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Chronic Pain and Health Care Spending: An Analysis of Longitudinal Data from the Medical Expenditure Panel Survey 下载免费PDF全文
ObjectiveTo estimate average incremental health care expenditures associated with chronic pain by health care service category, expanding on prior research that focused on specific pain conditions instead of general pain, excluded low levels of pain, or did not incorporate pain duration.ConclusionsChronic pain limitations are associated with higher health care expenditures. Results underscore the substantial cost of pain to the health care system. 相似文献
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Despite steadily declining incarceration rates overall, racial and ethnic minorities, namely African Americans, Latinos, and American Indians and Alaska Natives, continue to be disproportionately represented in the justice system. Ex-offenders commonly reenter communities with pressing health conditions but encounter obstacles to accessing care and remaining in care. The lack of health insurance coverage and medical treatment emerge as the some of the most reported reentry health needs and may contribute to observed health disparities. Linking ex-offenders to care and services upon release increases the likelihood that they will remain in care and practice successful disease management. The Affordable Care Act (ACA) offers opportunities to address health disparities experienced by the reentry population that places them at risk for negative health outcomes and recidivism. Coordinated efforts to link ex-offenders with these newly available opportunities may result in a trajectory for positive health and overall well-being as they reintegrate into society. 相似文献
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Michael Palmer Thuy Nguyen Teresa Neeman Helen Berry Terence Hull David Harley 《The International journal of health planning and management》2011,26(3):e151-e168
There is a need for nationally representative information on the affordability of health care by disability status to assist in the design of equitable health systems in developing countries. Using the Viet Nam National Health Survey (2001–2002), this paper analyses health care utilization, cost burden and coping strategies for people with disabilities versus the population at large. The results clearly show that the disabled population are more prone to hospitalization, and spend more on inpatient stays and pharmaceuticals. Households with disabled members are at greater risk of catastrophic health expenditures and debt financing, posing a serious threat to economic welfare. Copyright © 2010 John Wiley & Sons, Ltd. 相似文献
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America's Health Centers: Reducing Racial and Ethnic Disparities in Perinatal Care and Birth Outcomes 下载免费PDF全文
Leiyu Shi Gregory D. Stevens John T. Wulu Jr. Robert M. Politzer Jiahong Xu 《Health services research》2004,39(6P1):1881-1902
Objective. To examine whether community health centers (CHCs) reduce racial/ethnic disparities in perinatal care and birth outcomes, and to identify CHC characteristics associated with better outcomes.
Background. Despite great national wealth, the U.S. continues to rank poorly relative to other industrialized nations on infant mortality and other birth outcomes, and with wide inequities by race/ethnicity. Disparities in primary care (including perinatal care) may contribute to disparities in birth outcomes, which may be addressed by CHCs that provide safety-net medical services to vulnerable populations.
Methods. Data are from annual Uniform Data System reports submitted to the Bureau of Primary Health Care over six years (1996–2001) by about 700 CHCs each year.
Results. Across all years, about 60% of CHC mothers received first-trimester prenatal care and more than 70% received postpartum and newborn care. In 2001, Asian mothers were the most likely to receive both postpartum and newborn care (81.7% and 80.3%), followed by Hispanics (75.0% and 76.3%), blacks (70.8% and 69.9%), and whites (70.7% and 66.7%). In 2001, blacks had higher rates of low birth weight (LBW) babies (10.4%), but the disparity in rates for blacks and whites was smaller in CHCs (3.3 percentage points) compared to national disparities for low-socioeconomic status mothers (5.8 percentage points) and the total population (6.2 percentage points). In CHCs, greater perinatal care capacity was associated with higher rates of first-trimester prenatal care, which was associated with a lower LBW rate.
Conclusion. Racial/ethnic disparities in certain prenatal services and birth outcomes may be lower in CHCs compared to the general population, despite serving higher-risk groups. Within CHCs, increasing first-trimester prenatal care use through perinatal care capacity may lead to further improvement in birth outcomes for the underserved. 相似文献
Background. Despite great national wealth, the U.S. continues to rank poorly relative to other industrialized nations on infant mortality and other birth outcomes, and with wide inequities by race/ethnicity. Disparities in primary care (including perinatal care) may contribute to disparities in birth outcomes, which may be addressed by CHCs that provide safety-net medical services to vulnerable populations.
Methods. Data are from annual Uniform Data System reports submitted to the Bureau of Primary Health Care over six years (1996–2001) by about 700 CHCs each year.
Results. Across all years, about 60% of CHC mothers received first-trimester prenatal care and more than 70% received postpartum and newborn care. In 2001, Asian mothers were the most likely to receive both postpartum and newborn care (81.7% and 80.3%), followed by Hispanics (75.0% and 76.3%), blacks (70.8% and 69.9%), and whites (70.7% and 66.7%). In 2001, blacks had higher rates of low birth weight (LBW) babies (10.4%), but the disparity in rates for blacks and whites was smaller in CHCs (3.3 percentage points) compared to national disparities for low-socioeconomic status mothers (5.8 percentage points) and the total population (6.2 percentage points). In CHCs, greater perinatal care capacity was associated with higher rates of first-trimester prenatal care, which was associated with a lower LBW rate.
Conclusion. Racial/ethnic disparities in certain prenatal services and birth outcomes may be lower in CHCs compared to the general population, despite serving higher-risk groups. Within CHCs, increasing first-trimester prenatal care use through perinatal care capacity may lead to further improvement in birth outcomes for the underserved. 相似文献
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张国荣 《中国初级卫生保健》2014,28(10):49-51
目的 探究影响孕产妇利用保健服务的相关因素,并结合地区实际,提出了相关建议和措施.方法 对在我院进行保健服务的1558名孕产妇进行调查分析,结合实际情况用SPSS 18.0统计学软件进行系统分析.结果 文化程度、家庭年收入水平、居住地距离、职业和医保等因素对孕产妇保健服务利用影响较大;同时,在1 558名受访者中,接受孕前保健指导的比率相对较低,早孕检查、5次以上产检率和住院分娩率结果相对较高,说明近几年来孕产妇对保健服务利用的意识有所提高,但产后访视比例仅为21.76%,比例较低.结论 针对当前现状,研究认为,个人、基层医疗保健机构及卫生管理部门等各方应当分别在提高认识水平、提高服务水平及加强基层系统建设等方面进行改善,以提高孕产妇保健服务的利用,提高优生优育水平. 相似文献
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Disparities in Alcohol,Drug Use,and Mental Health Condition Prevalence and Access to Care in Rural,Isolated, and Reservation Areas: Findings From the South Dakota Health Survey 下载免费PDF全文
Melinda M. Davis PhD Margaret Spurlock MPH Kristen Dulacki MPH Thomas Meath MPH Hsin‐Fang Li PhD Dennis McCarty PhD Donald Warne MD MPH Bill Wright PhD K. John McConnell PhD 《The Journal of rural health》2016,32(3):287-302
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Objective. To assess whether black–white and Hispanic–white disparities increase or abate in the upper quantiles of total health care expenditure, conditional on covariates.
Data Source. Nationally representative adult population of non-Hispanic whites, African Americans, and Hispanics from the 2001–2005 Medical Expenditure Panel Surveys.
Study Design. We examine unadjusted racial/ethnic differences across the distribution of expenditures. We apply quantile regression to measure disparities at the median, 75th, 90th, and 95th quantiles, testing for differences over the distribution of health care expenditures and across income and education categories. We test the sensitivity of the results to comparisons based only on health status and estimate a two-part model to ensure that results are not driven by an extremely skewed distribution of expenditures with a large zero mass.
Principal Findings. Black–white and Hispanic–white disparities diminish in the upper quantiles of expenditure, but expenditures for blacks and Hispanics remain significantly lower than for whites throughout the distribution. For most education and income categories, disparities exist at the median and decline, but remain significant even with increased education and income.
Conclusions. Blacks and Hispanics receive significantly disparate care at high expenditure levels, suggesting prioritization of improved access to quality care among minorities with critical health issues. 相似文献
Data Source. Nationally representative adult population of non-Hispanic whites, African Americans, and Hispanics from the 2001–2005 Medical Expenditure Panel Surveys.
Study Design. We examine unadjusted racial/ethnic differences across the distribution of expenditures. We apply quantile regression to measure disparities at the median, 75th, 90th, and 95th quantiles, testing for differences over the distribution of health care expenditures and across income and education categories. We test the sensitivity of the results to comparisons based only on health status and estimate a two-part model to ensure that results are not driven by an extremely skewed distribution of expenditures with a large zero mass.
Principal Findings. Black–white and Hispanic–white disparities diminish in the upper quantiles of expenditure, but expenditures for blacks and Hispanics remain significantly lower than for whites throughout the distribution. For most education and income categories, disparities exist at the median and decline, but remain significant even with increased education and income.
Conclusions. Blacks and Hispanics receive significantly disparate care at high expenditure levels, suggesting prioritization of improved access to quality care among minorities with critical health issues. 相似文献
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目的了解流动人口孕产妇女保健服务利用现状,提出促进流动人口孕产妇女保健服务利用的建议。方法在北京和杭州两市流动人口聚集区,对1 446例流动孕产妇女进行问卷调查。结果43.3%的流动孕产妇女建立了孕产妇保健档案,5次及以上产前检查率为59.5%,住院分娩率为86.9%,产后访视率为11.6%。结论流动人口对孕产期保健服务利用率低,需要通过加强流动人口孕产妇管理、健康教育、打击非法接生,来促进流动人口接受孕产期保健服务。 相似文献
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To reduce racial and ethnic disparities in health care, managers, policy makers, and researchers need valid and reliable data on the race and ethnicity of individuals and populations. The federal government is one of the most important sources of such data. In this paper we review the strengths and weaknesses of federal data that pertain to racial and ethnic disparities in health care. We describe recent developments that are likely to influence how these data can be used in the future and discuss how local programs could make use of these data. 相似文献
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HEIDI ALLEN BILL J. WRIGHT KRISTIN HARDING LAUREN BROFFMAN 《The Milbank quarterly》2014,92(2):289-318