Bmc Health Serv Res
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Bmc Health Serv Res · Jun 2020
Country of first birth and neonatal outcomes in migrant and Norwegian-born parous women in Norway: a population-based study.
This study compares subsequent birth outcomes in migrant women who had already had a child before arriving in Norway with those in migrant women whose first birth occurred in Norway. The aim of this study was to investigate the associations between country of first birth and adverse neonatal outcomes (very preterm birth, moderately preterm birth, post-term birth, small for gestational age, large for gestational age, low Apgar score, stillbirth and neonatal death) in parous migrant and Norwegian-born women. ⋯ The increased odds of adverse neonatal outcomes for migrant and Norwegian-born women who had their first births outside Norway should serve as a reminder of the importance of taking a careful obstetric history in these parous women to ensure appropriate care for their subsequent pregnancies and births in Norway.
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Bmc Health Serv Res · Jun 2020
Examining racial and ethnic trends and differences in annual healthcare expenditures among a nationally representative sample of adults with arthritis from 2008 to 2016.
Disparities in health care utilization and outcomes for racial and ethnic minorities with arthritis are well-established. However, there is a paucity of research on racial and ethnic differences in healthcare expenditures and if this relationship has changed over time. Our objectives were to: 1) examine trends in annual healthcare expenditures for adults with arthritis by race and ethnicity, and 2) determine if racial and ethnic differences in annual healthcare expenditures were independent of other factors such as healthcare access and functional disability. ⋯ Race and ethnicity are independent drivers of healthcare expenditures among adults with arthritis independent of healthcare access and functional disability. This underscores the need for ongoing research on the factors that influence persistent racial and ethnic differences in this population.
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Policymakers, legislators, and clinicians have raised concerns that hospital-based clinicians may be incentivized to inappropriately prescribe and administer opioids when addressing pain care needs of their patients, thus potentially contributing to the ongoing opioid epidemic in the United States. Given the need to involve all healthcare settings, including hospitals, in joint efforts to curb the opioid epidemic, it is essential to understand if clinicians perceive hospitals as contributors to the problem. Therefore, we examined clinical perspectives on the role of hospitals in the opioid epidemic. ⋯ Our findings can inform efforts at decreasing inappropriate opioid use in hospitals.
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Bmc Health Serv Res · Jun 2020
Control of unreasonable growth of medical expenses in public hospitals in Shanghai, China: a multi-agent system model.
This study aims to establish a multi-agent system model to provide accurate suggestions for the policy proposal of controlling the unreasonable growth of medical expenses charged by public hospitals in China. ⋯ The main reasons for the unreasonable increase in patient medical expenses at public hospitals could be attributed to patients' unreasonable medical-seeking preferences, doctors' weak public welfare incentives, and the government's inadequate financial investment. Policy-makers should consider proposals to restrict and guide the behaviors of suppliers, demanders, and the government, simultaneously. The government should consider the feasibility, response speed, and implementation cost of policies as well.
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Bmc Health Serv Res · May 2020
A nation-wide cross-sectional study of variations in homecare nurses' assessments of informational continuity - the importance of horizontal collaboration and municipal context.
Numerous studies have revealed challenges associated with ensuring informational continuity in municipal care services for older adults with comprehensive, prolonged and complex care needs. Most research is qualitative and on the micro-level. The aim of the current study is to map variation in homecare nurses' assessments of available information in the municipalities' documentation system and investigate the extent to which these assessments are associated with perceived quality of collaborations and with municipal context. ⋯ Documentation systems have a limited focus on long-term care needs of older care recipients beyond clinical and medical information. There is a potential for enhanced communication- and care-pathways between GPs, the allotment office and nurses in homecare services. This can support the coordinating role of homecare nurses in ensuring informational continuity for older adults with prolonged and complex care needs and help develop the facilitating role of (electronic) documentation systems.