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The association of hospital competition with inpatient costs of stroke: Evidence from China
Publication date: Available online 21 April 2019Source: Social Science & MedicineAuthor(s): Liyong Lu, Jay PanAbstractThe main purpose of this article is to analyze the association between hospital competition and stroke inpatient costs. Stroke is selected as the representative of a class of diseases characterized by asymmetric information and lack of autonomy of service choice. A total of 98,061 observations are selected from a medical record dataset in the Sichuan Province. The fixed radius approach of 15 miles and Herfindahl-Hirschman Index (HHI) are employed to define the hospital market and measure the competition int...
Source: Social Science and Medicine - April 22, 2019 Category: Psychiatry & Psychology Source Type: research

The roles of specialisation and evidence-based practice in inter-professional jurisdictions: A qualitative study of stroke services in England, Sweden and Poland
Publication date: Available online 3 March 2016 Source:Social Science & Medicine Author(s): Juan I. Baeza, Annette Boaz, Alec Fraser This paper investigates how the concepts of clinical specialisation and evidence influence the jurisdictional power of doctors, nurses and therapists involved in stroke care in Sweden, England and Poland. How stroke care has become a distinct specialism across Europe and the role that evidence has played in this development are critically analysed. Five qualitative case studies were undertaken across the three countries, consisting of 119 semi-structured interviews with a range o...
Source: Social Science and Medicine - March 5, 2016 Category: Psychiatry & Psychology Source Type: research

Does informal care impact utilization of healthcare services? Evidence from a longitudinal study of stroke patients
Publication date: Available online 5 November 2014 Source:Social Science & Medicine Author(s): Aleksandra Torbica , Stefano Calciolari , Giovanni Fattore Understanding the interplay between informal care and formal healthcare is important because it sheds light on the financial implications of such interactions and may result in different policies. On the basis of a major database on 544 Italian stroke patients enrolled in the period 2007-2008, we investigated whether the presence of a potential caregiver and the amount of informal care provided influences the use and the costs of healthcare services, and in part...
Source: Social Science and Medicine - November 11, 2014 Category: Psychiatry & Psychology Source Type: research

Heterogeneous effects of patient choice and hospital competition on mortality
Publication date: Available online 9 September 2018Source: Social Science & MedicineAuthor(s): Giuseppe Moscelli, Hugh Gravelle, Luigi Siciliani, Rita SantosAbstractWe examine whether the relaxation of constraints on patient choice of hospital in the English National Health Service in 2006 led to greater changes in mortality for hospitals which faced more rivals before the choice reform. We use patient level data from 2002 to 2010 for three high volume emergency conditions with high mortality risk: acute myocardial infarction (AMI) (288,279 patients), hip fracture (91,005 patients), stroke (214,103 patients). Since mortali...
Source: Social Science and Medicine - September 10, 2018 Category: Psychiatry & Psychology Source Type: research

Effects of introducing a fee for “inpatient overstays” on the rate of death and readmissions across municipalities in Norway
This study examines the effects of the reform on the rate of death and readmissions occurring within 60 days of hospitalization. We use aggregated municipal data for years 2009, 2010, 2012–2014 (N = 1646) for Norwegian patients (age 18+) hospitalized in the same years for COPD/asthma, heart failure, hip fracture, and stroke. We stratify our analyses of the municipal data by these patient groups. Our linear regression models test for moderated (interaction) effects whereby associations between the reform and the rate of death and readmissions vary by whether or not patients were classified as ready for discharge and in ...
Source: Social Science and Medicine - April 11, 2019 Category: Psychiatry & Psychology Source Type: research

Effects of introducing a fee for inpatient overstays on the rate of death and readmissions across municipalities in Norway
This study examines the effects of the reform on the rate of death and readmissions occurring within 60 days of hospitalization. We use aggregated municipal data for years 2009, 2010, 2012–2014 (N = 1646) for Norwegian patients (age 18+) hospitalized in the same years for COPD/asthma, heart failure, hip fracture, and stroke. We stratify our analyses of the municipal data by these patient groups. Our linear regression models test for moderated (interaction) effects whereby associations between the reform and the rate of death and readmissions vary by whether or not patients were classified as ready for discharge and in ...
Source: Social Science and Medicine - April 24, 2019 Category: Psychiatry & Psychology Source Type: research

A scalable climate health justice assessment model
Publication date: May 2015 Source:Social Science & Medicine, Volume 133 Author(s): Yolanda J. McDonald , Sara E. Grineski , Timothy W. Collins , Young-An Kim This paper introduces a scalable “climate health justice” model for assessing and projecting incidence, treatment costs, and sociospatial disparities for diseases with well-documented climate change linkages. The model is designed to employ low-cost secondary data, and it is rooted in a perspective that merges normative environmental justice concerns with theoretical grounding in health inequalities. Since the model employs International Classification o...
Source: Social Science and Medicine - April 24, 2015 Category: Psychiatry & Psychology Source Type: research

Bioidentical hormones, menopausal women, and the lure of the “natural” in U.S. anti-aging medicine
Publication date: May 2015 Source:Social Science & Medicine, Volume 132 Author(s): Jennifer R. Fishman , Michael A. Flatt , Richard A. Settersten Jr. In 2002, the Women's Health Initiative, a large-scale study of the safety of hormone replacement therapy (HRT) for women conducted in the United States, released results suggesting that use of postmenopausal HRT increased women's risks of stroke and breast cancer. In the years that followed, as rates of HRT prescription fell, another hormonal therapy rose in its wake: bioidentical hormone replacement therapy (BHRT). Anti-aging clinicians, the primary prescribers of ...
Source: Social Science and Medicine - March 19, 2015 Category: Psychiatry & Psychology Source Type: research

A closer look at the rural-urban health disparities: Insights from four major diseases in the Commonwealth of Virginia
This study help bridges this gap through investigation of four major diseases in the Commonwealth of Virginia: cancer, stroke, cardiovascular disease and chronic obstructive pulmonary disease. We utilize a unique inpatient hospital discharge billing dataset, and construct average patient counts at ZIP-code level over 2006–2008 where covariates from alternative sources are merged (806 ZIP-code areas, 190 urban, 616 rural). Count data regressions are first fitted to identify possible regional-level factors that affect disease incidences. A system of equations with rural-urban specification are then estimated via seemingly ...
Source: Social Science and Medicine - July 20, 2015 Category: Psychiatry & Psychology Source Type: research

Economic Hardship and Biological Weathering: The Epigenetics of Aging in a U.S. Sample of Black Women
Conclusions These findings support the view that chronic financial pressures associated with low income exerts a weathering effect that results in premature aging.
Source: Social Science and Medicine - December 11, 2015 Category: Psychiatry & Psychology Source Type: research

Invisible walls within multidisciplinary teams: Disciplinary boundaries and their effects on integrated care
Publication date: Available online 9 December 2015 Source:Social Science & Medicine Author(s): Elisa Giulia Liberati, Mara Gorli, Giuseppe Scaratti Delivery of interdisciplinary integrated care is central to contemporary health policy. Hospitals worldwide are therefore attempting to move away from a functional organisation of care, built around discipline-based specialisation, towards an approach of delivering care through multidisciplinary teams. However, the mere existence of such teams may not guarantee integrated and collaborative work across medical disciplines, which can be hindered by boundaries between...
Source: Social Science and Medicine - December 11, 2015 Category: Psychiatry & Psychology Source Type: research

As long as you've got your health: Longitudinal relationships between positive affect and functional health in old age
Conclusion This finding, obtained from a sample of older people, is in keeping with the bottom-up approach, and supports the popular adage “As long as you've got your health”. Limitations of this finding are reviewed and discussed. Models including longitudinal mediators, such as biomarkers and life style patterns, are needed to clarify the nature of the link between these constructs.
Source: Social Science and Medicine - January 12, 2016 Category: Psychiatry & Psychology Source Type: research

Understanding kidney transplant patients’ treatment choices: the interaction of emotion with medical and social influences on risk preferences
Publication date: Available online 18 February 2016 Source:Social Science & Medicine Author(s): Jean Harrington, Myfanwy Morgan Following renal transplantation patients experience on-going immunosuppressant medication to reduce the risk of graft rejection. Over the long term the side effects of immunosuppressive drugs may affect graft survival and significantly increase risks of cancers, stroke and cardiovascular disease. To reduce these risks research is underway to develop a biomarker test to identify those patients who are likely to be ‘tolerant’ to their graft and therefore able to reduce immunosuppress...
Source: Social Science and Medicine - February 19, 2016 Category: Psychiatry & Psychology Source Type: research

Understanding kidney transplant patients' treatment choices: The interaction of emotion with medical and social influences on risk preferences
Publication date: April 2016 Source:Social Science & Medicine, Volume 155 Author(s): Jean Harrington, Myfanwy Morgan Following renal transplantation patients experience on-going immunosuppressant medication to reduce the risk of graft rejection. Over the long term the side effects of immunosuppressive drugs may affect graft survival and significantly increase risks of cancers, stroke and cardiovascular disease. To reduce these risks research is underway to develop a biomarker test to identify those patients who are likely to be ‘tolerant’ to their graft and therefore able to reduce immunosuppression. Biomar...
Source: Social Science and Medicine - March 15, 2016 Category: Psychiatry & Psychology Source Type: research

Distinct Age and Self-Rated Health Crossover Mortality Effects for African Americans: Evidence from a National Cohort Study
This study examined these two mortality predictors simultaneously in a large epidemiological study of 12,181 African Americans and 17,436 Whites. Participants were 45 or more years of age when they enrolled in the national REasons for Geographic and Racial Differences in Stroke (REGARDS) study between 2003 and 2007. Consistent with previous studies, African Americans had poorer SRH than Whites even after adjusting for demographic and health history covariates. Survival analysis models indicated statistically significant and independent race*age, race*SRH, and age*SRH interaction effects on all-cause mortality over an avera...
Source: Social Science and Medicine - March 16, 2016 Category: Psychiatry & Psychology Source Type: research

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