Access & Equity

How health care resources are distributed across the population and how access and health outcomes vary across different groups. LDI Senior Fellows focus on how to achieve greater access for vulnerable populations and how to reduce disparities in health outcomes.

Evaluating the association between the built environment and primary care access for new Medicaid enrollees in an urban environment using Walk and Transit Scores

Jan. 24, 2018

Krisda H. Chaiyachati, Jeffrey K. Hom, Rebecca A. Hubbard, Charlene Wong, and ...

In Preventive Medicine Reports, Krisda Chaiyachati and colleagues, including Jeffrey Hom and David Grande, describe the association between the quality of an individual’s built environment, as reflected by Walk Score™ (a measure of walkability to neighborhood resources) and Transit Score™ (a measure of transit access), with having a usual source of care among low-income adults in Philadelphia. They ascertained usual source of care (other than a hospital or emergency department) with the question: “Is there a particular doctor's office, clinic, health center, or other place that...

Association of Patient Out-of-Pocket Costs With Prescription Abandonment and Delay in Fills of Novel Oral Anticancer Agents

Research Brief
Jan. 19, 2018

High out-of-pocket (OOP) costs may limit access to novel oral cancer medications. In a retrospective study, nearly one third of patients whose OOP costs were $100 to $500 and nearly half of patients whose OOP costs were more than $2,000 failed to pick up their new prescription for an oral cancer medication, compared to 10% of patients who were required to pay less than $10 at the time of purchase. Delays in picking up prescriptions were also more frequent among patients facing higher OOP costs. 

Pediatric Price Transparency: Still Opaque With Opportunities for Improvement

Oct. 25, 2017

Laura J. Faherty, Charlene A. Wong, Jordyn Feingold, Joan Li, Robert Town, Evan Fieldston, Rachel M. Werner

In Hospital Pediatrics, Laura J. Faherty and colleagues, including Evan Fieldston and Rachel Werner, describe online price transparency data for pediatric care and the consumer experience of obtaining an out-of-pocket estimate from children’s hospitals for a common procedure. Price transparency is gaining importance as families’ portion of health care costs rise.

The study consisted of three parts: an audit of 45 children’s hospital Web sites, "secret shopper" calls to the hospitals to request price estimates for a common pediatric procedure (a tonsillectomy-adenoidectomy...

Nursing Care Disparities in Neonatal Intensive Care Units

Oct. 11, 2017

Eileen T. Lake, Douglas Straiger, Erika Miles Edwards, Jessica G. Smith, Jeannette A. Rogowski

In Health Services Research, Eileen Lake and colleagues, including Jessica Smith and Jeannette Rogowski, compared missed nursing care for infants in neonatal intensive care units (NICUs) across hospitals with a predominantly-black versus non-black patient population. The authors sought to understand the factors that cause nurses to miss care. At sites across four states, NICU nurses completed a survey on the floor’s average patient load, nursing environment, and nursing professional characteristics, as well as their individual patient load and the care that they missed on their...

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