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[PMID]:29389995
[Au] Autor:Dalinjong PA; Wang AY; Homer CSE
[Ad] Endereço:Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
[Ti] Título:Has the free maternal health policy eliminated out of pocket payments for maternal health services? Views of women, health providers and insurance managers in Northern Ghana.
[So] Source:PLoS One;13(2):e0184830, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The free maternal health policy was implemented in Ghana in 2008 under the National Health Insurance Scheme (NHIS). The policy sought to eliminate out of pocket (OOP) payments and enhance the utilisation of maternal health services. It is unclear whether the policy had altered OOP payments for services. The study explored views on costs and actual OOP payments during pregnancy. The source of funding for payments was also explored. METHODS: A convergent parallel mixed methods design, involving quantitative and qualitative data collection approaches. The study was set in the Kassena-Nankana municipality, a rural area in Ghana. Women (n = 406) who utilised services during pregnancy were surveyed. Also, 10 focus groups discussions (FGDs) were held with women who used services during pregnancy as well as 28 in-depth interviews (IDIs) with midwives/nurses (n = 25) and insurance managers/directors (n = 3). The survey was analysed using descriptive statistics, focussing on costs from the women's perspective. Qualitative data were audio recorded, transcribed and translated verbatim into English where necessary. The transcripts were read and coded into themes and sub-themes. RESULTS: The NHIS did not cover all expenses in relation to maternal health services. The overall mean for OOP cost during pregnancy was GH¢17.50 (US$8.60). Both FGDs and IDIs showed that women especially paid for drugs and ultrasound scan services. Sixty-five percent of the women used savings, whilst twenty-two percent sold assets to meet the OOP cost. Some women were unable to afford payments due to poverty and had to forgo treatment. Participants called for payments to be eliminated and for the NHIS to absorb the cost of emergency referrals. All participants admitted the benefits of the policy. CONCLUSION: Women needed to make payments despite the policy. Measures should be put in place to eliminate payments to enable all women to receive services and promote universal health coverage.
[Mh] Termos MeSH primário: Pessoal Administrativo/psicologia
Atitude
Financiamento Pessoal
Pessoal de Saúde/psicologia
Serviços de Saúde Materna/economia
Programas Nacionais de Saúde/economia
[Mh] Termos MeSH secundário: Adulto
Antimaláricos/economia
Feminino
Gana
Seres Humanos
Cobertura do Seguro
Gravidez
Inquéritos e Questionários
Ultrassonografia Pré-Natal/economia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antimalarials)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180202
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0184830


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[PMID]:29178651
[Au] Autor:Laurino MY; Truitt AR; Tenney L; Fisher D; Lindor NM; Veenstra D; Jarvik GP; Newcomb PA; Fullerton SM
[Ad] Endereço:Cancer Prevention Program, Seattle Cancer Care Alliance, Seattle, Washington, USA.
[Ti] Título:Clinical verification of genetic results returned to research participants: findings from a Colon Cancer Family Registry.
[So] Source:Mol Genet Genomic Med;5(6):700-708, 2017 11.
[Is] ISSN:2324-9269
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The extent to which participants act to clinically verify research results is largely unknown. This study examined whether participants who received Lynch syndrome (LS)-related findings pursued researchers' recommendation to clinically verify results with testing performed by a CLIA-certified laboratory. METHODS: The Fred Hutchinson Cancer Research Center site of the multinational Colon Cancer Family Registry offered non-CLIA individual genetic research results to select registry participants (cases and their enrolled relatives) from 2011 to 2013. Participants who elected to receive results were counseled on the importance of verifying results at a CLIA-certified laboratory. Twenty-six (76.5%) of the 34 participants who received genetic results completed 2- and 12-month postdisclosure surveys; 42.3% of these (11/26) participated in a semistructured follow-up interview. RESULTS: Within 12 months of result disclosure, only 4 (15.4%) of 26 participants reported having verified their results in a CLIA-certified laboratory; of these four cases, all research and clinical results were concordant. Reasons for pursuing clinical verification included acting on the recommendation of the research team and informing future clinical care. Those who did not verify results cited lack of insurance coverage and limited perceived personal benefit of clinical verification as reasons for inaction. CONCLUSION: These findings suggest researchers will need to address barriers to seeking clinical verification in order to ensure that the intended benefits of returning genetic research results are realized.
[Mh] Termos MeSH primário: Neoplasias Colorretais Hereditárias sem Polipose/diagnóstico
Testes Genéticos
[Mh] Termos MeSH secundário: Adulto
Idoso
Neoplasias Colorretais Hereditárias sem Polipose/genética
Neoplasias Colorretais Hereditárias sem Polipose/psicologia
Proteínas de Ligação a DNA/genética
Família
Feminino
Pesquisa em Genética
Testes Genéticos/normas
Seres Humanos
Cobertura do Seguro
Laboratórios/normas
Masculino
Meia-Idade
Endonuclease PMS2 de Reparo de Erro de Pareamento/genética
Proteína 1 Homóloga a MutL/genética
Proteína 2 Homóloga a MutS/genética
Sistema de Registros
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (DNA-Binding Proteins); 0 (MLH1 protein, human); 0 (Msh6 protein, mouse); EC 3.6.1.- (PMS2 protein, human); EC 3.6.1.3 (MSH2 protein, human); EC 3.6.1.3 (Mismatch Repair Endonuclease PMS2); EC 3.6.1.3 (MutL Protein Homolog 1); EC 3.6.1.3 (MutS Homolog 2 Protein)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1002/mgg3.328


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[PMID]:29419379
[Au] Autor:Yeung EYH
[Ad] Endereço:Royal Lancaster Infirmary, Lancaster LA1 4RP, UK.
[Ti] Título:GPs to judge which patients deserve an NHS prescription.
[So] Source:BMJ;360:k404, 2018 02 01.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Prescrições de Medicamentos/economia
Médicos/legislação & jurisprudência
Medicina Estatal/economia
[Mh] Termos MeSH secundário: Necessidades e Demandas de Serviços de Saúde
Seres Humanos
Cobertura do Seguro/normas
Farmacêuticos/ética
Qualidade da Assistência à Saúde/normas
Medicina Estatal/legislação & jurisprudência
[Pt] Tipo de publicação:LETTER
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180209
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.k404


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[PMID]:29450525
[Au] Autor:Daw JR; Sommers BD
[Ad] Endereço:Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
[Ti] Título:Association of the Affordable Care Act Dependent Coverage Provision With Prenatal Care Use and Birth Outcomes.
[So] Source:JAMA;319(6):579-587, 2018 02 13.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: The effect of the Affordable Care Act (ACA) dependent coverage provision on pregnancy-related health care and health outcomes is unknown. Objective: To determine whether the dependent coverage provision was associated with changes in payment for birth, prenatal care, and birth outcomes. Design, Setting, and Participants: Retrospective cohort study, using a differences-in-differences analysis of individual-level birth certificate data comparing live births among US women aged 24 to 25 years (exposure group) and women aged 27 to 28 years (control group) before (2009) and after (2011-2013) enactment of the dependent coverage provision. Results were stratified by marital status. Main Exposures: The dependent coverage provision of the ACA, which allowed young adults to stay on their parent's health insurance until age 26 years. Main Outcomes and Measures: Primary outcomes were payment source for birth, early prenatal care (first visit in first trimester), and adequate prenatal care (a first trimester visit and 80% of expected visits). Secondary outcomes were cesarean delivery, premature birth, low birth weight, and infant neonatal intensive care unit (NICU) admission. Results: The study population included 1 379 005 births among women aged 24-25 years (exposure group; 299 024 in 2009; 1 079 981 in 2011-2013), and 1 551 192 births among women aged 27-28 years (control group; 325 564 in 2009; 1 225 628 in 2011-2013). From 2011-2013, compared with 2009, private insurance payment for births increased in the exposure group (36.9% to 35.9% [difference, -1.0%]) compared with the control group (52.4% to 51.1% [difference, -1.3%]), adjusted difference-in-differences, 1.9 percentage points (95% CI, 1.6 to 2.1). Medicaid payment decreased in the exposure group (51.6% to 53.6% [difference, 2.0%]) compared with the control group (37.4% to 39.4% [difference, 1.9%]), adjusted difference-in-differences, -1.4 percentage points (95% CI, -1.7 to -1.2). Self-payment for births decreased in the exposure group (5.2% to 4.3% [difference, -0.9%]) compared with the control group (4.9% to 4.3% [difference, -0.5%]), adjusted difference-in-differences, -0.3 percentage points (95% CI, -0.4 to -0.1). Early prenatal care increased from 70% to 71.6% (difference, 1.6%) in the exposure group and from 75.7% to 76.8% (difference, 0.6%) in the control group (adjusted difference-in-differences, 0.6 percentage points [95% CI, 0.3 to 0.8]). Adequate prenatal care increased from 73.5% to 74.8% (difference, 1.3%) in the exposure group and from 77.5% to 78.8% (difference, 1.3%) in the control group (adjusted difference-in-differences, 0.4 percentage points [95% CI, 0.2 to 0.6]). Preterm birth decreased from 9.4% to 9.1% in the exposure group (difference, -0.3%) and from 9.1% to 8.9% in the control group (difference, -0.2%) (adjusted difference-in-differences, -0.2 percentage points (95% CI, -0.3 to -0.03). Overall, there were no significant changes in low birth weight, NICU admission, or cesarean delivery. In stratified analyses, changes in payment for birth, prenatal care, and preterm birth were concentrated among unmarried women. Conclusions and Relevance: In this study of nearly 3 million births among women aged 24 to 25 years vs those aged 27 to 28 years, the Affordable Care Act dependent coverage provision was associated with increased private insurance payment for birth, increased use of prenatal care, and modest reduction in preterm births, but was not associated with changes in cesarean delivery rates, low birth weight, or NICU admission.
[Mh] Termos MeSH primário: Cobertura do Seguro
Reembolso de Seguro de Saúde/estatística & dados numéricos
Patient Protection and Affordable Care Act
Resultado da Gravidez
Cuidado Pré-Natal/utilização
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Cesárea/estatística & dados numéricos
Feminino
Seres Humanos
Recém-Nascido de Baixo Peso
Cobertura do Seguro/estatística & dados numéricos
Seguro Saúde
Unidades de Terapia Intensiva Neonatal
Modelos Lineares
Medicaid/estatística & dados numéricos
Gravidez
Nascimento Prematuro/epidemiologia
Cuidado Pré-Natal/economia
Estudos Retrospectivos
Estados Unidos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180217
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2018.0030


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[PMID]:29394486
[Au] Autor:Rollins JA
[Ti] Título:Healthcare: It's 'So Complicated'.
[So] Source:Pediatr Nurs;43(2):58, 102, 2017 Mar-Apr.
[Is] ISSN:0097-9805
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Reforma dos Serviços de Saúde/economia
Cobertura do Seguro/economia
Seguro Saúde/economia
Patient Protection and Affordable Care Act
[Mh] Termos MeSH secundário: Seres Humanos
Sociedades Médicas
Sociedades de Enfermagem
Estados Unidos
[Pt] Tipo de publicação:EDITORIAL
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE


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[PMID]:29240657
[Au] Autor:Morteruel M; Rodriguez-Alvarez E; Martin U; Bacigalupe A
[Ad] Endereço:Maite Morteruel, PhD, is Researcher in the Department of Nursing I and Member of the OPIK-Research Group for Social Determinants of Health and Demographic Change, and Elena Rodriguez-Alvarez, PhD, is Professor in the Department of Nursing I and Member of the OPIK-Research Group for Social Determinants of Health and Demographic Change, University of the Basque Country (UPV/EHU), Leioa, Spain. Unai Martin, PhD, is Assistant Professor in the Department of Sociology 2 and Member of OPIK-Research Group for Social Determinants of Health and Demographic Change, and Amaia Bacigalupe, PhD, is Assistant Professor in the Department of Sociology 2 and Member of the OPIK-Research Group for Social Determinants of Health and Demographic Change, University of the Basque Country (UPV/EHU), Leioa, Spain.
[Ti] Título:Inequalities in Health Services Usage in a National Health System Scheme: The Case of a Southern Social European Region.
[So] Source:Nurs Res;67(1):26-34, 2018 Jan/Feb.
[Is] ISSN:1538-9847
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Health services can reduce inequalities caused by other determinants of health or increase them due to the effect of the inverse care law-the principle that the availability of good quality care tends to vary inversely with the need for it in the population served. OBJECTIVE: The purpose of the research was to describe inequalities in the use of nursing services, medical services in primary care, specialist care, and services not fully covered by the Basque public health system in Spain. METHODS: A cross-sectional study of adults aged at least 25 years who completed the 2013 Basque Health Survey (N = 10,454) was conducted. Age-standardized prevalence and prevalence ratios for use of services that are covered and noncovered in the health system were computed. The association of health services usage with socioeconomic variables was estimated using a Poisson regression model with robust variance. The relative index of inequality (RII) was used to measure the magnitude of socioeconomic status inequalities in health service use. All analyses were carried out separately for men and women. RESULTS: Individuals with lower socioeconomic status were more likely to use primary care (RII = 0.87, 95% CI [0.79, 0.97]) and less likely to use specialist services (RII = 0.82, 95% CI [0.75, 0.89]). Across noncovered health services, inequalities between the highest and lowest social groups were significant in all cases and especially marked in men's use of physiotherapists (RII = 0.46, 95% CI [0.35, 0.61]) and podiatrists (RII = 0.24, 95%CI [0.15, 0.38]). DISCUSSION: There are significant inequalities in primary and specialist health service use based on individual socioeconomic status, particularly for services that are not provided free of charge within the existing health system. This suggests that health service systems that are not explicitly designed to provide universal access may actually amplify preexisting social and health inequalities within their target populations.
[Mh] Termos MeSH primário: Assistência à Saúde/estatística & dados numéricos
Acesso aos Serviços de Saúde/estatística & dados numéricos
Disparidades nos Níveis de Saúde
Programas Nacionais de Saúde/organização & administração
Fatores Socioeconômicos
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Idoso
Estudos Transversais
Europa (Continente)
Feminino
Serviços de Saúde/estatística & dados numéricos
Seres Humanos
Cobertura do Seguro/estatística & dados numéricos
Masculino
Meia-Idade
Classe Social
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE
[do] DOI:10.1097/NNR.0000000000000256


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[PMID]:27771817
[Au] Autor:Cooley LA; Hoots B; Wejnert C; Lewis R; Paz-Bailey G; NHBS Study Group
[Ad] Endereço:Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, MS-E46, Atlanta, GA, 30329, USA. LCooley@cdc.gov.
[Ti] Título:Policy Changes and Improvements in Health Insurance Coverage Among MSM: 20 U.S. Cities, 2008-2014.
[So] Source:AIDS Behav;21(3):615-618, 2017 Mar.
[Is] ISSN:1573-3254
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Recent policy changes have improved the ability of gay, bisexual, and other men who have sex with men (MSM) to secure health insurance. We wanted to assess changes over time in self-reported health insurance status among MSM participating in CDC's National HIV Behavioral Surveillance (NHBS) in 2008, 2011, and 2014. We analyzed NHBS data from sexually active MSM interviewed at venues in 20 U.S. cities. To determine if interview year was associated with health insurance status, we used a Poisson model with robust standard errors. Among included MSM, the overall percentage of MSM with health insurance rose 16 % from 2008 (68 %) to 2014 (79 %) (p value for trend < 0.001). The change in coverage over time was greatest in key demographic segments with lower health insurance coverage all three interview years, by age, education, and income. Corresponding with recent policy changes, health insurance improved among MSM participating in NHBS, with greater improvements in historically underinsured demographic segments. Despite these increases, improved coverage is still needed. Improved access to health insurance could lead to a reduction in health disparities among MSM over time.
[Mh] Termos MeSH primário: Infecções por HIV/prevenção & controle
Política de Saúde
Disparidades nos Níveis de Saúde
Homossexualidade Masculina
Cobertura do Seguro/tendências
Seguro Saúde
[Mh] Termos MeSH secundário: Adolescente
Adulto
Cidades
Infecções por HIV/diagnóstico
Infecções por HIV/economia
Infecções por HIV/epidemiologia
Inquéritos Epidemiológicos
Seres Humanos
Masculino
Assunção de Riscos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1007/s10461-016-1567-7


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[PMID]:29390313
[Au] Autor:Parikh-Patel A; Morris CR; Kizer KW
[Ad] Endereço:California Cancer Reporting and Epidemiologic Surveillance (CalCARES) Program, Institute for Population Health Improvement, University of California Davis Health.
[Ti] Título:Disparities in quality of cancer care: The role of health insurance and population demographics.
[So] Source:Medicine (Baltimore);96(50):e9125, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Escalating costs and concerns about quality of cancer care have increased calls for quality measurement and performance accountability for providers and health plans. The purpose of the present cross-sectional study was to assess variability in the quality of cancer care by health insurance type in California.Persons with breast, ovary, endometrium, cervix, colon, lung, or gastric cancer during the period 2004 to 2014 were identified in the California Cancer Registry. Individuals were stratified into 5 health insurance categories: private insurance, Medicare, Medicaid, dual Medicare and Medicaid eligible, and uninsured. Quality of care was evaluated using Commission on Cancer quality measures. Logistic regression models were generated to assess the independent effect of health insurance type on stage at diagnosis, quality of care and survival after adjusting for age, sex, race/ethnicity, and socioeconomic status (SES).A total of 763,884 cancer cases were evaluated. Individuals with Medicaid or Medicare-Medicaid dual-eligible coverage and the uninsured had significantly lower odds of receiving recommended radiation and/or chemotherapy after diagnosis or surgery for breast, endometrial, and colon cancer, relative to those with private insurance. Dual eligible patients with gastric cancer had 21% lower odds of having the recommended number of lymph nodes removed and examined compared to privately insured patients.After adjusting for known demographic confounders, substantial and consistent disparities in quality of cancer care exist according to type of health insurance in California. Further study is needed to identify particular factors and mechanisms underlying the identified treatment disparities across sources of health insurance.
[Mh] Termos MeSH primário: Demografia
Disparidades em Assistência à Saúde
Cobertura do Seguro
Seguro Saúde
Neoplasias/economia
Neoplasias/terapia
Qualidade da Assistência à Saúde
[Mh] Termos MeSH secundário: California
Estudos Transversais
Feminino
Seres Humanos
Masculino
Sistema de Registros
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009125


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[PMID]:27773453
[Au] Autor:Liu Y; Vela M; Rudakevych T; Wigfield C; Garrity E; Saunders MR
[Ad] Endereço:Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA.
[Ti] Título:Patient factors associated with lung transplant referral and waitlist for patients with cystic fibrosis and pulmonary fibrosis.
[So] Source:J Heart Lung Transplant;36(3):264-271, 2017 Mar.
[Is] ISSN:1557-3117
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Since 2005, the Lung Allocation Score (LAS) has prioritized patient benefit and post-transplant survival, reducing waitlist to transplant time to <200 days and decreasing mortality on the waitlist. A current challenge is the wait for the waitlist-the time between the patient's transplant-eligible diagnosis and waitlist registration. METHODS: We investigated whether sociodemographic (age, sex, race, insurance, marital status, median household income) and clinical (forced expiratory volume in 1 second [FEV ] percent of predicted, body mass index, depression/anxiety, alcohol/substance misuse, absolute/relative contraindications) factors influenced referral and waitlist registration. We conducted a retrospective cohort study through chart review of hospitalized patients on the University of Chicago general medicine service from 2006 to 2014 who met transplant-eligible criteria and ICD-9 billing codes for cystic fibrosis (CF) and pulmonary fibrosis (PF). We analyzed the times from transplant eligibility to referral, work-up and waitlisting using Kaplan-Meier curves and log-rank tests. RESULTS: Overall, the referral rate for transplant-eligible patients was 64%. Of those referred, approximately 36% reach the lung transplant waitlist. Referred CF patients were significantly more likely to reach the transplant waitlist than PF patients (CF 60% vs PF 22%, p < 0.05). In addition, CF patients had a shorter wait from transplant eligibility to waitlist than PF patients (329 vs 2,369 days, respectively [25th percentile], p < 0.05). Patients with PF and CF both faced delays from eligibility to referral and waitlist. CONCLUSIONS: Quality improvement efforts are needed to better identify and refer appropriate patients for lung transplant evaluation. Targeted interventions may facilitate more efficient evaluation completion and waitlist appearance.
[Mh] Termos MeSH primário: Fibrose Cística/cirurgia
Transplante de Pulmão/métodos
Fibrose Pulmonar/cirurgia
Encaminhamento e Consulta/estatística & dados numéricos
Listas de Espera
[Mh] Termos MeSH secundário: Centros Médicos Acadêmicos
Adulto
Estudos de Coortes
Comorbidade
Fibrose Cística/diagnóstico
Fibrose Cística/mortalidade
Feminino
Rejeição de Enxerto
Sobrevivência de Enxerto
Seres Humanos
Cobertura do Seguro
Estimativa de Kaplan-Meier
Transplante de Pulmão/mortalidade
Masculino
Meia-Idade
Seleção de Pacientes
Fibrose Pulmonar/diagnóstico
Fibrose Pulmonar/mortalidade
Testes de Função Respiratória
Estudos Retrospectivos
Medição de Risco
Índice de Gravidade de Doença
Estatísticas não Paramétricas
Análise de Sobrevida
Estados Unidos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:29385378
[Au] Autor:Iglehart JK
[Ad] Endereço:Mr. Iglehart is a national correspondent for the Journal.
[Ti] Título:The Challenging Quest to Improve Rural Health Care.
[So] Source:N Engl J Med;378(5):473-479, 2018 Feb 01.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Disparidades nos Níveis de Saúde
Serviços de Saúde Rural
Saúde da População Rural
[Mh] Termos MeSH secundário: Política de Saúde
Acesso aos Serviços de Saúde
Hospitais Rurais
Seres Humanos
Cobertura do Seguro
Expectativa de Vida
Medicaid
Patient Protection and Affordable Care Act
Atenção Primária à Saúde/recursos humanos
Serviços de Saúde Rural/economia
Serviços de Saúde Rural/recursos humanos
Serviços de Saúde Rural/normas
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMhpr1707176



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