scholarly journals Health Care Use, Out-of-Pocket Expenditure, and Macroeconomic Conditions during the Great Recession

2015 ◽  
Vol 15 (1) ◽  
pp. 119-156 ◽  
Author(s):  
Juan Du ◽  
Takeshi Yagihashi
Keyword(s):  
Health Care ◽  
Great Recession ◽  
Health Care Use ◽  
Care Utilization ◽  
Program Participation ◽  
Consumer Expenditure ◽  
Macroeconomic Conditions ◽  
Individual Level ◽  
The Great Recession ◽  
The Individual

Abstract We study how macroeconomic conditions during the Great Recession affected health care utilization and out-of-pocket expenditures of American households. We use two data sources: the Consumer Expenditure (CE) Survey and the Survey of Income and Program Participation (SIPP); each has its own advantages. The CE contains quarterly frequency variables, and the SIPP provides panel data at the individual level. Consistent evidence across the two datasets shows that utilization of routine medical care was counter-cyclical, whereas hospital care was pro-cyclical during the Great Recession. When we examine the pre-recession period, the relationship between macroeconomic conditions and health care use was either non-existent or in opposite directions, suggesting that this relationship may have been unique to the Great Recession.

scholarly journals A Clinical Economy of Speculation: Financial Trading and Gambling Disorder in Spain

2017 ◽  
Vol 32 (2) ◽  
pp. 269-293 ◽  
Author(s):  
Jorge Núñez
Keyword(s):  
Financial Markets ◽  
Great Recession ◽  
Gambling Disorder ◽  
Problem Gambler ◽  
Individual Level ◽  
The Great Recession ◽  
Financial Trading ◽  
Financial Speculation ◽  
The Individual

This article concerns itself with financial traders in Spain who have been diagnosed with gambling disorder. It analyzes what I call the clinical economy of speculation, in which the category of problem gambler is repurposed to draw new lines around proper financial trading. In exploring the expansion of post–financial crisis regulatory mechanisms for credit and debt, as well as widening inequalities across the field of investment, I depict how both traders and clinicians become invested in medicalizing trading as gambling disorder. My theorizing interrogates whether and why common speculative practices are seen as sick and unsafe when everyday people, instead of banks and other financial institutions, perform them. I argue that the pathologized trader is an attempt to regulate, at the individual level, the increasing use of borrowed capital to make financial profits. The commodification of debt, however, is not a gender-neutral development. Female traders pay a greater price for venturing into the heights of finance. This focus on gender brings into view the redefinition of credit and debt within the domain of trading, and shows the role of debt-fueled financial speculation in the expansion of financial markets. These ethnographic findings are particularly relevant in a country like Spain, where the Great Recession has bred more new millionaires than ever before, even as the smaller fish of the economy are being medicalized and sometimes even incarcerated.

scholarly journals Radical-Left Populism during the Great Recession: Podemos and Its Competition with the Established Radical Left

2016 ◽  
Vol 65 (1_suppl) ◽  
pp. 108-126 ◽  
Author(s):  
Luis Ramiro ◽  
Raul Gomez
Keyword(s):  
Economic Crisis ◽  
Great Recession ◽  
Individual Level ◽  
The Great Recession ◽  
Left Party ◽  
The Individual ◽  
Populist Party ◽  
Radical Left

The 2008 Great Recession has altered party allegiances in many countries. This has been very visible in some of the countries hardest hit by the crisis, such as Spain. The Spanish case stands out as the only one in which a fully newly created radical-left populist party, Podemos, has attracted sizeable support. Its success is more intriguing given its capacity to attract many former supporters of the established radical left, Izquierda Unida. This article analyses what factors explain the support for the new radical-left populist party Podemos, identifying the individual-level features that lead voters to support it rather than an already established anti-austerity radical-left party. As the results show, Podemos supporters do not correspond to the conventional descriptions of populist voters, the losers of ‘globalisation’ and the economic crisis. Instead, a combination of elements – protest, anti-mainstream sentiment and unfulfilled expectations – distinguishes Podemos supporters from the established radical-left electorate.

Navigating the health care system: perceptions of patients with chronic pain

2009 ◽  
Vol 29 (4) ◽  
pp. 162-168
Author(s):  
AL Dewar ◽  
K Gregg ◽  
MI White ◽  
J Lander
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Health Care System ◽  
Health Care Professionals ◽  
Primary Care Physicians ◽  
Treatment Compliance ◽  
Care Utilization ◽  
Semistructured Interviews ◽  
The Individual ◽  
Care System

A new framework is needed for patients with chronic pain and their primary care physicians that acknowledges the individual’s experiences and provides evidence-informed education and better linkages to community-based resources. This study describes the experience of 19 chronic-pain sufferers who seek relief via the health care system. Their experiences were recorded through in-depth semistructured interviews and analyzed through qualitative methods. The participants reported early optimism, then disillusionment, and finally acceptance of living with chronic pain. Both individuals with chronic pain and their health care professionals need evidence-informed resources and information on best practices to assist them to manage pain. Empathetic communication between health care professionals and individuals with chronic pain is crucial because insensitive communication negatively affects the individual, reduces treatment compliance and increases health care utilization.

Missing Data in Research on Youth and Family Programs

2021 ◽  
pp. 003329412110268
Author(s):  
Jaime Ballard ◽  
Adeya Richmond ◽  
Suzanne van den Hoogenhof ◽  
Lynne Borden ◽  
Daniel Francis Perkins
Keyword(s):  
Missing Data ◽  
Statistical Methods ◽  
Self Report ◽  
Program Participation ◽  
Multilevel Data ◽  
Individual Level ◽  
Level Data ◽  
Before And After ◽  
Post Test ◽  
The Individual

Background Multilevel data can be missing at the individual level or at a nested level, such as family, classroom, or program site. Increased knowledge of higher-level missing data is necessary to develop evaluation design and statistical methods to address it. Methods Participants included 9,514 individuals participating in 47 youth and family programs nationwide who completed multiple self-report measures before and after program participation. Data were marked as missing or not missing at the item, scale, and wave levels for both individuals and program sites. Results Site-level missing data represented a substantial portion of missing data, ranging from 0–46% of missing data at pre-test and 35–71% of missing data at post-test. Youth were the most likely to be missing data, although site-level data did not differ by the age of participants served. In this dataset youth had the most surveys to complete, so their missing data could be due to survey fatigue. Conclusions Much of the missing data for individuals can be explained by the site not administering those questions or scales. These results suggest a need for statistical methods that account for site-level missing data, and for research design methods to reduce the prevalence of site-level missing data or reduce its impact. Researchers can generate buy-in with sites during the community collaboration stage, assessing problematic items for revision or removal and need for ongoing site support, particularly at post-test. We recommend that researchers conducting multilevel data report the amount and mechanism of missing data at each level.

scholarly journals Understanding Patients’ Decisions to Obtain Unplanned, High-Resource Health Care After Colorectal Surgery

2021 ◽  
pp. 104973232110024
Author(s):  
Stephanie T. Lumpkin ◽  
Eileen Harvey ◽  
Paul Mihas ◽  
Timothy Carey ◽  
Alessandro Fichera ◽  
...  
Keyword(s):  
Health Care ◽  
Colorectal Surgery ◽  
Health Care Utilization ◽  
Care Coordination ◽  
Health Care Use ◽  
Care Utilization ◽  
Discharge Instructions ◽  
Care Needs ◽  
High Resource ◽  
Optimal Health

Readmissions and emergency department (ED) visits after colorectal surgery (CRS) are common, burdensome, and costly. Effective strategies to reduce these unplanned postdischarge health care visits require a nuanced understanding of how and why patients make the decision to seek care. We used a purposefully stratified sample of 18 interview participants from a prospective cohort of adult CRS patients. Thirteen (72%) participants had an unplanned postdischarge health care visit. Participant decision-making was classified by methodology (algorithmic, guided, or impulsive), preexisting rationale, and emotional response to perceived health care needs. Participants voiced clear mental algorithms about when to visit an ED. In addition, participants identified facilitators and barriers to optimal health care use. They also identified tangible targets for health care utilization reduction efforts, such as improved care coordination with streamlined discharge instructions and improved communication with the surgical team. Efforts should be directed at improving postdischarge communication and care coordination to reduce CRS patients’ high-resource health care utilization.

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