Health affairs scholar最新文献_第6页

Retraction and replacement of: Strategic pathways to International Classification of Diseases, 11th Revision adoption in France and the United States. 撤回和替换：《国际疾病分类战略路径》第11次修订在法国和美国通过。

Health affairs scholar Pub Date : 2025-07-01 DOI: 10.1093/haschl/qxaf098

引用次数: 0

Geographical variation in physician supply and its relationship to utilization of care across older adults in the United States. 医生供应的地理差异及其与美国老年人护理利用的关系。

Health affairs scholar Pub Date : 2025-06-30 eCollection Date: 2025-07-01 DOI: 10.1093/haschl/qxaf127

Mason Barnard, Jose F Figueroa, Jessica Phelan, E John Orav, Irene Papanicolas

{"title":"Geographical variation in physician supply and its relationship to utilization of care across older adults in the United States.","authors":"Mason Barnard, Jose F Figueroa, Jessica Phelan, E John Orav, Irene Papanicolas","doi":"10.1093/haschl/qxaf127","DOIUrl":"10.1093/haschl/qxaf127","url":null,"abstract":"Introduction: Scholars express concern that general practitioner shortages and specialist surpluses induce overspecialization, with overuse of costly specialist services and underuse of cost-effective primary care services. Yet few studies directly assess the relationship between physician supply and patient utilization. Given this gap, this paper examines the associations between physician supply, care utilization, and patient need and whether patients use more specialists in areas with lower primary care supply.Methods: Using a 20% sample of 2018 Medicare fee-for-service claims, this paper first assessed the correlation between county physician densities and county physician visits. It then modeled individual patient consumption of primary and specialty care services in relation to physician supply through linear regression, adjusting for health and demographics.Results: While county supplies of primary care practitioners (PCPs) and specialists were positively correlated, we found no correlation between local PCP supply and local primary care visits. We also found no evidence that patients substitute specialist care for primary care, even in areas with PCP shortages.Conclusion: These findings suggest that factors other than PCP supply play an important role in primary care underuse. Scholars should also consider how care models, limited gatekeeping, and excess consumption among well-resourced populations influence the distribution of primary care utilization.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"3 7","pages":"qxaf127"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12248419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628331","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

Interventions that strengthen the care workforce: a realist synthesis review. 加强护理人员队伍的干预措施：现实主义综合审查。

Health affairs scholar Pub Date : 2025-06-28 eCollection Date: 2025-07-01 DOI: 10.1093/haschl/qxaf128

Christine Kelly, Lisette Dansereau, Ellie Jack, Salina Pirzada, Yuns Oh, Pranav Bhushan, Lorine Pelly, Janice Linton, Carey McCarthy, Giorgio Cometto

{"title":"Interventions that strengthen the care workforce: a realist synthesis review.","authors":"Christine Kelly, Lisette Dansereau, Ellie Jack, Salina Pirzada, Yuns Oh, Pranav Bhushan, Lorine Pelly, Janice Linton, Carey McCarthy, Giorgio Cometto","doi":"10.1093/haschl/qxaf128","DOIUrl":"10.1093/haschl/qxaf128","url":null,"abstract":"Introduction: Health systems depend on care workers to provide \"hands-on\" direct care with eating, dressing, and other needs, as well as indirect care with household tasks, meals, and transport. Care workers are in high demand to support growing populations who need help in daily life, yet they often fall outside of health human resource planning. Recruiting, supporting, and retaining the care workforce are urgent priorities for health workforce planners.Methods: This realist synthesis review asks: Which interventions strengthen the care workforce? We systematically identified 7396 peer-reviewed sources and 481 gray literature sources, with 151 included in the review.Results: The sources document a variety of interventions that strengthen the care workforce, with an emphasis on pre-service and ongoing training for care workers. There were ambitious interventions that aimed to support the care workforce on multiple fronts.Conclusion: Policy makers and researchers are encouraged to implement complex interventions that cover multiple factors simultaneously. We recommend focusing on legislative structures, educational oversight, and material working conditions, such as scheduling and pay, as highly promising avenues for strengthening the care workforce across multiple contexts.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"3 7","pages":"qxaf128"},"PeriodicalIF":0.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628332","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 cooperative difference: perceived drivers of higher care quality at home care cooperatives. 合作差异：家庭护理合作社中较高护理质量的感知驱动因素。

Health affairs scholar Pub Date : 2025-06-27 eCollection Date: 2025-06-01 DOI: 10.1093/haschl/qxaf118

Geoffrey M Gusoff, Miguel A Cuevas, Catherine Sarkisian, Madeline R Sterling, Ariel C Avgar, Gery W Ryan

{"title":"The cooperative difference: perceived drivers of higher care quality at home care cooperatives.","authors":"Geoffrey M Gusoff, Miguel A Cuevas, Catherine Sarkisian, Madeline R Sterling, Ariel C Avgar, Gery W Ryan","doi":"10.1093/haschl/qxaf118","DOIUrl":"10.1093/haschl/qxaf118","url":null,"abstract":"Introduction: The quality of care provided by home care workers (HCWs), on whom millions of Americans rely, is undermined by practices, structures, and policies that marginalize this workforce. Home care cooperatives-agencies co-owned and controlled by HCWs-represent a promising model for reducing HCW marginalization and improving care, but the specific ways in which the cooperative model may facilitate higher care quality are not well understood.Methods: We conducted 32 semistructured interviews with HCWs and other staff across 5 home care cooperatives to identify perceived drivers of improved care quality at cooperatives.Results: Respondents identified 4 main drivers of improved care quality at cooperatives: (1) increased HCW input into patient care decisions; (2) additional motivation derived from being co-owners; (3) preferential selection of high-performing, mission-driven HCWs; and (4) access to high-quality, hands-on training.Conclusions: Increasing the prevalence of these perceived quality drivers through the expansion of home care cooperatives, the adoption of cooperatives' practices by traditional agencies, and the implementation of industry-wide policies that facilitate them may significantly improve care quality across the home care sector. However, additional research is needed to determine the role each perceived driver plays in home care quality.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"3 6","pages":"qxaf118"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12201916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531964","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

Assessing the value of health information exchange organizations to hospital interoperability. 评估卫生信息交换组织对医院互操作性的价值。

Health affairs scholar Pub Date : 2025-06-27 eCollection Date: 2025-07-01 DOI: 10.1093/haschl/qxaf133

Chelsea Richwine, Catherine Strawley, Wei Chang, Jordan Everson

{"title":"Assessing the value of health information exchange organizations to hospital interoperability.","authors":"Chelsea Richwine, Catherine Strawley, Wei Chang, Jordan Everson","doi":"10.1093/haschl/qxaf133","DOIUrl":"10.1093/haschl/qxaf133","url":null,"abstract":"Introduction: Various federal efforts have supported the development of local, regional, and state health information exchange organizations (HIOs), a type of network that promotes secure electronic exchange of patient health information among hospitals, healthcare providers, community-based organizations, and public health authorities. With the emergence of complementary and alternative modes to facilitate exchange, we sought to assess the value of HIOs to hospital interoperability.Methods: We leveraged nationally representative survey data from a unique linked dataset of N = 2200 hospitals linked to HIOs to examine the relationship between hospitals' engagement in a range of interoperability activities and participation in an HIO that offers services to support those activities.Results: We found that hospital participation in an HIO was significantly associated with greater engagement in clinical information exchange, public health reporting, and health-related social needs information exchange. However, among hospitals participating in an HIO, we did not find strong evidence of a relationship between specific HIO capabilities or services and hospital engagement in exchange.Conclusion: Our findings indicate HIOs offer a useful avenue for exchange but are only one path through which exchange takes place as there are various alternatives available to support interoperability activities.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"3 7","pages":"qxaf133"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628330","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 effect of providing Medicare Advantage enrollees diagnosed with cancer additional time to reassess enrollment. 为诊断为癌症的医疗保险优惠参保人提供额外的时间来重新评估参保的效果。

Health affairs scholar Pub Date : 2025-06-27 eCollection Date: 2025-07-01 DOI: 10.1093/haschl/qxaf131

Emma M Achola-Kothari, Stacie B Dusetzina, John A Graves, David G Stevenson, Laura M Keohane

{"title":"The effect of providing Medicare Advantage enrollees diagnosed with cancer additional time to reassess enrollment.","authors":"Emma M Achola-Kothari, Stacie B Dusetzina, John A Graves, David G Stevenson, Laura M Keohane","doi":"10.1093/haschl/qxaf131","DOIUrl":"10.1093/haschl/qxaf131","url":null,"abstract":"Introduction: Beneficiaries enrolled in Medicare Advantage (MA) and newly diagnosed with cancer may be incentivized to switch coverage, particularly if their MA plan restricts their access to cancer care. Beginning January 2019, the deadline to disenroll from an MA plan changed from February 14 to March 31 and, for the first time, beneficiaries could switch to a different MA plan as opposed to having to enter traditional Medicare.Methods: We used 2016-2019 Surveillance, Epidemiology, and End Results (SEER) Medicare data to conduct a difference-in-differences analysis, estimating the effect of this new policy on rates of MA plan switching 1 month and 2 months after diagnosis.Results: For beneficiaries diagnosed with cancer in March, the policy was associated with a modest increase in both overall rates of switching and in switching to a new MA plan 1 month after diagnosis. Results indicated that the policy had a modest positive effect on changes in Medicare coverage for enrollees diagnosed in January when outcomes were measured 2 months after diagnosis.Conclusion: Relaxing enrollment rules for MA enrollees may not exacerbate adverse selection into traditional Medicare, given this evidence that beneficiaries with high-cost new diagnoses rarely exercised the option to change their MA plan.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"3 7","pages":"qxaf131"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12248418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628335","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

Access to medication treatment for opioid use disorder in fee-for-service medicare. 在按服务收费的医疗保险中获得阿片类药物使用障碍的药物治疗。

IF 2.7

Health affairs scholar Pub Date : 2025-06-26 eCollection Date: 2025-07-01 DOI: 10.1093/haschl/qxaf130

Erin A Taylor, Jonathan Cantor, Julie Lai, Denis Agniel, Kosali I Simon, Bradley D Stein

引用次数: 0

Prevalence of interstate telehealth comparing internet protocol and home address. 州际远程医疗的流行比较互联网协议和家庭地址。

Health affairs scholar Pub Date : 2025-06-26 eCollection Date: 2025-07-01 DOI: 10.1093/haschl/qxaf129

Kaustav P Shah, Ateev Mehrotra, Eric Bressman

引用次数: 0

The cost of misaligned incentives in the pharmaceutical supply chain. 药品供应链中不一致激励的成本。

IF 2.7

Health affairs scholar Pub Date : 2025-06-25 eCollection Date: 2025-07-01 DOI: 10.1093/haschl/qxaf126

Geoffrey Joyce

引用次数: 0

The American fentanyl epidemic: geographic variation in mortality and policy implications. 美国芬太尼流行病：死亡率的地理差异和政策影响。

Health affairs scholar Pub Date : 2025-06-25 eCollection Date: 2025-07-01 DOI: 10.1093/haschl/qxaf124

Thomas M Wickizer, Evan V Goldstein, Rachel Mason, Nasser Sharareh

{"title":"The American fentanyl epidemic: geographic variation in mortality and policy implications.","authors":"Thomas M Wickizer, Evan V Goldstein, Rachel Mason, Nasser Sharareh","doi":"10.1093/haschl/qxaf124","DOIUrl":"10.1093/haschl/qxaf124","url":null,"abstract":"Introduction: The American fentanyl epidemic has become the worst man-made epidemic the country has faced to date, claiming tens of thousands of lives each year.Methods: Using population-based data provided by the Centers for Disease Control and Prevention, we examined the increase in unintentional, fatal fentanyl overdose since 2005 and analyzed the geographic variation in fentanyl mortality among census divisions, states, and counties.Results: In 2022, 70 813 persons died of an unintentional fentanyl overdose, a 31-fold increase over the 2139 deaths that occurred in 2012; the age-adjusted mortality rate increased similarly. Fentanyl deaths resulted in ∼2.0-2.6 million estimated years of life lost. We estimated the economic loss to the nation resulting from premature mortality was on the order of $57-$67 billion. The impact of the fentanyl epidemic varied widely by geographic area. The mortality rate of West Virginia was 15 times greater than that of South Dakota.Conclusion: Containing the fentanyl epidemic will require new, data-driven preventive and treatment approaches, coordinated across sectors, including public health, health care, law enforcement, education, and social services. Interventions should be based upon the risk profile of geographic areas and include harm reduction activities as well as social marketing campaigns to improve public awareness of fentanyl's health risks.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"3 7","pages":"qxaf124"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628334","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