Health affairs scholar最新文献_第6页

Nurse practitioner race and ethnicity and interest in independent primary care practice and serving Medicaid enrollees. 执业护士的种族、民族和对独立初级保健实践的兴趣，以及对医疗补助计划参保者的服务。

Health affairs scholar Pub Date : 2024-11-19 eCollection Date: 2024-12-01 DOI: 10.1093/haschl/qxae153

Ulrike Muench, Amy Quan, Rosalind de Lisser, Timothy Bates, Joanne Spetz

{"title":"Nurse practitioner race and ethnicity and interest in independent primary care practice and serving Medicaid enrollees.","authors":"Ulrike Muench, Amy Quan, Rosalind de Lisser, Timothy Bates, Joanne Spetz","doi":"10.1093/haschl/qxae153","DOIUrl":"10.1093/haschl/qxae153","url":null,"abstract":"Nurse practitioners (NPs) are important providers of primary care to underserved populations, particularly in areas with lower physician supply. In 2023, California implemented new regulations aimed at improving access to care, especially primary care services, by providing a pathway for NPs to practice without formal supervision after 3 years of practice and without any physician relationship after 5 years of practice. This study used data from a representative survey of California-licensed NPs fielded in late 2022 to examine NPs' current practice and intentions following implementation of the new regulations. Results indicated notable differences in the characteristics of NPs who are considering establishing an independent primary care practice and who are considering changing their practice to serve more Medicaid enrollees at the advent of expanded scope of practice. The strong association between racial/ethnic identity and greater interest in practice change suggests that after the elimination of physician collaboration requirements, increasing the diversity of the NP workforce may be one of the most important strategies for increasing access to care for Californians and especially for people receiving Medicaid.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"2 12","pages":"qxae153"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814963","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

Correction to: No Surprises Act independent dispute resolution outcomes for emergency services. 更正：紧急服务无意外法》的独立争议解决结果。

Health affairs scholar Pub Date : 2024-11-19 eCollection Date: 2024-11-01 DOI: 10.1093/haschl/qxae150

引用次数: 0

Standardizing social determinants of health data: a proposal for a comprehensive screening tool to address health equity a systematic review. 健康数据的社会决定因素标准化：关于采用综合筛查工具解决健康公平问题的建议，系统综述。

Health affairs scholar Pub Date : 2024-11-14 eCollection Date: 2024-12-01 DOI: 10.1093/haschl/qxae151

Sarju Ganatra, Sumanth Khadke, Ashish Kumar, Sadiya Khan, Zulqarnain Javed, Khurram Nasir, Sanjay Rajagopalan, Rishi K Wadhera, Sourbha S Dani, Sadeer Al-Kindi

{"title":"Standardizing social determinants of health data: a proposal for a comprehensive screening tool to address health equity a systematic review.","authors":"Sarju Ganatra, Sumanth Khadke, Ashish Kumar, Sadiya Khan, Zulqarnain Javed, Khurram Nasir, Sanjay Rajagopalan, Rishi K Wadhera, Sourbha S Dani, Sadeer Al-Kindi","doi":"10.1093/haschl/qxae151","DOIUrl":"10.1093/haschl/qxae151","url":null,"abstract":"Social determinants of health (SDoH) significantly impacts health outcomes and disparities. While the Centers for Medicare and Medicaid Services has mandated hospitals to collect standardized SDoH data, existing tools lack key elements. This systematic review identified 78 studies and 20 screening tools addressing various SDoH domains. However, most tools were missing several key domains and lacked standardization. We propose a comprehensive tool meeting essential criteria: validated questions, brevity, actionability, cultural appropriateness, workflow integration, and community linkage. Our tool addresses gaps in available tools and incorporates standardized and validated questions to enable patient-centered screening for diverse social and environmental determinants of health. It uniquely includes detailed race/ethnicity data collection, housing characteristics, physical activity assessment, access to healthy food measures, and environmental exposure evaluation. The tool aims to provide actionable data for immediate interventions while informing broader population health strategies and policy initiatives. By offering a holistic assessment of SDoH across multiple domains, our tool enables standardized data collection, risk stratification, and focused initiatives to address health inequities at both individual and population levels. Further research is needed to develop evidence-based pathways for integrating SDoH data into real-world patient care workflows, improve risk prediction algorithms, address health-related social needs, and reduce disparities.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"2 12","pages":"qxae151"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11642620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831512","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

All-cause nursing home mortality rates have remained above pre-pandemic levels after accounting for decline in occupancy. 在考虑到入住率下降的因素后，养老院的全因死亡率仍高于大流行前的水平。

Health affairs scholar Pub Date : 2024-11-14 eCollection Date: 2024-11-01 DOI: 10.1093/haschl/qxae126

Max Weiss, Sharon-Lise T Normand, David C Grabowski, Deborah Blacker, Joseph P Newhouse, John Hsu

引用次数: 0

Charting new territory: the early lessons in integrating social determinant of health (SDOH) measures into practice. 开辟新领域：将健康的社会决定因素（SDOH）措施纳入实践的早期经验。

Health affairs scholar Pub Date : 2024-11-14 eCollection Date: 2024-11-01 DOI: 10.1093/haschl/qxae138

Adrianna Nava, Kristen Bishop, Polina Lissin, Rachel L Harrington

{"title":"Charting new territory: the early lessons in integrating social determinant of health (SDOH) measures into practice.","authors":"Adrianna Nava, Kristen Bishop, Polina Lissin, Rachel L Harrington","doi":"10.1093/haschl/qxae138","DOIUrl":"10.1093/haschl/qxae138","url":null,"abstract":"Quality measures for social determinants of health (SDOH) have been introduced or proposed in more than 20 federal programs, initiatives, or guidance documents to capture performance, but understanding the scope of work needed to effectively collect and align with these new measurement requirements is still in its early stages. The National Committee for Quality Assurance (NCQA) recently developed the Social Need Screening and Intervention (SNS-E) measure and is currently building 2 new domains of interest: utility insecurity and social connection. Before these domains can be leveraged to drive population health, the feasibility of collecting and reporting on them must be assessed. This report describes qualitative data collection on the barriers and facilitators of collecting data elements for utility insecurity and social connection from 8 diverse health plans. Although plans reported that collecting SDOH data was feasible, they identified barriers associated with multiple data systems, coding, as well as data formatting, storage, extraction, and mapping. Further research is needed to explore additional codes, mechanisms for collecting SDOH data in a patient-centric manner, and ensuring that health plans, health care systems, and community partners can align with national measurement initiatives. Standardizing these data will be key to improving outcomes for all.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"2 11","pages":"qxae138"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635057","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

Aligning training, regulation, and payment policy to advance the behavioral health workforce. 调整培训、监管和薪酬政策，以提高行为卫生工作队伍的水平。

Health affairs scholar Pub Date : 2024-11-13 eCollection Date: 2025-01-01 DOI: 10.1093/haschl/qxae148

Brianna Lombardi, Lisa de Saxe Zerden, Erin Fraher

引用次数: 0

Scenarios, not shortage forecasts, are key to better workforce policy. 要制定更好的劳动力政策，关键在于情景预测，而不是短缺预测。

Health affairs scholar Pub Date : 2024-11-13 eCollection Date: 2024-11-01 DOI: 10.1093/haschl/qxae149

Melinda J B Buntin, Mingxin Chen, David I Auerbach

引用次数: 0

Economic insecurity during the COVID-19 pandemic among healthcare workers by educational attainment. COVID-19大流行期间卫生保健工作者受教育程度的经济不安全感。

Health affairs scholar Pub Date : 2024-11-13 eCollection Date: 2024-12-01 DOI: 10.1093/haschl/qxae144

Tracy M Mroz, Ben S Dunlap, Bianca K Frogner

{"title":"Economic insecurity during the COVID-19 pandemic among healthcare workers by educational attainment.","authors":"Tracy M Mroz, Ben S Dunlap, Bianca K Frogner","doi":"10.1093/haschl/qxae144","DOIUrl":"10.1093/haschl/qxae144","url":null,"abstract":"Prior to the COVID-19 pandemic, healthcare workers with less formal education (eg, nursing assistants and home care aides) vs more formal education (eg, physicians and nurses) were more likely to experience economic insecurity, the real and/or perceived risk of financial losses. Given the unprecedented impact of COVID-19 on healthcare workers, we sought to describe economic insecurity among these workers during the pandemic. Using data from the U.S. Census Bureau's Household Pulse Survey from July 2021 to July 2023, we examined economic insecurity among healthcare workers by educational attainment. Higher proportions of healthcare workers with an associate degree or below reported difficulty paying usual expenses, food insufficiency, and being behind on rent/mortgage payments compared to healthcare workers with a bachelor's degree or higher. Accounting for other sociodemographic characteristics, higher educational attainment was associated with significantly lower odds of economic insecurity. Since the public health emergency has ended and temporary policies to support low-wage workers during the pandemic have sunsetted, targeted policies to promote economic security among financially vulnerable low-wage workers are critical to enable recruitment and retention of these essential healthcare workers.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"2 12","pages":"qxae144"},"PeriodicalIF":0.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815384","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

Factors impacting vaccine uptake among adult Medicaid beneficiaries: a systematic literature review. 影响成年医疗补助受益人接种疫苗的因素：系统性文献综述。

Health affairs scholar Pub Date : 2024-11-12 eCollection Date: 2024-11-01 DOI: 10.1093/haschl/qxae143

Emily Moss, Amanda L Eiden, Louise Hartley, Justin Carrico, Raymond Farkouh, Sara Poston, Meghan Gabriel, Anna Hundt Golden, Alexandra Bhatti

{"title":"Factors impacting vaccine uptake among adult Medicaid beneficiaries: a systematic literature review.","authors":"Emily Moss, Amanda L Eiden, Louise Hartley, Justin Carrico, Raymond Farkouh, Sara Poston, Meghan Gabriel, Anna Hundt Golden, Alexandra Bhatti","doi":"10.1093/haschl/qxae143","DOIUrl":"10.1093/haschl/qxae143","url":null,"abstract":"Vaccine uptake is suboptimal among adult Medicaid beneficiaries. To evaluate factors affecting vaccine uptake among adult Medicaid beneficiaries and/or affecting healthcare providers who vaccinate adult Medicaid beneficiaries, we conducted a systematic literature review in Embase, Medline, Database of Abstracts of Reviews of Effects, and the Cochrane Library for articles published from January 2005 through July 2022 and relevant conferences. For included studies, data were extracted on the study characteristics, patient and provider cost barriers, patient and provider perceived risks/benefits, and other barriers faced by patients and providers. Quality assessments were conducted using a checklist from the Joanna Briggs Institute. Twenty-one studies analyzed patient-related factors (14 studies) and/or provider-related factors (8 studies). Reviewed studies indicate that vaccine uptake is influenced by insurance benefit and cost-coverage policies, including cost-sharing, access to vaccination services, and vaccine education and awareness. Financial factors, including reimbursement for vaccine acquisition and administration, influence providers' vaccination practices for Medicaid beneficiaries. Our findings suggest that reducing or eliminating vaccination cost-sharing, promoting vaccine education and awareness about the importance and safety of vaccines, increasing access, and exploring reimbursement rates equivalent with other public or private insurance plans could mitigate barriers to vaccination for the adult Medicaid population.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"2 11","pages":"qxae143"},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712322","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

Measuring hospital inpatient Procedure Access Inequality in the United States. 衡量美国医院住院病人就医程序不平等的情况。

Health affairs scholar Pub Date : 2024-11-06 eCollection Date: 2024-11-01 DOI: 10.1093/haschl/qxae142

Alon Bergman, Guy David, Ashwin Nathan, Jay Giri, Michael Ryan, Soumya Chikermane, Christin Thompson, Seth Clancy, Candace Gunnarsson

{"title":"Measuring hospital inpatient Procedure Access Inequality in the United States.","authors":"Alon Bergman, Guy David, Ashwin Nathan, Jay Giri, Michael Ryan, Soumya Chikermane, Christin Thompson, Seth Clancy, Candace Gunnarsson","doi":"10.1093/haschl/qxae142","DOIUrl":"10.1093/haschl/qxae142","url":null,"abstract":"Geographic disparities in access to inpatient procedures are a significant issue within the US healthcare system. This study introduces the Procedure Access Inequality (PAI) index, a standardized metric to quantify these disparities while adjusting for disease prevalence. Using data from the Healthcare Cost and Utilization Project State Inpatient Databases, we analyzed inpatient procedure data from 18 states between 2016 and 2019. The PAI index reveals notable variability in access inequality across different procedures, with minimally invasive and newer procedures exhibiting higher inequality. Key findings indicate that procedures such as skin grafts and minimally invasive gastrectomy have the highest PAI scores, while cesarean sections and percutaneous coronary interventions have the lowest. The study highlights that higher inequality is associated with greater market concentration and in particular, fewer hospitals offering these procedures. These findings emphasize the need for targeted policy interventions to address procedural access disparities to promote more equitable healthcare delivery across the United States.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"2 11","pages":"qxae142"},"PeriodicalIF":0.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678157","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