Racial, Socioeconomic, and Geographic Disparities in Preamputation Vascular Care for Patients With Chronic Limb-Threatening Ischemia.

Background: Black patients, those with low socioeconomic status (SES), and those living in rural areas have elevated rates of major lower extremity amputation, which may be related to a lack of subspecialty chronic limb-threatening ischemia care. We evaluated the association between race, rurality, SES, and preamputation vascular care.

Methods: Among patients aged 66 to 86 years with fee-for-service Medicare who underwent major lower extremity amputation for chronic limb-threatening ischemia from July 2010 to December 2019, we compared the proportion who received vascular care in the 12 months before amputation by race (Black versus White), rurality, and SES (dual eligibility for Medicaid versus no dual eligibility) using multivariable logistic regression adjusting for clinical and demographic covariates.

Prospective Interventions to Reduce Stroke Care Variation in a Hub-and-Spokes System.

Background: Care variation reduction (CVR) is a central objective of quality management to decrease wasted spending.

Objective: To analyze stroke care variation at a hub-and-spokes system and determine interventions to prospectively reduce unwarranted variation.

Methods: In this prospective cohort single arm intervention study providers were blinded to pre-specified endpoints.

Accessibility of antiretroviral therapy in Ghana: convenience of access.

The convenience of accessing antiretroviral therapy (ART) is important for initial access to care and subsequent adherence to ART. We conducted a qualitative study of people living with HIV/AIDS (PLWHA) and ART healthcare providers in Ghana in 2005. The objective of this study was to explore the participants' perceived convenience of accessing ART by PLWHA in Ghana.

African American patients' attitudes toward proactive health behaviors after exposure to direct-to-consumer advertising.

Background: Previous research on direct-to-consumer advertising (DTCA) has not focused exclusively on the African American population.

Purposes: The purpose of this study was to explore African Americans' attitudes toward proactive health behaviors following exposure to DTCA of atorvastatin calcium (Lipitor, Pfizer Inc).

Materials And Methods: One-hundred fifty African American patients participated in the study.

Diabetic patient experiences in a Medicaid managed care system.

Objective: When Tennessee received a federal waiver to place all Medicaid enrollees in managed care organizations (MCOs), patients with chronic conditions such as diabetes were deemed especially vulnerable. This survey assessed patients' perceptions of diabetic care, self-care procedures, and satisfaction with medical care before and after enrollment in a Medicaid MCO.

Methods: A telephone survey was designed and pilot tested before surveying 57 patients meeting inclusion criteria of continuous enrollment in Medicaid for two years before, and in the MCO for two years after, the initiation of Tennessee's Medicaid managed care system (TennCare).