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Готовность системы здравоохранения к лечению вирусного гепатита во Вьетнаме и на Филиппинах: результаты краткой оценки состояния медицинских учреждений.

СПРАВОЧНАЯ ИНФОРМАЦИЯ: Хронический гепатит В (ХБВ) и гепатит С (ГХВ) создают серьезные проблемы в области здравоохранения во Вьетнаме и на Филиппинах. Обе страны приступили к осуществлению национальных стратегий, направленных на децентрализацию услуг по лечению гепатита до первичного медико-санитарного обслуживания, однако наличие и готовность этих учреждений к лечению гепатита остаются неясными. Цель этого исследования состояла в том, чтобы оценить наличие и готовность учреждений по оказанию первичной медико-санитарной помощи во Вьетнаме и на Филиппинах к предоставлению комплексных услуг по л

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BACKGROUND: Chronic hepatitis B (HBV) and hepatitis C (HCV) pose significant public health challenges in Viet Nam and the Philippines. Both … medications, and adequately trained healthcare workers. A key barrier was the lack of social health insurance coverage or reimbursement for hepatitis services at the primary care level in both countries. CONCLUSION: Gaps identified may require coordinated action from both national and subnational stakeholders. Expanding social health insurance coverage to i …

Late-night dinner, skipping breakfast, and the risk of dementia in Japan: the LIFE Study.

Evidence on meal timing and dementia is limited. We examined late-night dinner and skipping breakfast in relation to incident dementia. We conducted a population-based cohort study using linked medical insurance claims, long-term care insurance claims, and government-subsidized health checkup data from 19 participating in the Longevity Improvement & Fair Evidence (LIFE) Study. Cohort entry was from April 2016 to March 2021. Late-night dinner (dinner within 2 h of bedtime ≥ 3 times/week) and skipping breakfast (≥ 3 times/week) were assessed at health checkup and analyzed as dichotomous exposure…

Foundations and Operational Mechanics of Value-Based Care.

The global escalation of healthcare expenditures alongside fluctuating clinical outcomes has forced a paradigm shift from volume-driven reim … ly integrated regional health clusters, strategic purchasing through the Center for National Health Insurance (CNHI), and private sector capitation rules enforced by the Council of Health Insurance (CHI). Despite complex execution bottlenecks - including systemic data fragmentation, provider cultural inertia, and the logistical challenges of micro-costing m …

Medication trajectories among persons with multiple sclerosis in a Quebec birth cohort.

BACKGROUND: Polypharmacy in individuals with multiple sclerosis (MS) is associated with reduced quality of life. There is limited evidence on the long-term use of any medication and its evolution among individuals living with MS in the province of Quebec, Canada. OBJECTIVE: To identify medication trajectories and describe characteristics of individuals within these trajectories. METHODS: In a birth cohort, people with MS were identified from a validated algorithm based on use of health services from 1997 onward. Those covered by public drug insurance during at least three years until 2014 we…

Financial toxicity and distress among prostate cancer patients in Lebanon: a cross-sectional study.

BACKGROUND: Financial toxicity is a major component of the cancer experience. Prostate cancer often requires prolonged treatment and follow-up, increasing financial and psychological burden. Lebanon's economic crisis has disrupted health-care financing and insurance coverage, potentially worsening these burdens. This study evaluated financial toxicity among male patients with prostate cancer in Lebanon and its relationship with psychological distress. METHODS: We conducted a cross-sectional telephone survey of adult males (≥18 years) with confirmed prostate cancer receiving active treatment o…

Exploring Factors That Impact Genetic Counseling Referral and Uptake Using Learning Health Approaches.

INTRODUCTION: Germline testing and pretest genetic counseling are advised for many cancer patients, yet not all receive these services. Elec … ter from January 1, 2018, to June 30, 2022. Demographic factors-age at diagnosis, race, employment, insurance, and geographic region-were assessed for associations with genetic counseling referral and uptake. Analyses involved descriptive statistics, two-group comparisons, and regression models. RESULTS: Among 356 prostate cancer patients, only 34.2% recei …

Factors Associated with Cervical Cancer Screening for Women in New York State: Analyzing the 2022 NYS BRFSS.

Introduction: Cervical cancer remains a significant public health challenge despite being largely preventable through early screening and tr … observed by race (aOR: 1.55; CI: 1.27-1.89), income (aOR: 1.81; CI: 1.33-2.47), as well as type of insurance (aOR: 0.71; CI: 0.56-0.89). Health behaviors, such as having a prior checkup (aOR: 1.42; CI: 1.13-1.79) or flu vaccination (aOR: 1.32; CI: 1.10-1.57), were strongly associated with adherence, whereas personal economic barriers and general health cha …

Financial buy-in does not affect outcomes of endoscopic sleeve gastroplasty: Retrospective cohort.

BACKGROUND AND STUDY AIMS: Endoscopic sleeve gastroplasty (ESG) is an effective treatment for obesity but typically is not covered by insurance. It is not known whether patients with financial investment in their endoscopic procedure are more likely to achieve and/or maintain weight loss as compared with those who have no financial buy-in. We aimed to compare treatment adherence and outcomes between patients paying out-of-pocket (OOP) and those who underwent ESG as part of any clinical trial where costs were covered by a study protocol (no payment; NP). PATIENTS AND METHODS: Data were collect…

Identifying health disparities in lenalidomide access.

IntroductionLenalidomide is dispensed through a limited distribution network, leading to longer prescription fill times. Acquiring lenalidomide involves navigating the risk evaluation and mitigation strategies (REMS) program, insurance prior authorization, and financial assistance for out-of-pocket costs. Health disparities, including socioeconomic status, health literacy, language barriers, and geography, can further delay access. This study aimed to identify and analyze factors contributing to delays in access to lenalidomide.MethodsThis retrospective study used electronic health records wit…

The Predictors of Dietary Supplement Use Among Women With Musculoskeletal Disease: A Population-Based Complex Sample Designed Study.

Supplement use is influenced by personal factors such as sex, knowledge, health status, and sociocultural factors. Korean women with musculo … dietary supplement user and non-user groups in terms of age (χ2 = 12.21, P = .009), type of health insurance (χ2 = 4.01, P = .049), education level (χ2 = 42.86, P < .001), and presence of diabetes mellitus (χ2 = 9.16, P = .005). Functional health literacy was higher in the user group than in the non-user group (χ² = 5.48, P = .050). We found that younger i …

Social Determinants of Health Impact COVID-19-Related Mortality Among Liver Transplant Recipients in the United States.

BACKGROUND: Liver transplant (LT) recipients are vulnerable to COVID-19 due to immunosuppression and comorbidities. This study evaluated the … ), Native American/American Indian race (SHR  =  3.59; 95% CI  =  2.29-5.64; ref = White), Medicare insurance (SHR  =  1.40; 95% CI = 1.16-1.69; ref = private insurance), less than high school-level education (SHR  =  1.35; 95% CI  =  1.14-1.59; ref = > high school-level education), and residency in highly distressed communities (highest Distressed Communit …

Adherence to multi-target stool DNA screening and timeliness of follow-up colonoscopy: a real-world study from Tufts Medical Center.

OBJECTIVE: This study evaluated adherence to multitarget stool DNA (mt-sDNA) testing, positivity rate, and timeliness of follow-up colonosco … identified factors associated with adherence, adjusting for demographics, socioeconomic variables, insurance type, provider specialty, and patient return history. RESULTS: Adherence was 71.7%, with a positivity rate of 13.3%; FU-CY completion after a positive test was 75.8% within 12 months. Younger patients (45-49 years) demonstrated the highest adherenc …

Financial toxicity in pediatric cancer: lived experiences and coping strategies of parents.

PURPOSE: Parents and other caregivers of pediatric cancer patients often experience severe financial toxicity due to prolonged treatment dur … g cancer-related factors, limited household economic resilience, societal expectations, and gaps in insurance coverage. Consequences included asset depletion, ongoing financial hardship, and restricted access to optimal care. Parents reported substantial psychological distress-such as anxiety, depression, and social isolation-and primarily employed passive …

Associations between past-year receipt of government assistance, Medicaid, and substance use treatment utilization among adults with substance use disorder in the United States.

AIM: Most people who need substance use disorder (SUD) treatment do not receive care, often due to costs and lack of health insurance. We investigated whether receipt of government assistance and Medicaid among people with SUDs was associated with past-year SUD treatment use. METHODS: We included working-age adults (ages 18-64) with any SUD from the 2015-2019 National Survey of Drug Use and Health (n = 21,461). Government assistance was categorized as past-year receipt of ≥1 assistance programs (e.g., SSI, SNAP, welfare, cash assistance). We estimated the adjusted odds of past-year SUD treatm…

Disparities in Receipt of Tobacco Cessation Advice Among U.S. Adult Healthcare Patients Who Use Tobacco.

INTRODUCTION: Healthcare systems could reduce disparities in the toll of tobacco use by advising all patients who use tobacco to quit. This … elow $30,000; those with no college degree; those in rural areas; and those with non-Medicare or no insurance. Rates of receiving quitting advice were lower among people who use alcohol or cannabis; those with cannabis use disorder; men; minoritized racial/ethnic groups; those with incomes below $30,000; and those in urban areas. Conversely, people with no …

Impact of socioeconomic status on postoperative complications and revision rates in free flap breast reconstruction.

BACKGROUND: Socioeconomic status (SES) can predict postoperative outcomes in some specialties, but its influence on autologous breast reconstruction is yet to be defined. We examined the impact of SES on postoperative complications and esthetic revisions in free flap breast reconstruction. METHODS: This was a retrospective single-center review of consecutive patients who underwent free flap breast reconstruction between 2013 and 2023. Surgical outcomes, time from mastectomy to reconstruction, and rates of esthetic revision were analyzed while considering race, insurance status, and SES variab…

Tobacco use disorder is associated with increased risk of cardiomyopathy in a population-based study from Taiwan.

This population-based, individually matched case-control study aimed to examine the association between tobacco use disorder (TUD) and cardiomyopathy. We conducted a retrospective case-control analysis using data from the 2005 Longitudinal Health Insurance Database, a subset of Taiwan's National Health Insurance Research Database (NHIRD). A total of 10,426 newly diagnosed cardiomyopathy cases and 41,704 matched controls (matched 1:4 by age, sex, and index year) from 2000 to 2015 were identified. TUD exposure was defined using ICD-9-CM codes. Conditional logistic regression was applied to estim…

Association of sustained extremely low income and income decrease with the risk of Parkinson's disease: A population-based nationwide cohort study in Korea.

OBJECTIVE: Previous studies on the association between income and Parkinson's disease assessed income status at a single time point, without considering changes over time. This study aimed to evaluate the longitudinal association between various income dynamics and the risk of Parkinson's disease. METHODS: We used the Korean National Health Insurance Service data, enrolling 2,644,550 individuals who participated in the 2012 National Health Screening Program. The national health insurance premium was used as a proxy measure of income, with four levels (quartile 1 [low] to 4 [high]). Additional…

The Effect of Medicaid Expansion on Care for Patients With Diabetes by Primary Care Provider Supply.

OBJECTIVE: We examined whether Medicaid expansion led to improvements in health, access, and preventive care for low-income adults with diabetes, varying by primary care provider (PCP) supply. RESEARCH DESIGN AND METHODS: Using 2011-2021 Behavioral Risk Factor Surveillance System data and a difference-in-differences approach, we compared outcomes before and after expansion in states classified by PCP supply. The sample included 85,375 adults aged 18-64 with incomes below 138% of the federal poverty level and a diabetes diagnosis. Outcomes were self-reported: health insurance coverage, persona…

Navigating Disparities and Overcoming Barriers to Access Diabetic Kidney Disease Therapies: A Proposed Multifactorial Approach.

<p>Background: Diabetic kidney disease (DKD) is a serious complication arising from long-term diabetes, disproportionately affecting historically marginalized populations, such as racial and ethnic minority groups, populations with low socioeconomic status, or a lower level of education. This review explores the causes of these disparities and barriers to accessing DKD therapies and proposes solutions. Summary: Socioeconomic factors like lack of health insurance, low income, and limited health literacy significantly hinder access to DKD therapies for marginalized communities. Additionally, ina…