JAMA network open
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Comparative Study
Comparative Performance of Private Equity-Owned US Nursing Homes During the COVID-19 Pandemic.
It is not known whether nursing homes with private equity (PE) ownership have performed better or worse than other nursing homes during the coronavirus disease 2019 (COVID-19) pandemic. ⋯ In this cross-sectional study, PE-owned nursing homes performed comparably on staffing levels, resident cases, and deaths with nursing homes with other types of ownership, although their shortages of PPE may warrant monitoring.
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Little is known about cannabis vaping trajectories across adolescence and young adulthood or the co-occurrence with nicotine vaping. ⋯ In this cohort study, the prevalence and type of nicotine vaping and cannabis vaping developmental trajectories from late adolescence to young adulthood were similar. Polysubstance vaping was common from late adolescence to young adulthood, particularly among those reporting more frequent vaping use. The findings suggest that public health policy and clinical interventions should address polysubstance vaping in both adolescence and young adulthood.
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Comparative Study
Comparison of Community-Level and Patient-Level Social Risk Data in a Network of Community Health Centers.
Responding to the substantial research on the relationship between social risk factors and health, enthusiasm has grown around social risk screening in health care settings, and numerous US health systems are experimenting with social risk screening initiatives. In the absence of standard social risk screening recommendations, some health systems are exploring using publicly available community-level data to identify patients who live in the most vulnerable communities as a way to characterize patient social and economic contexts, identify patients with potential social risks, and/or to target social risk screening efforts. ⋯ Although there is overlap, patient-level and community-level approaches for assessing patient social risks are not equivalent. Using community-level data to guide patient-level activities may mean that some patients who could benefit from targeted interventions or care adjustments would not be identified.
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Medicaid expansion is associated with increased access to health services, increased quality of medical care delivered, and reduced mortality, but little is known about its association with use of long-term care. ⋯ In this study, ACA-funded Medicaid expansion was associated with an increase in any long-term care use among newly eligible low-income, middle-aged adults, suggesting that the population covered by the Medicaid expansion may have had unmet long-term care needs before expansion.
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Comparative Study
Association of Peer Comparison Emails With Electronic Health Record Documentation of Cancer Stage by Oncologists.
Systematically capturing cancer stage is essential for any serious effort by health systems to monitor outcomes and quality of care in oncology. However, oncologists do not routinely record cancer stage in machine-readable structured fields in electronic health records (EHRs). ⋯ In a quality improvement pilot trial, peer comparison emails were associated with a substantial increase in oncologist use of the structured field in the EHR to document stage of disease.