scholarly journals The Impact of Culturally-Centered Care on Peripartum Experiences of Autonomy and Respect in Community Birth Centers: A Comparative Study

2021 ◽  
Author(s):  
Jennifer I. Almanza ◽  
J.’Mag Karbeah ◽  
Katelyn M. Tessier ◽  
Carrie Neerland ◽  
Kathrin Stoll ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Perinatal Care ◽  
Ethnic Disparities ◽  
Birth Center ◽  
Experience Of Care ◽  
Birth Centers ◽  
The Us ◽  
Centered Care ◽  
White Clients ◽  
The Impact

Abstract Objective National studies report that birth center care is associated with reduced racial and ethnic disparities and reduced experiences of mistreatment. In the US, there are very few BIPOC-owned birth centers. This study examines the impact of culturally-centered care delivered at Roots, a Black-owned birth center, on the experience of client autonomy and respect. Methods To investigate if there was an association between experiences of autonomy and respect for Roots versus the national Giving Voice to Mothers (GVtM) participants, we applied Wilcoxon rank-sum tests for the overall sample and stratified by race. Results Among BIPOC clients in the national GVtM sample and the Roots sample, MADM and MORi scores were statistically higher for clients receiving culturally-centered care at Roots (MADM p < 0.001, MORi p = 0.011). No statistical significance was found in scores between BIPOC and white clients at Roots Birth Center, however there was a tighter range among BIPOC individuals receiving care at Roots showing less variance in their experience of care. Conclusions for Practice Our study confirms previous findings suggesting that giving birth at a community birth center is protective against experiences of discrimination when compared to care in the dominant, hospital-based system. Culturally-centered care might enhance the experience of perinatal care even further, by decreasing variance in BIPOC experience of autonomy and respect. Policies on maternal health care reimbursement should add focus on making community birth sustainable, especially for BIPOC provider-owners offering culturally-centered care.

scholarly journals Reductions in US life expectancy from COVID-19 by Race and Ethnicity: Is 2021 a repetition of 2020?

2021 ◽  
Author(s):  
Theresa Andrasfay ◽  
Noreen Goldman
Keyword(s):  
Life Expectancy ◽  
Race And Ethnicity ◽  
Ethnic Disparities ◽  
White Population ◽  
Widespread Distribution ◽  
Life Expectancy At Birth ◽  
The Us ◽  
The Impact ◽  
Racial Ethnic ◽  
Black And Latino

COVID-19 had a huge mortality impact in the US in 2020 and accounted for the majority of the 1.5-year reduction in 2020 life expectancy at birth. There were also substantial racial/ethnic disparities in the mortality impact of COVID-19 in 2020, with the Black and Latino populations experiencing reductions in life expectancy at birth over twice the reduction experienced by the White population. Despite continued vulnerability of the Black and Latino populations, the hope was that widespread distribution of effective vaccines would mitigate the overall impact and reduce racial/ethnic disparities in 2021. In this study, we use cause-deleted life table methods to estimate the impact of COVID-19 mortality on 2021 US period life expectancy. Our partial-year estimates, based on provisional COVID-19 deaths for January-early October 2021 suggest that racial/ethnic disparities have persisted and that life expectancy at birth in 2021 has already declined by 1.2 years from pre-pandemic levels. Our projected full-year estimates, based on projections of COVID-19 deaths through the end of 2021 from the Institute for Health Metrics and Evaluation, suggest a 1.8-year reduction in US life expectancy at birth from pre-pandemic levels, a steeper decline than the estimates produced for 2020. The reductions in life expectancy at birth estimated for the Black and Latino populations are 1.6-2.4 times the impact for the White population.

Coping With the Unexpected in Childbirth: A Thematic Analysis

2021 ◽  
Vol 30 (3) ◽  
pp. 159-167
Author(s):  
Katherine Hinic
Keyword(s):  
Thematic Analysis ◽  
Maternity Care ◽  
Perinatal Care ◽  
Care Staff ◽  
Health Care Staff ◽  
Original Research ◽  
Experience Of Care ◽  
Birth Satisfaction ◽  
Centered Care ◽  
Birth Processes

This article reports original research that describes new mothers' experiences of birth and maternity care. Qualitative data were collected through a survey on birth satisfaction, which included space for women to provide comments about their birth and experience of care. Thirty-nine women provided comments that were analyzed using the thematic analysis method. Two themes emerged from the women's experiences: “Unexpected birth processes: expectations and reality” and “Coping with birth: the role of health-care staff.” Participants described unexpected birthing processes, their experiences of care, and maternity care staff's contributions to coping with birth. Implications for practice for childbirth professionals include promotion of physiologic birth, respectful person-centered care during all phases of perinatal care, and the value of childbirth preparation.

scholarly journals Improving the patient experience through a comprehensive performance framework to evaluate excellence in person-centred care

2019 ◽  
Vol 8 (4) ◽  
pp. e000737 ◽  
Author(s):  
Sara Guastello ◽  
Karin Jay
Keyword(s):  
Patient Experience ◽  
Scientific Evidence ◽  
Evaluation Approach ◽  
Experience Of Care ◽  
Person Centered Care ◽  
Patient Loyalty ◽  
Centered Care ◽  
Certification Programme ◽  
The Impact ◽  
Staff Engagement

BackgroundPerson-centred care (PCC) is now recognised as an important component of healthcare quality. However, a lack of consensus of its most critical elements and absence of a global measure of person-centredness has limited the ability to evaluate the impact of implementation.AimIntroduce a measurable construct for PCC that yields improvement in quality, patient loyalty and staff engagement.MethodsInformed by scientific evidence and the voices of patients, families and healthcare professionals, the Person-Centered Care Certification Programme was developed as a comprehensive measure of PCC (Person-Centered Care Certification is a registered trademark of Planetree Registered in the US Patent and Trademark Office). Ten years after its development, the programme was redesigned to offer a more complete evaluative framework to focus organisations’ PCC efforts and better understand their impact. Drawing on the National Academy of Medicine’s Guiding Framework for Patient and Family Engaged Care, five drivers for excellence were identified that delineate the critical inputs required to create and maintain a culture of PCC. Aligned within the drivers are 26 interventions that connect staff to purpose, promote partnership with patients and families, engage individuals in care and promote continuous learning. A multimethod evaluation approach assesses how effectively these PCC strategies have been executed within the organisation and to understand their impact on the human experience of care.ResultsThe Person-Centered Care Certification Programme is associated with improvements in patient experience, patient loyalty and staff engagement.ConclusionThe structured Certification framework can help organisations identify PCC improvement opportunities, guide their implementation efforts, and better understand the impact on patient and staff outcomes. Tested in cultures around the world and across the care continuum, the framework has proven effective in converting PCC into a definable, measurable and attainable goal. This paper outlines how the programme was designed, the measurable benefits derived by organisations and lessons learnt through the process.

scholarly journals Prospective payment system and racial/ethnic disparities: a national retrospective observational study in anaemia complication among end-stage renal disease patients in the US

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Nga TQ. Nguyen ◽  
Alexander P. Maxwell ◽  
Michael Donnelly ◽  
Ciaran O’Neill
Keyword(s):  
Native American ◽  
Renal Disease ◽  
Ethnic Groups ◽  
End Stage Renal Disease ◽  
Ethnic Disparities ◽  
Policy Changes ◽  
The Us ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact

Abstract Background A series of policy changes in 2011 altered reimbursement arrangements and guidance on use of erythropoiesis-stimulating agents for end-stage renal disease (ESRD) patients with anaemia in the US. While the policy changes were principally directed at care delivered in an outpatient setting, these had the potential to affect inpatient care also. This study used HCUP-NIS data (2008–2016) to examine trends in recorded anaemia among ESRD hospitalizations and analyse disparities in inpatient outcomes among ethnic groups following policy changes. Methods The International Classification of Diseases codes were used to identify ESRD admissions, recorded anaemia due to chronic kidney disease (CKD), and to generate an age-adjusted Deyo-Charlson comorbidity index. Linear splines with a knot placed at the time point of policy changes and multivariable logistic regression were used to examine the likelihood of recorded anaemia, adjusted for a range of socio-demographic and clinical covariates. Difference-in-difference analyses investigated the impact of policies on recorded anaemia. Other outcomes included hospital cost, mortality and place of discharge. Results The percentage of inpatient episodes with recorded anaemia arising from CKD increased from 26.2% in 2008 to 50.0% in 2016. Anaemia was more likely to be recorded as a complication of ESRD among minority ethnic groups and Native American admissions, in particular, (OR 1.20, 95%CI 1.15–1.25) relative to White American admissions; and these disparities widened following changes to reimbursement. Minorities were less likely to die in hospital and to be discharged to another healthcare facility, and (with the exception of Black American admissions) they were more expensive to treat. Conclusions Our findings provide evidence of an increase in recorded anaemia consistent with a shift of patients from outpatient to inpatient settings in the wake of changes to reimbursement enacted in 2011. In addition, the study highlights the existence of ethnic disparities that widened after the policy initiated reimbursement changes.

scholarly journals The Impact of Diabetes and Edentulism on All-Cause Mortality: Racial and Ethnic Disparities

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 206-207
Author(s):  
Huabin Luo ◽  
Frank Sloan ◽  
Brenda Plassman ◽  
Samrachana Adhikari ◽  
Mark Schwartz ◽  
...  
Keyword(s):  
Risk Factor ◽  
Ethnic Groups ◽  
Proportional Hazards ◽  
Ethnic Disparities ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Models ◽  
The Us ◽  
The Impact ◽  
Racial Ethnic ◽  
Retirement Study

Abstract This study examined the relationships between the concomitance of diabetes mellitus (DM) and edentulism and mortality among Black, Hispanic, and White older adults in the US. We used data from the 2006-2016 Health and Retirement Study with 2,108 Black, 1,331 Hispanic, and 11,544 White respondents aged 50+. Results of weighted Cox proportional hazards models showed that the concomitance of DM and edentulism was associated with a higher mortality risk for Blacks (Hazard Ratio [HR] = 1.58, p &lt; 0.01), Hispanics (HR = 2.16, p &lt; 0.001) and Whites (HR = 1.61, p &lt; 0.001). Findings also indicated that DM was a risk factor for mortality across all racial/ethnic groups, but edentulism was a risk factor only for Whites (HR = 1.30, p &lt; 0.001). This study revealed that the risk of DM and edentulism on mortality varied among racial/ethnic groups. Our study gives alternative explanations for the observed findings.

scholarly journals Improving the Patient Experience by Implementing an ICU Diary for Those at Risk of Post-intensive Care Syndrome

2017 ◽  
Vol 4 (1) ◽  
pp. 4-9 ◽  
Author(s):  
K Taylor A Blair ◽  
Sarah D Eccleston ◽  
Hannah M Binder ◽  
Mary S McCarthy
Keyword(s):  
Intensive Care ◽  
Family Members ◽  
Health Care Team ◽  
Life Outcomes ◽  
Family Presence ◽  
The Us ◽  
Centered Care ◽  
The Impact ◽  
Icu Diary ◽  
Post Intensive Care Syndrome

The critical care literature in the US has recently brought attention to the impact an ICU experience can have long after the patient survives critical illness, particularly if delirium was present. Current recommendations to mitigate post-intensive care syndrome (PICS) are embedded in patient and family-centered care and aim to promote family presence in the ICU, provide support for decision-making, and enhance communication with the health-care team. Evidence-based interventions are few in number but include use of an ICU diary to minimize the psychological and emotional sequelae affecting patients and family members in the months following the ICU stay. In this paper we describe our efforts to implement an ICU diary and solicit feedback on its role in fostering teamwork and communication between patients, family members, and ICU staff. Next steps will involve a PICS follow-up clinic where trained staff will coordinate specialty referrals and perform long-term monitoring of mental health and other quality of life outcomes.

Percutaneous Coronary Intervention in Patients with Diabetes and Multivessel or Left Main Disease – a Review

2012 ◽  
Vol 7 (1) ◽  
pp. 37
Author(s):  
Donald E Cutlip ◽  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Statistical Significance ◽  
Bare Metal Stents ◽  
Coronary Intervention ◽  
Metal Stents ◽  
Increased Risk ◽  
Percutaneous Coronary ◽  
Patients With Diabetes ◽  
The Impact

Coronary artery disease in patients with diabetes is frequently a diffuse process with multivessel involvement and is associated with increased risk for myocardial infarction and death. The role of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) in patients with diabetes and multivessel disease who require revascularisation has been debated and remains uncertain. The debate has been continued mainly because of the question to what degree an increased risk for in-stent restenosis among patients with diabetes contributes to other late adverse outcomes. This article reviews outcomes from early trials of balloon angioplasty versus CABG through later trials of bare-metal stents versus CABG and more recent data with drug-eluting stents as the comparator. Although not all studies have been powered to show statistical significance, the results have been generally consistent with a mortality benefit for CABG versus PCI, despite differential risks for restenosis with the various PCI approaches. The review also considers the impact of mammary artery grafting of the left anterior descending artery and individual case selection on these results, and proposes an algorithm for selection of patients in whom PCI remains a reasonable strategy.

Systematic review methodology for development: An example from microfinance

2018 ◽  
Vol 43 (1) ◽  
pp. 65-77 ◽  
Author(s):  
Carina Van Rooyen ◽  
Ruth Stewart ◽  
Thea De Wet
Keyword(s):  
Systematic Review ◽  
International Development ◽  
Health Sector ◽  
Evidence Based ◽  
Systematic Review Methodology ◽  
Development Interventions ◽  
The Us ◽  
Sub Saharan ◽  
The Impact ◽  
Evidence Based Decision Making

Big international development donors such as the UK’s Department for International Development and USAID have recently started using systematic review as a methodology to assess the effectiveness of various development interventions to help them decide what is the ‘best’ intervention to spend money on. Such an approach to evidence-based decision-making has long been practiced in the health sector in the US, UK, and elsewhere but it is relatively new in the development field. In this article we use the case of a systematic review of the impact of microfinance on the poor in sub-Saharan African to indicate how systematic review as a methodology can be used to assess the impact of specific development interventions.

The Impact of Monetary and Fiscal Policies on the Stock Market in the United States (U.S); Evidence from Linear ARDL Framework

2020 ◽  
Vol 11 (1) ◽  
pp. 132-132
Author(s):  
Aref Emamian
Keyword(s):  
United States ◽  
Stock Market ◽  
The United States ◽  
Real Effective Exchange Rate ◽  
Annual Data ◽  
Fiscal Policies ◽  
Long Run ◽  
The Us ◽  
Short Run ◽  
The Impact

This study examines the impact of monetary and fiscal policies on the stock market in the United States (US), were used. By employing the method of Autoregressive Distributed Lags (ARDL) developed by Pesaran et al. (2001). Annual data from the Federal Reserve, World Bank, and International Monetary Fund, from 1986 to 2017 pertaining to the American economy, the results show that both policies play a significant role in the stock market. We find a significant positive effect of real Gross Domestic Product and the interest rate on the US stock market in the long run and significant negative relationship effect of Consumer Price Index (CPI) and broad money on the US stock market both in the short run and long run. On the other hand, this study only could support the significant positive impact of tax revenue and significant negative impact of real effective exchange rate on the US stock market in the short run while in the long run are insignificant. Keywords: ARDL, monetary policy, fiscal policy, stock market, United States

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