Access to Care

The extent to which someone can gain access to the health care system, and the financial, social, and organizational factors that affect a person’s ability to get needed care in a timely way.

These Key Telehealth Policy Changes Would Improve Buprenorphine Access While Advancing Health Equity

Sep. 11, 2020

[Original post: Utsha Khatri, Corey S. Davis, Noa Krawczyk, Michael Lynch, Justin Berk, Elizabeth A. Samuels, These Key Telehealth Policy Changes Would Improve Buprenorphine Access While Advancing Health Equity, Health Affairs Blog, September 11, 2020. Copyright ©2020 Health Affairs by Project HOPE – The People-to-People Health Foundation, Inc.]

Implementing Inclusive Strategies To Deliver High Quality LGBTQ+ Care In Health Care Systems

Sep. 1, 2020

Dane Menkin, Dawn Tice, Dalmacio Flores

Abstract [from journal]

Aim: There is a growing recognition of the need to provide inclusive care for LGBTQ+ individuals. Our aim is to provide guidance for nurse managers contemplating similar inclusive changes in their workplace. The role of nurse managers as change agents is discussed based on our experience transforming a traditional suburban healthcare system to one that is now more LGBTQ+ inclusive.

Background: LGBTQ+ individuals require and deserve high-quality care. Nurse managers can serve as patient


Neither Mad Nor Bad? The Classification Of Antisocial Personality Disorder Among Formerly Incarcerated Adults

Jason S. Schnittker, PhD
Aug. 17, 2020

Jason Schnittker, Savannah H. Larimore, Hedwig Lee

Abstract [from journal]

Using the National Comorbidity Survey, this study explores the presence and symptoms of antisocial personality disorder (ASPD) among people with varying degrees of contact with the criminal justice system. The study finds an elevated prevalence of ASPD among formerly incarcerated persons, but also that ASPD is not a simple linear function of actual or potential contact with the criminal justice system. For example, among people who have been arrested the prevalence of ASPD is not much greater than among those who committed a crime


In-Person Outreach And Telemedicine In Liver And Intestinal Transplant: A Survey Of National Practices, Impact Of COVID-19 And Areas Of Opportunity

Aug. 9, 2020

Courtney B. Sherman, Adnan Said, Michael Kriss, Vishnu Potluri, Josh Levitsky, Peter P. ReeseJudy A. SheaMarina Serper

Abstract [from journal]

Little is known about national practices and use of in-person outreach clinics and telemedicine in transplantation. We initially aimed to assess contemporary use of in-person outreach and telemedicine in liver and intestinal transplantation in the U.S. We conducted a national survey of liver and intestinal transplant programs to assess use of outreach and telemedicine from January to March of 2019. Given the coronavirus disease 2019 (COVID-19) pandemic, we distributed a second survey wave in April 2020 to assess changes in


Transplant Center Experience Influences Spontaneous Survival And Waitlist Mortality In Acute Liver Failure: An Analysis Of The UNOS Database

Aug. 2, 2020

Natalie Z. Wong, Douglas E. Schaubel, K. Rajender Reddy, Therese Bittermann

Abstract [from journal]

Transplant centers coordinate complex care in acute liver failure (ALF), for which liver transplantation (LT) can be lifesaving. We studied associations between waitlist outcomes and center (i) ALF waitlist volume (low: <20; medium: 20-39; high: 40+ listings) and (ii) total LT volume (<600; 600-1199; 1200+ LTs) in a retrospective cohort of 3,248 adults with ALF listed for LT at 92 centers nationally from 2002-2019. Predicted outcome probabilities (LT, died/too sick, spontaneous survival [SS]) were obtained with multinomial


Achieving Better Postpartum Care

Jul. 30, 2020

The year after giving birth is an important one for mothers and their infants. Care delivered during this period is critical to improving mother and infants’ long-term health and reducing future health risks. However, a recent study shows that all too often, this is a missed opportunity to deliver important preventive care to adult women.

Hepatitis C and The Layering of Disease-Related Stigma

Jul. 28, 2020
“That's exactly how I feel like they look at you. Like, ‘You on drugs, you dirty, you homeless, you don't got nowhere to take yourself, staying yourself and take yourself.’ Why should they try to help you and give you the best care possible? For what? They could save it for somebody else that's doing all the right things versus give it to the people that's doing all the wrong things.” – HIV/HCV-coinfected study participant

The Landscape Of Cardiovascular Clinical Trials In The United States Initiated Before And During COVID-19

Jul. 27, 2020

Senthil Selvaraj, Stephen J. Greene, Sameed Ahmed M. KhatanaAshwin S. Nathan, Scott D. Solomon, Deepak L. Bhatt

Abstract [from journal]

The Coronavirus Disease 2019 (COVID-19) pandemic has taken an unprecedented toll on the American healthcare system and economy. While numerous COVID-19 clinical trials have been initiated in hopes of curtailing its impact, most pre-existing clinical trials have been forced to suspend or limit activity, which itself can have significant consequences. Missed or postponed trial-related assessments may hinder data quality, and heterogeneity in data collection both across the country and over time introduces bias. In addition, COVID-19


Responding to the Trauma of COVID-19

Jul. 2, 2020

As the country looks to reopen and epidemiologists anticipate future waves of coronavirus (COVID-19) cases, we must address an equally important “pandemic:” the virus’ far-reaching mental health and trauma-related consequences. Whether balancing activities of essential work with exposure risk, bearing witness to suffering or loss, or feeling anguish or guilt for not “doing more” during this time, our society is facing great adversity with potentially devastating consequences.

Setting Standards for Affordable Health Care

Issue Brief
Jun. 16, 2020

In the run-up to the presidential election, the affordability of health care remains a top concern of the American voting public. But how do we know when health care is affordable? On a policy level, how do we set a standard for affordability that can be implemented in a reformed system? Sometimes policy debates about affordability focus only on whether insurance premiums are affordable, although consumers tend to be concerned about both premiums and out-of-pocket costs. At Penn LDI’s Medicare for All and Beyond conference, a panel of researchers, policy experts, and consumer advocates discussed and debated affordability in theory and practice. This issue brief summarizes the panel’s insights.

Pediatric Outpatient Utilization By Differing Medicaid Payment Models In The United States

Jun. 12, 2020

Therese L Canares, Ari Friedman, Jonathan Rodean, Rebecca R. Burns, Deena Berkowitz, Matt Hall, Elizabeth Alpern, Amanda Montalbano

Abstract [from journal]

Background: In the United States (US), Medicaid capitated managed care costs are controlled by optimizing patients' healthcare utilization. Adults in capitated plans utilize primary care providers (PCP) more than emergency departments (ED), compared to fee-for-service (FFS). Pediatric data are lacking. We aim to determine the association between US capitated and FFS Medicaid payment models and children's outpatient utilization.

Methods: This retrospective cohort compared outpatient utilization