Social science & medicine
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Social science & medicine · May 2018
Observational StudyBereaved relatives' decision about deceased organ donation: An integrated psycho-social study conducted in Spain.
Family refusal to organ donation of a deceased relative represents one of the most important barriers to organ transplantation. Although a large literature about family decisions has amassed, the existing evidence needs further integration and structuring. ⋯ Understanding of family decisions underlying organ donation may greatly benefit from a more complex, integrated, and theoretically based approach. Educational efforts should stress the need to register or simply communicate own willingness to donate organs. However, an adequate training and performance of the health-staff involved in the organ donation process may generate substantive differences in consent rates.
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Social science & medicine · May 2018
The effect of copayments on the utilization of the GP service in Norway.
We examine the effect of copayment on the utilization of the GP service in Norway. We use a regression discontinuity design to study two key aspects of the policy. First, we examine the overall effect of copayments on total utilization of the GP service. ⋯ Patients with general complaints and symptoms, chronic diseases and psychological diseases all react strongly to the copayment. The two latter groups capture patients with conditions that typically warrant medical attention. This paper thus suggests that the current flat fee copayment policy is inefficient at targeting unnecessary use of the GP service at the cost of patients with real medical concerns.
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Social science & medicine · Apr 2018
The effect of health insurance on sexual health: Evidence from the Affordable Care Act's dependent coverage mandate.
This study estimates changes in sexually transmitted disease rates for young adults in the United States following the Affordable Care Act's dependent coverage mandate; a provision that allows dependents to remain covered under their parents' health insurance plans until the age of 26. This study is the first to analyze changes in reported chlamydia and gonorrhea rates resulting from the dependent coverage mandate. ⋯ I also find evidence of an increase in gonorrhea rates for females in this age group. I find no evidence that the mandate induced ex ante moral hazard.
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Social science & medicine · Mar 2018
Health care experiences of pregnant, birthing and postnatal women of color at risk for preterm birth.
Chronic stress is a known risk factor for preterm birth, yet little is known about how healthcare experiences add to or mitigate perceived stress. In this study, we described the pregnancy-related healthcare experiences of 54 women of color from Fresno, Oakland, and San Francisco, California, with social and/or medical risk factors for preterm birth. ⋯ The women in this study perceived their prenatal healthcare as a largely disrespectful and stressful experience. Our findings add to the growing literature that women of color experience discrimination, racism and disrespect in healthcare encounters and that they believe this affects their health and that of their infants.
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Social science & medicine · Feb 2018
A safe haven for the injured? Urban trauma care at the intersection of healthcare, law enforcement, and race.
Patients with traumatic injuries often interact with police before and during hospitalization, particularly when their injuries are due to violence. People of color are at highest risk for violent injuries and have the poorest outcomes after injury. The purpose of this study was to describe how injured, Black patients perceived their interactions with police and what these perceptions reveal about police involvement within trauma care systems. ⋯ Injured participants valued police officers' involvement when they perceived that officers provided safety at the scene, speed of transport to the hospital, or support and information after injury. Injured participants also found police questioning to be stressful and, at times, disrespectful or conflicting with clinical care. Communities, trauma centers, and professional societies have the opportunity to enact policies that standardize law enforcement access in trauma centers and balance patients' health, privacy, and legal rights with public safety needs.