John (Xuefeng) Jiang, Peter Cram, Kangkang Qi, Gei Bai
The US health care response during the early stages of the COVID-19 pandemic unveiled challenges in public health reporting systems and electronic clinical data exchange. Using data from the 2020 and 2022 American Hospital Association information technology supplement surveys, this study examined US hospitals’ experiences in public health reporting, accessing clinical data from external providers for COVID-19 patient care, and their success in reporting vaccine-related adverse events to relevant state and federal agencies. Results showcase significant disparities in reporting practices across government levels due to inconsistent requirements. Although many hospitals leaned toward automated data transmission, a substantial portion continued to depend on manual processes. Pertaining to electronic clinical data, while entities like large commercial laboratories outperformed others, a considerable number were sluggish in delivering critical information. Moreover, a small percentage of hospitals reported challenges in recording vaccine-related adverse events, emphasizing the need for transparent reporting systems. The study underscores the necessity for standardized reporting protocols, explicit directives, and a pivot from manual to automated processes. Tackling these challenges is pivotal for ensuring prompt and reliable data, bolstering future public health responses, and rejuvenating public trust in health institutions.
{"title":"Challenges and dynamics of public health reporting and data exchange during COVID-19: insights from US hospitals","authors":"John (Xuefeng) Jiang, Peter Cram, Kangkang Qi, Gei Bai","doi":"10.1093/haschl/qxad080","DOIUrl":"https://doi.org/10.1093/haschl/qxad080","url":null,"abstract":"\u0000 The US health care response during the early stages of the COVID-19 pandemic unveiled challenges in public health reporting systems and electronic clinical data exchange. Using data from the 2020 and 2022 American Hospital Association information technology supplement surveys, this study examined US hospitals’ experiences in public health reporting, accessing clinical data from external providers for COVID-19 patient care, and their success in reporting vaccine-related adverse events to relevant state and federal agencies. Results showcase significant disparities in reporting practices across government levels due to inconsistent requirements. Although many hospitals leaned toward automated data transmission, a substantial portion continued to depend on manual processes. Pertaining to electronic clinical data, while entities like large commercial laboratories outperformed others, a considerable number were sluggish in delivering critical information. Moreover, a small percentage of hospitals reported challenges in recording vaccine-related adverse events, emphasizing the need for transparent reporting systems. The study underscores the necessity for standardized reporting protocols, explicit directives, and a pivot from manual to automated processes. Tackling these challenges is pivotal for ensuring prompt and reliable data, bolstering future public health responses, and rejuvenating public trust in health institutions.","PeriodicalId":502462,"journal":{"name":"Health Affairs Scholar","volume":"16 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139457379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Women perform 77% of healthcare jobs in the US, but gender inequity within the healthcare sector harms women’s compensation and advancement in healthcare jobs. Using data from 2003 to 2021 of the Annual Social and Economic Supplement of the Current Population Survey (CPS), we measure women’s representation and the gender wage gap in healthcare jobs by education level and occupational category. We find descriptively that women’s representation in healthcare occupations has increased over time in occupations that require a master’s or doctoral/professional degree (e.g., physicians, therapists), while men’s representation has increased slightly in nursing occupations (e.g., registered nurses, LPNs/LVNs, aides and assistants). The adjusted wage gap between women and men is the largest among workers in high-education healthcare (e.g., physicians, advanced practitioners) but has decreased substantially over the last 20 years, while descriptively the gender wage gap has stagnated or grown larger in some lower education occupations. Our policy recommendations include gender equity reviews within healthcare organizations, prioritizing women managers, and realigning Medicare and Medicaid reimbursement policies to promote greater gender equity within and across healthcare occupations.
{"title":"The gender wage gap among healthcare workers across educational and occupational groups","authors":"Janette S Dill, Bianca K Frogner","doi":"10.1093/haschl/qxad090","DOIUrl":"https://doi.org/10.1093/haschl/qxad090","url":null,"abstract":"Women perform 77% of healthcare jobs in the US, but gender inequity within the healthcare sector harms women’s compensation and advancement in healthcare jobs. Using data from 2003 to 2021 of the Annual Social and Economic Supplement of the Current Population Survey (CPS), we measure women’s representation and the gender wage gap in healthcare jobs by education level and occupational category. We find descriptively that women’s representation in healthcare occupations has increased over time in occupations that require a master’s or doctoral/professional degree (e.g., physicians, therapists), while men’s representation has increased slightly in nursing occupations (e.g., registered nurses, LPNs/LVNs, aides and assistants). The adjusted wage gap between women and men is the largest among workers in high-education healthcare (e.g., physicians, advanced practitioners) but has decreased substantially over the last 20 years, while descriptively the gender wage gap has stagnated or grown larger in some lower education occupations. Our policy recommendations include gender equity reviews within healthcare organizations, prioritizing women managers, and realigning Medicare and Medicaid reimbursement policies to promote greater gender equity within and across healthcare occupations.","PeriodicalId":502462,"journal":{"name":"Health Affairs Scholar","volume":"30 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139154180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Over the past quarter century, Product Development Partnerships (PDPs) have importantly brought health technologies, particularly for neglected diseases, to market for low- and middle-income countries (LMICs). With public sector financing, PDPs derisk the gulf between where the global burden of disease falls and where paying markets exist. From fighting COVID-19 to developing novel antibiotics, the work of PDPs now extends beyond these traditional bounds. As PDPs have shepherded more health technologies to market, they are also confronting new access challenges. This article lays out five areas to leverage strategically the PDP model for better access to new health technologies. Making the case for enhanced support of the PDP approach will require greater transparency, as well as recognition of the contributions made by both public and private sector partners. The governance and funding of PDPs must be accountable to meeting the needs and building capacity of target beneficiaries in LMICs. To take an end-to-end approach, PDPs must work in tandem with other public sector institutions as well as local manufacturers as part of a larger innovation ecosystem. PDPs will need to keep pace with both the dynamics of diseases and markets in delivering the next generation of much needed health technologies.
{"title":"Enabling Product Development Partnerships to Bring Forward the Next Generation of Health Technologies","authors":"Anthony D So, Joshua Woo, Matthias Helble","doi":"10.1093/haschl/qxad088","DOIUrl":"https://doi.org/10.1093/haschl/qxad088","url":null,"abstract":"Over the past quarter century, Product Development Partnerships (PDPs) have importantly brought health technologies, particularly for neglected diseases, to market for low- and middle-income countries (LMICs). With public sector financing, PDPs derisk the gulf between where the global burden of disease falls and where paying markets exist. From fighting COVID-19 to developing novel antibiotics, the work of PDPs now extends beyond these traditional bounds. As PDPs have shepherded more health technologies to market, they are also confronting new access challenges. This article lays out five areas to leverage strategically the PDP model for better access to new health technologies. Making the case for enhanced support of the PDP approach will require greater transparency, as well as recognition of the contributions made by both public and private sector partners. The governance and funding of PDPs must be accountable to meeting the needs and building capacity of target beneficiaries in LMICs. To take an end-to-end approach, PDPs must work in tandem with other public sector institutions as well as local manufacturers as part of a larger innovation ecosystem. PDPs will need to keep pace with both the dynamics of diseases and markets in delivering the next generation of much needed health technologies.","PeriodicalId":502462,"journal":{"name":"Health Affairs Scholar","volume":"51 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139162292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adam Sacarny, Ian Williamson, Weston Merrick, T. Avilova, Mireille Jacobson
Clinician use of Prescription Drug Monitoring Programs (PDMPs) has been linked to better patient outcomes, but state requirements to use PDMPs are unevenly enforced. We assessed PDMP use in Minnesota, which requires opioid prescribers to hold accounts and, in most cases, search the PDMP before prescribing, but where enforcement authority is limited. Using 2023 PDMP data, we find that four in ten opioid prescribers did not search and three in ten did not hold an account. PDMP use was strongly associated with prescribing volume, but even among the top decile of opioid prescribers, 8% never searched the PDMP. 32% of opioid fills came from clinicians who did not search. Failures to use the PDMP may be driven by a lack of information about state requirements, beliefs that these requirements are not enforced, and the costs of accessing the PDMP relative to the benefits. These results highlight the potential for policymakers to promote safer and better-informed prescribing of opioids and other drugs by addressing the forces that have limited PDMP use so far.
{"title":"Prescription Drug Monitoring Program Use by Opioid Prescribers: A Cross Sectional Study","authors":"Adam Sacarny, Ian Williamson, Weston Merrick, T. Avilova, Mireille Jacobson","doi":"10.1093/haschl/qxad067","DOIUrl":"https://doi.org/10.1093/haschl/qxad067","url":null,"abstract":"Clinician use of Prescription Drug Monitoring Programs (PDMPs) has been linked to better patient outcomes, but state requirements to use PDMPs are unevenly enforced. We assessed PDMP use in Minnesota, which requires opioid prescribers to hold accounts and, in most cases, search the PDMP before prescribing, but where enforcement authority is limited. Using 2023 PDMP data, we find that four in ten opioid prescribers did not search and three in ten did not hold an account. PDMP use was strongly associated with prescribing volume, but even among the top decile of opioid prescribers, 8% never searched the PDMP. 32% of opioid fills came from clinicians who did not search. Failures to use the PDMP may be driven by a lack of information about state requirements, beliefs that these requirements are not enforced, and the costs of accessing the PDMP relative to the benefits. These results highlight the potential for policymakers to promote safer and better-informed prescribing of opioids and other drugs by addressing the forces that have limited PDMP use so far.","PeriodicalId":502462,"journal":{"name":"Health Affairs Scholar","volume":" 41","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139206900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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