Disparities in Alcohol‐Associated Liver Disease Hospital Encounters Amongst a Texas‐Based Cohort of Patients

Alimentary Pharmacology & Therapeutics, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 16, 2025

ABSTRACT Introduction Alcohol‐associated liver disease (ALD) disproportionately impacts men, racial and ethnic minorities, individuals of low socioeconomic status; however, it's unclear how recent increases in ALD burden have impacted these disparities. We aimed to describe trends racial, disparities alcohol‐associated hospital encounters. Methods conducted a retrospective cohort study adult encounters with diagnoses from three health systems between January 2016 December 2021. The was divided into eras: ‘Historical Era,’ (Oct 2016—June 2018, used only for trends); ‘Era 1’ (July 2018—March 2020); 2’ (April 2020—December 2021). Kaplan Meier Cox regression analyses were performed identify factors associated overall survival. Results identified 19,295 (44.7% White, 29.8% Hispanic, 21.8% non‐Hispanic Black (NHB) individuals), greater increase observed eras 1 2 than the historical era Era (8.7% vs. 5.0%, p < 0.01). By age sex, greatest youngest oldest females but males. race ethnicity, Hispanic had compared White (14.8% 7.5% 6.3%, Older (aSHR: 1.03, 95% CI: 1.03–1.0), higher MELD 1.08, 1.0–1.09), hepatic encephalopathy 1.42, 1.06–1.90), hepatocellular carcinoma (HCC) 3.20, 2.29–4.49) increased mortality. Conclusion highest amongst young NHB women, highlighting variation by age, ethnicity. These merit further investigation elucidate underlying mechanisms develop tailored interventions improve outcomes.

Language: Английский

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Telehealth and people with disabilities in the United Kingdom: a scoping review

Frontiers in Public Health, Journal Year: 2025, Volume and Issue: 13

Published: Feb. 12, 2025

Introduction Telehealth, also sometimes known as telemedicine, is the use of communication technologies to deliver healthcare remotely, has become increasingly vital, particularly since COVID-19 pandemic. While telehealth can improve access, it may exacerbate inequities for people with disabilities. This scoping review explores needs, experiences, and difficulties disabilities face when accessing services in United Kingdom’s (UK) National Health Service (NHS). Methods A systematic search was conducted using PRISMA Scoping Reviews (PRISMA-ScR) guidelines. The terms included variations “telehealth,” “disability,” “impairment,” “United Kingdom,” “NHS.” Studies published after January 2010 were if they addressed experiences telehealth. Ten studies met inclusion criteria, findings synthesized into five key themes: patient carer satisfaction, benefits telehealth, provider perspectives, disability-specific barriers, technological barriers. Results highlighted varied across different disabilities, technologies, medical specialties. patients carers generally expressed satisfaction telehealth’s convenience accessibility, a preference face-to-face consultations remained. Key barriers challenges such poor internet connectivity, unfamiliarity digital tools, device well challenges, sensory impairments. Reported improved access care flexibility However, perspectives concerns about ability build rapport perform thorough assessments remotely. Conclusion Telehealth should complement traditional through hybrid approach. Future efforts must focus on improving training providers, co-designing solutions promote equitable

Language: Английский

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Virtual Health Care Encounters for Lung Cancer Screening in a Safety-Net Population: Observations From the COVID-19 Pandemic

JCO Clinical Cancer Informatics, Journal Year: 2025, Volume and Issue: 9

Published: March 1, 2025

The COVID-19 pandemic disrupted normal mechanisms of health care delivery and facilitated the rapid widespread implementation telehealth technology. As a result, effectiveness virtual visits in diverse populations represents an important consideration. We used lung cancer screening as prototype to determine whether subsequent adherence differs between in-person encounters urban, safety-net system. conducted retrospective analysis initial low-dose computed tomography (LDCT) ordered for from March 2020 through February 2023 within Parkland Health, integrated provider Dallas County, TX. collected data on patient characteristics, visit type, LDCT completion electronic medical record. Associations among these variables were assessed using chi-square test. also performed interaction analyses according type. Initial orders placed total 1,887 patients, whom 43% female, 45% Black, 17% Hispanic. Among orders, 343 (18%) during visits. From August 2020, 79 163 (48%) visits; after that time, 264 1,724 (15%) No characteristics significantly associated with type (in-person v virtual) or completion. Rates 95% 97% (P = .13). In population, patients likely complete postvisit when encounter encounter.

Language: Английский

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Swallowing and Voice Difficulties in Children: Prevalence and Contributors to Receipt of Specialized Services

Perspectives of the ASHA Special Interest Groups, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 12

Published: April 4, 2025

Purpose: This study used a nationally representative sample of children aged 3–17 years to evaluate the likelihood having voice or swallowing disorder, reported duration and extent condition, as well seeing health professional for treatment evaluation. Method: Multivariable logistic regression was applied data from 2022 National Health Interview Survey calculate prevalence difficulties in differences duration, severity, these accounting demographic, household, environmental heterogeneity. Results: Analyses showed that 2.26% 4.40% had difficulty with voice, respectively, but only 21.4% 12.4% those saw professional. Children developmental disabilities (DD) were more likely have (odds ratio [ OR ] = 1.49, confidence interval [CI; 1.28, 1.74]) ( 1.71, CI [1.14, 2.58]) difficulties. Hispanic 0.38, [0.21, 0.69]) less than White while low-income households 2.55, [1.02, 6.36]) their counterparts. Among problems, low 3.706, [1.13, 6.85]) middle 3.11, [1.81, 8.43]) income greater degree counterparts lower nonmetropolitan areas 0.03, [0.01, 0.12]). Conclusion: highlighted disparities both severity among household areas.

Language: Английский

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Overall and Telehealth Addiction Treatment Utilization by Age, Race, Ethnicity, and Socioeconomic Status in California After COVID-19 Policy Changes

JAMA Health Forum, Journal Year: 2023, Volume and Issue: 4(5), P. e231018 - e231018

Published: May 19, 2023

Importance Addiction treatment rapidly transitioned to a primarily telehealth modality (telephone and video) during the COVID-19 pandemic, raising concerns about disparities in utilization. Objective To examine whether there were differences overall addiction utilization after policy changes pandemic by age, race, ethnicity, socioeconomic status. Design, Setting, Participants This cohort study examined electronic health record claims data from Kaiser Permanente Northern California for adults (age ≥18 years) with drug use problems before (from March 1, 2019, December 31, 2019) early phase of (March 2020, 2020; hereafter referred as onset). Analyses conducted between 2021 2023. Exposure The expansion services onset. Main Outcomes Measures Generalized estimating equation models fit compare onset that pandemic. Utilization measures included Healthcare Effectiveness Data Information Set initiation engagement (including inpatient, outpatient, encounters or receipt medication opioid disorder [OUD]), 12-week retention (days treatment), OUD pharmacotherapy retention. Telehealth also examined. Differences age group, status (SES) Results Among 19 648 participants pre–COVID-19 (58.5% male; mean [SD] 41.0 [17.5] years), 1.6% American Indian Alaska Native; 7.5%, Asian Pacific Islander; 14.3%, Black; 20.8%, Latino Hispanic; 53.4%, White; 2.5%, unknown race. 16 959 (56.5% 38.9 [16.3] 7.4%, 14.6%, 22.2%, 51.0%, 3.2%, Odds increased all SES subgroups except patients aged 50 years older; 18 34 had greatest increases (adjusted odds ratio [aOR], 1.31; 95% CI, 1.22-1.40). patient without variation SES, although greater (aOR, 7.17; 6.24-8.24). 1.13; 1.03-1.24) subgroups. Retention 1.4 days (95% 0.6-2.2 days), did not change difference, −5.2 days; −12.7 2.4 days). Conclusions In this insured problems, policies changed There was no evidence exacerbated, younger may have particularly benefited transition telehealth.

Language: Английский

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COVID-19 and Americans’ Mental Health: A Persistent Crisis, Especially for Emerging Adults 18 to 29

Journal of Adult Development, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 15, 2024

Language: Английский

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Psychotherapy Disruption Before and After the Transition to Virtual Mental Health Care Induced by the COVID-19 Pandemic

Psychiatric Services, Journal Year: 2023, Volume and Issue: 75(2), P. 108 - 114

Published: Oct. 11, 2023

This study aimed to examine population-level disruption in psychotherapy before and after the rapid shift virtual mental health care induced by onset of COVID-19 pandemic United States.

Language: Английский

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The design and implementation of a multi-center, pragmatic, individual-level randomized controlled trial to evaluate Baby2Home, an mHealth intervention to support new parents

Contemporary Clinical Trials, Journal Year: 2024, Volume and Issue: 142, P. 107571 - 107571

Published: May 12, 2024

Language: Английский

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Impact of a pharmacist-led collaborative approach to care for treatment of COVID-19 in the outpatient setting

American Journal of Health-System Pharmacy, Journal Year: 2024, Volume and Issue: unknown

Published: Aug. 12, 2024

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon possible after acceptance. Accepted have been peer-reviewed and copyedited, but are posted before technical formatting author proofing. These not final version record will be replaced with article (formatted per style proofed by authors) at a later time.

Language: Английский

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Addressing Digital Disparities in Alzheimer’s Disease: Improving Access to Alzheimer’s Resources for Spanish-speaking Latino/as in Los Angeles County (Preprint)

Published: Oct. 3, 2024

The COVID-19 pandemic disrupted traditional healthcare delivery models, exacerbating disparities between those with and without ready access to digital technology. This divide poses a structural barrier accessing equitable healthy aging resources dementia care. Latinos Hispanics, constituting nearly half of Los Angeles County's population facing projected tripling Alzheimer's disease related dementias (AD) prevalence by 2040, are particularly impacted. paper aims examine the barriers facilitators affecting health education for AD prevention care management in during pandemic. study focuses on possibly hindering Spanish-speaking Hispanics County from utilizing online services offering critical amid We developed conceptual model based users’ access/web literacy language as impacting brain resources. Between January February 2022, we identified 15 websites local organizations providing preventative applied our qualitatively evaluate websites. Out websites, 5 featured web navigation accessibility tools, 4 provided content available Spanish, 2 included family dialogue about management. One website showed cultural linguistic responsiveness their content. uncovered other unforeseen access, including email subscription requirements, English-language centered forms, unavailability staff. Our highlights tailored needs values Hispanic communities living County. findings emphasize need bridge gap incorporating user-friendly features culturally linguistically responsive elements design, implementation. approach will move field towards mitigating that sustain Latino communities.

Language: Английский

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