Integrating Cost into Shared Decision-Making for Heart Failure with Reduced Ejection Fraction (POCKET-COST-HF): A Trial Providing Out-of-Pocket Costs for Heart Failure Medications during Clinical Encounters.

Background: Evidence-based medical therapy for heart failure with reduced ejection fraction (HFrEF) often entails substantial out-of-pocket costs that can vary appreciably between patients. This has raised concerns regarding financial toxicity, equity, and adherence to medical therapy. In spite of these concerns, cost discussions in the HFrEF population appear to be rare, partly because out-of-pocket costs are generally unavailable during clinical encounters.

Promoting Latinx health equity through community-engaged policy and practice reforms in North Carolina.

Introduction: The Latinx Advocacy Team & Interdisciplinary Network for COVID-19 (LATIN-19) is a unique multi-sector coalition formed early in the COVID-19 pandemic to address the multi-level health inequities faced by Latinx communities in North Carolina.

Methods: We utilized the National Institute on Minority Health and Health Disparities (NIMHD) Research Framework to conduct a directed content analysis of 58 LATIN-19 meeting minutes from April 2020 through October 2021. Application of the NIMHD Research Framework facilitated a comprehensive assessment of complex and multidimensional barriers and interventions contributing to Latinx health while centering on community voices and perspectives.

The consequences of heroization for exploitation.

The hero label has become a pervasive positive stereotype applied to many different groups and occupations, such as nurses, teachers, and members of the military. Although meant to show support, appreciation, and even admiration, we suggest that attaching this label to groups and occupations may actually have problematic consequences. Specifically, we theorize that the hero label may affect beliefs about the internal motivations of these group members that make them more vulnerable to exploitation.

Consequences of a shortage and rationing: Evidence from a pediatric vaccine.

Shortages and rationing are common in health care, yet we know little about the consequences. We examine an 18-month shortage of the pediatric Haemophilus Influenzae Type B (Hib) vaccine. Using insurance claims data and variation in shortage exposure across birth cohorts, we find that the shortage reduced uptake of high-value primary doses by 4 percentage points and low-value booster doses by 26 percentage points.

Asking for less (but receiving more): Women avoid impasses and outperform men when negotiators have weak alternatives.

Both research and conventional wisdom suggest that, due to their relational orientation, women are less likely than men to engage in agentic and assertive behaviors, leading them to underperform in zero-sum, distributive negotiations where one party's gain is equivalent to the other party's loss. However, past research tends to neglect the costs of reaching impasse by excluding impasses from measures of negotiation performance. Departing from this convention, we incorporate the economic costs of impasses into measures of negotiation performance to provide a more holistic examination of negotiation outcomes.

Financial Impact of Imaging Examination Site of Service in the Medicare Population.

Purpose: The financial sustainability of the US healthcare system is a growing concern in an environment of declining reimbursement and rising costs. Variable Centers for Medicare and Medicaid (CMS) reimbursement and denial rates for specific imaging examinations exist across sites of service, adding complexity to financial planning for healthcare organizations. Understanding the financial implications of site of service in existing CMS reimbursement for imaging may be of strategic importance for organizations going forward.

Dementia and Parkinson's disease diagnoses in electronic health records vs. Medicare claims data: a study of 101,980 linked patients.

Background: Medicare claims and electronic health record data are both commonly used for research and clinical practice improvement; however, it is not known how concordant diagnoses of neurodegenerative diseases (NDD, comprising dementia and Parkinson's disease) are in these data types. Therefore, our objective was to determine the sensitivity and specificity of neurodegenerative disease (NDD) diagnoses contained in structured electronic health record (EHR) data compared to Medicare claims data.

Methods: This was a retrospective cohort study of 101,980 unique patients seen at a large North Carolina health system between 2013-2017, which were linked to 100% North and South Carolina Medicare claims data, to evaluate the accuracy of diagnoses of neurodegenerative diseases in EHRs compared to Medicare claims data.

A Pragmatic Clinical Trial of Hearing Screening in Primary Care Clinics: Effect of Setting and Provider Encouragement.

Objectives: The prevalence of hearing loss increases with age. Untreated hearing loss is associated with poorer communication abilities and negative health consequences, such as increased risk of dementia, increased odds of falling, and depression. Nonetheless, evidence is insufficient to support the benefits of universal hearing screening in asymptomatic older adults.

Gender and Language in Letters of Recommendation for Obstetrics and Gynecology Fellowship Applications.

Objective: To delineate the use of gender-biased language in letters of recommendation for Obstetrics and Gynecology fellowships and its impact on applicants.

Design: Fellowship letters of recommendation from 4 Obstetrics and Gynecology specialties at a single institution in 2020 were included.

Primary Outcome: frequency of agentic and communal language in letters of recommendation using Linguistics Inquiry Word Count software.

Thinking about God increases acceptance of artificial intelligence in decision-making.

Thinking about God promotes greater acceptance of Artificial intelligence (AI)-based recommendations. Eight preregistered experiments ( = 2,462) reveal that when God is salient, people are more willing to consider AI-based recommendations than when God is not salient. Studies 1 and 2a to 2d demonstrate across a wide variety of contexts, from choosing entertainment and food to mutual funds and dental procedures, that God salience reduces reliance on human recommenders and heightens willingness to consider AI recommendations.

Neighborhood socioeconomic deprivation, healthcare access, and 30-day mortality and readmission after sepsis or critical illness: findings from a nationwide study.

Background: To determine if neighborhood socioeconomic deprivation independently predicts 30-day mortality and readmission for patients with sepsis or critical illness after adjusting for individual poverty, demographics, comorbidity burden, access to healthcare, and characteristics of treating healthcare facilities.

Methods: We performed a nationwide study of United States Medicare beneficiaries from 2017 to 2019. We identified hospitalized patients with severe sepsis and patients requiring prolonged mechanical ventilation, tracheostomy, or extracorporeal membrane oxygenation (ECMO) through Diagnosis Related Groups (DRGs).

Financial Health of People Living With Dementia and Their Informal Care Partners: Protocol for a Mixed Methods Study.

Background: There is a growing body of academic literature focusing on the significant financial burdens placed on people living with cancer, but little evidence exists on the impact of rising costs of care in other vulnerable populations. This financial strain, also known as financial toxicity, can impact behavioral, psychosocial, and material domains of life for people diagnosed with chronic conditions and their care partners. New evidence suggests that populations experiencing health disparities, including those with dementia, face limited access to health care, employment discrimination, income inequality, higher burdens of disease, and exacerbating financial toxicity.

Time and Punishment: Time Delays Exacerbate the Severity of Third-Party Punishment.

Punishments are not always administered immediately after a crime is committed. Although scholars and researchers claim that third parties should normatively enact punishments proportionate to a given crime, we contend that third parties punish transgressors more severely when there is a time delay between a transgressor's crime and when they face punishment for it. We theorize that this occurs because of a perception of unfairness, whereby third parties view the process that led to time delays as unfair.

Hyperglycemia, Ischemic Lesions, and Functional Outcomes After Intracerebral Hemorrhage.

Background Ischemic lesions observed on diffusion-weighted imaging (DWI) magnetic resonance imaging are associated with poor outcomes after intracerebral hemorrhage (ICH). We evaluated the association between hyperglycemia, ischemic lesions, and functional outcomes after ICH. Methods and Results This was a retrospective observational analysis of 1167 patients who received magnetic resonance imaging in the ERICH (Ethnic and Racial Variations in Intracerebral Hemorrhage) study.

Neighborhood Socioeconomic Disadvantage, Healthcare Access, and Outcomes of Hospitalizations for Common Pulmonary Conditions: A National Study of Medicare Beneficiaries.

Understanding how systemic forces and environmental exposures impact patient outcomes is critical to advancing health equity and improving population health for patients with pulmonary disease. This relationship has not yet been assessed at the population level nationally. To determine whether neighborhood socioeconomic deprivation is independently associated with 30-day mortality and readmission for hospitalized patients with pulmonary conditions, after controlling for demographics, access to healthcare resources, and characteristics of admitting healthcare facilities.

Tying the value of goals to social class.

Although everyone strives toward valued goals, we suggest that not everyone will be perceived as doing so equally. In this research, we examine the tendency to use social class as a cue to understand the importance of others' goals. Six studies find evidence of a goal-value bias: Observers perceive goals across a variety of domains as more valuable to higher class than to lower class individuals (Studies 1-6).

Stretch goals have enduring appeal, but are the right organisations using them?

Background: The healthcare industry faces significant challenges and opportunities that demand lofty aspirations and novel approaches. Pursuing seemingly impossible goals, popularly known as 'stretch goals', can be a way to instigate dramatic change and innovation, but such extreme goals also come with substantial risks. After briefly reporting the results of a national survey we conducted to provide examples of how stretch goals are used in healthcare, we review and translate prior research on the effects of stretch goals on organisations and their members.

Deciding Whether to Take Sacubitril/Valsartan: How Cardiologists and Patients Discuss Out-of-Pocket Costs.

Background Out-of-pocket costs have significant implications for patients with heart failure and should ideally be incorporated into shared decision-making for clinical care. High out-of-pocket cost is one potential reason for the slow uptake of newer guideline-directed medical therapies for heart failure with reduced ejection fraction. This study aims to characterize patient-cardiologist discussions involving out-of-pocket costs associated with sacubitril/valsartan during the early postapproval period.

Does "Jamal" receive a harsher sentence than "James"? First-name bias in the criminal sentencing of Black men.

Objective: Using archival and experimental methods, we tested the role that racial associations of first names play in criminal sentencing.

Hypotheses: We hypothesized that Black defendants with more stereotypically Black names (e.g.

Insights on Coaching, Mentorship, and Leadership from Business to Health Care.

The still-evolving global pandemic has accelerated changes in how we work, how we lead, and how we interact. The power dynamic that once drove institutions has shifted to an infrastructure and operating framework encouraging new employee expectations, including the humanization of leadership from those in power. Trends in the corporate world show organizations have shifted to operational frameworks with humanized leadership models: leader-as-coach and leader-as-mentor.

Enabling Medical Leaders Through Mentoring.

Mentoring is important to the development and enhancement of the medical profession and to organizational performance. The challenge is to implement a mentoring program within your organization. Leaders can use this article to assist in training both mentors and mentees.