The Affordable Care Act and Health Care Access and Utilization Among White, Asian, and Latino Immigrants in California
Conclusions: Insurance coverage increased significantly for these 3 immigrant groups after the ACA. While Latino immigrants had the largest gain in insurance coverage, the proportion of Latino immigrants with insurance remained the lowest among the 3 immigrant racial/ethnic groups. (Source: Medical Care)
Source: Medical Care - September 1, 2021 Category: Health Management Tags: Original Articles Source Type: research

Commentary on the Affordable Care Act and Health Care Access and Utilization Among White, Asian, and Latino Immigrants in California
No abstract available (Source: Medical Care)
Source: Medical Care - September 1, 2021 Category: Health Management Tags: Editorial Source Type: research

Did Access to Care Improve Since Passage of the Veterans Choice Act? Differences Between Rural and Urban Veterans: Erratum
No abstract available (Source: Medical Care)
Source: Medical Care - July 15, 2021 Category: Health Management Tags: Errata Source Type: research

Elective Surgical Delays Due to COVID-19: The Patient Lived Experience: Erratum
No abstract available (Source: Medical Care)
Source: Medical Care - July 15, 2021 Category: Health Management Tags: Errata Source Type: research

Measuring Multimorbidity: Selecting the Right Instrument for the Purpose and the Data Source
Conclusions: The accuracy of multimorbidity measurement can be enhanced with appropriate measurement selection, combining data sources and special considerations for fully capturing multimorbidity burden in underrepresented racial/ethnic populations, children, individuals with multiple Adverse Childhood Events and older adults experiencing functional limitations, and other geriatric syndromes. The increased availability of comprehensive electronic health record systems offers new opportunities not available through other data sources. (Source: Medical Care)
Source: Medical Care - July 15, 2021 Category: Health Management Tags: Original Articles Source Type: research

Institutional Postacute Care Use May Help Reduce Readmissions for Ischemic Stroke Patients
We examined the causal impact of institutional PAC use on 30-day readmission rates for Medicare fee-for-service patients initially admitted for ischemic stroke. Data Sources: The 2010–2016 Medicare Provider Analysis and Review files. Research Design: We used the method of instrumental variable (IV) analysis to control for unobserved differences in the types of patients admitted to each PAC facility. We chose the distance from the patient’s residence to the closest institutional PAC provider and the number of PAC providers of each type within a county where the patient resides as IVs. Principal Findings...
Source: Medical Care - July 15, 2021 Category: Health Management Tags: Original Articles Source Type: research

How Should We Organize Care for Patients With Human Immunodeficiency Virus and Comorbidities? A Multisite Qualitative Study of Human Immunodeficiency Virus Care in the United States Department of Veterans Affairs
Conclusions: Provision of high-quality HIV care and high-quality co-morbidity care require different care structures and processes. Provision of both requires a focus on providing care aligned with PCMH principles, integrating psychosocial needs into care, and establishing explicit consistent approaches to comorbidity management. (Source: Medical Care)
Source: Medical Care - July 15, 2021 Category: Health Management Tags: Original Articles Source Type: research

Evaluation of the Reliability of Medicare Spending Per Beneficiary for Post-Acute Care
Conclusions: CMS should consider adopting a more stringent reliability standard for setting minimum case counts for MSPB-PAC and other measures. Its current threshold (R-statistic=0.4) reflects more random variation than differences in actual provider performance. To include as many providers as possible, CMS should consider pooling data over multiple years to avoid drawing incorrect conclusions about low-volume providers. (Source: Medical Care)
Source: Medical Care - July 15, 2021 Category: Health Management Tags: Original Articles Source Type: research

Burnout and Physician Gender: What Do We Know?
Conclusions: BO is important for both female and male physicians; although women doctors may experience it to a greater degree. Women doctors will benefit from talent management approaches by health care organizations that recognize their greater tendency to BO compared with men. These approaches should be aimed at ameliorating the factors that give rise to feelings of emotional exhaustion in particular. Additional research is needed to better understand the full extent to which physician gender plays a role in BO. (Source: Medical Care)
Source: Medical Care - July 15, 2021 Category: Health Management Tags: Original Articles Source Type: research

Trends in Health Care Utilization and Expenditures in the United States Across 5 Decades: 1977–2017
Conclusions: This article provides the first extended snapshot of the dynamics of health care utilization and expenditures in the United States. Aspects of health care are much different today than in previous decades, yet the inpatient setting still dominates the expenditures. (Source: Medical Care)
Source: Medical Care - July 15, 2021 Category: Health Management Tags: Brief Reports Source Type: research

Primary Care Providers in Federally Qualified Health Centers Can Treat Hepatitis C Effectively Without Ongoing Consultative Support From Specialists
Conclusions: After 2 years of consultative support from specialists, primary care providers at FQHCs can deliver HCV treatment effectively without ongoing support. However, more research is needed to determine whether our findings are generalizable across primary care settings. (Source: Medical Care)
Source: Medical Care - July 15, 2021 Category: Health Management Tags: Brief Reports Source Type: research

Pre-existing Disparities and Potential Implications for the Rapid Expansion of Telemedicine in Response to the Coronavirus Disease 2019 Pandemic
Background: Concerns exist regarding exacerbation of existing disparities in health care access with the rapid implementation of telemedicine during the coronavirus disease 2019 (COVID-19) pandemic. However, data on pre-existing disparities in telemedicine utilization is currently lacking. Objective: We aimed to study: (1) the prevalence of outpatient telemedicine visits before the COVID-19 pandemic by patient subgroups based on age, comorbidity burden, residence rurality, and median household income; and (2) associated diagnosis categories. Research Design: This was a retrospective cohort study. Subje...
Source: Medical Care - July 15, 2021 Category: Health Management Tags: Brief Reports Source Type: research

Can Collaboration Between Nonprofit Hospitals and Local Health Departments Influence Population Health Investments by Nonprofit Hospitals?
Conclusions: Policymakers have sought to encourage hospitals to increase their investment in population health; however, overall community benefit spending on population health has remained flat. We found that requiring hospital-LHD collaboration was associated with increased hospital investment in population health. It may be that hospitals increase population health spending because collaboration improves expected effectiveness or increases hospital accountability. (Source: Medical Care)
Source: Medical Care - July 15, 2021 Category: Health Management Tags: From the States Source Type: research

Dementia Diagnosis Disparities by Race and Ethnicity
The objective of this study was to examine racial and ethnic disparities in the timeliness of receiving a clinical diagnosis of dementia. Research Design: This was a prospective cohort study. Subjects: A total of 3966 participants age 70 years and above with probable dementia in the Health and Retirement Study, linked with their Medicare and Medicaid claims. Measures: We performed logistic regression to compare the likelihood of having a missed or delayed dementia diagnosis in claims by race/ethnicity. We analyzed dementia severity, measured by cognition and daily function, at the time of a dementia di...
Source: Medical Care - July 15, 2021 Category: Health Management Tags: Original Articles Source Type: research

Aligning Health Care and Social Services to Reduce Hospitalizations and Emergency Department Visits: An Evaluation of the Community Care Connections Program
The objective of this study was to evaluate the Community Care Connections (CCC) program, a cross-sector collaboration designed to align social and health care services for older adults. Research Design: We compared hospitalizations and emergency department (ED) visits 90 days after enrollment with a propensity score–matched group of non-CCC patients. Subgroup analyses were also conducted for adults with hypertension, diabetes, and high cholesterol. Subjects: A total of 1004 patients enrolled in CCC between June 1, 2016, and November 15, 2018, and 1004 matched patients from the same metropolitan area. Me...
Source: Medical Care - July 15, 2021 Category: Health Management Tags: Original Articles Source Type: research