THE LEADING PREventable cause of death in the United States. 1 In an effort to target public health interventions, recent studies have focused on smoking distinct populations, such as pregnant women 2 and adolescents. 3e believe those with mental illness are another group that merits special attention.Previous found high rates among selected populations persons illness, psychiatric outpatients 4 patients a state hospital. 5][8][9][10][11] Persons may encounter greater difficulty tobacco...

We analyzed the prevalence of chronic illnesses, including mental illness, and access to health care among US inmates.

A decade ago, the administrative costs of health care in United States greatly exceeded those Canada. We investigated whether ascendancy computerization, managed care, and adoption more businesslike approaches to have decreased costs.For Canada, we calculated insurers, employers' benefit programs, hospitals, practitioners' offices, nursing homes, home agencies 1999. analyzed published data, surveys physicians, employment detailed cost reports filed by agencies. In calculating share spending,...

We compared health status, access to care, and utilization of medical services in the United States Canada disparities according race, income, immigrant status.We analyzed population-based data on 3505 Canadian 5183 US adults from Joint Canada/US Survey Health. Controlling for gender, age, we used logistic regression analyze country as a predictor quality satisfaction with care these measures.In multivariate analyses, respondents (compared Canadians) were less likely have regular doctor,...

In 2001, 1.458 million American families filed for bankruptcy. To investigate medical contributors to bankruptcy, we surveyed 1,771 personal bankruptcy filers in five federal courts and subsequently completed in-depth interviews with 931 of them. About half cited causes, which indicates that 1.9–2.2 Americans (filers plus dependents) experienced Among those whose illnesses led out-of-pocket costs averaged $11,854 since the start illness; 75.7 percent had insurance at onset illness. Medical...

A 1993 study found a 25% higher risk of death among uninsured compared with privately insured adults. We analyzed the relationship between uninsurance and more recent data.We conducted survival analysis data from Third National Health Nutrition Examination Survey. participants aged 17 to 64 years determine whether at time interview predicted death.Among all participants, 3.1% (95% confidence interval [CI]=2.5%, 3.7%) died. The hazard ratio for mortality insured, adjustment age gender only,...

Previous studies based on local case series estimated the annual incidence of endocarditis in U.S. at about 4 per 100,000 population. Small-scale elsewhere have reported similar rates. However, no nationally-representative population-based verified these estimates.Using 1998-2009 Nationwide Inpatient Sample, which provides diagnoses from 8 million hospitalizations annually, we examined hospitalizations, bacteriology, co-morbidities, outcomes and costs. Hospital admissions for rose 25,511...

<h3>Objective:</h3> To evaluate racial and ethnic differences in the utilization of neurologic care across a wide range conditions United States. <h3>Methods:</h3> We analyzed nationally representative data from 2006–2013 Medical Expenditure Panel Survey (MEPS), including information on demographics, patient-reported health conditions, neurology visit rates, costs. Using diagnostic codes, we identified persons with any self-identified disorder except back pain, as well 5 subgroups (Parkinson...

Psychiatric and behavior problems are common among children young adults, many go without care or only receive treatment in carceral settings. We examined racial ethnic disparities children's adults' receipt of mental health substance abuse using nationally representative data from the 2006-2012 Medical Expenditure Panel Surveys. Blacks' Hispanics' visit rates (and per capita expenditures) were about half those non-Hispanic whites for all types definitions outpatient services. Disparities...

A few studies have noted the outsize administrative costs of US hospitals, but no research has compared these across multiple nations with various types health care systems. We assembled a team international policy experts to conduct just such challenging analysis hospital eight nations: Canada, England, Scotland, Wales, France, Germany, Netherlands, and United States. found that accounted for 25.3 percent total expenditures—a percentage is increasing. Next highest were Netherlands (19.8...

AffiliationsDavid U. Himmelstein and Steffie Woolhandler are with Hunter College, City University of New York, NY, Harvard Medical School, Boston, MA. Robert M. Lawless is the Illinois College Law, Champaign. Deborah Thorne Department Sociology & Anthropology, Idaho, Moscow. Pamela Foohey Maurer School Indiana University, Bloomington.

Ideas and Opinions7 April 2020Intersecting U.S. Epidemics: COVID-19 Lack of Health InsuranceFREESteffie Woolhandler, MD, MPH David U. Himmelstein, MDSteffie MPHCity University New York at Hunter College, York, Harvard Medical School Cambridge Alliance, Cambridge, Massachusetts (S.W., D.U.H.) MDCity D.U.H.)Author, Article, Disclosure Informationhttps://doi.org/10.7326/M20-1491 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions...

<h3>Importance</h3> In the US, Black people receive less health care than White people. Data on long-term trends in these disparities, which provide historical context for interpreting contemporary inequalities, are lacking. <h3>Objective</h3> To assess Black-White disparities use since 1963. <h3>Design, Setting, and Participants</h3> This cross-sectional study analyzed 29 US surveys conducted between 1963 2019 of noninstitutionalized non-Hispanic civilians. <h3>Exposures</h3> Self-reported...

Objectives. Two thirds of nursing homes are investor owned. This study examined whether ownership affects quality. Methods. We analyzed 1998 data from state inspections 13 693 facilities. used a multivariate model and controlled for case mix, facility characteristics, location. Results. Investor-owned facilities averaged 5.89 deficiencies per home, 46.5% higher than nonprofit 43.0% public In analysis, predicted 0.679 additional home; chain an 0.633 deficiencies. Nurse staffing was lower at...

The proportion of health maintenance organization (HMO) members enrolled in investor-owned plans has increased sharply, yet little is known about the quality these compared with not-for-profit HMOs.To compare quality-of-care measures for and HMOs.Analysis Health Plan Employer Data Information Set (HEDIS) Version 3.0 from National Committee Quality Assurance's Compass 1997, which included 1996 data 329 HMO (248 81 not-for-profit), representing 56% total enrollment United States.Rates 14 HEDIS...

Objectives. We compared the health care expenditures of immigrants residing in United States with US-born persons. Methods. used 1998 Medical Expenditure Panel Survey linked to 1996–1997 National Health Interview analyze data on 18398 persons and 2843 immigrants. Using a 2-part regression model, we estimated total expenditures, as well for emergency department (ED) visits, office-based hospital-based outpatient inpatient prescription drugs. Results. Immigrants accounted $39.5 billion (SE=$4...

In fiscal year 1990, administration accounted for 24.8 percent of total hospital costs in the United States — nearly twice share Canada. Studies from 1970s and early 1980s found high costs, especially administration, at for-profit hospitals.

No recent national studies have assessed chronic illness prevalence or access to care among persons without insurance in the United States.To compare reports of conditions and U.S. adults, by self-reported status.Population-based survey.National Health Nutritional Examination Survey (1999-2004).12,486 patients age 18 64 years.Estimates rates cardiovascular disease, hypertension, diabetes, hypercholesterolemia, active asthma obstructive pulmonary previous cancer, measures care.On basis...

Cost containment has dominated recent debate on health policy. Most analysts agree that skyrocketing costs necessitate constraints the amount of medical care delivered, but best way to effect such rationing remains controversial.1 , 2 Clinical epidemiologists and economists have used cost-effectiveness analysis other tools dissect necessary from superfluous in practice.3 4 Government industry applied blunter instruments prospective payment systems reductions number people with insurance...

As emergency department (ED) patient volumes increase throughout the United States, are patients waiting longer to see an ED physician? We evaluated change in wait time physician from 1997 2004 for all adult patients, diagnosed with acute myocardial infarction (AMI), and whom triage personnel designated as needing “emergent” attention. Increases times of 4.1 percent per year occurred but were especially pronounced AMI, waits increased 11.2 year. Blacks, Hispanics, women, seen urban EDs...