Journal of health care for the poor and underserved
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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.
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J Health Care Poor Underserved · Jan 2016
Language Access and Health Equity: Changes under the Affordable Care Act.
Health disparities between English-proficient and limited English-proficient (LEP) groups in the United States have been widely documented. Provisions of the Affordable Care Act (ACA), including increased funding to community health centers and resources to help consumers who are purchasing Marketplace coverage afford new access to health care for speakers of languages other than English, which includes more than 60 million individuals, one-third of whom are LEP. This commentary discusses the legislative precedent for, successes of, and potential future directions for the implementation of the ACA as it relates to language access, health disparities, health equity, access to health care, and the linguistic needs of the LEP population in the United States.
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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.