Missed and Delayed Preventive Health Care Visits Among US Children Due to the COVID-19 Pandemic

2021 ◽  
pp. 003335492110613
Author(s):  
Lydie A. Lebrun-Harris ◽  
Olivia R. Sappenfield ◽  
Michael D. Warren
Keyword(s):  
Health Care ◽  
Preventive Care ◽  
State Level ◽  
Preventive Health Care ◽  
The Us ◽  
Households With Children ◽  
Appointment Availability ◽  
Us Children ◽  
Us Census ◽  
Preventive Health Care Visits

Objective: The COVID-19 pandemic led to a substantial drop in US children’s preventive care, which had not fully rebounded by the end of 2020. We sought to estimate the overall prevalence of missed, skipped, or delayed preventive checkups among households with children in the last 12 months because of the pandemic. Methods: We used data from the US Census Bureau’s Household Pulse Survey, Phase 3.1 (collected April–May 2021). The analytic sample included 48 824 households with ≥1 child or adolescent aged <18 years. We estimated both national and state-level prevalences, examined associations with sociodemographic and household characteristics, and described reasons for missed or delayed preventive visits. Results: Overall, 26.4% (95% CI, 25.5%-27.2%) of households reported that ≥1 child or adolescent had missed or delayed a preventive visit because of COVID-19; percentages varied by state, from 17.9% in Wyoming to 37.0% in Vermont. The prevalence of missed or delayed preventive visits was significantly higher among respondents who reported material hardships (ie, not caught up on rent/mortgage, difficulty paying usual household expenses, children not eating enough because of lack of affordability) than among respondents who did not report material hardships. The most common reasons for missing or delaying preventive visits were concern about visiting a health care provider, limited appointment availability, and the provider’s location being closed. Conclusions: Programs and policies could reduce gaps in children’s preventive care caused by the pandemic, with a particular focus on addressing social determinants of health.

scholarly journals Spillover Effects of Drug Safety Warnings on Preventive Health Care Use

2015 ◽  
Vol 15 (1) ◽  
pp. 179-208
Author(s):  
N. Meltem Daysal ◽  
Chiara Orsini
Keyword(s):  
Health Care ◽  
Women’S Health ◽  
Women's Health ◽  
Preventive Care ◽  
Drug Safety ◽  
Hormone Replacement ◽  
Preventive Health Care ◽  
Spillover Effects ◽  
Health Care Use ◽  
Preventive Health

Abstract We examine how new medical information on drug safety impacts preventive health care use. We exploit the release of the findings of the Women’s Health Initiative Study (WHIS) – the largest randomized controlled trial of women’s health – which demonstrated in 2002 the health risks associated with the long-term use of hormone replacement therapy (HRT). We first show that, after the release of the WHIS findings, HRT use dropped sharply among post-menopausal women. We then estimate the spillover effects of the WHIS findings on preventive care by means of a difference-in-differences methodology comparing changes in preventive care use among 60 to 69 year-old women (who have high rates of HRT use) with the change among women aged 75 and above (who have much lower rates of HRT use). Using data from the Behavioral Risk Factor Surveillance System for the period 1998–2007, we find that women aged 60–69 had statistically and economically significant declines in their annual mammography checks, checkups, cholesterol checks and blood stool tests, when compared to older women.

scholarly journals State-Level Health Disparity Is Associated with Sarcoidosis Mortality

2021 ◽  
Vol 10 (11) ◽  
pp. 2366
Author(s):  
Yu-Che Lee ◽  
Ko-Yun Chang ◽  
Mehdi Mirsaeidi
Keyword(s):  
Health Care ◽  
Health Disparities ◽  
African Americans ◽  
New York State ◽  
State Level ◽  
The United States ◽  
Mortality Data ◽  
State Health ◽  
European Americans ◽  
The Us

Background: Sarcoidosis is associated with significant morbidity and rising health care utilization, which contribute to the health care burden and disease outcome. In the United States (US), evaluation of sarcoidosis mortality by individual states has not been investigated. Methods: We examined sarcoidosis mortality data for 1999–2018 from the Centers for Disease Control and Prevention (CDC). America’s Health Rankings (AHR) assesses the nation’s health on a state-by-state basis to determine state health rankings. The numbers of certified Sarcoidosis Clinics within the US were obtained from World Association for Sarcoidosis and Other Granulomatous Disorders (WASOG) and Foundation for Sarcoidosis Research (FSR). The associations between sarcoidosis mortality and state health disparities were calculated by linear regression analyses. Results: From 1999 to 2018, the mean age-adjusted mortality rate (AAMR) in all populations, African Americans and European Americans were 2.9, 14.8, and 1.4 per 1,000,000 population, respectively. South Carolina had the highest AAMR for all populations (6.6/1,000,000) and African Americans (20.8/1,000,000). Both Utah and Vermont had the highest AAMR for European Americans (2.6/1,000,000). New York State and South Atlantic had the largest numbers of FSR-WASOG Sarcoidosis Clinics (6 and 13, respectively). States with better health rankings were significantly associated with lower AAMR in all population (R2 = 0.170, p = 0.003) but with higher AAMR in European Americans (R2 = 0.223, p < 0.001). Conclusions: There are significant variations in sarcoidosis mortality within the US. Sarcoidosis mortality was strongly associated with state health disparities. The current study suggests sarcoidosis mortality could be an indicator to reflect the state-level health care disparities in the US.

The Shortage of Trauma Surgeons in the US

2021 ◽  
pp. 000313482098880
Author(s):  
Adel Elkbuli ◽  
Mason Sutherland ◽  
Carol Sanchez ◽  
Huazhi Liu ◽  
Darwin Ang ◽  
...  
Keyword(s):  
Trauma Patient ◽  
Cohort Analysis ◽  
State Level ◽  
Educational Interventions ◽  
The United States ◽  
Census Bureau ◽  
The Us ◽  
Control And Prevention ◽  
Trauma Surgeons ◽  
Us Census

Background As the United States (US) population increases, the demand for more trauma surgeons (TSs) will increase. There are no recent studies comparing the TS density temporally and geographically. We aim to evaluate the density and distribution of TSs by state and region and its impact on trauma patient mortality. Methods A retrospective cohort analysis of the American Medical Association Physician Masterfile (PM), 2016 US Census Bureau, and Centers for Disease Control and Prevention (CDC’s) Web-based Injury Statistics Query and Reporting System (WISQARS) to determine TS density. TS density was calculated by dividing the number of TSs per 1 000 000 population at the state level, and divided by 500 admissions at the regional level. Trauma-related mortality by state was obtained through the CDC’s WISQARS database, which allowed us to estimate trauma mortality per 100 000 population. Results From 2007 to 2014, the net increase of TS was 3160 but only a net increase of 124 TSs from 2014 to 2020. Overall, the US has 12.58 TSs/1 000 000 population. TS density plateaued from 2014 to 2020. 33% of states have a TS density of 6-10/1 000 000 population, 43% have a density of 10-15, 12% have 15-20, and 12% have a density >20. The Northeast has the highest density of TSs per region (2.95/500 admissions), while the Midwest had the lowest (1.93/500 admissions). Conclusion The density of TSs in the US varies geographically, has plateaued nationally, and has implications on trauma patient mortality. Future studies should further investigate causes of the TS shortage and implement institutional and educational interventions to properly distribute TSs across the US and reduce geographic disparities.

scholarly journals Health promotion and preventive health care service guidelines for the care of people with spina bifida

2020 ◽  
Vol 13 (4) ◽  
pp. 513-523
Author(s):  
Ellen Fremion ◽  
David Kanter ◽  
Margaret Turk
Keyword(s):  
Health Care ◽  
Health Promotion ◽  
Spina Bifida ◽  
Acute Care ◽  
Preventive Care ◽  
Chronic Conditions ◽  
Preventive Health Care ◽  
Preventive Health ◽  
Care Utilization ◽  
Acute Care Utilization

Individuals with Spina Bifida (SB) have unique lifelong medical and social needs. Thus, when considering how to promote health and offer preventive care, providers must adapt general healthcare screening and counseling recommendations to their patients’ physical and cognitive impairments along with discerning how to monitor secondary or chronic conditions common to the population. This article provides an update on the health promotion and preventive health care guidelines developed as part of the Spina Bifida Association’s fourth edition of the Guidelines for the Care of People with Spina Bifida. The guidelines highlight accommodations needed to promote general preventive health, common secondary/chronic conditions such as obesity, metabolic syndrome, hypertension, musculoskeletal pain, and considerations for preventing acute care utilization for the SB population throughout the lifespan. Further research is needed to understand the effectiveness of preventive care interventions in promoting positive health outcomes and mitigating potentially preventable acute care utilization.

PREVENTIVE HEALTH CARE IN RELATION TO HEALTH INSURANCE SYSTEM IN SLOVAKIA

2019 ◽  
Vol 7 ◽  
Author(s):  
Barbara Pavlíková
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Preventive Care ◽  
Preventive Health Care ◽  
Preventive Health ◽  
Insurance Companies ◽  
Socially Disadvantaged ◽  
Cover Concrete ◽  
Health Insurance Companies ◽  
High Control

Introduction: Preventive measures in a field of health care are cheaper than addressing the consequences of neglected diagnosis and treatment. Aim of this study is to present the Slovak legislation and national plans in the field of preventive health care. This issue is discussed in relation to financing of health care from the health insurance. Methods: This study was conducted by using the method of content analysis of selected legislative and non-legislative documents and statistical reports of the Slovak ministries (finance, health) and of health insurance companies. Results: In Slovakia, universal and selective preventive health care is available for health care payers. Number of people who undergo the preventive examination differs in selected areas and the expenditure on medical treatment and addressing the consequences of neglected prevention are still high. Control plans are vague and do not cover concrete steps leading to achievement of goals presented. Access of marginalized groups of population to the preventive health care is still at very low level. Conclusion: The system of preventive health care measures in Slovakia is relatively well-defined in legislation and supports the provision of preventive care. However, it is not enforced. There are no serious sanctions in case of neglecting patient´s obligations and people are not motivated to undergo preventive examinations. Only sanctions that in some cases work are financial. The detailed research of access of people from socially disadvantaged environment to the preventive care is desirable.

scholarly journals Routine Preventive Care and Cancer Surveillance in Long-Term Survivors of Colorectal Cancer: Results From National Surgical Adjuvant Breast and Bowel Project Protocol LTS-01

2010 ◽  
Vol 28 (36) ◽  
pp. 5274-5279 ◽  
Author(s):  
Hiroko Kunitake ◽  
Ping Zheng ◽  
Greg Yothers ◽  
Stephanie R. Land ◽  
Louis Fehrenbacher ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Cancer Screening ◽  
Preventive Care ◽  
Preventive Health Care ◽  
Cancer Surveillance ◽  
Antigen Test ◽  
National Surgical Adjuvant Breast ◽  
Bowel Project

Purpose National Surgical Adjuvant Breast and Bowel Project (NSABP) protocol LTS-01 examines routine preventive care and cancer surveillance in long-term colorectal cancer (CRC) survivors previously treated in NSABP adjuvant trials. Patients and Methods Long-term CRC survivors (≥ 5 years) from five completed NSABP trials (Protocols C-05, C-06, C-07, R-02, and R-03) at 60 study sites were recruited and surveyed using preventive health care items from the National Health Interview Survey (NHIS). A 3:1 comparison cohort case-matched by age, sex, race, and education was created from the 2005 NHIS. Contingency tables and multivariate models were used to compare cohorts and determine predictors of preventive care and cancer surveillance. Results A total of 708 patients in protocol LTS-01 (681 patients with colon cancer, 27 patients with rectal cancer) completed the interview: 57.1% male, mean age 66.2 years (standard deviation = 10.6), median survival 8 years. Patients in the LTS-01 protocol were more likely to have a usual source of health care (97.7% v 93.8%, P < .0001), have received a flu shot in the past 12 months (67.5% v 44.3%, P < .0001), and have undergone cancer screening by Pap smear (67.3% v 54.8%, P < .0001), mammogram (80.4% v 70.7%, P < .0001), and prostate-specific antigen test (84.5% v 74.5%, P < .0001) than patients in the NHIS cohort. For CRC surveillance, 96.5% of patients in protocol LTS-01 had a colonoscopy, 88.2% had a carcinoembryonic antigen test, and 66.4% had a computed tomography scan in the previous 5 years. Health insurance was the best predictor of cancer screening for all three methods (odds ratio = 2.6 to 4.5). No factor was uniformly associated with CRC surveillance. Conclusion This select population of long-term CRC survivors who participated in clinical trials achieved better routine preventive care and cancer screening than the general population and high rates of cancer surveillance.

Preventive Health Care for Young Children: Findings from a 10-Country Study and Directions for United States Policy

PEDIATRICS ◽  
1992 ◽  
Vol 89 (5) ◽  
pp. 983-998
Keyword(s):  
Health Care ◽  
Infant Health ◽  
Survival Rates ◽  
Preventive Health Services ◽  
Preventive Health Care ◽  
Social Benefit ◽  
Preventive Health ◽  
Federal Republic Of Germany ◽  
The United Kingdom ◽  
The Us

Infant health and survival in the US compare unfavorably with other Western industrial democracies. Circumstances that contribute to favorable pregnancy outcomes in other countries include nearly complete participation of pregnant women in early prenatal care and linkage of care to extensive support benefits.1 The study reported here extends these earlier observations to preventive health services for children from infancy through adolescence and to the social benefit programs that support their families. This report looks at the condition of children in 10 European countries: Belgium, Denmark, France, the Federal Republic of Germany, Ireland, the Netherlands, Norway, Spain, Switzerland, and the United Kingdom. All of these countries have better infant survival rates than the US, and they all share elements of pluralism in their systems of health care.

US Interstate Underground Trade Flow: A Gravity Model Approach

2017 ◽  
Vol 13 (2) ◽  
Author(s):  
Travis Wiseman ◽  
Paul Walker
Keyword(s):  
Gravity Model ◽  
Trade Flow ◽  
State Level ◽  
Census Bureau ◽  
Formal Sector ◽  
The Us ◽  
Trading Partners ◽  
Interstate Trade ◽  
Using Data ◽  
Us Census

AbstractIn this paper we model interstate trade in US shadow economies using a traditional gravity model, updated to control for factors that encourage (discourage) underground exchange among formal sector trading partners. Using data on interstate trade flow from the US Census Bureau, and a unique dataset measuring US state-level shadow economy size, we develop a first-ever estimate of interstate underground trade flow (UTF) for the US. Using a UTF ratio, measured as the portion of state

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