All health care systems face problems of justice and efficiency related to setting priorities for allocating a limited pool resources population. Because many the central issues are same in all systems, United States other countries can learn from successes failures that have explicitly addressed question priorities.We review explicit priority efforts Norway, Sweden, Israel, Netherlands, Denmark, New Zealand, Kingdom state Oregon US. The approaches used be divided into those centered on...

To determine whether the 2014 Medicaid expansions facilitated by Affordable Care Act affected overall and early-stage cancer diagnosis for nonelderly adults.We used Surveillance, Epidemiology, End Results Cancer Registry data from 2010 through to estimate a difference-in-differences model of rates, both stage, comparing changes in county-level rates US states that expanded with those did not expand Medicaid.Among 611 counties this study, expansion was associated an increase diagnoses 13.8...

Background: This analysis describes associations between area deprivation and patient-reported outcomes among patients with advanced cancer. Methods: is a cross-sectional of baseline data from multisite primary palliative care intervention trial. Participants were adult Patient-level scores calculated using the Area Deprivation Index (ADI). Quality life symptom burden measured. Uni- multivariate regressions estimated interest. Results: Among 672 patients, ∼0.5 (54%) women most (94%)...

Importance Medicare Advantage (MA) plans are designed to incentivize the use of less expensive drugs through capitated payments, formulary control, and preauthorizations for certain drugs. These conditions may reduce spending on high-cost therapies such as cancer, a condition that is among most treat. Objective To determine whether patients insured by MA receive than those traditional (TM). Design, Setting, Participants This cohort study used data from linked Colorado All Payer Claims...

Changes in Insurance Coverage Among Cancer Patients Under the Affordable Care ActThe Act (ACA) has reduced number of uninsured persons United States to a historic low.Debate continues about potential changes law that could affect coverage for millions, particularly those with preexisting conditions.Meanwhile, cancer is leading cause death among Americans aged 19 64 years. 1 Treatment often unaffordable patients, 2 and some studies suggest expanding insurance improve cancer-related outcomes....

In the context of COVID-19, cancer survivors represent a particularly vulnerable population that may be "doubly hit" by both costs treatment and financial strain imposed pandemic.We performed review literature pertaining to cancer, toxicity, economic challenges.Multiple societies have put forth recommendations modify delivery care in order minimize patient exposure virus. Cancer survivors, especially patients with head neck been disproportionately affected rising unemployment levels...

Introduction: Rural populations routinely rank poorly on common health indicators. While it is understood that rural residents face barriers to care, the exact nature of these remains unclear. To further define barriers, a qualitative study primary care physicians practicing in communities was performed. Methods: Semistructured interviews were conducted with areas within western Pennsylvania, third largest population USA, using purposively sampling. Data then transcribed, coded, and analyzed...

PURPOSE People experiencing housing insecurity (PEHI) may face barriers to preventive cancer screening, but the extent which PEHI receive screening at population level is understudied. Therefore, this study examined disparities in utilization of breast associated with (HI) among women beneficiaries enrolled a large Medicaid program. METHODS We assessed receipt biennial mammography beneficiaries, age 50-64 years, administrative data linked encounter-level records on housing-related services...

Purpose: For patients with muscle-invasive bladder cancer (MIBC), time to cystectomy and receipt of neoadjuvant chemotherapy are associated improved survival. Travel burden may be an important barrier timely guideline concordant treatment. Materials Methods: We conducted a cross-sectional study in Pennsylvania first lifetime diagnosis MIBC who underwent radical at nonfederal short-term general hospitals identified 2010 2016 Cancer Registry linked Healthcare Cost Containment Council (PHC4)...

Abstract The Patient Protection and Affordable Care Act (ACA) included multiple provisions expected to increase cancer screening subsequently early diagnosis of cancer. Key new coverage options for low-income adults young adults, as well elimination cost sharing recommended preventive services across most health insurance plans. This article reviews relevant quantitative studies published since the ACA’s passage assess whether goal increasing access has been met. Because lags in data...

Structural barriers to HIV care are particularly challenging in the US South, which has higher diagnosis rates, poverty, uninsurance, stigma, and rurality, fewer comprehensive public health programs versus other regions. Focusing on one structural barrier, we examined geographic accessibility comprehensive, coordinated (HIVCCC) South. We integrated publicly available data study travel time HIVCCC 16 Southern states District of Columbia. geocoded service locations estimated drive between...

Dental coverage for adult enrollees is an optional benefit under Medicaid. Thirty-one states and the District of Columbia have expanded eligibility Medicaid Affordable Care Act. Millions low-income adults gained health care and, in offering dental benefits, oral as well. Using data 2010 2014 from Behavioral Risk Factor Surveillance System, we examined impact expansions on adults' use care. We found that provided benefits beyond emergency-only were more likely to had a visit past year,...

Human immunodeficiency virus (HIV)-experienced clinicians are critical for positive outcomes along the HIV care continuum. However, access to HIV-experienced may be limited, particularly in nonmetropolitan areas, where is increasing. We examined clinician workforce capacity, focusing on experience and urban-rural differences, Southern United States.We used Medicaid claims characteristics (Medicaid Analytic eXtract [MAX] MAX Provider Characteristics, 2009-2011), county-level rurality...

Little is documented regarding objective financial metrics and their impact on subjective toxicity in head neck cancer (HNC) survivors.In a cross-sectional analysis, 71 survivors with available claims data for HNC-specific out-of-pocket expenses (OOPE) completed survey including patient-reported, outcome tools: the Comprehensive Score Toxicity (COST) Financial Distress Questionnaire (FDQ).Worse COST scores were significantly associated lower earnings at administration (coefficient = 3.79;...

Domestic violence is a serious, preventable health problem affecting more than thirty million Americans annually, yet little known about federally funded service provision. We used the National Census of Violence Services, an innovative victim-safety focused survey, to count services provided by 2,000 programs. During twenty-four-hour survey period, 48,350 people these services. The results show substantial unmet demand for (10 percent requests) because resource constraints, particularly in...

Achieving US state and municipal benchmarks to end the HIV epidemic promote health equity requires access comprehensive care. However, this care may not be geographically accessible for all people living with (PLHIV). We estimated county-level drive time suboptimal geographic accessibility across contiguous US, assessing regional urban-rural differences. integrated publicly available data from four federal databases identify geocode sites providing in 2015, defined as co-located provision of...

Objective Medicaid coverage for low‐income women may play an important role in ensuring access to preventive care. This study examines how eligibility expansions nonelderly adults impact cervical cancer screening among women. Data Sources We use data from the Behavioral Risk Factor Surveillance System 2000 2010. The primary outcome of interest is whether relevant guideline consistent age range reported having a Pap test previous year. Study Design difference‐in‐differences approach with...

Importance Prior research found that pediatric direct-to-consumer (DTC) telemedicine visits are associated with more antibiotic prescribing than in-person primary care visits. It is unclear whether this difference modality of (telemedicine vs in-person) or the context (primary not care). Objective To compare management during practitioners (PCPs) commercial companies for acute respiratory tract infections (ARTIs). Design, Setting, and Participants This retrospective, cross-sectional study...