Download or read book The Impact of Medicaid Expansion on Breast and Cervical Cancer Screening Rates written by Madelyn Jane Sather and published by . This book was released on 2021 with total page 40 pages. Available in PDF, EPUB and Kindle. Book excerpt: Screenings are an important public health intervention to prevent breast and cervical cancer. Previous studies have indicated a relationship between Medicaid expansion under the Affordable Care Act (ACA) and breast and cervical cancer screenings, but the results have been mixed and inconclusive. We examined the relationship between Medicaid expansion and breast and cervical cancer screenings among low-income women. In our secondary analyses, we assessed if this association was modified by race/ethnicity or rural residence status. We used data from the Behavioral Risk Factor Surveillance System from 2012-2019, excluding 2017. States that expanded Medicaid before the ACA were excluded. A total of 27 states were considered Medicaid expansion states and 17 were considered non-expansion states. Participants included women with incomes up to 138% of the Federal Poverty Level (FPL) without a previous cancer diagnosis, excluding Medicare-eligible ages. Using a difference-in-difference time series event design, this study compared the odds ratio of breast and cervical cancer screenings for a total of 8 years pre- and post-Medicaid expansion controlling for age, race/ethnicity, education, income, employment, having a regular healthcare provider, rurality, and year and state fixed effects. Dummy variables on years from expansion were created from 7 years before expansion up to 5 years after expansion, including a dummy variable indicating the expansion year. The expansion year dummy variable was coded as 1 if the year of observation was equivalent to the year when the state expanded Medicaid and 0 otherwise. Stratified analyses were used to test if there was an interaction at the multiplicative level by race/ethnicity or rurality. Among 27,290 women aged 40-64, 76.4% of the women residing in expansion states reported having an up-to-date breast cancer screening compared to 70.8% of women residing in non-expansion states. Among 30,808 women aged 18-64, 82.3% of the women residing in expansion states reported having an up-to-date cervical cancer screening compared to 79.9% of women residing in non-expansion states. Medicaid expansion was associated with 2.89-fold higher rate of up-to-date breast cancer screenings 1 year post-expansion (aOR 2.89; 95% CI: 1.34, 6.23). The odds ratios relating Medicaid expansion and up-to-date cervical cancer screenings during the expansion year and 4 years post-expansion were 1.35 (95% CI: 1.14, 1.61) and 1.37 (95% CI: 1.01, 1.85), respectively. The associations were stronger among White non-Hispanic, Black non-Hispanic women, and urban women for both breast and cervical cancer screenings. Medicaid expansion led to higher rates of up-to-date breast and cervical cancer screenings during some years pre- and post-expansion. These associations were modified by race/ethnicity and rurality. Future research should control for baseline rates of up-to-date breast and cervical cancer screening rates. A longitudinal study should be conducted to further control for time-varying confounders. Findings support adoption of Medicaid expansion should be adopted by all states to improve breast and cervical cancer screening rates for low-income women.
Download or read book The Affordable Care Act s Dependent Mandate and Medicaid Expansion written by Marisela R. M. Moran and published by . This book was released on 2021 with total page 33 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cervical cancer screenings increased following passaging of the Affordable Care Act (ACA) of 2010. The ACA's goals were to expand comprehensive women's health screenings, expand coverage for young adults up to age 26 through the Dependent Coverage Mandate, and provide coverage for low socio-economic citizens by expanding Medicaid. This paper is a qualitative analysis of archival data from peer-reviewed journal articles about the enactment of the Affordable Care Act and how it has affected cervical cancer screenings for young adults' pre-ACA and post-ACA. In this paper, a comparative analysis was assessed for states that enacted the Medicaid Expansion versus those that did not, and the effect on racial/ethnic, low socioeconomic, and educated female populations. Peer-reviewed journals were reviewed and analyzed from the California State University, Northridge Library database. The keywords used when searching the database and 2,434 articles were initially retrieved, and 1,783 were excluded. These were limited done to those published between 2010 and 2020, with cervical cancer screening in the United States being the keywords most identified. Articles were assessed that addressed the changes to cervical cancer screenings pre-ACA and post-ACA for young adults, Medicaid, and social disparities. These studies were compared using a difference-in-difference methodology. The Affordable Care Act was a legislative process for the newly elected President Barrack Obama and his Democratic Congress in 2008. Both Republicans and Democrats have proposed healthcare reform going all the way back to World War II when unions advocated for their workers. It remained a debated topic in to the 2000s as to whom would mandate and provide healthcare coverage, the federal government, or the states. This analysis examines, through Kingdon's Model, the need and process of reform that enabled the Affordable Care Act to pass. Following the enactment of the ACA, one in five young adult women were uninsured, whereas prior to the ACA one in three were uninsured. There was an increase in screening for young adults following the ACA from 2009 to 2011 (67.9% vs 84.3%), however there has been a recent decline in screening, while there has been an increase in HPV vaccines, the only known vaccine that prevents Cervical cancer. For states that enacted the Medicaid expansion, Medicaid visits increased from 33.8% in 203 to 52.7% in 2015. Analysis was conducted for socioeconomic and racial disparities, and it showed the same positive statistic for an increase in screening. For non-Hispanic Blacks in expansion states their screening rates went from 43.5% pre-ACA to 51.2% post-ACA. Though cervical cancer screenings increased following the enactment of the ACA, there remains barriers to compliance for women to be screened for this preventable cancer. Not all 50 states have expanded Medicaid, leaving low socio-economic and ethnic groups at a disadvantage to seeking low-cost screenings that Medicaid would cover. Health literacy remains a large barrier to inform adults about the need for routine cervical cancer screenings, as they write most medical information at a higher reading level. With more young adults receiving the HPV vaccine, the American Cancer Society is investigating if it is a more worthwhile endeavor to test for HPV and replace the cervical Pap Smear test with HPV testing only. The ACA's goal of screening more women was achieved, however there still is the Healthy People goal of screening 84.3% of the US female population by 2030. More research would need to be conducted to examine hesitancy for screening rates 10 years following the ACA and how to reach subgroups of young adults and underserved populations.
Download or read book Medicaid written by James C. Cosgrove and published by DIANE Publishing. This book was released on 2009-12 with total page 44 pages. Available in PDF, EPUB and Kindle. Book excerpt: Tens of thousands of women die each year from breast or cervical cancer. While screening and early detection -- followed by treatment -- can improve survival, low-income, uninsured women are often not screened. In 1990, Congress authorized the CDC to fund screening and diagnostic services for such women. An Act signed into law in 2000 allowed states to extend Medicaid eligibility to women screened under the Early Detection Program (EDP) and who need breast or cervical cancer treatment. This report examined the EDP's screening of eligible women, states' implementation of the Treatment Act, Medicaid enrollment and spending under the Treatment Act, and alternatives available to women ineligible for Medicaid under the Treatment Act. Illus.
Download or read book Participation in Cervical Cancer Screenings by Low income Women During Affordable Care Act Medicaid Expansion in Pennsylvania written by Tonya Y. Miller and published by . This book was released on 2018 with total page 221 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Breast and Cervical Cancer Screening in Virginia written by Kamila Somayaji and published by . This book was released on 2007 with total page 56 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Fulfilling the Potential of Cancer Prevention and Early Detection written by National Research Council and published by National Academies Press. This book was released on 2003-05-07 with total page 564 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cancer ranks second only to heart disease as a leading cause of death in the United States, making it a tremendous burden in years of life lost, patient suffering, and economic costs. Fulfilling the Potential for Cancer Prevention and Early Detection reviews the proof that we can dramatically reduce cancer rates. The National Cancer Policy Board, part of the Institute of Medicine, outlines a national strategy to realize the promise of cancer prevention and early detection, including specific and wide-ranging recommendations. Offering a wealth of information and directly addressing major controversies, the book includes: A detailed look at how significantly cancer could be reduced through lifestyle changes, evaluating approaches used to alter eating, smoking, and exercise habits. An analysis of the intuitive notion that screening for cancer leads to improved health outcomes, including a discussion of screening methods, potential risks, and current recommendations. An examination of cancer prevention and control opportunities in primary health care delivery settings, including a review of interventions aimed at improving provider performance. Reviews of professional education and training programs, research trends and opportunities, and federal programs that support cancer prevention and early detection. This in-depth volume will be of interest to policy analysts, cancer and public health specialists, health care administrators and providers, researchers, insurers, medical journalists, and patient advocates.
Download or read book Health United States 2016 with Chartbook on Long Term Trends in Health written by National Center for Health Statistics and published by Government Printing Office. This book was released on 2017-08-16 with total page 494 pages. Available in PDF, EPUB and Kindle. Book excerpt: This annual overview report of national trends in health statistics contains a Chartbook that assesses the nation's health by presenting trends and current information on selected measures of morbidity, mortality, health care utilization and access, health risk factors, prevention, health insurance, and personal health-care expenditures. Chapters devoted to population characteristics, prevention, health risk factors, health care resources, personal health care expenditures, health insurance, and trend tables may provide the health/medical statistician, data analyst, biostatistician with additional information to complete experimental studies or provide necessary research for pharmaceutical companies to gain data for modeling and sampling. Undergraduate students engaged in applied mathematics or statistical compilations to graduate students completing biostatistics degree programs to include statistical inference principles, probability, sampling methods and data analysis as well as specialized medical statistics courses relating to epidemiology and other health topics may be interested in this volume. Related products: Your Guide to Choosing a Nursing Home or Other Long-Term Services & Supports available here: https://bookstore.gpo.gov/products/your-guide-choosing-nursing-home-or-other-long-term-services-supports Health Insurance Coverage in the United States, 2014 available here: https://bookstore.gpo.gov/products/health-insurance-coverage-united-states-2014 "Some System of the Nature Here Proposed": Joseph Lovell's Remarks on the Sick Report, Northern Department, U.S. Army, 1817, and the Rise of the Modern US Army Medical Department can be found here: https://bookstore.gpo.gov/products/some-system-nature-here-proposed-joseph-lovells-remarks-sick-report-northern-department-us Guide to Clinical Preventive Services 2014: Recommendations of the U.S. Preventive Services Task Force (ePub) -Free digital eBook download available at the US Government Online Bookstore here: https://bookstore.gpo.gov/products/guide-clinical-preventive-services-2014-recommendations-us-preventive-services-task-force --Also available for FREE digital eBook download from Apple iBookstore, BarnesandNoble.com (Nook Bookstore), Google Play eBookstore, and Overdrive -Please use ISBN: 9780160926426 to search these commercial platforms.
Download or read book Research Methods in International Business written by Lorraine Eden and published by Springer Nature. This book was released on 2019-12-06 with total page 501 pages. Available in PDF, EPUB and Kindle. Book excerpt: Showcasing methodological rigour and state-of-the-art methods as hallmarks of modern international business (IB) research, this book offers a collection of the most relevant and highly cited research methods articles from the Journal of International Business Studies (JIBS). Each piece is accompanied by a new Commentary written by experts in the field; some also include Further Reflections by the original authors. Encompassing both qualitative and quantitative approaches, this comprehensive volume explores research design, testing and reporting, as well as specific methodological issues such as endogeneity, common method variance, and theorising from case studies. With recommendations for best practices relating to interaction effects, hypothesis testing, and replicability, this book is a unique and up-to-date reference source on the latest research methods and practices in international business. The book will also be essential reading for those studying any sub-discipline of IB research, including international economics, entrepreneurship, finance, management and marketing.
Download or read book Delivering Affordable Cancer Care in the 21st Century written by Institute of Medicine and published by National Academies Press. This book was released on 2013-06-20 with total page 95 pages. Available in PDF, EPUB and Kindle. Book excerpt: Rising health care costs are a central fiscal challenge confronting the United States. National spending on health care currently accounts for 18 percent of gross domestic product (GDP), but is anticipated to increase to 25 percent of GDP by 2037. The Bipartisan Policy Center argues that "this rapid growth in health expenditures creates an unsustainable burden on America's economy, with far-reaching consequences". These consequences include crowding out many national priorities, including investments in education, infrastructure, and research; stagnation of employee wages; and decreased international competitiveness.In spite of health care costs that far exceed those of other countries, health outcomes in the United States are not considerably better. With the goal of ensuring that patients have access to high-quality, affordable cancer care, the Institute of Medicine's (IOM's) National Cancer Policy Forum convened a public workshop, Delivering Affordable Cancer Care in the 21st Century, October 8-9, 2012, in Washington, DC. Delivering Affordable Cancer Care in the 21st Century summarizes the workshop.
Download or read book Tumor Vascularization written by Domenico Ribatti and published by Academic Press. This book was released on 2020-01-21 with total page 198 pages. Available in PDF, EPUB and Kindle. Book excerpt: Tumor Vascularization discusses the different types of growth of tumor blood vessels and their implications on research and healthcare. The book is divided into three parts: the first one, General Mechanisms, discusses different vessel growth mechanisms, such as sprouting angiogenesis, non-angiogenesis dependent growth, intussusceptive microvascular growth, vascular co-option and vasculogenic mimicry. The second and third parts, entitled Clinical Implications and Therapeutic Implications are dedicated to translating recent findings in this field to patient treatment and healthcare. This book is a valuable source for cancer researchers, oncologists, graduate students and members of the biomedical field who are interested in tumor progression and blood vessels. Explains new, non-orthodox concepts recently developed and related to the modality of growth of tumor blood vessels Provides information on the types of angiogenesis, non-angiogenesis dependent growth and vascular co-option, discussing both their similarities and differences Encompasses a discussion on clinical implications of tumor vascularization to translate research findings into treatment
Download or read book Health Care Utilization as a Proxy in Disability Determination written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-04-02 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
Download or read book Ensuring Quality Cancer Care written by National Cancer Policy Board and published by National Academies Press. This book was released on 1999-08-04 with total page 257 pages. Available in PDF, EPUB and Kindle. Book excerpt: We all want to believe that when people get cancer, they will receive medical care of the highest quality. Even as new scientific breakthroughs are announced, though, many cancer patients may be getting the wrong care, too little care, or too much care, in the form of unnecessary procedures. How close is American medicine to the ideal of quality cancer care for every person with cancer? Ensuring Quality Cancer Care provides a comprehensive picture of how cancer care is delivered in our nation, from early detection to end-of-life issues. The National Cancer Policy Board defines quality care and recommends how to monitor, measure, and extend quality care to all people with cancer. Approaches to accountability in health care are reviewed. What keeps people from getting care? The book explains how lack of medical coverage, social and economic status, patient beliefs, physician decision-making, and other factors can stand between the patient and the best possible care. The board explores how cancer care is shaped by the current focus on evidence-based medicine, the widespread adoption of managed care, where services are provided, and who provides care. Specific shortfalls in the care of breast and prostate cancer are identified. A status report on health services research is included. Ensuring Quality Cancer Care offers wide-ranging data and information in clear context. As the baby boomers approach the years when most cancer occurs, this timely volume will be of special interest to health policy makers, public and private healthcare purchasers, medical professionals, patient advocates, researchers, and people with cancer.
Download or read book Improving Breast Imaging Quality Standards written by National Research Council and published by National Academies Press. This book was released on 2005-09-27 with total page 240 pages. Available in PDF, EPUB and Kindle. Book excerpt: Mammography is an important tool for detecting breast cancer at an early stage. When coupled with appropriate treatment, early detection can reduce breast cancer mortality. At the request of Congress, the Food and Drug Administration (FDA) commissioned a study to examine the current practice of mammography and breast cancer detection, with a focus on the FDA's oversight via the Mammography Quality Standards Act (MQSA), to identify areas in need of improvement. Enacted in 1993, MQSA provides a general framework for ensuring national quality standards in facilities performing screening mammography, requires that each mammography facility be accredited and certified, and mandates that facilities will undergo annual inspections. This book recommends strategies for achieving continued progress in assuring mammography quality, including changes to MQSA regulation, as well as approaches that do not fall within the purview of MQSA. Specifically, this book provides recommendations aimed at improving mammography interpretation; revising MQSA regulations, inspections, and enforcement; ensuring an adequate workforce for breast cancer screening and diagnosis; and improving breast imaging quality beyond mammography.
Download or read book Integrating Social Care into the Delivery of Health Care written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2020-01-30 with total page 195 pages. Available in PDF, EPUB and Kindle. Book excerpt: Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health was released in September 2019, before the World Health Organization declared COVID-19 a global pandemic in March 2020. Improving social conditions remains critical to improving health outcomes, and integrating social care into health care delivery is more relevant than ever in the context of the pandemic and increased strains placed on the U.S. health care system. The report and its related products ultimately aim to help improve health and health equity, during COVID-19 and beyond. The consistent and compelling evidence on how social determinants shape health has led to a growing recognition throughout the health care sector that improving health and health equity is likely to depend â€" at least in part â€" on mitigating adverse social determinants. This recognition has been bolstered by a shift in the health care sector towards value-based payment, which incentivizes improved health outcomes for persons and populations rather than service delivery alone. The combined result of these changes has been a growing emphasis on health care systems addressing patients' social risk factors and social needs with the aim of improving health outcomes. This may involve health care systems linking individual patients with government and community social services, but important questions need to be answered about when and how health care systems should integrate social care into their practices and what kinds of infrastructure are required to facilitate such activities. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health examines the potential for integrating services addressing social needs and the social determinants of health into the delivery of health care to achieve better health outcomes. This report assesses approaches to social care integration currently being taken by health care providers and systems, and new or emerging approaches and opportunities; current roles in such integration by different disciplines and organizations, and new or emerging roles and types of providers; and current and emerging efforts to design health care systems to improve the nation's health and reduce health inequities.
Download or read book Understanding the Well Being of LGBTQI Populations written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2021-01-23 with total page 437 pages. Available in PDF, EPUB and Kindle. Book excerpt: The increase in prevalence and visibility of sexually gender diverse (SGD) populations illuminates the need for greater understanding of the ways in which current laws, systems, and programs affect their well-being. Individuals who identify as lesbian, gay, bisexual, asexual, transgender, non-binary, queer, or intersex, as well as those who express same-sex or -gender attractions or behaviors, will have experiences across their life course that differ from those of cisgender and heterosexual individuals. Characteristics such as age, race and ethnicity, and geographic location intersect to play a distinct role in the challenges and opportunities SGD people face. Understanding the Well-Being of LGBTQI+ Populations reviews the available evidence and identifies future research needs related to the well-being of SDG populations across the life course. This report focuses on eight domains of well-being; the effects of various laws and the legal system on SGD populations; the effects of various public policies and structural stigma; community and civic engagement; families and social relationships; education, including school climate and level of attainment; economic experiences (e.g., employment, compensation, and housing); physical and mental health; and health care access and gender-affirming interventions. The recommendations of Understanding the Well-Being of LGBTQI+ Populations aim to identify opportunities to advance understanding of how individuals experience sexuality and gender and how sexual orientation, gender identity, and intersex status affect SGD people over the life course.
Download or read book Access to Health Care in America written by Institute of Medicine and published by National Academies Press. This book was released on 1993-02-01 with total page 240 pages. Available in PDF, EPUB and Kindle. Book excerpt: Americans are accustomed to anecdotal evidence of the health care crisis. Yet, personal or local stories do not provide a comprehensive nationwide picture of our access to health care. Now, this book offers the long-awaited health equivalent of national economic indicators. This useful volume defines a set of national objectives and identifies indicatorsâ€"measures of utilization and outcomeâ€"that can "sense" when and where problems occur in accessing specific health care services. Using the indicators, the committee presents significant conclusions about the situation today, examining the relationships between access to care and factors such as income, race, ethnic origin, and location. The committee offers recommendations to federal, state, and local agencies for improving data collection and monitoring. This highly readable and well-organized volume will be essential for policymakers, public health officials, insurance companies, hospitals, physicians and nurses, and interested individuals.
Download or read book America s Uninsured Crisis written by Institute of Medicine and published by National Academies Press. This book was released on 2009-07-01 with total page 238 pages. Available in PDF, EPUB and Kindle. Book excerpt: When policy makers and researchers consider potential solutions to the crisis of uninsurance in the United States, the question of whether health insurance matters to health is often an issue. This question is far more than an academic concern. It is crucial that U.S. health care policy be informed with current and valid evidence on the consequences of uninsurance for health care and health outcomes, especially for the 45.7 million individuals without health insurance. From 2001 to 2004, the Institute of Medicine (IOM) issued six reports, which concluded that being uninsured was hazardous to people's health and recommended that the nation move quickly to implement a strategy to achieve health insurance coverage for all. The goal of this book is to inform the health reform policy debateâ€"in 2009â€"with an up-to-date assessment of the research evidence. This report addresses three key questions: What are the dynamics driving downward trends in health insurance coverage? Is being uninsured harmful to the health of children and adults? Are insured people affected by high rates of uninsurance in their communities?
