scholarly journals Factors associated with insurance coverage of tofacitinib for alopecia areata: A retrospective review from an academic institution

2020 ◽  
Vol 83 (5) ◽  
pp. 1509-1510
Author(s):  
Hannah J. Thompson ◽  
Theresa Vavra ◽  
Ali Jabbari
Keyword(s):  
Alopecia Areata ◽  
Retrospective Review ◽  
Insurance Coverage ◽  
Academic Institution ◽  
Factors Associated

Socioeconomic factors associated with limb salvage versus amputation for adult extremity bone sarcomas in patients with insurance coverage

2021 ◽  
pp. 101664
Author(s):  
Matthew T. Houdek ◽  
Michael B. Stuart ◽  
Elizabeth P. Wellings ◽  
Eric R. Wagner ◽  
Dennis Asante ◽  
...  
Keyword(s):  
Socioeconomic Factors ◽  
Limb Salvage ◽  
Insurance Coverage ◽  
Factors Associated ◽  
Bone Sarcomas

scholarly journals Correlates of health care access problems among reproductive age women in Ethiopia: In-depth analysis of 2016 Ethiopia demographic Health Survey

2019 ◽  
Author(s):  
koku Tamirat ◽  
Zemenu Tadesse Tessema ◽  
Fentahun Bikale Kebede
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Access ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Reproductive Age ◽  
Rural Residence ◽  
Factors Associated ◽  
Care Access ◽  
Reproductive Age Women

Abstract Background Health care access is timely use of personal health services to achieve best health outcomes. Difficulties to access health care among reproductive age women may led to different negative health outcomes to death and disability. Therefore, this study aimed to assess factors associated with problems of accessing health care among reproductive age women in Ethiopia.Method This study was based on 2016 Ethiopia Demography and Health Survey. Individual women record (IR) file was used to extract the dataset and 15, 683 women were included in the final analysis. A composite variable of problem of accessing health care were created from four questions used to rate problem of accessing health care among reproductive age women. Generalized estimating equation (GEE) model was fitted to identify factors associated with problem of accessing health care. Crude and Adjusted odds ratio with a 95%CI computed to assess the strength of association between independent and outcome variables.Result In this study the magnitude of problem in accessing health care among reproductive age women was 69.9% of with 95%CI (69.3 to 70.7). Rural residence (AOR= 2.13, 95%CI: 1.79 to 2.53), women age 35-49 years (AOR= 1.24, 95%CI: 1.09 to 1.40), married/live together (AOR= 0.72, 95%CI: 0.64 to 0.81), had health insurance coverage (AOR=0.83, 95%CI: 0.70 to 0.95), wealth index [middle (AOR=0.75,95%CI: 0.66 to 0.85) and rich (AOR=0.47,95%CI:0.42 to 0.53)], primary education(AOR= 0.80, 95%CI: 0.73 to 0.88), secondary education (AOR= 0.57, 95%CI:0.50 to 0.64) and diploma and higher education (AOR= 0.43, 95%CI: 0.37 to 0.50) were factors associated with problem of health care access among reproductive age women.Conclusion Despite better coverage of health system, problems of health care access among reproductive age women were considerably high. Health insurance coverage, middle and rich wealth, primary and above educational level were negatively associated with problems health care access. In contrast, older age and rural residence were positively associated with problems of health care access among reproductive age women. This suggests that further interventions are necessary to increase universal reproductive health care access for the achievement of sustainable development goals.

Change in facility-level share of Medicaid patients with cancer following implementation of the affordable care act.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18543-e18543
Author(s):  
Matthew Buck ◽  
Patrick C Demkowicz ◽  
James Nie ◽  
Victoria A. Marks ◽  
Michelle C. Salazar ◽  
...  
Keyword(s):  
Affordable Care Act ◽  
Insurance Coverage ◽  
Study Endpoint ◽  
Primary Study ◽  
Factors Associated ◽  
Percentage Points ◽  
The Affordable Care Act ◽  
Facility Level ◽  
Insured Patients ◽  
Medicaid Expansions

e18543 Background: Although Medicaid expansions associated with the Affordable Care Act (ACA) significantly increased insurance coverage for Americans with cancer, there is evidence that some facilities limit the number of Medicaid patients they treat due to lower reimbursement. We aimed to assess facility-level changes in the proportion of patients with Medicaid who were diagnosed with cancer in relation to Medicaid expansions associated with the ACA. Methods: We identified adult patients with the 19 most commonly diagnosed cancers using the National Cancer Database who were diagnosed with cancer from 2010 through 2017. We clustered Commission on Cancer (CoC) accredited institutions and included those diagnosing at least 10 patients in each year. The primary study endpoint was the change in the proportion of Medicaid-insured individuals relative to the implementation of the ACA (pre- and post-Jan 1, 2014). We used adjusted difference-in-differences (DID) estimation and multivariable logistic regression to examine patient and facility-level factors associated with changes in the proportion of Medicaid insured individuals. Results: We identified 1,064 eligible facilities in the study period. There were considerable changes in the share of Medicaid insured patients at the facility-level (range -20.0% to +44.7%, IQR -0.64% to +5.63%). There were significantly larger changes in facilities located in Medicaid expansion states (11.5 to 16.5% percentage points) versus non-expansion states (9.2 to 8.9% percentage points) with adjusted DID +5.79% (p < 0.001). Despite overall increases, 14.6% of facilities in expansion states experienced reductions in their share of Medicaid insured patients. Facility factors associated with decreasing share of Medicaid patients were non-expansion status (OR: 6.25, 95% CI 3.89 – 9.98, p < 0.001) and higher baseline Medicaid population (OR: 2.93, 95% CI 2.00 – 4.35, p < 0.001). There was also significant regional variation with larger decreases in the West South Central (OR: 5.86, 95% CI 2.30 – 15.74, p < 0.001) and West North Central (OR: 2.46, 95% CI 1.07 – 5.87, p = 0.037) regions. Conclusions: Although state expansions associated with the ACA led to increases in the share of Medicaid-insured patients diagnosed with cancer at CoC facilities, there was considerable variation in changes at the facility-level. These findings highlight that improved insurance coverage may not be sufficient to improve access to care, and facility-level policies may remain a source of access disparity.

scholarly journals Patient-Level Factors Associated With Lack of Health Care Provider Recommendation for the Human Papillomavirus Vaccine Among Young Cancer Survivors

2020 ◽  
Vol 38 (25) ◽  
pp. 2892-2901
Author(s):  
Jocelyn M. York ◽  
James L. Klosky ◽  
Yanjun Chen ◽  
James A. Connelly ◽  
Karen Wasilewski-Masker ◽  
...  
Keyword(s):  
Health Care ◽  
Cancer Survivors ◽  
Health Care Provider ◽  
Care Provider ◽  
Hpv Vaccine ◽  
Insurance Coverage ◽  
Hpv Vaccination ◽  
Factors Associated ◽  
Patient Level ◽  
Vaccine Recommendation

PURPOSE Young cancer survivors are at increased risk for morbidities related to infection with the human papillomavirus (HPV), yet their HPV vaccine initiation rates remain low. Patient-/parent-reported lack of health care provider recommendation for HPV vaccination is strongly associated with vaccine noninitiation. We aimed to identify patient-level factors associated with survivor-/parent-reported lack of provider recommendation for HPV vaccination among young cancer survivors. METHODS Cancer survivors ages 9-26 years and 1-5 years off therapy completed a cross-sectional survey (parent-completed for survivors 9-17 years of age). Lack of health care provider HPV vaccine recommendation was the outcome of interest in a multivariable logistic regression model that included relevant patient-level sociodemographic, clinical, and vaccine-related variables. RESULTS Of 955 survivors, 54% were male, 66% were non-Hispanic White, and 36% had leukemia. At survey participation, survivors were an average age (± standard deviation) of 16.3 ± 4.7 years and 32.8 ± 14.7 months off therapy. Lack of provider HPV vaccine recommendation was reported by 73% (95% CI, 70% to 75%) of survivors. For the entire cohort, patient-level factors associated with lack of reported provider recommendation included perceived lack of insurance coverage for the HPV vaccine (odds ratio [OR], 4.0; 95% CI, 2.7 to 5.9; P < .001), male sex (OR, 2.8; 95% CI, 1.9 to 4.0; P < .001), and decreased parent-survivor communication regarding HPV vaccination (OR, 1.7 per unit decrease in score; 95% CI, 1.3 to 2.2; P < .001). In the sex- and age-stratified models, perceived lack of insurance coverage (all models) and male sex (age-stratified models) were also significantly associated with lack of reported provider recommendation. CONCLUSION We identified factors characterizing survivors at risk for not reporting receipt of a health care provider HPV vaccine recommendation. Future research is needed to develop interventions that facilitate effective provider recommendations for HPV vaccination among all young cancer survivors.

Retrospective review of insurance coverage for patch testing

2019 ◽  
Vol 122 (5) ◽  
pp. 508-512
Author(s):  
Azam A. Qureshi ◽  
Olabola Awosika ◽  
Kamaria Nelson ◽  
Spencer Brodsky ◽  
Haijun Wang ◽  
...  
Keyword(s):  
Patch Testing ◽  
Retrospective Review ◽  
Insurance Coverage

Barriers to Outpatient Pediatric Chronic Pain Clinic Participation Among Referred Patients

2020 ◽  
Vol 59 (9-10) ◽  
pp. 859-864
Author(s):  
Sushmitha S. Boppana ◽  
Rebecca Miller ◽  
Aubrey Wrona ◽  
Dmitry Tumin ◽  
Sharon Wrona ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Logistic Regression ◽  
Retrospective Review ◽  
Treatment Initiation ◽  
Private Insurance ◽  
Pain Clinic ◽  
Factors Associated ◽  
Head Pain ◽  
Pediatric Chronic Pain ◽  
Chronic Pain Clinic

Initial clinic evaluation among referred patients and factors limiting treatment initiation are not well characterized. We conducted a retrospective review of referrals to our outpatient pain clinic to identify intake visits and factors associated with treatment initiation among adolescents with chronic pain. We identified adolescents aged 13 to 18 years at the time of referral to clinic (2010-2016). Factors associated with completion of visits were evaluated using logistic regression. Patients who completed visits more frequently had private insurance than public or no insurance ( P = .053). The most common reasons for caregiver decision not to attend the pain clinic included use of another pain clinic, that services were not wanted or no longer needed, and that their child was undergoing further testing. The current study demonstrated that patients with head pain were more likely to complete an intake visit, while there was a trend showing that lack of private insurance decreased this likelihood.

scholarly journals Outcomes of Different Methods for Analysis of Biliary Brush Cytology and of Factors Associated with Positive Diagnosis in an Age-Dependent Retrospective Review

2018 ◽  
Vol 26 (1) ◽  
pp. 5-13 ◽  
Author(s):  
Mariana Costa ◽  
Jorge Canena ◽  
Luís Mascarenhas-Lemos ◽  
Rafaela Loureiro ◽  
Mário Silva ◽  
...  
Keyword(s):  
Retrospective Review ◽  
Brush Cytology ◽  
Positive Diagnosis ◽  
Factors Associated ◽  
Age Dependent

scholarly journals Exploring spatial variations and factors associated with skilled birth attendant delivery in Ethiopia: geographically weighted regression and multilevel analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Achamyeleh Birhanu Teshale ◽  
Adugnaw Zeleke Alem ◽  
Yigizie Yeshaw ◽  
Sewnet Adem Kebede ◽  
Alemneh Mekuriaw Liyew ◽  
...  
Keyword(s):  
Multilevel Analysis ◽  
Insurance Coverage ◽  
Secondary Analysis ◽  
Skilled Birth Attendant ◽  
Spatial Variations ◽  
Weighted Regression ◽  
Poverty Level ◽  
Binary Logistic Regression Model ◽  
Wealth Status ◽  
Factors Associated

Abstract Background Skilled birth attendant (SBA) delivery is vital for the health of mothers and newborns, as most maternal and newborn deaths occur at the time of childbirth or immediately after birth. This problem becomes worsen in Ethiopia in which only 28% of women give birth with the help of SBA. Therefore, this study aimed to explore the spatial variations of SBA delivery and its associated factors in Ethiopia. Methods A secondary analysis was carried out using the 2016 Ethiopian Demographic and Health Survey. A total weighted sample of 11,023 women who had a live birth in the 5 years preceding the survey was included in the analysis. Arc-GIS software was used to explore the spatial distribution of SBA and a Bernoulli model was fitted using SaTScan software to identify significant clusters of non-SBA delivery. The Geographic Weighted Regression (GWR) was employed in modeling spatial relationships. Moreover, a multilevel binary logistic regression model was fitted to identify factors associated with SBA delivery. Results In this study, SBA delivery had spatial variations across the country. The SaTScan spatial analysis identified the primary clusters’ spatial window in southeastern Oromia and almost the entire Somalia. The GWR analysis identified different predictors of non- SBA delivery across regions of Ethiopia. In the multilevel analysis, mothers having primary and above educational status, health insurance coverage, and mothers from households with higher wealth status had higher odds of SBA delivery. Being multi and grand multiparous, perception of distance from the health facility as big problem, rural residence, women residing in communities with medium and higher poverty level, and women residing in communities with higher childcare burden had lower odds of SBA delivery. Conclusion Skilled birth attendant delivery had spatial variations across the country. Areas with non-skilled birth attendant delivery and mothers who had no formal education, not health insured, mothers from poor households and communities, Primiparous women, mothers from remote areas, and mothers from communities with higher childcare burden could get special attention in terms of allocation of resources including skilled human power, and improved access to health facilities.

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