2,159 results match your criteria expanded insurance

Variation in Hospital Performance Measures from the Turkey Ministry of Health.

Int J Qual Health Care 2021 Jul 30. Epub 2021 Jul 30.

Precision Vaccines Program, Department of Pediatrics, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA.

Background: The Turkish healthcare system has seen broad population-based improvements in expanded health insurance coverage and access to healthcare services. Hospital performance in this national system is understudied. We aimed to identify trends in hospital performance over time following implementation of the Health Transformation Program and describe how regional outcomes correlate with regional vital statistics. Read More

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Reducing Cardiovascular Maternal Mortality by Extending Medicaid for Postpartum Women.

J Am Heart Assoc 2021 Jul 29:e022040. Epub 2021 Jul 29.

Cardiovascular Division Washington University School of Medicine St. Louis MO.

Maternal mortality has been increasing in the United States over the past 3 decades, while decreasing in all other high-income countries during the same period. Cardiovascular conditions account for over one fourth of maternal deaths, with two thirds of deaths occurring in the postpartum period. There are also significant healthcare disparities that have been identified in women experiencing maternal morbidity and mortality, with Black women at 3 to 4 times the risk of death as their White counterparts and women in rural areas at heightened risk for cardiovascular morbidity and maternal morbidity. Read More

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Effects of medicaid expansion on poverty disparities in health insurance coverage.

Int J Equity Health 2021 Jul 26;20(1):171. Epub 2021 Jul 26.

Department of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 1900, Louisiana, 70112, New Orleans, USA.

Background: More than 30 states have either expanded Medicaid or are actively considering expansion. The coverage gains from this policy are well documented, however, the impacts of its increasing coverage on poverty disparity are unclear at the national level.

Method: American Community Survey (2012-2018) was used to examine the effects of Medicaid expansion on poverty disparity in insurance coverage for nonelderly adults in the United States. Read More

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The Relationship Between Unemployment and Health Insurance Coverage: Before and After the Affordable Care Act's Coverage Expansions.

Med Care 2021 Jul 26. Epub 2021 Jul 26.

Department of Health Management and Policy, College of Public Health, University of Kentucky, Lexington, KY The Hilltop Institute, University of Maryland Baltimore County, Baltimore, MD Division of Health, Services Management and Policy, College of Public Health, Ohio State University, Columbus, OH.

Objective: The objective of this study was to determine whether the Affordable Care Act's (ACA) major coverage expansions mitigated the impact of unemployment on health insurance coverage status.

Data Source: A 2011-2019 versions of the American Community Survey developed by the University of Minnesota Integrated Public Use Microdata Series program.

Research Design: We use difference-in-difference-in-differences (ie, triple difference) regressions to compare changes in the short-run impacts of local unemployment rates before and after the ACA. Read More

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Prevalence, progress, and social inequalities of home deliveries in Ghana from 2006 to 2018: insights from the multiple indicator cluster surveys.

BMC Pregnancy Childbirth 2021 Jul 21;21(1):518. Epub 2021 Jul 21.

Department of Family Health Care Nursing, School of Nursing, University of California San Francisco, San Francisco, CA, USA.

Background: Delivery in unsafe and unsupervised conditions is common in developing countries including Ghana. Over the years, the Government of Ghana has attempted to improve maternal and child healthcare services including the reduction of home deliveries through programs such as fee waiver for delivery in 2003, abolishment of delivery care cost in 2005, and the introduction of the National Health Insurance Scheme in 2005. Though these efforts have yielded some results, home delivery is still an issue of great concern in Ghana. Read More

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Medical Debt in the US, 2009-2020.

JAMA 2021 07;326(3):250-256

National Bureau of Economic Research, Cambridge, Massachusetts.

Importance: Medical debt is an increasing concern in the US, yet there is limited understanding of the amount and distribution of medical debt, and its association with health care policies.

Objective: To measure the amount of medical debt nationally and by geographic region and income group and its association with Medicaid expansion under the Affordable Care Act.

Design, Setting, And Participants: Data on medical debt in collections were obtained from a nationally representative 10% panel of consumer credit reports between January 2009 and June 2020 (reflecting care provided prior to the COVID-19 pandemic). Read More

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The process of National Health Insurance coverage for Chuna Manual Therapy in Korea: A qualitative study.

Integr Med Res 2022 Mar 26;11(1):100746. Epub 2021 May 26.

Division of Humanities and Social Medicine, School of Korean Medicine, Pusan National University, Yangsan, Korea.

Background: Chuna Manual Therapy (CMT) has been widely used in Korea, and coverage in Korean National Health Insurance (NHI) was finally implemented in 2019. The objectives of this study were to analyze the process of NHI coverage for CMT qualitatively, and to summarize important roles, streams, and implications regarding its inclusion in the modern public health insurance system.

Methods: Related literature was collected and 8 key personnel involved in the policy-making process were qualitatively interviewed, and Zahariadis' version of the Multiple Streams Framework (MSF) was applied to analyze the policy agenda setting and the roles of stakeholders. Read More

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Evaluating Medicaid Expansion Benefits for Patients with Cancer: National Cancer Database Analysis and Systematic Review.

J Cancer Policy 2021 Sep 5;29. Epub 2021 Jun 5.

Department of Neurological Surgery, Keck School of Medicine, University of Southern California, 1200 North State Street, Suite 3300, Los Angeles, CA, 90033, USA.

Background: Insurance status modifies healthcare access and inequities. The Affordable Care Act expanded Medicaid coverage for people with low incomes in the United States. This study assessed the consequences of this policy change for cancer care after expansion in 2014. Read More

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September 2021

Oncologist Perspectives on Telemedicine for Patients With Cancer: A National Comprehensive Cancer Network Survey.

JCO Oncol Pract 2021 Jul 15:OP2100195. Epub 2021 Jul 15.

University of Washington Medical Center, Seattle, WA.

Purpose: The use of telemedicine expanded dramatically in March 2020 following the COVID-19 pandemic. We sought to assess oncologist perspectives on telemedicine's present and future roles (both phone and video) for patients with cancer.

Methods: The National Comprehensive Cancer Network (NCCN) Electronic Health Record (EHR) Oncology Advisory Group formed a Workgroup to assess the state of oncology telemedicine and created a 20-question survey. Read More

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Evaluating the impact of the nationwide public-private mix (PPM) program for tuberculosis under National Health Insurance in South Korea: A difference in differences analysis.

PLoS Med 2021 Jul 14;18(7):e1003717. Epub 2021 Jul 14.

Korean Institute of Tuberculosis, Korean National Tuberculosis Association, Cheongju, Republic of Korea.

Background: Public-private mix (PPM) programs on tuberculosis (TB) have a critical role in engaging and integrating the private sector into the national TB control efforts in order to meet the End TB Strategy targets. South Korea's PPM program can provide important insights on the long-term impact and policy gaps in the development and expansion of PPM as a nationwide program.

Methods And Findings: Healthcare is privatized in South Korea, and a majority (80. Read More

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Insurance expansions and hospital utilization: Relabeling and reabling?

J Health Econ 2021 Jun 5;78:102482. Epub 2021 Jun 5.

The World Bank. Electronic address:

The 2010 Patient Protection & Affordable Care Act (ACA) significantly expanded access to private and public health insurance for low-income individuals through income-based subsidies and income-based eligibility expansions, respectively. In this paper, we use the universe of hospitals from 2009 to 2015 to characterize how these expansions affected the financing of hospital visits, along with price, utilization, and potential spillovers in the quality of care. The insurance coverage expansions generated a shift in the composition of payers and a modest increase in the utilization of hospital outpatient services. Read More

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The COVID-19 crisis and policy responses by continental European welfare states.

Soc Policy Adm 2021 Mar 16;55(2):326-338. Epub 2021 Mar 16.

Erasmus School of Social and Behavioural Sciences Department of Public Administration and Sociology Erasmus University Rotterdam The Netherlands.

Social protection in Germany, Belgium and the Netherlands share Bismarckian roots. Over time, these welfare states were however in constant flux and incorporated to a greater or lesser extend elements of both the Anglo-Saxon and Nordic models. While the Netherlands has from the beginning deviated from the Bismarckian model, in recent years this welfare state has undergone important reforms that have made it increasingly evolve into a "Bismarck Beveridge" model. Read More

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Implementation of a hybrid angiography-CT system: increased short-term revenue at an academic radiology department.

Abdom Radiol (NY) 2021 Jul 6. Epub 2021 Jul 6.

Department of Radiology, University of Chicago, Chicago, IL, USA.

Purpose: To analyze the financial impact following implementation of a hybrid Angio-CT system at a tertiary care academic medical center.

Methods: Aggregate case types and volumes were compared 24 months before and 12 months after a hybrid Angio-CT system replaced a traditional interventional C-arm angiography suite at an academic medical center. Procedure revenues from this 36-month study period were derived from five payors mixes (Medicare, Medicaid, commercial insurance, out-of-pocket and managed care program) and Medicare-rate adjusted to each individual payor types. Read More

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Successful Implementation of Newborn Screening for Hemoglobin Disorders in the Philippines.

Int J Neonatal Screen 2021 Jun 17;7(2). Epub 2021 Jun 17.

UCSF Benioff Children's Hospital Oakland, Oakland, CA 94609, USA.

The Philippine newborn bloodspot screening (NBS) program began in 1996 with 24 hospitals and was formalized by legislation in 2004. The NBS panel was recently expanded to include a number of additional hereditary congenital conditions. Expertise and experiences from other NBS programs already screening for hemoglobinopathies were essential to its successful integration into the ongoing dried bloodspot NBS program in the Philippines. Read More

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Sexual health difficulties among service women: the influence of posttraumatic stress disorder.

J Affect Disord 2021 Sep 5;292:678-686. Epub 2021 Jun 5.

Leidos, San Diego, CA, USA; Deployment Health Research Department, Naval Health Research Center, San Diego, CA, USA.

Background Sexual health among service women remains understudied, yet is related to health and quality of life. This study examined if the associations between recent combat and sexual assault with sexual health difficulties were mediated by mental disorders and identified factors associated with sexual health difficulties among service women. Methods Data from two time points (2013 and 2016) of the Millennium Cohort Study, a large military cohort, were used. Read More

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September 2021

Impact of Insurance Expansion on Disposition for Pediatric Trauma Patients: A National Trauma Data Bank Cohort Study.

J Surg Res 2021 Jun 16;267:109-116. Epub 2021 Jun 16.

Division of General Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah.

Background: The insurance status of pediatric trauma patients is associated with access to post-discharge resources, including inpatient rehabilitation. Our goal was to understand the impact of changes in insurance coverage on access to post-acute care resources for pediatric trauma patients.

Materials And Methods: We utilized the National Trauma Data Bank from 2012 to 2016 for all pediatric trauma patients with a highest body region abbreviated injury score >2. Read More

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The impact of expanding health insurance coverage for anti-cancer drugs on cancer survival in Korea.

Cancer Med 2021 Jul 18;10(13):4555-4563. Epub 2021 Jun 18.

Department of Research, Health Insurance Review & Assessment Service, Wonju, South Korea.

Background: To reduce out-of-pocket costs, the Korean government expanded health insurance reimbursement in anti-cancer drugs for cancer patients in 2013. Our objective was to examine the impact of the benefit coverage expansion policy on healthcare utilization and overall survival (OS) among patients with six types of solid cancer after the policy of expanding health insurance coverage.

Methods: This study analyzed a before-and-after retrospective cohort of patients newly diagnosed with six types of solid cancer (stomach cancer, colorectal cancer, lung cancer, liver cancer, breast cancer, and prostate cancer) from January 1, 2009 to December 31, 2015 in Korea. Read More

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Training dental hygienists to place interim therapeutic restorations in a school-based teledentistry program: Oregon's virtual dental home.

J Public Health Dent 2021 Jun 17. Epub 2021 Jun 17.

Department of Community Dentistry, School of Dentistry, Oregon Health & Science University, Portland, Oregon, USA.

Objectives: The objectives of this study on Oregon's virtual dental home were to: 1) demonstrate the feasibility of pilot project training of existing Expanded Practice Dental Hygienists (EPDHs) to perform interim therapeutic restorations (ITRs) in the community settings after diagnosis by the supervising dentist via teledentistry and 2) evaluate satisfaction of parents/guardians of children participating in a pilot program that provides school-based/on-site preventive dental care services utilizing expanded scope EPDHs to conduct dental screenings and place ITRs.

Methods: This demonstration project was a 4-years longitudinal cohort study (2016-2019) in the school/community-based settings focusing on children in kindergarten to 3rd grade. EPDHs and dentists from a Dental Care Organization were trained to utilize teledentistry and EPDHs were trained to place ITRs, the latter provided onsite dental care. Read More

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Development of Kampo(traditional Japanese medicine)e-learning program: evaluation of the flipped classroom for medical students.

Med Educ Online 2021 Dec;26(1):1938504

Medical Education Center, Aichi Medical University School of Medicine, Aichi, Japan.

In May 2019, the World Health Assembly, in an unprecedented move, endorsed the inclusion of traditional medicine in the International Classification of Diseases, 11th Revision. In Japan, traditional medicine (known as Kampo) is regulated by the government and prescribed by over 90% of physicians along with modern medicine under the national health insurance system. Although Kampo education must be included in Japan's core medical curricula, there are significant challenges to implementation. Read More

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December 2021

Did Dental Insurance Expansion Improve Dental Care Needs among Korean Adults? Difference in Difference Analysis.

J Epidemiol 2021 Jun 12. Epub 2021 Jun 12.

Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health.

Background: In 2012, the Korean government expanded dental insurance for the elderly to promote improved access to dental care. We examined the causal effect of this policy on dental care needs, focusing on low-income older adults.

Methods: We compared data before and after policy implementation using double difference (DD) and triple difference (DDD) analyses. Read More

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Buprenorphine use and disparities in access among emergency department patients with opioid use disorder: A cross-sectional study.

J Subst Abuse Treat 2021 Apr 20;130:108405. Epub 2021 Apr 20.

Cooper Medical School of Rowan University, 401 Broadway, Camden, NJ 08103, United States of America; Cooper University Hospital, Department of Emergency Medicine, Keleman 152, 1 Cooper Plaza, Camden, NJ 08103, United States of America. Electronic address:

Background: Buprenorphine, a partial mu-opioid agonist and kappa-opioid antagonist, is an approved treatment for opioid use disorder (OUD). Studies demonstrate that buprenorphine decreases cravings for other opioids, effectively ameliorates withdrawal symptoms, and decreases opioid overdose and mortality. However, buprenorphine remains under-utilized. Read More

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Medicaid Expansion Association With End-Stage Liver Disease Mortality Depends on Leniency of Medicaid Hepatitis C Virus Coverage.

Liver Transpl 2021 Jun 12. Epub 2021 Jun 12.

Department of Medicine, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, NY.

The Affordable Care Act expanded Medicaid around the same time that direct-acting antivirals became widely available for the treatment of hepatitis C virus (HCV). However, there is significant variation in Medicaid HCV treatment eligibility criteria between states. We explored the combined effects of Medicaid expansion and leniency of HCV coverage under Medicaid on liver outcomes. Read More

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Expanded Health Insurance Access Through the ACA: An Important But Insufficient Step in Improving Health Care Access and Equity.

Sarah M Lyon

Chest 2021 Jun;159(6):2129-2130

Department of Pulmonary, Allergy and Critical Care Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA. Electronic address:

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Disparities in Primary Care Wait Times in Medicaid versus Commercial Insurance.

J Am Board Fam Med 2021 May-Jun;34(3):571-578

From the University of Pennsylvania, Philadelphia (EGG, MKC); Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, East Garden City, NY (KVR); Leonard Davis Institute of Health Economics, Philadelphia, PA (MKC); Penn Center for Mental Health, Philadelphia, PA (MKC).

Background: Timely access to primary care is important, particularly among patients with acute conditions and patients seeking gateways to specialty care. Due to concerns that expanded Medicaid eligibility would compromise access to primary care among new Medicaid beneficiaries, an experimental study was conducted to test the ability to obtain timely appointments. Although access to primary care appointments for simulated Medicaid patients significantly increased, wait times also increased. Read More

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September 2020

Patterns of Proton Beam Therapy Use in Clinical Practice Between 2007 and 2019 in Korea.

Cancer Res Treat 2021 May 17. Epub 2021 May 17.

Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Purpose: Proton beam therapy (PBT) is a state-of-the-art technology employed in radiotherapy (RT) for cancer patients. This study characterized how PBT has been used in clinical practice in Korea.

Materials And Methods: Patients who received any type of RT between 2007 and 2019 were identified from the radiation oncology registry of the two PBT facilities operating in Korea (National Cancer Center and Samsung Medical Center). Read More

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Associations of Medicaid Expansion With Insurance Coverage, Stage at Diagnosis, and Treatment Among Patients With Genitourinary Malignant Neoplasms.

JAMA Netw Open 2021 May 3;4(5):e217051. Epub 2021 May 3.

Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia.

Importance: Health insurance coverage is associated with improved outcomes in patients with cancer. However, it is unknown whether Medicaid expansion through the Patient Protection and Affordable Care Act (ACA) was associated with improvements in the diagnosis and treatment of patients with genitourinary cancer.

Objective: To assess the association of Medicaid expansion with health insurance status, stage at diagnosis, and receipt of treatment among nonelderly patients with newly diagnosed kidney, bladder, or prostate cancer. Read More

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Values-Based Foundation for a U.S. Single Payer Health System Model.

Front Sociol 2021 28;6:627560. Epub 2021 Apr 28.

School of Health Professions, School of Nursing, Hofstra University, Hempstead, NY, United States.

A universal, single payer model for the American health system aligns with and should emanate from commonly held values contained within the country's foundational religious teachings, morals, ethics and democratic heritage. The Affordable Care Act in its attempt to create expanded health access has met with significant challenges. The conservative Supreme Court decreases the likelihood of a federal mandated single payer model. Read More

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Increasing inclusivity in patient centered research begins with language.

Prev Med 2021 08 13;149:106621. Epub 2021 May 13.

Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA; Boston Children's Hospital, Division of Emergency Medicine, 300 Longwood Ave, Boston, MA 02115, USA. Electronic address:

Emergency departments frequently serve marginalized populations. Spanish-speaking families who come to the ED often have high rates of unmet social needs. Our study investigated how to efficiently screen families for unmet social needs in an emergency department. Read More

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"A decade's worth of work in a matter of days": The journey to telehealth for the whole population in Australia.

Int J Med Inform 2021 07 7;151:104483. Epub 2021 May 7.

Australian Government Department of Health, Australia.

Introduction: Internationally the COVID-19 pandemic has triggered a dramatic and unprecedented shift in telehealth uptake as a means of protecting healthcare consumers and providers through remote consultation modes. Early in the pandemic, Australia implemented a comprehensive and responsive set of policy measures to support telehealth. Initially targeted at protecting vulnerable individuals, including health professionals, this rapidly expanded to a "whole population" approach as the pandemic evolved. Read More

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