American journal of preventive medicine
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Pragmatic Clinical Trial
Cost-Effectiveness of a Comprehensive Primary Care Smoking Treatment Program.
Smoking is the leading preventable cause of death and disease in the U.S. This study evaluates the cost-effectiveness from a healthcare system perspective of a comprehensive primary care intervention to reduce smoking rates. ⋯ Implementation of a comprehensive and proactive smoking cessation outreach and treatment program for adult primary care patients who smoke meets typical cost-effectiveness thresholds for healthcare.
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This study documents cost trends in oral anticoagulants (OAC) in patients with newly diagnosed atrial fibrillation. ⋯ There was a substantial increase in the overall cost burden of OACs and OAC initiation rates in patients with newly diagnosed atrial fibrillation in 2014-2021; these findings provide insights into the current and anticipated impact of rising drug prices on patients' and payers' financial burden.
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Observational Study
Gaps in U.S. Public Health Monitoring and Surveillance Systems in Puerto Rico.
Puerto Rico (PR) has an ambiguous status within Centers for Disease Control and Prevention (CDC) public health monitoring and surveillance systems. However, as a U.S. territory, PR relies on federal health resource allocation processes that are informed by these data sources. This study sought to quantify the coverage of PR within CDC-supported systems compared with the 50 states, describe coverage across critical system-types, and assess the availability of data collection instruments in Spanish. ⋯ There are significant gaps in the coverage of PR within CDC-supported systems. Future efforts must be made to identify the reasons for this exclusion and increase the territory's representation within these essential public health data systems.
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Sexual violence is a major public health problem in the U.S. that is associated with numerous health impacts, including pregnancy. U.S. population-based estimates (2010-2012) found that three million women experienced a rape-related pregnancy during their lifetimes. The current study presents more recent estimates of rape and sexual coercion-related pregnancy and examines prevalence by demographic characteristics. ⋯ Pregnancy as a consequence of rape or sexual coercion is experienced by an estimated six million U.S. women. Prevention efforts may include healthcare screenings to identify violence exposure and use of evidence-based prevention approaches to reduce sexual violence.
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Breast cancer screening (BCS) disparities leave historically underserved groups more vulnerable to adverse outcomes. This study explores granular associations between BCS and patient sociodemographic factors in a large urban safety-net health system. ⋯ Multiple unique variables contribute to BCS disparities, influenced by patient and health system factors. Defining and understanding the interplay of these variables can guide policymaking and identify avenues to improve BCS for vulnerable or traditionally under-resourced populations.