Journal of general internal medicine
-
Atherosclerotic cardiovascular disease (CVD) is the leading cause of death in the USA. Many with CVD or cardiovascular risk factors (CVRFs) lacked insurance coverage and access to care before enactment of the Affordable Care Act (ACA). ⋯ The ACA increased coverage and access for adults with CVD or multiple CVRFs; substantial gaps remain, particularly for minorities and those in Medicaid non-expansion states.
-
Multicenter Study Observational Study
Changes in Physical Health After Supported Housing: Results from the Collaborative Initiative to End Chronic Homelessness.
The permanent supported housing model is known to improve housing outcomes, but there has been sparse research on the effects of supported housing on physical health. Various organizations including the National Academy of Sciences have called for research in this area. ⋯ Entry into supported housing with linked primary care services was not associated with improvements in physical HRQOL. Improvement in other medical outcome measures was not specifically associated with improved housing status.
-
Reduced physical function and polypharmacy (PPha) are two highly prevalent negative effects of aging, which are expected to increase more, since demographic aging is expected to grow rapidly within the next decades. Previous research suggests that polypharmacy (PPha) is a predictor of poor physical function and vice versa in older adults and therefore we conducted a systematic review of the literature to summarize and critically analyze the relationship between physical function and PPha and vice versa in older adults, in order to provide recent scientific evidence. ⋯ Evidence examining the effect of PPha on physical function and vice versa in older adults suggests a strong bidirectional association between these two factors and clinicians should be aware of this strong relationship. The limitations of our study include the high variability in PPha definitions and physical function measures, and the treatment of PPha and physical function as constant instead of time-varying variables in the studies' analyses.
-
Since 2017, four states have successfully adopted the Medicaid expansion through ballot initiative. We analyze how states could potentially use ballot initiatives to implement these programs. ⋯ Amongst those states, there are challenges that limit the development, scope, and implementation of an initiative. Whether a state adopts the Medicaid expansion has important implications for health care providers.