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Pediatrics Mar 2016Premiums are required in Medicaid and the Children's Health Insurance Program in many states. Effects of premiums are raised in policy debates. (Review)
Review
BACKGROUND
Premiums are required in Medicaid and the Children's Health Insurance Program in many states. Effects of premiums are raised in policy debates.
OBJECTIVE
Our objective was to review effects of premiums on children's coverage and access.
DATA SOURCES
PubMed was used to search academic literature from 1995 to 2014.
STUDY SELECTION
Two reviewers initially screened studies by using abstracts and titles, and 1 additional reviewer screened proposed studies. Included studies focused on publicly insured children, evaluated premium changes in at least 1 state/local program, and used longitudinal or repeated cross-sectional data with pre/postchange measures.
DATA EXTRACTION
We identified 263 studies of which 17 met inclusion criteria.
RESULTS
Four studies examined population-level coverage effects by using national survey data, 11 studies examined trends in disenrollment and reenrollment by using administrative data, and 2 studies measured additional outcomes. No eligible studies evaluated health status effects. Increases in premiums were associated with increased disenrollment rates in 7 studies that permitted comparison. Larger premium increases and stringent enforcement tended to have larger effects on disenrollment. At a population level, premiums reduce public insurance enrollment and may increase the uninsured rate for lower-income children. Little is known about effects of premiums on spending or access to care, but 1 study reveals premiums are unlikely to yield substantial revenue.
LIMITATIONS
Effect sizes were difficult to compare across studies with administrative data.
CONCLUSIONS
Public insurance premiums often increase disenrollment from public insurance and may have unintended consequences on overall coverage for low-income children.
Topics: Child; Child Health Services; Children's Health Insurance Program; Health Services Accessibility; Humans; Insurance, Health; Medicaid; Poverty; State Health Plans; United States
PubMed: 26908708
DOI: 10.1542/peds.2015-2440 -
Presse Medicale (Paris, France : 1983) Nov 2019Hypertension is a major risk factor for cardiovascular diseases. Because of the high frequency of hormonal contraceptives use, assessing their side effects is an...
Hypertension is a major risk factor for cardiovascular diseases. Because of the high frequency of hormonal contraceptives use, assessing their side effects is an important public health issue. In this perspective, we conducted a review of the risk of hypertension associated with the use of hormonal contraceptives, either combined estrogen-progestin or only progestin. The use of combined hormonal contraceptives, regardless of its type and route of administration, is associated with a slight increase in blood pressure, both systolic and diastolic blood pressures. The frequency of onset of hypertension in women who use combined hormonal contraception is between 0.6% and 8.5%. Progestin-only contraception seems safe with respect to the risk of hypertension. It is therefore important to remember that the use of combined hormonal contraception is contra-indicated in hypertensive women, even well controlled. Finally, we propose a prescription assistance algorithm according to the recommendations of an expert panel. It should be remembered that taking blood pressure at each contraceptive consultation (initial and follow-up) is essential.
Topics: Adolescent; Adult; Blood Pressure; Blood Pressure Determination; Contraception; Contraceptives, Oral, Combined; Contraceptives, Oral, Hormonal; Female; Humans; Hypertension; Middle Aged; Progestins; Risk Factors; Young Adult
PubMed: 31757732
DOI: 10.1016/j.lpm.2019.07.033 -
International Journal of Environmental... Nov 2022: Child marriage is a serious public health issue with dire implications at the individual and societal level. Almost half of all child marriages globally originate from... (Meta-Analysis)
Meta-Analysis Review
: Child marriage is a serious public health issue with dire implications at the individual and societal level. Almost half of all child marriages globally originate from South Asia. The aim of this study is to identify consistent factors associated with and resulting from child marriage in South Asia through a review of available evidence. This systematic review adhered to the 2015 Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines. Six computerized bibliographic databases, namely PsycINFO, CINAHL, EMBASE, Ovid Medline, PUBMED, and Scopus were searched. Retrieved studies were exported to EndNote and screened for eligibility using pre-determined criteria. The quality of the included studies was rated using 14 quality appraisal criteria derived from the National Institutes of Health (NIH) Tool. A total of 520 articles were retrieved from six databases. Of these, 13 articles met the eligibility criteria and were included in this study. Factors consistently associated with child marriage in South Asia were rural residence, low level of education, poor economic background, low exposure to mass media and religion (Hindu and Muslim in particular countries). Maternal health care factors resulting from child marriage included: low utilization of antenatal care services, low institutional delivery, and low delivery assistance by a skilled birth attendant. Child marriage results from an interplay of economic and social forces. Therefore, to address the complex nature of child marriage, efforts targeting improvement in education, employment, exposure to health information via mass media, and gender egalitarianism are required. This systematic review was registered with PROSPERO [CRD42020190410].
Topics: United States; Child; Humans; Female; Pregnancy; Marriage; Maternal Health Services; Educational Status; Prenatal Care; Asia
PubMed: 36429857
DOI: 10.3390/ijerph192215138 -
International Journal of Environmental... Jan 2022One of the most basic needs globally, food assistance refers to the multitude of programs, both governmental and non-governmental, to improve food access and consumption... (Review)
Review
One of the most basic needs globally, food assistance refers to the multitude of programs, both governmental and non-governmental, to improve food access and consumption by food-insecure individuals and families. Despite the importance of digital and mobile Health (mHealth) strategies in food insecurity contexts, little is known about their specific use in food assistance programs. Therefore, the purpose of this study was to address that gap by conducting a scoping review of the literature. Keywords were defined within the concepts of food assistance and digital technology. The search included relevant peer-reviewed and grey literature from 2011 to 2021. Excluded articles related to agriculture and non-digital strategies. PRISMA guidelines were followed to perform a partnered, two-round scoping literature review. The final synthesis included 39 studies of which most (84.6%) were from the last five years and United States-based (93.2%). The top three types of articles or studies included text and opinion, qualitative research, and website, application, or model development (17.9%). The top three types of digital tools were websites (56.4%), smartphone applications (20.5%), and chatbots (5.1%). Nineteen digital features were identified as desirable. Most tools included just one or two features. The most popular feature to include was online shopping ( = 14), followed by inventory management, and client tracking. Digital tools for individual food assistance represent an opportunity for equitable and stable access to programs that can enhance or replace in-person services. While this review identified 39 tools, all are in early development and/or implementation stages. Review findings highlight an overall lack of these tools, an absence of user-centered design in their development, and a critical need for research on their effectiveness globally. Further analysis and testing of current digital tool usage and interventions examining the health and food security impacts of such tools should be explored in future studies, including in the context of pandemics, where digital tools allow for help from a distance.
Topics: Food Assistance; Humans; Mobile Applications; Pandemics; Telemedicine; Text Messaging
PubMed: 35162351
DOI: 10.3390/ijerph19031328 -
Pediatrics Jun 2018Given a large and consistent literature revealing a link between housing and health, publicly supported housing assistance programs might play an important role in...
CONTEXT
Given a large and consistent literature revealing a link between housing and health, publicly supported housing assistance programs might play an important role in promoting the health of disadvantaged children.
OBJECTIVE
To summarize and evaluate research in which authors examine housing assistance and child health.
DATA SOURCES
PubMed, Web of Science, PsycInfo, and PAIS (1990-2017).
STUDY SELECTION
Eligible studies were required to contain assessments of public housing, multifamily housing, or vouchers in relation to a health outcome in children (ages 0-21); we excluded neighborhood mobility interventions.
DATA EXTRACTION
Study design, sample size, age, location, health outcomes, measurement, program comparisons, analytic approach, covariates, and results.
RESULTS
We identified 14 studies, including 4 quasi-experimental studies, in which authors examined a range of health outcomes. Across studies, the relationship between housing assistance and child health remains unclear, with ∼40% of examined outcomes revealing no association between housing assistance and health. A sizable proportion of observed relationships within the quasi-experimental and association studies were in favor of housing assistance (50.0% and 37.5%, respectively), and negative outcomes were less common and only present among association studies.
LIMITATIONS
Potential publication bias, majority of studies were cross-sectional, and substantial variation in outcomes, measurement quality, and methods to address confounding.
CONCLUSIONS
The results underscore a need for rigorous studies in which authors evaluate specific housing assistance programs in relation to child outcomes to establish what types of housing assistance, if any, serve as an effective strategy to reduce disparities and advance equity across the lifespan.
Topics: Child; Child Health; Humans; Public Assistance; Public Housing
PubMed: 29765008
DOI: 10.1542/peds.2017-2742 -
Family Process Sep 2023Single-parent families led by fathers are an increasing demographic globally, Furthermore, single fatherhood is associated with poorer self-reported health and mental...
Single-parent families led by fathers are an increasing demographic globally, Furthermore, single fatherhood is associated with poorer self-reported health and mental health, lifestyle practices and habits, increased health complications, psychological symptoms, hospital admissions, and higher mortality. However, there is still a dearth of evidence exploring single fathers' experiences. A systematic review and meta-synthesis were conducted using Sandelowski and Barroso's approach. Six electronic databases were searched from each database's inception to December 2021, and 34 studies were included in this review. In total, six themes were synthesized: (i) "Doing it alone": Double the work, stress, and tears; (ii) Beyond ambivalence and towards stability, (iii) Walking into the lion's den; (iv) Education as a foundation for a better future; (v) "Single but not alone": Support systems; (vi) "Reconceptualising my predicament": Double the love and growth. Our findings suggest the need to: help fathers better navigate their relationships with their children and ex-partners, increased awareness and availability of parent-teaching and support programs, and reform guidelines and policies to enable greater participation and involvement of fathers in future judicial systems, and social and public assistance services.
Topics: Male; Child; Humans; Parenting; Fathers; Single-Parent Family; Mental Health; Life Style
PubMed: 36305198
DOI: 10.1111/famp.12830 -
Complementary Therapies in Clinical... Nov 2022The aim of this systematic review and meta-analysis is to evaluate whether osteopathic manipulative interventions can reduce pain levels and enhance the functional... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The aim of this systematic review and meta-analysis is to evaluate whether osteopathic manipulative interventions can reduce pain levels and enhance the functional status in patients with non-specific neck pain (NS-NP).
METHODS
A systematic review and meta-analysis was conducted following the 2020 PRISMA statement. Randomized controlled trials (RCTs) were searched in five databases, assessed through a standardized form, and evaluated using the "13 items Cochrane risk of bias (RoB) tool". Effect sizes (ES) were calculated post-treatment, and the quality of evidence was assessed through GRADE criteria.
RESULTS
Five articles were included in the review, and none of these was completely judged at low RoB. Four of these were included in the meta-analysis. Osteopathic interventions compared to no intervention/sham treatment showed statistically significant results for pain levels (ES = -1.57 [-2.50, -0.65]; P = 0.0008) and functional status (ES = -1.71 [-3.12, -0.31]; P = 0.02). The quality of evidence was "very low" for all the assessed outcomes. Other results were presented in a qualitative synthesis.
CONCLUSIONS
Osteopathic interventions could be effective for pain levels and functional status improvements in adults with NS-NP. However, these findings are affected by a very low quality of evidence. Therefore, further high-quality RCTs are necessary to improve the quality of evidence and generalize the results.
Topics: Adult; Humans; Low Back Pain; Neck Pain; Manipulation, Osteopathic; Osteopathic Medicine; Neck
PubMed: 35986986
DOI: 10.1016/j.ctcp.2022.101655 -
PloS One 2022The progress of Universal health coverage (UHC) is measured using tracer indicators of key interventions, which have been implemented in healthcare system. UHC is about... (Review)
Review
BACKGROUND
The progress of Universal health coverage (UHC) is measured using tracer indicators of key interventions, which have been implemented in healthcare system. UHC is about population, comprehensive health services and financial coverage for equitable quality services and health outcome. There is dearth of evidence about the extent of the universality of UHC in terms of types of health services, its integrated definition (dimensions) and tracer indicators utilized in the measurement of UHC. Therefore, we mapped the existing literature to assess universality of UHC and summarize the challenges towards UHC.
METHODS
The checklist Preferred Reporting Items for Systematic reviews and Meta-analysis extension for Scoping Reviews was used. A systematic search was carried out in the Web of Science and PubMed databases. Hand searches were also conducted to find articles from Google Scholar, the World Bank Library, the World Health Organization Library, the United Nations Digital Library Collections, and Google. Article search date was between 20 October 2021 and 12 November 2021 and the most recent update was done on 03 March 2022. Articles on UHC coverage, financial risk protection, quality of care, and inequity were included. The Population, Concept, and Context framework was used to determine the eligibility of research questions. A stepwise approach was used to identify and select relevant studies, conduct data charting, collation and summarization, as well as report results. Simple descriptive statistics and narrative synthesis were used to present the findings.
RESULTS
Forty-seven papers were included in the final review. One-fourth of the articles (25.5%) were from the African region and 29.8% were from lower-middle-income countries. More than half of the articles (54.1%) followed a quantitative research approach. Of included articles, coverage was assessed by 53.2% of articles; financial risk protection by 27.7%, inequity by 25.5% and quality by 6.4% of the articles as the main research objectives or mentioned in result section. Most (42.5%) of articles investigated health promotion and 2.1% palliation and rehabilitation services. Policy and healthcare level and cross-cutting barriers of UHC were identified. Financing, leadership/governance, inequity, weak regulation and supervision mechanism, and poverty were most repeated policy level barriers. Poor quality health services and inadequate health workforce were the common barriers from health sector challenges. Lack of common understanding on UHC was frequently mentioned as a cross-cutting barrier.
CONCLUSIONS
The review showed that majority of the articles were from the African region. Methodologically, quantitative research design was more frequently used to investigate UHC. Palliation and rehabilitation health care services need attention in the monitoring and evaluation of UHC progress. It is also noteworthy to focus on quality and inequity of health services. The study implies that urgent action on the identified policy, health system and cross-cutting barriers is required to achieve UHC.
Topics: Delivery of Health Care; Health Services; Income; Medical Assistance; Universal Health Insurance
PubMed: 35994455
DOI: 10.1371/journal.pone.0269507 -
Studies in Health Technology and... May 2021Care pathways and supporting health information systems (HIS) have been permeate the discipline of Health Information Systems Research (HISR) over years. Traditional...
Care pathways and supporting health information systems (HIS) have been permeate the discipline of Health Information Systems Research (HISR) over years. Traditional objectives of workflow assistance are increasingly extended by interdisciplinary goals from technology, medicine, management and public health research. A systematic literature review is dedicated to this integrating character. It examines the interdisciplinary mesh of objectives associated with care pathways and pathway-supporting HIS in the HISR literature. From 47 identified articles, 6 thematic themes were derived. Their consolidation supports in particular design and development processes as it describes the solution space of future pathway-supporting HIS addressing requirements stated by multiple stakeholders.
Topics: Health Information Systems; Workflow
PubMed: 33965923
DOI: 10.3233/SHTI210093 -
Journal of Epidemiology and Global... Mar 2023World Health Organization Eastern Mediterranean Region (WHO EMR) has 40% people in the world in need of humanitarian assistance. This systematic review explores selected... (Review)
Review
BACKGROUND AND OBJECTIVE
World Health Organization Eastern Mediterranean Region (WHO EMR) has 40% people in the world in need of humanitarian assistance. This systematic review explores selected vector-borne and zoonotic diseases (VBZDs) of importance to EMR in terms of disease burden across countries and periods, disaggregated across sex, age groups, education levels, income status, and rural/urban areas, related vector or animal source reduction measures, and public health, social and economic impacts and related interventions.
METHODS
We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and reviewed articles in PubMed, Embase, and WHO Global Index Medicus published between 1st of January 2011 and 27th of June 2022. Thirteen VBZDs with at least one reported outbreak in the last five years in the region or prioritized as per previous analysis at the WHO global and regional level and based on expert consultations, were included as part of the analysis.
RESULTS
The review included 295 studies-55% on leishmaniasis and dengue combined, and 75% studies from Pakistan, Kingdom of Saudi Arabia, and Iran combined. Hospital-based and nationally representative studies constituted 60% and 10% respectively. Males were predominantly affected in most diseases; children reported high burden of Leishmaniasis, whereas elderly had a higher burden of Dengue Fever and Middle East Respiratory Syndrome. Although very few studies reported on socioeconomic differences in burden, the ones that reported showed higher burden of diseases among the disadvantaged socioeconomic groups such as the poor and the less educated. More than 80% studies reported an increase in burden over the years.
CONCLUSION
The literature is scanty for most of the diseases reviewed and the number of studies from countries with humanitarian challenges is very low. The need for more nationally representative, population-based studies calls for prioritizing research investments.
Topics: Male; Animals; Humans; Zoonoses; Iran; Leishmaniasis; World Health Organization; Saudi Arabia
PubMed: 36757670
DOI: 10.1007/s44197-023-00091-7