Outcomes from the model were expressed as cost per quality-adjusted life-year QALY. Using a decision tree model that incorporated both clinical trial and real-world data, duloxetine was a more cost-effective option than pregabalin in the treatment of PDN from the perspective of third-party payers. To improve access to care, the Veterans Health Administration VHA increased its patient travel reimbursement rate from 11 to We identified characteristics of veterans more likely to receive travel reimbursements and evaluated the impact of these increases on utilization of the benefit.
Methods We examined the likelihood of receiving any reimbursement, number of reimbursements, and dollar amount of reimbursements for VHA patients before and after both reimbursement rate increases.
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Rurality and categorical distance from the nearest VHA facility were examined in separate regressions. Findings Our cohort contained , veterans. Compared to individuals without mental health problems, individuals with mental health problems may have higher discount rates and derive greater utility from spending i.
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If the mentally ill have these characteristics, we would expect them to purchase goods and services that give immediate enjoyment, sacrificing longer-term savings goals. However, mental health disorders may result in a sense of worthlessness and lethargy such that less utility is derived from spending and less energy is available for spending, which would give us the opposite prediction. Using the Panel Study of Income Dynamics, we generally find a negative effect of mental illness on household spending, although the specific effects vary by the measure of mental illness, by the expenditure category, and by gender and couple status.
Of particular concern, single and married women with mental illness reduce spending on education, which suggests a long-term financial cost of mental illness. In addition, we find some evidence of retail therapy with respect to a mental health screen for single and married women and with respect to a mental diagnosis for married men. The objective of this meta-analysis was to indirectly compare incidence of nephrotoxicity in trials using cisplatin CIS for treatment of solid tumors when renal function was assessed using serum creatinine SCr or creatinine clearance CrCl for eligibility criteria.
Clinical pharmacy services CPS in the primary care setting have been shown to help patients attain treatment goals and improve outcomes. However, the availability of CPS in community-based primary care is not widespread. One reason is that current fee-for-service models offer limited reimbursement opportunities for CPS in the community setting. Furthermore, data demonstrating the value of CPS in this setting are limited, making it difficult for providers to determine the feasibility and sustainability of incorporating CPS into primary care practice. Pharmacists are accessible health care professionals and can provide diabetes education and counseling tounderserved patients.
Knowledge of hemoglobin A1C, blood pressure and cholesterol ABC implications andtreatment targets may improve diabetes self-management. This article describes ABC education in a communitypharmacy with a large uninsured and underinsured patient population. Medical assistants MAs are a rapidly growing and increasingly important workforce. High MA turnover, however, is common and employers report applicants frequently do not meet their needs. The survey included questions from the Nursing Minimum Data Set employment status, job characteristics, demographics, education, and credentials as well as questions about satisfaction with their current nursing position, career plans, salary, and employment history.
This report summarizes the findings from this survey. Medical assistants MAs are key members of the healthcare team, with expanding roles in office and clinic-based health care settings, and in there were , to , employed MAs in the U. MAs are listed among the 20 fastest-growing occupations in the nation, fueled by increasing demand for primary care services and mounting pressure to reduce healthcare costs through task shifting to lower-cost providers. In Washington, the only state to credential MAs, employers report that recruiting and maintaining a qualified MA workforce is difficult despite a relatively large number of MAs relative to demand.
Given that entry-level healthcare jobs are among the fastest growing jobs in the U. Recent work in the long-term care sector, however, found that half of the exiting healthcare workers, most of which are in entry-level occupations i. This trend brings about concerns that the health workforce pipeline may not be sufficient to keep up with the demand for these types of workers. Systematically quantifying and tracking the evolution of the health workforce is a challenge, yet is important for identifying emerging demands for different skills and competencies.
Real Time Labor Market Information RT-LMI , a source of data that is increasingly used to monitor workforce demand, extracts information from online job ads to track demand for general labor market skills, including for the health workforce. The purpose of this study is to identify how five domains of emerging roles in healthcare have been incorporated into the job titles and descriptions of healthcare occupations by using RT-LMI data from LinkUp, a job search engine company. The key findings from this study are:. In this study we found that RT-LMI can provide valuable information on the emergence of new skills and roles in the health workforce, including for many allied health occupations.
Findings from this study contribute to the development of methods for monitoring and tracking changing healthcare workforce demands using large electronic databases of job ads. This important information on how employers associate skills with posted job titles can help educational institutions, training programs, accrediting bodies and health workforce planners better prepare workers with the competencies to meet market demand. The number of primary care physicians per capita varied greatly by county, with more than twice as many in counties with the highest physician density compared with counties having the lowest density.
Comparisons of county-level physician, NP and PA workforce supply with indicators of population health show some areas of the state where the availability of providers may be affecting access to healthcare, suggesting areas for further examination. Racial and ethnic diversity in the health workforce can facilitate access to healthcare for underserved populations and meet the health needs of an increasingly diverse population.
In this study, we explored 1 changes in the racial and ethnic diversity of the health workforce in the United States over the last decade, and 2 evidence on the effectiveness of programs designed to promote racial and ethnic diversity in the U. Findings suggest that although the health workforce overall is becoming more diverse, people of color are most often represented among the entry-level, lower-skilled health occupations. Promising practices to help facilitate diversity in the health professions were identified in the literature, namely comprehensive programs that integrated multiple interventions and strategies.
While some efforts have been found to be promising in increasing the interest, application, and enrollment of racial and ethnic minorities into health profession schools, there is still a missing link in understanding persistence, graduation, and careers. Objective To assess how medical staffing mix changed over time in association with the adoption of electronic health records EHRs in community health centers CHCs.
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Study Design Estimated how the change in the share of total medical staff full-time equivalents FTE by provider category between and was associated with EHR adoption using fractional multinomial logit. Principal Findings Having an EHR system did significantly shift the share of workers over time between physicians and each of the other categories of health care workers. While an EHR system significantly shifted the share of physician and other medical staff, this effect did not significantly vary over time.
CHCs with EHRs by the end of the study period had a relatively greater proportion of other medical staff compared to the proportion of physicians. Conclusions Electronic health records appeared to influence staffing allocation in CHCs such that other medical staff may be used to support adoption of EHRs as well as be leveraged as an important care provider. This study used the Current Population Survey to examine the sector and occupation shifts that underlie this growth trend.
The entering workforce has been increasingly taking on low-skilled occupations.
Better information about the skills required in health occupations and the paths to career advancement could provide opportunities for workers as well as improved health care. With a good demand outlook and the relatively low entry requirements for several of these jobs, health care occupations appear to be a good career path.
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The Association of Schools of Allied Health Professions has identified 66 such occupations; the Health Professions Network, a collaborative group representing the leading allied health professions, has identified over 45; and the Commission on Accreditation of Allied Health Education Programs provided accreditation in to 28 occupations.
These jobs may or may not involve direct patient care, and some do not require specialized skill at entry. Many require less than a baccalaureate degree for entry.
The pathway to an allied health career can be unclear, especially in relatively new and emerging positions. Clear career pathways and ladders that lead to socioeconomic success need to be clarified in order to direct investments for attracting and retaining a competent workforce.
Our task here, then, is to describe what is known about the career pathways into middle-skill allied health careers and the challenges that exist for individuals seeking such careers. Oral health is an integral part of overall health and an important part of healthy U. Department of Health and Human Services, The oral cavity is the gateway to the body and its first line of defense. Infections in the teeth and gums can contribute to health consequences elsewhere in the body and, conversely, health conditions and their treatment can affect the mouth.
Older adults are at special risk for oral health problems, and those living in rural areas face additional challenges accessing dental care. Gum tissue shrinks with age, leaving the roots of teeth more vulnerable to caries decay , while chronic illnesses such as diabetes can trigger gum infection and inflammation. Another factor contributing to dental decay is dry mouth xerostomia , which is a side effect of many medications taken by older adults—medications such as those used for pain narcotics , high blood pressure diuretics , seasonal allergies antihistamines , and depression numerous antidepressants.
Smoking tobacco and using smokeless tobacco—practices prevalent in many rural-area populations—also increase the risk of periodontal gum disease, dental caries, and oropharyngeal cancer. If unchecked, periodontal disease can lead to tooth loss.
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Significantly, adults who have lost their teeth are still at risk for cancerous lesions and should have regular oral examinations and evaluations of their dentures. Older adults with poor dentition and chewing capacity can experience malnutrition or over-consumption of soft foods that are calorie-dense but nutrient-poor and are potentially cariogenic cavity-causing.
Concurrent with an increase in their oral health needs, older adults frequently experience diminished neuromotor or cognitive abilities, which, along with other medical problems, may hinder their capacity to maintain oral hygiene and to access dental care.
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