Characteristics of Emergency Department Visits Made by Individuals With Sickle Cell Disease in the U.S., 1999-2020.

Introduction: Individuals living with sickle cell disease experience high levels of morbidity that result in frequent utilization of the emergency department. The objective of this study was to provide updated national estimates of emergency department utilization associated with sickle cell disease in the U.S.

Racial/Ethnic Differences in Association Between Medicaid Expansion and Causes and Costs of Readmission After Acute Ischemic Stroke.

Objective: The purpose of this study was to examine whether the relative frequency of leading causes and total associated costs of readmission after acute ischemic stroke changed with Medicaid expansion, and how these changes differed by racial/ethnic group.

Methods: We used a difference-in-differences approach to compare changes in the relative frequency of leading causes of unplanned 30-day readmission and to examine changes in the costs associated with unplanned readmission between expansion states (AR, MD, NM, and WA) and non-expansion states (FL and GA). To estimate the differential effect of Medicaid expansion by race/ethnicity on the causes and cost of readmission, we added a time*treatment*race interaction.

Feasibility of Technology-Enhanced Faculty Mentorship Use to Increase Retention of Minority Nursing Students.

Mentoring can enhance retention of academically at-risk students. The purpose of this project was to determine the feasibility of technology-enhanced faculty mentorship use in retention of minority undergraduate nursing students. The project consisted of a unique, blended (face-to-face and tablet-based) mentoring approach.

Factors associated with postpartum contraception in Togo, West Africa.

The health benefits of postpartum contraception are well established. Using 2013/14 Togo Demographic and Health Survey (DHS) data, we examine the association between contraceptive use among women who gave birth within 24 months of the DHS and four health service use indicators - antenatal care, institutional delivery, postpartum care, and immunization of the last child - in addition to socio-demographic factors. Factors associated with postpartum contraceptive use in Togo included having their last birth in a health facility, having a postnatal check within two months of birth, youngest child receiving the first diphtheria-pertussis-tetanus vaccine, wanting to space children more than two years from last birth or not have more children, living outside the Savanes region, husband's desire for number of children agreeing with the woman's, and increasing breastfeeding duration.

Medicaid Expansion and Racial/Ethnic Differences in Readmission After Acute Ischemic Stroke.

To examine whether rates of 30-day readmission after acute ischemic stroke changed differentially between Medicaid expansion and non-expansion states, and whether race/ethnicity moderated this change, we conducted a difference-in-differences analysis using 6 state inpatient databases (AR, FL, GA, MD, NM, and WA) from the Healthcare Cost and Utilization Project. Analysis included all patients aged 19-64 hospitalized in 2012-2015 with a principal diagnosis of ischemic stroke and a primary payer of Medicaid, self-pay, or no charge, who resided in the state where admitted and were discharged alive (N=28 330). No association was detected between Medicaid expansion and readmission overall, but there was evidence of moderation by race/ethnicity.

Associations of Medicaid Expansion With Access to Care, Severity, and Outcomes for Acute Ischemic Stroke.

Background: Multiple states have not expanded Medicaid under the Affordable Care Act, resulting in higher uninsured rates in states with high stroke burdens. This study aimed to evaluate the association of Medicaid expansion with changes in health insurance coverage, severity of presentation, access to care, and outcomes among patients with acute ischemic stroke.

Methods: A retrospective, difference-in-differences analysis of Get With The Guidelines-Stroke registry data.

Prescription drug spending and hospital use among Medicare beneficiaries with heart failure.

Background: Heart failure (HF) is a common cause of hospitalization in Medicare. Optimal medication adherence lowers hospitalization risk in HF patients. Although out-of-pocket spending can adversely affect adherence to HF medications, it is unknown whether medication spending ultimately increases hospital use for Medicare beneficiaries with HF.

Cost-Effectiveness and Challenges of Implementing Intensive Blood Pressure Goals and Team-Based Care.

Purpose Of Review: Review the effectiveness, cost-effectiveness, and implementation challenges of intensive blood pressure (BP) control and team-based care initiatives.

Recent Findings: Intensive BP control is an effective and cost-effective intervention; yet, implementation in routine clinical practice is challenging. Several models of team-based care for hypertension management have been shown to be more effective than usual care to control BP.

Prescription Drug Spending and Medication Adherence Among Medicare Beneficiaries with Heart Failure.

Background: Evidence suggests that cost sharing adversely affects appropriate prescription drug use for chronic disorders. However, few studies have evaluated this effect in heart failure (HF), the most common cause of hospitalization in Medicare.

Objective: To determine whether spending on HF pharmacotherapy by Medicare Part D enrollees was associated with prescription refill adherence.

Changing HIV clinical knowledge and skill in context: the impact of longitudinal training in the Southeast United States.

In the Southeast United States, HIV care is provided in a context of disproportionate HIV prevalence and barriers to care, including rural locales, higher proportions of African American and uninsured patients, and inadequate health care workforce and infrastructure. The authors describe a regional on-site longitudinal training program developed to target multidisciplinary teams providing HIV primary care at clinical sites in the region. The effect of this training program was evaluated using pre- and 3-month post-program knowledge and skills tests, a post-training evaluation questionnaire, and a post-program focus group.