Journal of health care for the poor and underserved
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J Health Care Poor Underserved · Jan 2016
Emergency Department Use for Dental Problems among Homeless Individuals: A Population-Based Cohort Study.
To evaluate emergency department (ED) visits for dental problems among Toronto's homeless population (Ontario, Canada). ⋯ The high rate of ED visits for dental problems by people who are homeless suggests that access to dental care is inadequate. The large number of repeat visits indicates that ED settings are ineffective for treatment of dental problems.
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J Health Care Poor Underserved · Jan 2016
Out of Sight, Out of Mind: The Implementation and Impact of the Affordable Care Act in U.S. Farmworker Communities.
Farmworkers are a unique population within rural communities and are often overlooked and undercounted. They face significant disparities in health and health care access compared with the general rural population. One goal of the Patient Protection and Affordable Care Act (ACA) is to increase access to health care and health insurance for the country's most vulnerable and underserved populations. ⋯ Apart from anecdotal accounts, we lack the necessary data to assess the ACA's impact on farmworker communities. This commentary imparts information about farmworker enrollment in and barriers to accessing health insurance, collected through individual conversations, focus groups, interviews, and informal surveys. Based on identified challenges and limitations, we make policy recommendations to assess and improve the implementation and relevance of the ACA in farmworker communities.
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J Health Care Poor Underserved · Jan 2016
Randomized Controlled TrialTikanga Māori (Māori Customary Practices) in Oral Health Research.
Early childhood caries is a global health issue for Indigenous populations. The study, "Reducing disease burden and health inequalities arising from chronic dental disease among Indigenous children: an early childhood caries intervention," is being conducted in Australia, Canada, and Aotearoa/New Zealand.
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J Health Care Poor Underserved · Jan 2016
Reducing Medical School Admissions Disparities in an Era of Legal Restrictions: Adjusting for Applicant Socioeconomic Disadvantage.
A diverse physician workforce is needed to increase access to care for underserved populations, particularly as the Affordable Care Act expands insurance coverage. Yet legal restrictions constrain the extent to which medical schools may use race/ethnicity in admissions decisions. ⋯ We found that socioeconomic and under-represented minority disparities in admissions could be eliminated while maintaining academic readiness. Adjusting applicant academic metrics using socioeconomic information on medical school applications may be a race-neutral means of increasing the socioeconomic and racial/ethnic diversity of the physician workforce.
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J Health Care Poor Underserved · Jan 2016
What Is the Potential of Community Paramedicine to Fill Rural Health Care Gaps?
Community paramedicine (CP) uses emergency medical services (EMS) providers to help rural communities increase access to primary care and public health services. This study examined goals, activities, and outcomes of 31 rural-serving CP programs through structured interviews of program leaders and document review. Common goals included managing chronic disease (90.3%); and reducing emergency department visits (83.9%), hospital admissions/readmissions (83.9%), and costs (83.9%). ⋯ Programs provided assessment, testing, preventive care, and post-discharge services. Reported outcomes were promising, but few programs used rigorous evaluation methods. Rural-serving CP programs provided services to shift costs to less expensive settings and provide appropriate care where vulnerable patients live, but more evidence is needed that care is safe, effective, and economical.