The American journal of managed care
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This study explored the contributions of social determinants of health (SDOH) to measures of population health-specifically cost, hospitalization rates, rate of emergency department utilization, and health status-in Texas. ⋯ This study and the developed population-based matrices can provide a valuable framework for reporting the impact of SDOH on health care quality. The variation suggests the need for further research on how age groups react to the social environment.
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The primary aim was to examine the association of social risks with avoiding/delaying health care after controlling for sociodemographic covariates, and the secondary aim was to examine the association of social risks with emergency department (ED) visits after controlling for avoiding/delaying health care and sociodemographic covariates. ⋯ Social risks are important factors in patients' decisions to avoid/delay health care and are associated with increased odds of any ED visits. To reduce ED visits, policy-level efforts need to be made to address these social challenges.
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As home-based care utilization rises, an exploration of potential unintended consequences is necessary. The authors focus on support gaps, informal caregiving, and failure to meaningfully engage clinicians.
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Pulmonary arterial hypertension (PAH) is a rare, progressive disorder associated with a poor prognosis if not treated appropriately. Fortunately, new treatment options have significantly improved survival rates and prognosis. Despite these advances, many patients do not receive the diagnosis until years into their disease or are inappropriately diagnosed. ⋯ Pharmacologic therapies carry a very high cost for PAH; however, extensive utilization of management strategies may hinder access to medication and may lead to disease progression. Cost containment strategies may help to facilitate care coordination for earlier diagnosis and initiation of treatment, adherence to PAH medications, and patient education to ensure they are using medications appropriately to optimize therapy. Managed care pharmacists can play a crucial role in the multidisciplinary team in terms of medication safety, adherence, patient education, and follow-up to improve patient engagement that leads to improved outcomes.