We examined the prevalence of self-reported chronic conditions and out-of-pocket spending using 2005 Medical Expenditure Panel Survey (MEPS) made comparisons to previously published MEPS data. Our study found that is increasing among not only old-old but also people in midlife earlier old age. The greatest growth occurred number affected by multiple diseases, a group with sizable spending. Policymakers should be aware cost sharing at point care can disproportionately burden discourage...

<h3>PURPOSE</h3> Engaging patients, caregivers, and other health care stakeholders as partners in planning, conducting, disseminating research is a promising way to improve clinical decision making outcomes. Many researchers, stakeholders, however, lack clarity about when how engage within the process. To address need for guidance on creating meaningful stakeholder partnerships patient-centered comparative effectiveness research, Patient-Centered Outcomes Research Institute (PCORI) developed...

Understanding health insurance is central to affording and accessing care in the United States. Efforts support consumers making wise purchasing decisions using their advantage would benefit from development of a valid reliable measure assess literacy. This article reports on Health Insurance Literacy Measure (HILM), self-assessment consumers' ability select use private insurance. The authors developed conceptual model literacy based formative research stakeholder guidance. Survey items were...

Background: Despite broad agreement among researchers about the value of examining how context shapes implementation improvement programs and projects, limited attention has been paid to contextual effects on Lean. Purpose: To help reduce gaps in knowledge intraorganizational context, we researched Lean initiatives five organizations examined 12 their rapid projects. All projects aimed at improving clinical care delivery. Methodology/Approach: On basis literature Lean, innovation, quality...

Objective: To determine if there is a difference in the prevalence of vasomotor symptoms between African American and white postmenopausal women. Methods: We conducted cross-sectional study to evaluate baseline women enrolled randomized, placebo-controlled trial dietary soy supplements. The Menopause-Specific Quality Life Questionnaire (MENQOL) subscale was used measure symptoms, including hot flashes night sweats. Results: In total, 104 112 (mean age 56.8 ± 5.6 years) were studied. A...

Abstract Purpose: To evaluate the cost‐effectiveness of case management by a nurse practitioner (NP) to lower blood lipids in patients with coronary heart disease (CHD) from managed care perspective. Data sources: A total 228 consecutive, eligible adults hypercholesterolemia and CHD were recruited during hospitalization after revascularization. Patients randomized receive lipid management, including individualized lifestyle modification pharmacologic intervention an NP for 1 year discharge...

This study assessed the perceptions and actions of rural hospital nurse executives with regard to patient safety quality improvement (QI). A national sample (n = 300) completed a survey measuring 4 domains related QI: (a) "Safety Culture," (b) adequacy QI "Resources," (c) "Barriers" QI, (d) "Nurse Leader Engagement" in activities supporting QI. Perceptions Safety Culture were strong but 47% Resources needed carry out inadequate, 29% Barriers moderate major, 25% Nurse Engagement performed...

Randomized controlled trials that test the effectiveness of mobile health-based weight loss programs are attractive to participants, funders, and researchers because low implementation cost, minimal participant burden, ability recruit participants from longer distances. Collecting data geographically dispersed is a challenge. Relying on self-report one approach collection, but epidemiologic studies indicate self-reported anthropometric may be inaccurate. We provided women enrolled in...

The oral route is compromised for nearly all patients at the end of life (EOL). This article reviews benefits and burdens usual alternative routes medication delivery when fails presents a case study on use new innovation rectal to control EOL symptoms. A 62-year-old male hospice patient with end-stage metastatic prostate cancer presented severe symptoms (Face, Legs, Activity, Cry Consolability scale score, 9/10) that were uncontrollable medications given via or sublingual routes. goals...

Objectives: To observe gestational diabetes mellitus (GDM) prevalence among participants receiving enhanced prenatal care through one of three models: Birth Centers, Group Prenatal Care, and Maternity Care Homes. Materials Methods: This study draws upon data collected from 2014 to 2017 as part the Strong Start II evaluation includes nearly 46,000 women enrolled across 27 awardees with more than 200 sites throughout United States. Descriptive statistical analyses utilized participant surveys...

People with arthritis, a leading cause of disability, may be prescribed long-term opioid therapy to manage chronic pain. Regular use opioids can increase risk overdose and disorder (OUD). The purpose our research was validate an instrument screen for harmful in people disability pain due arthritis (PWDA). We tested the Current Opioid Misuse1 Measure (COMM), designed monitoring on opioids, 318 PWDA who are taking long term from February-June 2020. validated COMM against Diagnostic Statistical...

To help reduce gaps in knowledge of how context shapes improvement initiatives, we report a qualitative study Lean implementation 5 divergent organizations. Our conceptual model distinguishes the external and internal (organizational) contexts; methodology; project organizational outcomes. Using interviews, documents, data, observations, analyzed 6 projects prospectively retrospectively. Organizational factors facilitating success ( primarily defined as attainment intended targets) overall...

Objective To assess whether patients with autoimmune disease would accept advanced practice providers (APPs) as an option to fill the growing shortage of rheumatologists. Methods We administered a cross‐sectional survey 500 or parents children who reported having been diagnosed qualifying conditions and had seen their primary rheumatology in past 6 months. Respondents self‐reported were rheumatologists APPs. Our analysis compared attitude experience whose APPs those Results Of respondents,...