It takes quality improvement to cross the chasm.

Healthcare organisations in the USA rank significantly lower in quality of care compared with other developed nations. Research shows US performance emphasises expensive treatment over effective prevention programmes. This study demonstrates how a comprehensive quality improvement programme can improve health outcomes in a large county-based Medicaid health plan.

A higher Asthma Medication Ratio (AMR) predicts a decrease in ED visits among African American and Hispanic children.

Introduction: Higher rates of ED visits and hospitalizations for asthma among African American and Hispanic children may indicate suboptimal management of asthma, leading to a greater financial burden of healthcare. It is not well known if an association of race/ethnicity with controller medication and hospital-based care utilization exists.

Objective: This study examines whether the Asthma Medication Ratio (AMR) predicts healthcare utilization for asthma by race/ethnicity.

Determinants of racial and ethnic disparities in utilization of hospital-based care for asthma among Medi-Cal children in Los Angeles.

Objective: We sought to identify racial/ethnic patterns of health care utilization for asthma among asthmatic children (ages 0-18) and address unequal access to optimal asthma management as a determinant of asthma disparities.

Methods: We used children Medi-Cal (California's Medicaid program) enrollees, including African American, Asian, Hispanic, and White children in Los Angeles and retrieved individual hospital utilization records of 69,118 asthmatic children (2013-2018). We applied Hierarchical Generalized Linear Models (HGMLs) to identify the patterns of health care utilization at the individual level, controlling for demographic and neighborhood characteristics.

Are severe depressive symptoms associated with infertility-related distress in individuals and their partners?

Study Question: Are severe depressive symptoms in women and men associated with individual and dyadic infertility-related stress in couples undergoing infertility treatment?

Summary Answer: Severe depressive symptoms were significantly associated with increased infertility-related distress at both the individual and partner level. WHAT IS KNOWN ALREADY?: An infertility diagnosis, the stress of medical treatments and a prior history of depression are risk factors for future depression in those undergoing fertility treatments. Studies examining the impact of severe depressive symptoms on infertility-related distress in couples are lacking.

Fertility awareness and parenting attitudes among American male and female undergraduate university students.

Background: In the USA, the postponement of childbearing reflects contemporary social norms of delaying marriage, pursing educational goals and securing economic stability prior to attempting conception. Although university students are more likely to delay childbearing, it is unclear to what extent they are aware of age-related fertility decline. The current study is the first of its kind to assess fertility awareness and parenting attitudes of American undergraduate university students.

Marital benefit and coping strategies in men and women undergoing unsuccessful fertility treatments over a 5-year period.

Objective: To assess the relationship between infertility, marital benefit, and coping in a sample of men and women undergoing unsuccessful fertility treatments.

Design: Prospective longitudinal cohort design using multilevel modeling.

Setting: Danish public and private hospitals (n = 5) specializing in treating fertility patients.

Impact of patient-centered medical home assignment on emergency room visits among uninsured patients in a county health system.

The Medical Services Initiative program--a safety net-based system of care--in Orange County included assignment of uninsured, low-income residents to a patient-centered medical home. The medical home provided case management, a team-based approach for treating disease, and increased access to primary and specialty care among other elements of a patient-centered medical home. Providers were paid an enhanced fee and pay-for-performance incentives to ensure delivery of comprehensive treatment.

A randomized trial of methods to help clinicians learn motivational interviewing.

The Evaluating Methods for Motivational Enhancement Education trial evaluated methods for learning motivational interviewing (MI). Licensed substance abuse professionals (N = 140) were randomized to 5 training conditions: (a) clinical workshop only; (b) workshop plus practice feedback; (c) workshop plus individual coaching sessions; (d) workshop, feedback, and coaching; or (e) a waiting list control group of self-guided training. Audiotaped practice samples were analyzed at baseline, posttraining, and 4, 8, and 12 months later.