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Health Services Research Feb 1989Current knowledge on health care for the rural poor and uninsured demonstrates little descriptive and empirical knowledge on this population. Policy strategies call for... (Review)
Review
Current knowledge on health care for the rural poor and uninsured demonstrates little descriptive and empirical knowledge on this population. Policy strategies call for a better understanding of the gaps in insurance coverage and the special problems of rural residents, especially those with low incomes.
Topics: Adolescent; Adult; Child; Hospitalization; Humans; Insurance, Health; Medicaid; Medical Indigency; Middle Aged; Poverty; Rural Health; Rural Population; United States
PubMed: 2645253
DOI: No ID Found -
American Journal of Public Health Jul 1990To gauge the impact of the new federal patient transfer provisions following the federal Combined Budget Reconciliation Act of 1985 (COBRA), we monitored all emergency...
To gauge the impact of the new federal patient transfer provisions following the federal Combined Budget Reconciliation Act of 1985 (COBRA), we monitored all emergency interhospital transfers to a public hospital emergency department in the Memphis, Tennessee area during three identical time periods: June 1 to August 31 of 1986, 1987, and 1988. A high number of transfers in the summer of 1986 diminished only slightly in summer 1987 (following implementation of COBRA). Far greater reductions occurred in summer 1988, when overcrowding forced our hospital to refuse most transfers. In contrast to changes in hospital policy, COBRA alone had little effect in this area.
Topics: Emergency Service, Hospital; Evaluation Studies as Topic; Hospitals, County; Hospitals, Public; Humans; Medical Indigency; Patient Selection; Patient Transfer; Severity of Illness Index; Tennessee; Transfer Agreement
PubMed: 2356913
DOI: 10.2105/ajph.80.7.864 -
American Journal of Public Health Oct 1976
Topics: Community Health Centers; Community Health Services; Medical Indigency; Outpatient Clinics, Hospital; Quality of Health Care; United States
PubMed: 970512
DOI: 10.2105/ajph.66.10.955 -
Journal of General Internal Medicine Apr 1999
Topics: Community Health Services; Education, Medical; Health Services Needs and Demand; Ill-Housed Persons; Humans; Medical Indigency; Students, Medical; Volunteers
PubMed: 10203640
DOI: 10.1046/j.1525-1497.1999.00328.x -
Journal of Cancer Survivorship :... Dec 2011This study was conducted to compare cost-related medication nonadherence among elderly Medicare enrollees with and without cancer and to describe the strategies cancer...
OBJECTIVES
This study was conducted to compare cost-related medication nonadherence among elderly Medicare enrollees with and without cancer and to describe the strategies cancer survivors used to offset the costs of medications.
METHODS
Using the 2005 Medicare Current Beneficiary Survey and Medicare claims, we compared self-reported cost-related medication nonadherence (CRN), spending less on basic needs to afford medicines, and cost reduction strategies among elderly beneficiaries with and without cancer. Descriptive statistics and logistic regression models were used to characterize and compare these populations.
RESULTS
In a nationally representative sample of 9,818 non-institutionalized elderly Medicare enrollees, 1,392 (14%) were classified as cancer survivors based on Medicare claims. Cancer survivors were older, more highly educated, more likely to be male and non-Hispanic, and more likely to have multiple comorbidities, poorer health status, and employer-paid medication coverage. While 10% of cancer survivors and 11% without cancer reported CRN, about 6% and 9% (p = 0.004) of those with and without cancer, respectively, reported spending less on basic needs to offset the costs of medications. Cancer survivors who reported CRN (n = 143) had lower income (62.2% versus 48.6%, p = 0.11) and were more likely to be African-American (13.0% versus 6.4%, p = 0.033) and have non-employer-based medication insurance (p = 0.002) compared to those who did not report CRN. In adjusted analyses, CRN among the two groups was similar, but with some subgroup differences noted by gender and cancer type. Use of cost reduction strategies was mostly similar among cancer survivors and those without cancer.
CONCLUSION
Cost-related medication nonadherence medication is common among elderly Medicare beneficiaries, but appears to be similar among those with and without cancer.
Topics: Black or African American; Aged; Aged, 80 and over; Drug Costs; Female; Humans; Longitudinal Studies; Male; Medical Indigency; Medicare; Medication Adherence; Neoplasms; Prognosis; Survival Rate; Survivors; United States
PubMed: 21800053
DOI: 10.1007/s11764-011-0188-4 -
Journal of the National Medical... Apr 2004The United States spends more than the rest of the world on healthcare. In 2000, the U.S. health bill was 1.3 trillion dollars, 14.5% of its gross domestic product. Yet,... (Comparative Study)
Comparative Study
The United States spends more than the rest of the world on healthcare. In 2000, the U.S. health bill was 1.3 trillion dollars, 14.5% of its gross domestic product. Yet, according to the WHO World Health Report 2000, the United States ranked 37th of 191 member nations in overall health system performance. Racial/ethnic disparities in health outcomes are the most obvious examples of an unbalanced healthcare system. This presentation will examine health disparities in the United States and reveal how health disparities among and within countries affect the health and well-being of the African Diaspora.
Topics: Black or African American; Black People; Global Health; Health Policy; Health Services Accessibility; Humans; Medical Indigency; National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division; Social Justice; Socioeconomic Factors; Sociology, Medical; United States
PubMed: 15101675
DOI: No ID Found -
Indian Journal of Medical Ethics 2007
Topics: Coercion; Family; Hospital Charges; Humans; India; Medical Indigency; Patient Credit and Collection
PubMed: 18624149
DOI: 10.20529/IJME.2007.062 -
Journal of Travel Medicine May 1999
Topics: Africa, Eastern; Antimalarials; Atovaquone; Developing Countries; Drug Combinations; Drug Industry; Humans; Internationality; Malaria; Medical Indigency; Proguanil; World Health Organization
PubMed: 23573550
DOI: No ID Found -
American Journal of Public Health May 1984We studied 458 consecutive patient transfers from 14 private hospitals to a public hospital emergency room during a six-month period. The transferred patients were...
We studied 458 consecutive patient transfers from 14 private hospitals to a public hospital emergency room during a six-month period. The transferred patients were predominantly male, young, and uninsured, and included large numbers of minority group members. We established criteria to identify patients at high risk for adverse effects of transfer and reviewed the clinical records of the 103 patients meeting these criteria. We judged that transfer resulted in substandard care for 33 of these patients, either because they were at risk for life-threatening complications in transit or because urgently needed diagnosis or therapy was delayed. In the community studied, transfer is a common and potentially dangerous medical intervention which appears to reinforce racial and class inequalities of access to medical care.
Topics: Adult; California; Emergency Medical Services; Emergency Service, Hospital; Female; Health Status; Hospitals, Public; Humans; Male; Medical Indigency; Medical Records; Patient Selection; Prejudice; Risk Assessment; Transfer Agreement; Triage
PubMed: 6711726
DOI: 10.2105/ajph.74.5.494 -
The Laryngoscope Sep 2013This study was designed to describe the implementation, utilization, and outcomes of an otolaryngology clinic for indigent patients employing a novel design. (Comparative Study)
Comparative Study
OBJECTIVES/HYPOTHESIS
This study was designed to describe the implementation, utilization, and outcomes of an otolaryngology clinic for indigent patients employing a novel design.
STUDY DESIGN
Pilot study.
METHODS
A tertiary-care academic otolaryngology department partnered with a nonprofit outpatient clinic for indigent patients in order to provide free subspecialty consultation services. A novel format was utilized in which the department provided on-site, scheduled outpatient multidisciplinary consultation on weekends, staffed by volunteer health care providers and ancillary staff. A review of the program was conducted using prospectively collected data. Clinic design, staffing, utilization, and feasibility were described, along with demographic and clinical data for all patients participating in the clinic from October 2010 through January 2012.
RESULTS
Five clinics were held over 15 months, totaling 74 patient visits, with positive feedback regarding accessibility and quality of services provided. A total of 60 procedures were performed, including audiograms, endoscopies, otologic procedures, biopsies and/or excisions. The estimated value of medical services that were provided was $37,302. Four potentially life-threatening conditions were newly diagnosed. Twenty patients received conclusive evaluation and treatment at the time of their first visit. Eighteen patients required further subspecialty treatment and/or surgery that could not be provided in the outpatient setting, and were referred appropriately.
CONCLUSIONS
The partnership between an academic otolaryngology department and a nonprofit clinic provided free on-site consultation for indigent patients. Such an arrangement is feasible, well utilized, and successful in delivering comprehensive specialized services to indigent patients who lack traditional access to medical care.
Topics: Academic Medical Centers; Adolescent; Adult; Aged; Ambulatory Care Facilities; Feasibility Studies; Female; Health Plan Implementation; Health Services Accessibility; Humans; Male; Medical Indigency; Michigan; Middle Aged; Organizations, Nonprofit; Otolaryngology; Otorhinolaryngologic Diseases; Pilot Projects; Poverty; Program Development; Program Evaluation; Risk Assessment; Treatment Outcome; Young Adult
PubMed: 23842787
DOI: 10.1002/lary.23880