Disparities associated with Medicare Part D Star Ratings measures among patients with Alzheimer's disease and related dementias.

The Medicare Parts C and D Star Ratings system was established to improve care quality in Medicare. Previous studies reported racial/ethnic disparities in the calculation of medication adherence measures of Star Ratings in patients with diabetes, hypertension, and hyperlipidemia. This study aimed to identify possible racial/ethnic disparities in the calculation of adherence measures of Medicare Part D Star Ratings among patients with Alzheimer's disease and related dementias (ADRD) and diabetes, hypertension, or hyperlipidemia.

Effects of the Medicaid expansion under the Affordable Care Act on health insurance coverage, health care access, and use for people with disabilities.

Background: People with disabilities have higher health care needs, service utilization, and expenditures. They are also more likely to lack insurance and experience unmet need for medical care. There has been limited research on the effects of the Affordable Care Act Medicaid expansion on people with disabilities.

The Effect of the Affordable Care Act's Dependent Coverage Provisionon Health Insurance Gaps for Young Adults With SpecialHealthcare Needs.

Purpose: This study examined the impact of the 2010 Affordable Care Act's dependent coverage provision on gaps in insurance coverage for young adults with special healthcare needs (YASHCN).

Methods: We used the 2008 Survey on Income and Program Participation, a longitudinal survey covering 2008-2013. Our sample was comprised of 3,316 YASHCN ages 19-29.

Race and mental health disorders' impact on older patients' nursing home admissions upon hospital discharge.

Introduction: Despite policy efforts to reduce unwanted nursing home (NH) admissions, NH residents increasingly are being admitted from hospitals, with a significant share diagnosed with mental health disorders.

Objectives: We examined interactive effect of Black race and mental health disorder's impact on older patients' (age 65 and older) NH admission upon hospital discharge.

Material And Methods: We analyzed 186,646 older patients using pooled data from the 2007 through 2010 National Hospital Discharge Survey.

Relations among race/ethnicity, gender, and mental health status in primary care use.

Objective: Many working-age individuals with a serious mental health disability go without primary care. Gender and racial/ethnic disparities have been found in primary care utilization. This article examines whether the interaction of gender and race/ethnicity with serious mental health disability is associated with primary care use among working-age individuals.

State Design and Use of Medicaid 1915(c) Waivers and Related Benefits to Provide Services to Children and Youth With Autism Spectrum Disorder.

Medicaid is the most significant source of funding for medical services for individuals with autism spectrum disorder (ASD). We surveyed state Medicaid directors or their designees regarding their use of autism specific 1915(c) waivers and other Medicaid benefits to provide services to children and youth with ASD, with a response rate of 84%. Ten states used autism-specific waivers to provide services.

Do Juvenile Curfew Laws Reduce Underage Drinking?

Objective: Although not originally enacted to deter the problem of underage drinking in the United States, one set of laws that may influence this behavior is juvenile curfew laws. This research asked the following: (a) What is the effect of enacting a juvenile curfew law on youth drinking, and (b) do demographic variables moderate the relation between juvenile curfew law enactment and drinking? This study examined the effect of juvenile curfew laws on underage drinking, using data from 46 U.S.

Predicting State Investment in Medicaid Home- and Community-Based Services, 2000-2011.

Although state use of Medicaid home- and community-based services (HCBS) to provide long-term services and supports to older adults and individuals with physical disabilities continues to increase, progress is uneven across states. We used generalized linear models to examine state factors associated with increased allocation of Medicaid dollars to HCBS for the period 2000 to 2011. We observed enhanced growth in states that began the period with limited investment in HCBS, as reflected in significant year trends among these states.

A Systematic Review of the Impact of Juvenile Curfew Laws on Public Health and Justice Outcomes.

Context: Automobile crashes cause more than 800,000 youth injuries and deaths each year. Other youth suffer the consequences from being either a perpetrator or victim of a crime. One type of law that has an effect on youth behavior is juvenile curfew laws.

Facility Characteristics and Risk of Developing Pressure Ulcers in US Nursing Homes.

This research studied 12,507 residents in 1174 nursing homes from the 2004 National Nursing Home Survey. A multinomial logistic regression model was used to predict risk-adjusted probabilities of pressure ulcers with 4 stages. A medical director or a director of nursing on board reduced the odds of ulcers.

State adoption of Medicaid 1915(c) waivers for children and youth with Autism Spectrum Disorder.

Background: The prevalence of Autism Spectrum Disorder (ASD) has increased dramatically, with one in every 68 children in the U.S. currently diagnosed with ASD.

Disparities in access to health care among middle-aged and older adults with disabilities.

Disability is increasing among middle-aged adults and, reversing earlier trends, increasing among older adults as well. Disability is experienced disproportionately by Black and lower socioeconomic status (SES) individuals. We used Medical Expenditure Panel Survey data to examine health care disparities in access to health care for middle-aged (31 to 64 years of age) and older (65+ years of age) adults with disabilities by race and ethnicity, education, and income (n=13,174).

The relation between health insurance and health care disparities among adults with disabilities.

Objectives: We examined disparities among US adults with disabilities and the degree to which health insurance attenuates disparities by race, ethnicity, and socioeconomic status (SES).

Methods: We pooled data from the 2001-2007 Medical Expenditure Panel Survey on individuals with disabilities aged 18 to 64 years. We modeled measures of access and use as functions of predisposing, enabling, need, and contextual factors.

Race and ethnicity of mothers with Spanish surnames.

The objective of this study was to assess how hospital designation of race/ethnicity based on Spanish surnames of mothers correlated with the self-report, and explores how these mothers identified their own race/ethnicity using the National Institutes of Health (NIH) categories. 235 mothers were enrolled prospectively and asked to report their race/ethnicity. Positive predictive value (PPV) of using surnames as a tool for assigning race/ethnicity was determined.

Neurodevelopmental outcome of extremely low birth weight infants with Candida infection.

Objective: Candida remains an important cause of late-onset infection in preterm infants. Mortality and neurodevelopmental outcome of extremely low birth weight (ELBW) infants enrolled in the Candida study were evaluated based on infection status.

Study Design: ELBW infants born at Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (NRN) centers between March 2004 and July 2007 who were screened for suspected sepsis were eligible for inclusion in the Candida study.

Effects of gender, disability, and age in the receipt of preventive services.

Purpose Of The Study: We extend research to examine relations between gender, disability, and age in the receipt of preventive services.

Design And Methods: We pool Medical Expenditure Panel Survey data for years 2001-2007. Using logit models, we examine the relations between gender, disability, and age and the receipt of preventive services.

A profile of middle-aged and older adults admitted to nursing homes: 2000-2008.

Middle-aged adults are becoming an increasing share of the nursing home population. Minimum Data Set assessment data for 2000 and 2008 are used to explore similarities and differences in sociodemographic, residential, medical, and psychiatric characteristics of newly admitted middle-aged adults (31-64) compared to their older counterparts (65+). Relative to their share of the state population, Black middle-aged adults are overrepresented in nursing homes across 45 states and the District of Columbia.

Empiric antifungal therapy and outcomes in extremely low birth weight infants with invasive candidiasis.

Objective: To assess the impact of empiric antifungal therapy for invasive candidiasis on subsequent outcomes in premature infants.

Study Design: This was a cohort study of infants with a birth weight ≤ 1000 g receiving care at Neonatal Research Network sites. All infants had at least one positive culture for Candida.

Outcomes following candiduria in extremely low birth weight infants.

Background: Candidiasis carries a significant risk of death or neurodevelopmental impairment (NDI) in extremely low birth weight infants (ELBW; <1000 g). We sought to determine the impact of candiduria in ELBW preterm infants.

Methods: Our study was a secondary analysis of the Neonatal Research Network study Early Diagnosis of Nosocomial Candidiasis.

Relations among home- and community-based services investment and nursing home rates of use for working-age and older adults: a state-level analysis.

Objectives: I examined state-level rates of nursing home use for the period from 2000 to 2007.

Methods: I used multivariate fixed-effects models to examine associations between state sociodemographic, economic, supply, and programmatic characteristics and rates of use.

Results: Nursing home use declined among older adults (aged ≥65 years) in more than two thirds of states and the District of Columbia but increased among older working-age adults (aged 31-64 years) in all but 2 states.

Rurality and nursing home quality: evidence from the 2004 National Nursing Home Survey.

Purpose Of The Study: To evaluate the impact of rural geographic location on nursing home quality of care in the United States.

Design And Methods: The study used cross-sectional observational design. We obtained resident- and facility-level data from 12,507 residents in 1,174 nursing homes from the 2004 National Nursing Home Survey.

Neonatal candidiasis: epidemiology, risk factors, and clinical judgment.

Objective: Invasive candidiasis is a leading cause of infection-related morbidity and mortality in extremely low birth weight (<1000-g) infants. We quantified risk factors that predict infection in premature infants at high risk and compared clinical judgment with a prediction model of invasive candidiasis.

Methods: The study involved a prospective observational cohort of infants≤1000 g birth weight at 19 centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.

Factors that influence the receipt of eye care.

Objectives: To better understand what factors influence the receipt of eye care so that screening and education programs can be designed to promote early detection and treatment.

Methods: Twenty focus groups were conducted. Analyses entailed debriefing sessions, coding, and interpreting transcribed data.

Medicaid 1915(c) waiver use and expenditures for persons living with HIV/AIDS.

States' use of Medicaid 1915(c) waiver services for persons living with HIV/AIDS (PLWHA) has been limited. The authors examine state-level factors related to the decision to offer waiver services, as well as waiver use and expenditures in states offering waivers for PLWHA. They use fixed effects cross-sectional time series models to explore these state factors.