Does the Diabetes Health Plan Have a Differential Impact on Medication Adherence Among Beneficiaries with Fewer Financial Resources?

2021 ◽  
Author(s):  
Huang ◽  
MS Norman Turk ◽  
Susan L. Ettner ◽  
Mangione ◽  
Moin ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Propensity Score ◽  
Health Plan ◽  
Low Income ◽  
Income Group ◽  
Differential Impact ◽  
Individual Level ◽  
A Value ◽  
Quasi Experimental ◽  
The Impact

Abstract Background: The Diabetes Health Plan (DHP), a value-based insurance plan that reduces cost sharing, was previously shown to modestly increase employer-level medication adherence. However, it is unclear whether the DHP has a larger impact on individual-level medication adherence among lower- or higher-income beneficiaries. Methods: An employer-level propensity score match was done to identify suitable control employers, followed by individual-level propensity score weighting. These weights were applied to difference-in-difference (DID) models examining 1) the effect of the DHP and 2) the effect of income on changes in adherence to metformin, statins, and ACE/ARBs. The weights were then applied to a differences-in-differences-in-differences (DDD) model to estimate the differential impact of DHP status on changes in adherence by income group. This is a retrospective, quasi-experimental study.Results: There were no significant differences in changes to adherence for any medications between beneficiaries enrolled in the DHP versus standard plans. However, changes in adherence were higher for all medications among those in the highest income strata (>$75,000) versus those in the lowest income strata (<$50,000; p < 0.01). Finally, the DDD term examining the impact of income on the DHP effect was not significant for any comparisons. Conclusion: We did not find significant associations between the DHP and changes in individual-level medication adherence, even for low-income beneficiaries. New strategies to improve consumer engagement may be needed in order to translate value-based insurance designs into changes in patient behavior.

scholarly journals The Impact of Urban Recreation Environment on Residents’ Happiness—Based on a Case Study in China

2021 ◽  
Vol 13 (10) ◽  
pp. 5549
Author(s):  
Lei Kang ◽  
Zhaoping Yang ◽  
Fang Han
Keyword(s):  
Low Income ◽  
Subjective Evaluation ◽  
Objective Evaluation ◽  
Income Group ◽  
High Income Group ◽  
Rapid Urbanization ◽  
Indirect Impact ◽  
Negative Effect ◽  
The Impact ◽  
Urban Recreation

Rapid urbanization promotes the expansion of urban tourism and recreation functions, but it also brings many problems, which affect residents’ happiness. Previous studies have emphasized the direct impact of urban recreation environment on happiness, and few have explored the indirect impact of urban recreation environment on happiness through subjective evaluation. Based on the survey data of nearly 10,000 permanent residents in 40 key tourism cities in China, this paper establishes a theoretical framework of the direct and indirect impact of urban recreation environment on happiness. The objective evaluation of natural recreation environment and sociocultural recreation environment has an important influence on happiness, but the influence of natural recreation environment is greater than that of sociocultural recreation environment. Individual subjective satisfaction with urban recreation environment mediates the relationship between urban objective environment and happiness. Urban parks have a positive effect on happiness, while tourist attractions have a negative effect. The influence of urban location on happiness is nonlinear. The high-income group is more sensitive to the recreation environment, while the low-income group is less sensitive to the recreation environment. These findings provide insights for further improving citizens’ quality of life and designing urban construction in developing countries under the conditions of rapid urbanization.

Differential impact of on-site or telepharmacy in the intensive care unit: a controlled before–after study

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Joao Gabriel Rosa Ramos ◽  
Sandra Cristina Hernandes ◽  
Talita Teles Teixeira Pereira ◽  
Shana Oliveira ◽  
Denis de Melo Soares ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Phase 1 ◽  
Phase 2 ◽  
Differential Impact ◽  
Scarce Resources ◽  
Clinical Pharmacists ◽  
Versus Phase ◽  
Quasi Experimental ◽  
The Impact

Abstract Background Clinical pharmacists have an important role in the intensive care unit (ICU) team but are scarce resources. Our aim was to evaluate the impact of on-site pharmacists on medical prescriptions in the ICU. Methods This is a retrospective, quasi-experimental, controlled before-after study in two ICUs. Interventions by pharmacists were evaluated in phase 1 (February to November 2016) and phase 2 (February to May 2017) in ICU A (intervention) and ICU B (control). In phase 1, both ICUs had a telepharmacy service in which medical prescriptions were evaluated and interventions were made remotely. In phase 2, an on-site pharmacist was implemented in ICU A, but not in ICU B. We compared the number of interventions that were accepted in phase 1 versus phase 2. Results During the study period, 8797/9603 (91.6%) prescriptions were evaluated, and 935 (10.6%) needed intervention. In phase 2, there was an increase in the proportion of interventions that were accepted by the physician in comparison to phase 1 (93.9% versus 76.8%, P &lt; 0.001) in ICU A, but there was no change in ICU B (75.2% versus 73.9%, P = 0.845). Conclusion An on-site pharmacist in the ICU was associated with an increase in the proportion of interventions that were accepted by physicians.

scholarly journals Inequality, policy polarization and the income gap in turnout

2021 ◽  
pp. 135406882110119
Author(s):  
Matthew Polacko
Keyword(s):  
Income Inequality ◽  
Low Income ◽  
Party Systems ◽  
Individual Level ◽  
Income Gap ◽  
Income Groups ◽  
Logistic Regressions ◽  
Negative Impacts ◽  
The Impact ◽  
The Relationship

Previous research into the relationship between income inequality and turnout inequality has produced mixed results, as consensus is lacking whether inequality reduces turnout for all income groups, low-income earners, or no one. Therefore, this paper builds on this literature by introducing supply-side logic, through the first individual-level test of the impact that income inequality (moderated by policy manifesto positions) has on turnout. It does so through multilevel logistic regressions utilizing mixed effects, on a sample of 30 advanced democracies in 102 elections from 1996 to 2016. It finds that higher levels of income inequality significantly reduce turnout and widen the turnout gap between rich and poor. However, it also finds that when party systems are more polarized, low-income earners are mobilized the greatest extent coupled with higher inequality, resulting in a significantly reduced income gap in turnout. The findings magnify the negative impacts income inequality can exert on political behavior and contribute to the study of policy offerings as a key moderating mechanism in the relationship.

scholarly journals The Effect of Government Policy on Housing Delivery in Nigeria: A Case Study of Port Harcourt Low Income Housing Programme

2015 ◽  
Vol 61 ◽  
pp. 87-98 ◽  
Author(s):  
John Owuike Iheme ◽  
James Bassey Effiong ◽  
Samuel Bassey Ekung
Keyword(s):  
Low Income ◽  
Government Policy ◽  
Income Group ◽  
Mortgage Market ◽  
Government Policies ◽  
Survey Method ◽  
Related Factors ◽  
High Interest Rate ◽  
Housing Needs ◽  
The Impact

Housing is one of the most important needs of individuals next to food and clothing. Housing needs for low income earners has reached an alarming stage in Nigeria. On the supply side, numerous government policies have earlier aimed at disabling the massive shortage through numerous housing reform programmes. Despite these preceding efforts, housing remains an illusion to an average Nigerian. This research assessed the effect of government policy on housing delivery in Nigeria. The objectives were to determine housing needs of the low income group in Nigeria and to determine the impact of government policies on affordable housing provision to the low income group. Survey method was used to collect data from 44 respondents through the administration of questionnaires which was analyzed with statistical tools. The findings from the study shows that insufficient fund is closely related to other finance related factors identified as barriers to the accessibility of public housing by the low income group who are non-public servants. Such factors as high interest rate, low per capita income, lack of security of income, lack of collateral and high cost of public houses. The study suggest the creation of a viable secondary mortgage market, improvement of land registration and allocation, compassionate urban renewal programmes, cost saving house designs amongst others.

scholarly journals A Study on the Sustainability of Microfinance Institutions in Serving the Low-Income Group in Malaysia

2021 ◽  
Vol 8 (Special Issue) ◽  
pp. 339-353
Author(s):  
Nur Harena Redzuan ◽  
Amir Abidin Bashir
Keyword(s):  
Low Income ◽  
Income Group ◽  
Small Scale ◽  
Microfinance Institutions ◽  
Poverty Eradication ◽  
The People ◽  
Start Up ◽  
Low Income Groups ◽  
The Government ◽  
The Impact

A microfinance scheme was introduced in Malaysia in the year 1987 as one of the alternatives to poverty eradication strategies in the country by the government. Since then, several institutions have created to carry out the agenda of providing small loans to the low-income group to start up their small-scale business to generate more sources of income to support their household consumption. However, for a certain reason, the people still do not find microfinance an important tool to uplift their economic positions. Most of the low-income groups are still unaware of this golden opportunity tailored for them. Besides, the sustainability of these subsidized microfinance systems implemented by Malaysia had not been appropriately studied. This study explores the attractiveness of the products offered by microfinance institutions and emphasizes the option that the participants must start utilizing the product. This research also explores microfinance facilities that contain conventional finance element which is prohibited in Islamic trade. The study also discusses the measures and actions taken by microfinance institutions in serving the low-income group in Malaysia. This paper employs a qualitative method through interviews and content analysis. The report, journal publications, and other related documents were also analyzed in achieving the objectives. The study provides the impact that it may pave the way to an indistinct understanding of how Islamic microfinance institutions sustain their operations.

Effects of the Your Family, Your Neighborhood Intervention on Neighborhood Social Processes

2019 ◽  
Vol 43 (4) ◽  
pp. 235-246
Author(s):  
Daniel Brisson ◽  
Stephanie Lechuga Peña ◽  
Nicole Mattocks ◽  
Mark Plassmeyer ◽  
Sarah McCune
Keyword(s):  
Social Control ◽  
Social Cohesion ◽  
Low Income ◽  
Urban Neighborhoods ◽  
Social Processes ◽  
Neighborhood Social Cohesion ◽  
Quasi Experimental ◽  
And Control ◽  
The Impact ◽  
Larger Sample

Abstract The objective of this study was to ascertain whether participation in the Your Family, Your Neighborhood (YFYN) intervention, an intervention for families living in low-income neighborhoods, leads to improved perceptions of neighborhood social cohesion and informal neighborhood social control. Fifty-two families in three low-income, urban neighborhoods participated in the manualized YFYN intervention. In this quasi-experimental study treatment families (n = 37) in two low-income neighborhoods received YFYN and control families (n = 15) from one separate low-income neighborhood did not. Families receiving YFYN attended 10 two-hour skills-based curriculum sessions during which they gathered for a community dinner and participated in parent- and child-specific skills-based groups. Treatment families reported increases in both neighborhood social cohesion and informal neighborhood social control after receiving YFYN. However, families receiving YFYN did not experience statistically significant improvements in perceptions of neighborhood social cohesion or informal neighborhood social control compared with nontreatment families. In conclusion, the delivery of YFYN in low-income neighborhoods may improve perceptions of neighborhood social cohesion. Further testing, with randomization and a larger sample, should be conducted to provide a more robust understanding of the impact of YFYN.

Reappraising the Impact of Offending on Victimization: A Propensity Score Matching Approach

2017 ◽  
Vol 62 (8) ◽  
pp. 2374-2390
Author(s):  
Chad Posick
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Property Crime ◽  
Experimental Methods ◽  
Wide Range ◽  
Sample Data ◽  
Quasi Experimental ◽  
The Life Course ◽  
The Impact ◽  
The Relationship

Existing evidence clearly supports an empirical connection between offending and victimization. Often called the “victim–offender overlap,” this relationship holds for both sexes, across the life course, and across a wide range of countries and cultural environments. In addition, the relationship is sustained regardless of the study sample and statistical methods applied in the analyses of the sample data. However, there has yet to be a study that examines this relationship for violent and property crime using quasi-experimental methods accounting for a wide range of potential confounders including individual differences and cultural contexts. This study subjects the victim–offender relationship to testing through propensity score matching for both violent and property crimes using an international dataset. The results show that previous violent and theft offending increases the odds of victimization when matching on individual and contextual factors. This finding supports previous literature and suggests that delinquent behavior may act as a “switch” that exposes one to subsequent violent and theft victimization.

scholarly journals Nonlinear Dynamics in the Finance-Inequality Nexus in China-CHNS Data

2019 ◽  
Vol 11 (1) ◽  
pp. 191 ◽  
Author(s):  
Mohammad Masudur Rahman ◽  
Guan Fuquan ◽  
Laila Arjuman Ara
Keyword(s):  
Financial Development ◽  
Low Income ◽  
Income Group ◽  
High Income Group ◽  
Middle Income ◽  
Linear Effect ◽  
Quantile Regression Model ◽  
Income Groups ◽  
Using Data ◽  
The Impact

This paper empirically investigates the effects of financial development on incomes of Chinese residents particularly within various income groups using data from six provinces by applying the Quantile Regression model. The Greenwood and Jovanovich hypothesis that illustrates the inverted U shaped relationship between financial development and income inequality is tested. This empirical study demonstrates that financial development has a positive but non-linear effect on the annual income of individuals from various income groups at different quantiles. The effect is an inverted U or Kuznets effect indicating an increase at first and then a drop. As for the distribution of the impact on various income groups, the low-income group is under the most dominant influence followed by the high-income group with the middle-income groups receiving relatively smaller influence. Findings indicate that promoting balanced financial development would help to ease the income gap between Chinese residents.

Home Visiting Effects on Breastfeeding and Bedsharing in a Low-Income Sample

2020 ◽  
pp. 109019812096419
Author(s):  
Joshua P. Mersky ◽  
Colleen E. Janczewski ◽  
ChienTi Plummer Lee ◽  
Ross M. Gilbert ◽  
Cali McAtee ◽  
...  
Keyword(s):  
Low Income ◽  
Home Visiting ◽  
Health Department ◽  
The United States ◽  
Breastfeeding Duration ◽  
Breastfeeding Initiation ◽  
Public Health Department ◽  
Safe Sleep ◽  
Quasi Experimental ◽  
The Impact

Background Research suggests that home visiting interventions can promote breastfeeding initiation, though their effects on breastfeeding continuation are unclear. No known studies have assessed the impact of home visiting on bedsharing. Aims To test the effects of home visiting on breastfeeding and bedsharing in a low-income, urban sample in the United States. Methods During a field trial conducted in Milwaukee, Wisconsin, from April 2014 to March 2017, referrals to a public health department were randomized to a Healthy Families America (HFA) program or a prenatal care and coordination (PNCC) program. Of the 204 women who accepted services, 139 consented to the study and were allocated to the two treatment groups, which were compared with each other and a third quasi-experimental group of 100 women who did not accept services. Data were collected at four time points up to 12 months postpartum. Results Breastfeeding initiation was higher among 72 HFA participants (88.4%; odds ratio [OR] = 2.7) and 67 PNCC participants (88.5%; OR = 2.2) than 100 comparison participants (76.5%). Similar results emerged for breastfeeding duration, though group differences were not statistically significant. Unexpectedly, bedsharing prevalence was higher among HFA participants (56.5%) than PNCC participants (31.1%; OR = 2.9) and comparison group participants (38.8%; OR = 2.0). Discussion Home visiting was linked to increased breastfeeding, while effects on bedsharing varied by program. Progress toward precision home visiting will be advanced by identifying program components that promote breastfeeding and safe sleep. Conclusion Further research is needed to examine whether home visiting reduces disparities in breastfeeding and safe sleep practices.

scholarly journals Why women empowerment is needed post COVID-19?

2020 ◽  
Author(s):  
Prerna Karulkar
Keyword(s):  
Low Income ◽  
Social Transformation ◽  
Income Group ◽  
Women Empowerment ◽  
Financial Independence ◽  
Men And Women ◽  
Individual Level ◽  
The Social ◽  
Grass Root ◽  
Grass Root Level

The dreadful COVID-19 pandemic has brought forth many harsh realities. This has affected men and women differently. As it is, women already suffer the fate of the lesser gender due to the prevalent patriarchal society. The ongoing outbreak has increased this divide. Women face many challenges be it in urban or rural area, middle or low-income group; the issues differ to an extent, but they exist. The roles as defined by the social norms have become more prominent. This paper attempts to study the various consequences of the COVID-19 pandemic on women and men. It provides an assessment as to why women empowerment is the need of the hour and tries to find probable solutions to the pertaining problems. Education and financial independence are two primary ways of empowerment at individual level. As a society, we need to rethink and revamp the values, beliefs, attitudes towards gender norms and predefined roles. We need to make changes at the grass root level to bring in equality. Global social transformation is required in order to weaken the deep-rooted patriarchy.

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