insurance status
Recently Published Documents


TOTAL DOCUMENTS

1369
(FIVE YEARS 450)

H-INDEX

51
(FIVE YEARS 7)

2022 ◽  
Vol 270 ◽  
pp. 139-144
Author(s):  
Jennifer E. Sullivan ◽  
Suraj Panjwani ◽  
Mitchell A. Cahan

2022 ◽  
Vol 270 ◽  
pp. 22-30
Author(s):  
Kelly A. Stahl ◽  
Daleela Dodge ◽  
Elizabeth J. Olecki ◽  
Rolfy Perez Holguin ◽  
Christopher McLaughlin ◽  
...  

2022 ◽  
Vol 29 (1) ◽  
pp. 383-391
Author(s):  
Marie-France Savard ◽  
Elizabeth N. Kornaga ◽  
Adriana Matutino Kahn ◽  
Sasha Lupichuk

Metastatic breast cancer (MBC) patient outcomes may vary according to distinct health care payers and different countries. We compared 291 Alberta (AB), Canada and 9429 US patients < 65 with de novo MBC diagnosed from 2010 through 2014. Data were extracted from the provincial Breast Data Mart and from the National Cancer Institute’s SEER program. US patients were divided by insurance status (US privately insured, US Medicaid or US uninsured). Kaplan-Meier and log-rank analyses were used to assess differences in OS and hazard ratios (HR) were estimated using Cox models. Multivariate models were adjusted for age, surgical status, and biomarker profile. No difference in OS was noted between AB and US patients (HR = 0.92 (0.77–1.10), p = 0.365). Median OS was not reached for the US privately insured and AB groups, and was 11 months and 8 months for the US Medicaid and US uninsured groups, respectively. The 3-year OS rates were comparable between US privately insured and AB groups (53.28% (51.95–54.59) and 55.54% (49.49–61.16), respectively). Both groups had improved survival (p < 0.001) relative to the US Medicaid and US uninsured groups [39.32% (37.25–41.37) and 40.53% (36.20–44.81)]. Our study suggests that a universal health care system is not inferior to a private insurance-based model for de novo MBC.


2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Gang Li ◽  
Donglan Zhang ◽  
Zhuo Chen ◽  
Da Feng ◽  
Xinyan Cai ◽  
...  

Abstract Background Early accurate diagnosis and risk assessment for malaria are crucial for improving patients’ terminal prognosis and preventing them from progressing to a severe or critical stage. This study aims to describe the accuracy of the initial diagnosis of malaria cases with different characteristics and the factors that affect the accuracy in the context of the agenda for a world free of malaria. Methods A retrospective study was conducted on 494 patients admitted to hospitals with a diagnosis of malaria from January 2014 through December 2016. Descriptive statistics were calculated, and decision tree analysis was performed to predict the probability of patients who may be misdiagnosed. Results Of the 494 patients included in this study, the proportions of patients seeking care in county-level, prefecture-level and provincial-level hospitals were 27.5% (n = 136), 26.3% (n = 130) and 8.3% (n = 41), respectively; the proportions of patients seeking care in clinic, township health centre and Centres for Disease Control and Prevention were 25.9% (n = 128), 4.1% (n = 20), and 7.9% (n = 39), respectively. Nearly 60% of malaria patients were misdiagnosed on their first visit, and 18.8% had complications. The median time from onset to the first visit was 2 days (IQR: 0-3 days), and the median time from the first visit to diagnosis was 3 days (IQR: 0–4 days). The decision tree classification of malaria patients being misdiagnosed consisted of six categorical variables: healthcare facilities for the initial diagnosis, time interval between onset and initial diagnosis, region, residence type, insurance status, and age. Conclusions Insufficient diagnostic capacity of healthcare facilities with lower administrative levels for the first visit was the most important risk factor in misdiagnosing patients. To reduce diagnostic errors, clinicians, government decision-makers and communities should consider strengthening the primary care facilities, the time interval between onset and initial diagnosis, residence type, and health insurance status.


2022 ◽  
Author(s):  
Michelle Malnoske ◽  
Caroline Quill ◽  
Amelia Barwise ◽  
Anthony Pietropaoli

Abstract Background: Lung-protective ventilation is often used in critically ill patients with acute respiratory failure, including those without acute respiratory distress syndrome. While disparities exist in the delivery of critical care based on gender, race, and insurance status, it is unknown whether there are disparities in the use of lung-protective ventilation. The objective of our study was to determine whether gender-, racial / ethnic-, or insurance status-based disparities exist in the use of lung-protective ventilation for critically ill mechanically ventilated patients in the United States (U.S.).Methods: This was a secondary data analysis of the U.S. Critical Illness and Injury Trials Group Critical Illness Outcomes Study, a prospective multi-center cohort study conducted from 2010 - 2012. The dependent variable of interest was the proportion of patients receiving tidal volume > 8 mL/kg predicted body weight (PBW). The independent variables of interest were gender, insurance status, and race / ethnicity. Results: Our primary analysis included 1,595 mechanically ventilated patients from 59 intensive care units (ICUs) in the U.S. Women were more likely to receive tidal volumes > 8 ml/kg PBW than men (odds ratio [OR] = 3.25, 95% confidence interval [CI] = 2.58 – 4.09), though this relationship was substantially weakened after adjusting for gender differences in height (OR = 1.26 95% CI = 0.94 – 1.71). The underinsured were significantly more likely to receive tidal volume > 8 ml/kg PBW than the insured in multivariable analysis (odds ratio = 1.54, 95% confidence interval = 1.16 – 2.04). The prescription of > 8 ml/kg PBW tidal volume did not differ by racial or ethnic categories. Conclusions: In this prospective nationwide cohort of critically ill mechanically ventilated patients, women and the underinsured were less likely than their comparators to receive lung protective ventilation, with no apparent differences based on race / ethnicity alone. Differences in height between men and women do not fully explain this disparity. Future research should evaluate whether implicit bias affects tidal volume choice and other management decisions in critical care.


2022 ◽  
pp. 000313482110547
Author(s):  
Chelsea Knotts ◽  
Alexandra Van Horn ◽  
Krysta Orminski ◽  
Stephanie Thompson ◽  
Jacob Minor ◽  
...  

Background Previous literature demonstrates correlations between comorbidities and failure to complete adjuvant chemotherapy. Frailty and socioeconomic disparities have also been implicated in affecting cancer treatment outcomes. This study examines the effect of demographics, comorbidities, frailty, and socioeconomic status on chemotherapy completion rates in colorectal cancer patients. Methods This was an observational case-control study using retrospective data from Stage II and III colorectal cancer patients offered chemotherapy between January 01, 2013 and January 01, 2018. Data was obtained using the cancer registry, supplemented with chart review. Patients were divided based on treatment completion and compared with respect to comorbidities, age, Eastern Cooperative Oncology Group (ECOG) score, and insurance status using univariate and multivariate analyses. Results 228 patients were identified: 53 Stage II and 175 Stage III. Of these, 24.5% of Stage II and 30.3% of Stage III patients did not complete chemotherapy. Neither ECOG status nor any comorbidity predicted failure to complete treatment. Those failing to complete chemotherapy were older (64.4 vs 60.8 years, P = .043). Additionally, those with public assistance or self-pay were less likely to complete chemotherapy than those with private insurance ( P = .049). Both factors (older age/insurance status) remained significant on multivariate analysis (increasing age at diagnosis: OR 1.03, P =.034; public insurance: OR 1.84, P = .07; and self-pay status: OR 4.49, P = .03). Conclusions No comorbidity was associated with failure to complete therapy, nor was frailty, as assessed by ECOG score. Though frailty was not significant, increasing age was, possibly reflecting negative attitudes toward chemotherapy in older populations. Insurance status also predicted failure to complete treatment, suggesting disparities in access to treatment, affected by socioeconomic factors.


HPB ◽  
2022 ◽  
Author(s):  
Marianna V. Papageorge ◽  
Alison P. Woods ◽  
Susanna W.L. de Geus ◽  
Sing Chau Ng ◽  
Michael K. Paasche-Orlow ◽  
...  

2022 ◽  
Vol 226 (1) ◽  
pp. S734-S735
Author(s):  
Anne R. Waldrop ◽  
Giovanna Cruz ◽  
Paula Trepman ◽  
Sanaa Suharwardy

2022 ◽  
Vol 83 (1) ◽  
pp. 58-66
Author(s):  
Tsai-Ling Liu ◽  
Yhenneko J. Taylor ◽  
Johanna Claire Schuch ◽  
Lisa Tucker ◽  
Kathryn M. Zager ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document