Health affairs
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Controlled Clinical Trial
Benefits and costs of immunizing children against influenza at school: an economic analysis based on a large-cluster controlled clinical trial.
Current influenza vaccination recommendations focus on immunizing high-risk people; however, influenza mortality and morbidity remain elevated. U. S. policymakers are considering expansion of flu vaccination recommendations to include school-age children (ages 5-18). ⋯ This study examines the cost consequences of a large multistate, school-based influenza immunization program. The results show that immunization reduces disease among children and adults and is cost-saving to society. An epidemiologically based influenza immunization policy might be an important supplement to the existing risk-based policy.
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As emergency department (ED) patient volumes increase throughout the United States, are patients waiting longer to see an ED physician? We evaluated the change in wait time to see an ED physician from 1997 to 2004 for all adult ED patients, patients diagnosed with acute myocardial infarction (AMI), and patients whom triage personnel designated as needing "emergent" attention. Increases in wait times of 4.1 percent per year occurred for all patients but were especially pronounced for patients with AMI, for whom waits increased 11.2 percent per year. Blacks, Hispanics, women, and patients seen in urban EDs waited longer than other patients did.
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Comparative Study
Community variation: disparities in health care quality between Asian and white medicare beneficiaries.
Few studies have focused on Asian-white disparities. This study examines the use of selected cancer screening and diabetes services under the traditional Medicare program of whites and Asians by socioeconomic status and among U. ⋯ It finds that Asians often receive poorer quality of care than whites, but disparities differ among metropolitan areas. This research enables policymakers to better understand and target resources to address Asian-white disparities at the national and local community levels.
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The Institute of Medicine's 2003 Unequal Treatment report raised the public's and policymakers' awareness of racial and ethnic health care disparities, but federal policy-makers have implemented few of the report's more than two dozen recommendations. State health care reform efforts, however, are gaining support around the country and have great potential to reduce health care inequality. This paper offers a policy framework to explore how states can move toward eliminating disparities by addressing health care access and quality, state health care infrastructure, patient and community empowerment, state policy infrastructure, and social and community determinants of health.
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Comparative Study
Hospital pricing and the uninsured: do the uninsured pay higher prices?
Although the health care pricing literature has grown substantially in recent years, there has been little empirical analysis of how hospital pricing behavior affects the uninsured. We use unique data from California to compare actual prices paid by uninsured patients with prices paid by commercial and Medicare patients. We find that uninsured patients pay prices similar to those of Medicare patients. Further, we find that despite increased media attention, hospital prices to the uninsured have risen in recent years.