health affairs scholar Pub Date : 2024-08-09 DOI: 10.1093/haschl/qxae095

Daniel Ollendorf, Chris Henshall, Marie Phillips, Patricia Synnott, Lloyd Sansom, Sean Tunis

{"title":"Putting Meat on the Bone: How to Fast-Track Innovative Medicines to Those Who Need Them and Generate Data to Justify Continued Use","authors":"Daniel Ollendorf, Chris Henshall, Marie Phillips, Patricia Synnott, Lloyd Sansom, Sean Tunis","doi":"10.1093/haschl/qxae095","DOIUrl":"https://doi.org/10.1093/haschl/qxae095","url":null,"abstract":"\u0000 Regulatory agencies worldwide have taken significant steps to expedite approval and market authorization of medicines based on their potential to address areas of significant unmet medical need and severe disease burden. But initial approval of such medicines is often accompanied by limited evidence of benefit, posing a conundrum for payers and health systems who may desire greater certainty of their value. This paper describes a system of “accelerated access” to manage these tensions and coordinate activities across stakeholders, based on discussions held at a multi-stakeholder convening in June 2023. We focus on 6 core, near-term actions that can be taken to improve the current system: clarifying criteria for expedited regulatory approval; enhancing stakeholder coordination; creating expedited pathways in payer and health technology assessment settings; developing joint regulatory/payer/HTA guidance on study design and data needs; linking pricing policy to data uncertainty; and improving patient and public understanding of the processes involved as well as the risks and benefits of the relevant medicines. Many of these actions will require additional resources and personnel, and some will necessitate unprecedented levels of coordination. Nevertheless, each action is designed to work with minimal adjustments to the current system rather than demanding an entirely new approach.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141924197","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

Perceptions of prior authorization burden and solutions. 对预先授权负担的看法和解决方案。

Health affairs scholar Pub Date : 2024-08-06 eCollection Date: 2024-09-01 DOI: 10.1093/haschl/qxae096

Nikhil R Sahni, Brooke Istvan, Celia Stafford, David Cutler

{"title":"Perceptions of prior authorization burden and solutions.","authors":"Nikhil R Sahni, Brooke Istvan, Celia Stafford, David Cutler","doi":"10.1093/haschl/qxae096","DOIUrl":"https://doi.org/10.1093/haschl/qxae096","url":null,"abstract":"The prior authorization (PA) process consumes time and money on the part of patients, providers, and payers. While some research shows substantial possible savings in the PA process, identifying what different groups can do is not as well known. Thus, organizations have struggled to capture this opportunity. To understand different perspectives on PA burden and receptivity to possible changes in the PA process, we surveyed 1005 patients, 1010 provider employees, and 115 private payer employees. Patients reported the longest perceived wait times but indicated the highest perceived approval rates and lowest perceived burden. The relatively low burden for patients is because most do not have to engage in PA directly. Provider respondents reported spending time equivalent of more than 100 000 full-time registered nurses per year on prior authorization. Artificial intelligence (AI) represents a possible solution: 65% of private payer respondents reported that their organizations planned to incorporate AI into the process in the next 3 to 5 years. Intended adoption by provider respondents is much smaller (11%). Private payer respondents cited cybersecurity concerns and a lack of technical infrastructure as barriers; provider respondents cited lack of budget and limited trust in the technology.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11425057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335143","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

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