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Hardy RY, Boch SJ, Davenport MA, Chavez LJ, Kelleher KJ. Rural-urban differences in social and emotional protective factors and their association with child health and flourishing. J Rural Health 2024; 40:314-325. [PMID: 37859615 DOI: 10.1111/jrh.12802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/26/2023] [Accepted: 10/10/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Children in rural communities experience higher mortality rates and less access to health care services than those in urban communities. Protective factors like social support also vary by geography, but their contribution to differences in child health is understudied. Understanding geographic variation in protective health factors could provide insight into their impact on health and guide future intervention strategies. RESEARCH OBJECTIVE To examine protective factors' association with child flourishing and child health status in rural and urban communities. METHODS Publicly available data from the National Survey of Children's Health, 2018-2021, with nonmissing geographic data (N = 150,493) were used to assess the relationship between protective factors and child flourishing and health by rurality. Multivariate survey-weighted probit models examined these relationships, adjusting for child and caregiver characteristics. FINDINGS More than a third of children were not flourishing, according to parental report. An estimated 62% of rural children were flourishing compared to 66% of urban children (P<0.001). Urban caregivers also were more likely to report better adult mental and physical health status. Nevertheless, rural children were reported to receive more social support than urban children, while their caregivers reported more emotional support and living in supportive and safe neighborhoods (P<0.001). Rural caregivers reported more support from places of worship and less from counselors/other mental health care providers than urban caregivers. CONCLUSIONS Despite higher reported caregiver emotional support and child social support, fewer rural children are flourishing. Health systems and community organizations able to leverage these existing social and emotional protective factors in rural communities could help close this gap.
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Affiliation(s)
- Rose Y Hardy
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Samantha J Boch
- College of Nursing, University of Cincinnati, Cincinnati, Ohio, USA
- The James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Mattina A Davenport
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Laura J Chavez
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Kelly J Kelleher
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
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Hardy RY, Chavez LJ, Grant VR, Chisolm DJ, Daniels CJ, Jackson JL. Healthcare Use Among Black and White Congenital Heart Disease Medicaid Enrollees. Pediatr Cardiol 2023; 44:1754-1762. [PMID: 37535077 DOI: 10.1007/s00246-023-03249-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 07/24/2023] [Indexed: 08/04/2023]
Abstract
Congenital heart disease (CHD) is the most common birth anomaly in the US. Research shows lost-to-follow-up trends and racial disparities in healthcare use. This study examines racial differences in healthcare use among Medicaid-covered children with CHD. Using 2010-2019 claims data from a pediatric Medicaid Accountable Care Organization, 960 Black and White children with complex CHD and ≥ 3 years of continuous Medicaid coverage were identified. Three cohorts were constructed (starting age: < 1-year-olds, 1-5-year-olds, 6-15-year-olds) and followed for 3 years. Multivariate analysis assessed annual healthcare use (cardiology, primary care, emergency department) by race, adjusting for patient and provider covariates. Overall, 51% of patients had an annual cardiology visit, and 54% had an annual primary care visit. Among the 1-5-year-old cohort, Black children were predicted to be 13% less likely to have an annual cardiology visit compared to their White counterparts (p = 0.001). Older Black children were predicted to be more likely to have a primary care visit compared to their White counterparts. Nearly half of Medicaid-enrolled children with complex CHD did not receive recommended cardiology care. Young Black children were less likely to receive an annual cardiac visit, while older Black children were more likely to receive primary care. While the percentage with an annual cardiac visit was low, the majority had seen a cardiologist within the 3-year window, suggesting these children are still receiving cardiology care, if less frequently than recommended. Opportunities exist for cardiology and primary care to collaborate to ensure patients receive timely recommended care.
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Affiliation(s)
- Rose Y Hardy
- Center for Child Health Equity and Outcomes Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Dr., Columbus, OH, 43205, USA.
| | - Laura J Chavez
- Center for Child Health Equity and Outcomes Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Dr., Columbus, OH, 43205, USA
| | - Victoria R Grant
- Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Dr., Columbus, OH, 43205, USA
| | - Deena J Chisolm
- Center for Child Health Equity and Outcomes Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Dr., Columbus, OH, 43205, USA
| | - Curt J Daniels
- Division of Cardiovascular Medicine & Nationwide Children's Hospital, The Ohio State University Department of Internal Medicine, 473 W 12th Ave., Columbus, OH, 43210, USA
| | - Jamie L Jackson
- Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Dr., Columbus, OH, 43205, USA
- College of Medicine, Department of Pediatrics, The Ohio State University, 370 W 9th Ave., Columbus, OH, 43210, USA
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Hardy RY, Babu S, Jackson JL, George S, Andrews JG, Daskalov R, May SC, Miller P, Timmins S, Pike NA. Young adults with congenital heart disease heading to college: Are college health centers and providers prepared? J Am Assoc Nurse Pract 2023; 35:620-628. [PMID: 37471528 DOI: 10.1097/jxx.0000000000000914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 06/01/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND An estimated 1.4 million adults in the United States have congenital heart disease (CHD). As this population grows and many pursue postsecondary education, these adults' health care needs and concerns should be at the forefront for providers, particularly nurse practitioners, at college health centers. PURPOSE To understand how college health centers and providers identify and manage the care of students with chronic conditions to further support their health care transition, with a focus on students with CHD. METHODOLOGY Qualitative key informant interviews were performed with providers at five college health centers to understand the processes in place and the challenges health care providers on college campuses face when caring for students with CHD. RESULTS Most of the college health centers did not have formalized processes in place to care for these students. Although many felt that they had the capabilities in their health centers to manage these students' maintenance/preventive care needs, fewer felt comfortable with their urgent or emergent care needs. The onus was often on students or parents/guardians to initiate these transitions. CONCLUSIONS This study highlights some challenges to providing care to students with chronic conditions like CHD. More collaborative relationships with specialists may be critical to ensuring that all the care needs of chronic disease students are met on college campuses. IMPLICATIONS Nurse practitioners, who often staff these clinics, are well positioned to support this transition onto campuses and lead the development of processes to identify these students, ease care management transitions, and ensure easy provider communication that allow students with chronic diseases to thrive on campus.
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Affiliation(s)
- Rose Y Hardy
- Center for Child Health Equity, Nationwide Children's Hospital, Columbus, Ohio
| | - Suhas Babu
- Texas A&M University, College Station, Texas
| | - Jamie L Jackson
- Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, Ohio
| | | | | | | | - Susan C May
- Adult Congenital Heart Association (ACHA), Media, Pennsylvania
| | - Paula Miller
- Adult Congenital Heart Association (ACHA), Media, Pennsylvania
| | - Susan Timmins
- Adult Congenital Heart Association (ACHA), Media, Pennsylvania
| | - Nancy A Pike
- School of Nursing, University of California, Los Angeles, California, USA
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Boch SJ, Murnan AW, Pollard JF, Nidey NL, Hardy RY, Iruka IU. Assessment of US Federal Funding of Incarceration-Related Research, 1985 to 2022. JAMA Netw Open 2023; 6:e230803. [PMID: 36848087 PMCID: PMC9972190 DOI: 10.1001/jamanetworkopen.2023.0803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
IMPORTANCE The US leads the world in the raw number of incarcerated persons as well as the rate of incarceration, with detrimental effects on individual-, family-, community-, and population-level health; as such, federal research has a critical role in documenting and addressing the health-related impacts of the US criminal legal system. How often incarceration-related research is funded at the National Institutes of Health (NIH), National Science Foundation (NSF), and US Department of Justice (DOJ) levels has a direct association with the public attention given to mass incarceration as well as the efficacy of strategies to mitigate negative effects and poor health related to incarceration. OBJECTIVE To understand how many incarceration-related projects have been funded at the NIH, NSF, and DOJ. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used public historical project archives to search for relevant incarceration-related keywords (eg, incarceration, prison, parole) since January 1, 1985 (NIH and NSF), and since January 1, 2008 (DOJ). Quotations and Boolean operator logic were used. All searches and counts were conducted and double verified by 2 coauthors between December 12 and 17, 2022. MAIN OUTCOMES AND MEASURES Number and prevalence of funded projects related to incarceration and prison keywords. RESULTS The term incarceration resulted in 3540 of 3 234 159 total project awards (0.11%) and prisoner-related terms resulted in 11 455 total project awards (0.35%) across the 3 federal agencies since 1985. Nearly a tenth of all projects funded at NIH since 1985 related to education (256 584 [9.62%]) compared with only 3373 projects (0.13%) that related to criminal legal or criminal justice or correctional system and 18 projects (0.0007%) that related to incarcerated parents. Only 1857 (0.07%) of all NIH-funded projects have been funded related to racism since 1985. CONCLUSIONS AND RELEVANCE This cross-sectional study found that a very low number of projects about incarceration have historically been funded at the NIH, DOJ, and NSF. These findings reflect a dearth of federally funded studies investigating the effects of mass incarceration or intervention strategies to mitigate adverse effects. Given the consequences of the criminal legal system, it is undoubtedly time for researchers, and our nation, to invest more resources into studying whether this system should be maintained, the intergenerational effects of mass incarceration, and strategies to best mitigate its impact on public health.
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Affiliation(s)
- Samantha J. Boch
- College of Nursing, University of Cincinnati, Cincinnati, Ohio
- The James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Aaron W. Murnan
- College of Nursing, University of Cincinnati, Cincinnati, Ohio
| | | | - Nichole L. Nidey
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Rose Y. Hardy
- Center for Child Health Equity and Outcomes Research, Nationwide Children’s Hospital, Columbus, Ohio
| | - Iheoma U. Iruka
- Department of Public Policy, University of North Carolina at Chapel Hill
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Hardy RY, Liu GC, Conkol KJ, Gleeson SP, Kelleher KJ. Left behind again: Rural home health services in a Medicaid pediatric accountable care organization. J Rural Health 2021; 38:420-426. [PMID: 33978993 PMCID: PMC9291131 DOI: 10.1111/jrh.12587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Purpose To contrast trends in rural and urban pediatric home health care use among Medicaid enrollees. Methods Medicaid administrative claims data were used to assess differences in home health care use for child members in a large pediatric accountable care organization (ACO) in Ohio. Descriptive statistics assessed rural and urban differences in health care use over a 10‐year period between 2010 and 2019. Findings Pediatric home health care use increased markedly in the low‐income (CFC) and disabled (ABD) Medicaid categories. Over the past 10 years, CFC‐enrolled children from urban communities have seen more home health visits, fewer emergency department (ED) visits, and more well child visits compared to rural CFC‐enrolled children. Children enrolled due to disabilities in urban communities have also seen more home health visit use but fewer preventive care visits than their rural counterparts. Conclusions Within a pediatric ACO, rural home health care use has remained relatively stagnant over a 10‐year period, a stark contrast to increases in home health care use among comparable urban populations. There are likely multiple explanations for these differences, including overuse in urban communities, lack of access in rural communities, and changes to home health reimbursement. More can be done to improve rural home health access. Such improvement will likely necessitate large‐scale changes to home health care delivery, workforce, and financing. Improvements should be evaluated for return‐on‐investment not only in terms of direct costs, that is, reduced inpatient or ED costs, but also in terms of patient and family quality‐of‐life or key indicators of child well‐being such as educational attainment.
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Affiliation(s)
- Rose Y Hardy
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Center for Innovation in Pediatric Practice, Columbus, Ohio, USA
| | - Gilbert C Liu
- Partners For Kids, Columbus, Ohio, USA.,Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
| | | | - Sean P Gleeson
- Partners For Kids, Columbus, Ohio, USA.,Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Kelly J Kelleher
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Center for Innovation in Pediatric Practice, Columbus, Ohio, USA.,Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
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Gowda C, Hardy RY, Traylor S, Liu GC. Trends in healthcare utilisation for firearm-related injuries among a cohort of publicly insured children in Ohio. J Epidemiol Community Health 2021; 75:906-909. [PMID: 33637614 DOI: 10.1136/jech-2020-215940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/18/2021] [Accepted: 02/14/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To examine healthcare utilisation for all firearm-related injuries among publicly insured children. METHODS A retrospective analysis of firearm injury medical claims among paediatric (<21 years) Medicaid beneficiaries in Ohio from 2010 to 2018. Factors associated with unintentional and intentional firearm injury were explored using multivariable logistic regression. Average annual patient healthcare costs were determined in 2019 US$. RESULTS There were 1061 firearm injury-related claims (853 (80%) unintentional; 154 (15%) intentional; 54 (5%) unknown) occurring in 663 children over 2 736 517 available person-years. From 2010 to 2018, yearly total firearm claims rose from 19.7 to 31.3 per 100 000 persons (p=0.033). Urban children experienced a non-significant increase in firearm claims rate over time (26.1 vs 35.0/100 000; p=0.066) while the claims rate nearly tripled among those in rural areas (8.4 vs 24.0/100 000; p=0.012). Younger age, females and rural residence were associated with reduced odds of injury claims. The average annual costs for emergency department and inpatient visits, respectively, were $260 and $5735. CONCLUSION Risk and type of firearm injury claims among low-income children in Ohio varies by age, sex and residence. Prevention programmes should be tailored based on these demographics.
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Affiliation(s)
- Charitha Gowda
- Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Rose Y Hardy
- Center for Innovation in Pediatric Practice, Nationwide Children's Hospital, Columbus, Ohio, USA
| | | | - Gilbert C Liu
- Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
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Hardy RY, Liu GC, Kelleher K. Contribution of Social Determinant of Health Factors to Rural-Urban Preventive Care Differences Among Medicaid Enrollees. Acad Pediatr 2021; 21:93-100. [PMID: 32891801 DOI: 10.1016/j.acap.2020.08.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/14/2020] [Accepted: 08/30/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE 1) Assess whether rural-urban disparities are present in pediatric preventive health care utilization; and 2) use regression decomposition to measure the contribution of social determinants of health (SDH) to those disparities. METHODS With an Ohio Medicaid population served by a pediatric Accountable Care Organization, Partners For Kids, between 2017 and 2019, we used regression decomposition (a nonlinear multivariate regression decomposition model) to analyze the contribution of patient, provider, and SDH factors to the rural-urban well-child visit gap among children in Ohio. RESULTS Among the 453,519 eligible Medicaid enrollees, 61.2% of urban children received a well-child visit. Well-child visit receipt among children from large rural cities/towns and small/isolated towns was 58.2% and 55.5%, respectively. Comparing large rural towns to urban centers, 55.8% of the 3.0 percentage-point difference was explained by patient, provider, and community-level SDH factors. In comparing small/isolated town to urban centers, 89.8% of the 5.7 percentage-point difference was explained by these characteristics. Of provider characteristics, pediatrician providers were associated with increased well visit receipt. Of the SDH factors, unemployment and education contributed the most to the explained difference in large rural towns while unemployment, education, and food deserts contributed significantly to the small/isolated town difference. CONCLUSIONS The receipt of pediatric preventive care is slightly lower in rural communities. While modest, the largest part of the rural-urban preventive care gap can be explained by differences in provider type, poverty, unemployment, and education levels. More could be done to improve pediatric preventive care in all communities.
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Affiliation(s)
- Rose Y Hardy
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Center for Innovation in Pediatric Practice (RY Hardy and K Kelleher), Columbus, Ohio.
| | - Gilbert C Liu
- Partners For Kids, Nationwide Children's Hospital (GC Liu), Columbus, Ohio
| | - Kelly Kelleher
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Center for Innovation in Pediatric Practice (RY Hardy and K Kelleher), Columbus, Ohio; Department of Pediatrics, Nationwide Children's Hospital (K Kelleher), Columbus, Ohio
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Hardy RY, Keller D, Gurvitz M, McManus B, Varda D, Lindrooth RC. Patient Sharing and Health Care Utilization Among Young Adults With Congenital Heart Disease. Med Care Res Rev 2020; 78:561-571. [PMID: 32723144 DOI: 10.1177/1077558720945925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Transitions from pediatric to adult care by young adults with chronic conditions are fraught with challenges. Poor transitions lead to discontinuities of care that are avoidable with better communication between providers. We tested whether exposure to providers with sustained patient-sharing relationships resulted in fewer emergent admissions of young adults with congenital heart disease (CHD). Care transitions are particularly important for young adults with CHD. Though it is not possible to avoid planned admissions for scheduled procedures, emergency admissions are avoidable with proper care. We tested whether several different patient-sharing relationship measures influenced emergent admissions and found that compared with less severe CHD patients, those with severe CHD experienced a 4 to 10 percentage point decline in emergent admissions given a 5 percentage point increase in practice-level patient-sharing relationships. These results are consistent with our hypothesis that patient sharing improves communication and continuity of care across providers, especially for severe CHD patients.
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Affiliation(s)
- Rose Y Hardy
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - David Keller
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Beth McManus
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Abstract
Roughly 60 years after the first questions were raised about hospitalized patients, Kaslow and colleagues (see record 2020-40858-010) articulate the importance of patient- and family-centered care and outline recommendations for hospitalist care teams. They concisely point out the need for such practices, but more important, they provide many practical examples. Some of the main recommendations include (a) form partnerships, (b) prioritize communication, (c) discuss care goals, (d) share decision-making, (e) collaborate to implement the treatment plan, (f) negotiate differences, and (g) make special accommodations for discharge planning. Within each of these areas, the authors provide specific patient-centered and family-focused practices. At a global level, none of the recommendations provided are unique to hospitalists' practice. Almost all of them are similar to patient- and family-centered care recommendations from other settings. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Hardy RY, Lindrooth RC, Peach RK, Ellis C. Urban-Rural Differences in Service Utilization and Costs of Care for Racial-Ethnic Groups Hospitalized With Poststroke Aphasia. Arch Phys Med Rehabil 2019; 100:254-260. [DOI: 10.1016/j.apmr.2018.06.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/21/2018] [Accepted: 06/26/2018] [Indexed: 11/26/2022]
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Abstract
Decisions by states about whether to expand Medicaid under the Affordable Care Act (ACA) have implications for hospitals' financial health. We hypothesized that Medicaid expansion of eligibility for childless adults prevents hospital closures because increased Medicaid coverage for previously uninsured people reduces uncompensated care expenditures and strengthens hospitals' financial position. We tested this hypothesis using data for the period 2008-16 on hospital closures and financial performance. We found that the ACA's Medicaid expansion was associated with improved hospital financial performance and substantially lower likelihoods of closure, especially in rural markets and counties with large numbers of uninsured adults before Medicaid expansion. Future congressional efforts to reform Medicaid policy should consider the strong relationship between Medicaid coverage levels and the financial viability of hospitals. Our results imply that reverting to pre-ACA eligibility levels would lead to particularly large increases in rural hospital closures. Such closures could lead to reduced access to care and a loss of highly skilled jobs, which could have detrimental impacts on local economies.
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Affiliation(s)
- Richard C Lindrooth
- Richard C. Lindrooth ( ) is a professor in the Department of Health Systems, Management, and Policy, Anschutz Medical Campus, Colorado School of Public Health, University of Colorado, in Aurora
| | - Marcelo C Perraillon
- Marcelo C. Perraillon is an assistant professor in the Department of Health Systems, Management, and Policy, Anschutz Medical Campus, Colorado School of Public Health, University of Colorado
| | - Rose Y Hardy
- Rose Y. Hardy is a graduate student in the Department of Health Systems, Management, and Policy, Anschutz Medical Campus, Colorado School of Public Health, University of Colorado
| | - Gregory J Tung
- Gregory J. Tung is an assistant professor in the Department of Health Systems, Management, and Policy, Anschutz Medical Campus, Colorado School of Public Health, University of Colorado
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Hardy RY, Gurvitz M, Jackson JL, May S, Miller P, Daskalov R, Foster E. College students with congenital heart disease: A critical time for transition. J Am Coll Health 2018; 66:324-328. [PMID: 29452064 DOI: 10.1080/07448481.2018.1440583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
UNLABELLED As medical and surgical advances improve, more young adults with congenital heart disease (CHD) are attending college. This case study illustrates some of the issues that these young adults may face as they attend college and discusses the role that college health practitioners can play in easing that transition. PARTICIPANTS A case of a male with CHD presenting to the college health clinic with a new onset headache. METHODS The authors discuss some of the unique challenges that college health practitioners may face when caring for students with CHD. In addition, they make recommendations on how best to care for these patients and how best to coordinate care with CHD students other care providers. RESULTS This student with a history of coarctation of the aorta presented with new onset headaches and was found to have high blood pressure. He was diagnosed with recurrent coarctation, underwent percutaneous treatment with stenting and quickly resumed classes. CONCLUSIONS As more students with CHD enter college, college health providers will need to understand some of the health risks that CHD students face. In addition, understanding some of the optimal ways to coordinate care with CHD providers can ease the transition that CHD students face as they enter college.
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Affiliation(s)
- Rose Y Hardy
- a Department of Health Systems , Management and Policy, Colorado School of Public Health , Aurora , Colorado , USA
| | - Michelle Gurvitz
- b Department of Cardiology , Boston Children's Hospital , Boston , Massachusetts , USA
| | - Jamie L Jackson
- c Center for Biobehavioral Health, Nationwide Children's Hospital , Columbus , Ohio , USA
| | - Susan May
- d Congenital Heart Public Health Consortium, American Academy of Pediatrics , Elk Grove Village , Illinois , USA
| | - Paula Miller
- e Adult Congenital Heart Association , Philadelphia , Pennsylvania , USA
| | - Rachel Daskalov
- d Congenital Heart Public Health Consortium, American Academy of Pediatrics , Elk Grove Village , Illinois , USA
| | - Elyse Foster
- f Division of Cardiology, University of California - San Francisco , San Francisco , California , USA
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Ellis C, Hardy RY, Lindrooth RC. Greater healthcare utilization and costs among Black persons compared to White persons with aphasia in the North Carolina stroke belt. J Neurol Sci 2017; 376:76-83. [DOI: 10.1016/j.jns.2017.02.062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 01/31/2017] [Accepted: 02/28/2017] [Indexed: 11/29/2022]
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Ellis C, Hardy RY, Lindrooth RC, Peach RK. Racial-Differences in Speech-Language Pathology Utilization and Cost among Persons with Aphasia in the Stroke Belt. Arch Phys Med Rehabil 2016. [DOI: 10.1016/j.apmr.2016.08.292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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