Journal of health care for the poor and underserved
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J Health Care Poor Underserved · May 2011
Medicare's policy to limit payment for hospital-acquired conditions: the impact on safety net providers.
In 2008, Medicare implemented a policy limiting reimbursement to hospitals for treating avoidable hospital-acquired conditions (HACs). Although the policy will expand nationally to Medicaid programs in 2011, little is known about the impact on safety-net hospitals. ⋯ Hospitals in the lowest quintile for financial margins had higher rates of HACs on average than other hospitals. Safety-net hospitals and hospitals with the lowest financial margins may be more likely than others to be affected by policies that reduce payment for HACs.
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The impact of social and economic determinants of health status and the existence of racial and ethnic health care access disparities have been well-documented. This paper describes a model, the Health Care Access Barriers Model (HCAB), which provides a taxonomy and practical framework for the classification, analysis and reporting of those modifiable health care access barriers that are associated with health care disparities. ⋯ These barriers are associated with screening, late presentation to care, and lack of treatment, which in turn result in poor health outcomes and health disparities. By targeting those barriers that are measurable and modifiable the model facilitates root-cause analysis and intervention design.
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J Health Care Poor Underserved · May 2011
Improving medical care for detained immigrants: a call for a legislative solution.
Health care services provided to detained immigrants are inadequate to provide for the needs of this population. We analyzed the medical care policies and procedures for immigrants in detention, government reports on detainee medical care, and available mortality and morbidity data. ⋯ We suggest that a federal legislative solution is one essential component to address this issue and improve medical care. Principles to be embodied in a legislative proposal necessary to address the inadequacies in the current system are presented.