Emergency physician personnel crisis: a survey on attitudes of new generations in Slovenia.

BACKGROUND: Emergency departments globally are overburdened, and emergency medicine residency is losing popularity among students and physicians. This raises concerns about the collapse of a life-saving system. Our goal was to identify the key workforce reasoning and question medical staff employment behavior. METHODS: This was a prospective cross-sectional study. In December 2022, medical students and pre-residency doctors in Slovenia were invited to complete a web-based questionnaire. The data were analyzed using T-test, chi-square test, Mann‒Whitney-Wilcoxon tests, and principal component analysis. Open-ended questions were hand-categorized. RESULTS: There were 686 participatns who clicked on the first page and 436 of those finished the survey. 4% of participants gave a clear positive response, while 11% responded positively regarding their decision to pursue emergency medicine residency. The popularity of emergency medicine decreases significantly among recent medical school graduates upon their initial employment. People who choose emergency medicine are less concerned about its complexity and pressure compared to others. Most respondents preferred 12-hour shift lengths. The preferred base salary range for residents was I$ 3623-4529, and for specialists, it was I$ 5435-6341. The sample's primary personal priorities are achieving a satisfactory work-life balance, earning respect from colleagues, and engaging in academic activities. Factors that attract individuals to choose emergency medicine include high hourly wages, establishment of standards and norms, and reduced working hours. CONCLUSIONS: Our findings indicate that enhancing compensation, establishing achievable standards and norms, facilitating a beneficial work-life equilibrium, providing assistance with initial property acquisition, stimulating participation in deficit residency programs, fostering collegiality among peers, restricting the duration of shifts, and enabling pension accrual may be imperative in attracting more individuals to pursue emergency medicine residency.

Encuesta colombiana de neurología 2016-2020 / Colombian neurology survey 2016-2020

RESUMEN INTRODUCCIÓN: La práctica de la neurología como especialidad clínica es relativamente reciente en Colombia, a pesar de que esta área ha mostrado progresos académicos significativos; la información sociodemográfica es limitada. OBJETIVO: Describir las características sociodemográficas de los neurólogos laboralmente activos en Colombia. METODOLOGÍA: Estudio descriptivo en dos periodos. La información se obtuvo mediante encuestas autodiligenciadas a los asistentes al Congreso Nacional de Neurología del año 2016; la del 2020 se recolectó empleando cuestionarios en línea a través de formularios Google. RESULTADOS: Se contabilizaron 549 neurólogos laboralmente activos en el territorio colombiano. El análisis de las muestras 2016 y 2020 mostró que la mayor proporción de estos especialistas se concentraba en Bogotá (45,4 %), Medellín (13,4 %) y Cali (8,4 %), con una ocupación escasa en ciudades no capitales. La comparación de horas laborales e ingresos económicos al analizar 2016 y 2020 no mostró diferencias. El mayor tiempo de ejercicio se correlacionó con mayores ingresos, tanto en el 2016 (p < 0,001) como en el 2020 (p < 0,01). CONCLUSIONES: Excepto por el incremento en la población de nuevos neurólogos, las características socio-demográficas de los neurólogos en Colombia se mantienen sin variaciones al comparar los años 2016 y 2020.

ABSTRACT INTRODUCTION: Neurology practice is relatively recent in Colombia. Even though this area has shown significant academic advances, information regarding sociodemographic conditions is limited. OBJECTIVE: To describe sociodemographic characteristics of neurologists who are currently active in Colombia. METHODS: Descriptive study over two time periods. The information was obtained by means of self-administered surveys to the neurologists attending the neurology national congress in 2016. In 2020, data was collected by means of on-line questionnaires using google forms. RESULTS: The sample included 549 neurologists. The largest proportion of these specialists were located in Bogotá (45.4 %), Medellín (13.4 %) and Cali (8.4 %). After comparing working hours per week and income we did not identify differences between these 2 years. The time of work experience was correlated with economic income both in 2016 (p<0.001) as in 2020 (p<0.01). CONCLUSION: Except for increasing number of neurologists of recent graduation, the sociodemographic characteristics of Colombian neurologists remain stable when comparing 2016 and 2020.

Impacto del uso de pruebas de laboratorio para descarte de Covid-19 sobre el ausentismo laboral en una empresa constructora de Lima. Reporte de caso

La Organización Mundial de la Salud recomendó utilizar pruebas de laboratorio en individuos sintomáticos que cumplan criterios de caso Covid-19 tan pronto como sea posible desde el inicio de la enfermedad con enfoque de casos. Con el objetivo de mostrar el beneficio del uso de pruebas de laboratorio para Covid-19 sobre el ausentismo laboral, reportamos el caso de una empresa constructora de la ciudad de Lima, cuya evaluación se realizó entre junio 2020 y 2021. Se observó que la utilización de pruebas de laboratorio para casos sospechosos de Covid-19 permitió una disminución del 54% de días de ausentismo laboral proyectado y un ahorro de 51% respecto al costo proyectado de días de ausentismo laboral por casos descartados de la Covid-19. El uso de pruebas de laboratorio para Covid-19 resultó beneficioso, disminuyendo el ausentismo innecesario.

SUMMARY The World Health Organization recommended to use laboratory tests in symptomatic individuals that fulfill suspicion criteria for Covid-19 as soon as symptoms started. To show the benefits of using laboratory tests on work absenteeism we report the case of a building company in Lima from June 2020 to 2021. Using laboratory tests work absenteeism reduced in 54% and savings were increased in 51% compared to a projected scenario. The use of Covid-19 tests was beneficial, reducing unnecessary work absenteeism.

Are Australians willing to pay more tax to support wage increases for aged care workers? Findings from a national survey.

OBJECTIVE: To explore the perceptions of the Australian public regarding Australia's aged care workforce, including their willingness to pay more tax to fund better pay and conditions for aged care workers. METHODS: An online survey was developed and administered to a representative sample of Australian adults (aged ≥18 years) by age group, gender and Australian state. Survey respondents completed a series of attitudinal statements to elicit their perceptions of the value of Australia's aged care workforce and were asked to indicate their willingness to pay additional tax to fund better pay and conditions for aged care workers. Those who gave a positive response were then asked to indicate what percentage of additional tax per year they would be willing to pay to ensure better pay and conditions for aged care workers. RESULTS: A total of 2033 adult respondents completed the survey. A majority (78%) of respondents either 'agreed' or 'strongly agreed' that aged care workers should be paid more. Approximately half of the respondents (50.57%) expressed a willingness to pay more tax to ensure better pay and conditions for aged care workers. The mean willingness to pay was 1.31% additional tax overall, and mean percentage additional tax values were relatively consistent across key socio-demographic indicators. CONCLUSIONS: A majority of the Australian public are in favour of improving the wages and employment conditions of aged care workers. However, only one in two Australians is willing to pay more tax to ensure better pay and conditions for aged care workers.

Physicians' income in Brazil: a study on information sources

SUMMARY OBJECTIVE: Data on physicians' income are relevant for well-informed health policies, both due to their strategic role and the volume of resources that their activities represent to health systems. In Brazil, multiple sources of data measure the income of these professionals, each one with singularities that generate a complex and heterogeneous picture. This study explores the methodological aspects of different data sources, pointing to potentials and limitations to measuring the income of physicians. METHODS: We use the sources' documentation and data on the average monthly income in 2019, by gender and macro region, from four distinct surveys: Continuous Pnad (National Household Sample Survey), RAIS (Annual Listing of Social Information), Medical Demographics, and IRPF (Personal Income Tax). RESULTS: The results confirm the heterogeneity of definitions, variables, and methodologies. The data set can evidence phenomena such as the income difference between men and women. Regional inequalities are evident; however, the data interpretation is less assertive. CONCLUSIONS: Although eventual gaps and discrepancies among sources can limit some strong conclusions, the analysis of different methodologies employed can suggest relevant hypotheses for in-depth studies.

Top-level design and practice exploration of salary reform in public hospitals / 中华医院管理杂志

The salary reform of public hospitals has a positive incentive effect on enhancing the public welfare of public hospitals, stimulating the enthusiasm of medical staff, and promoting high-quality development. The authors introduced the practice and exploration of the sequential salary system reform in Union Hospital, Tongji Medical College of Huazhong University of Science and Technology since 2018. It included the reform of physician performance based on medical groups, the reform of nursing performance based on vertical nursing management, the reform of medical technology performance based on resource marginal utilization, and the reform of management performance based on job responsibilities and 360°evaluation. The practice has showed that the salary reform could promote the improvement of medical service ability, improve nurses′ satisfaction, shorten the waiting time for medical technical examination, and steadily improve the performance of " National Examination" and the comprehensive ranking of hospitals. When studying and implementing the policy requirements of salary system reform, hospitals in different regions should take measures in accordance with local conditions, with accurate and safe information systems as the support, and focus on the distribution mode, compensation structure and funding sources.

Discussion on the performance reform of administrative and logistics personnel in a large public hospital / 中华医院管理杂志

Because the work of administrative and logistics personnel in public hospitals is difficult to quantify and evaluate, its performance reform is difficult. A large public hospital in Wuhan has explored and established a distribution incentive mechanism that combines department performance appraisal, individual classification and grading, and secondary distribution within the department. Taking into account the completion of performance appraisal indicators of the national tertiary public hospital in the department, the results of the institutional " Excellent Management Team Ranking" , personal job grades, working years and other factors, a relatively mature and operable system has been formed, which could provide reference for the performance reform of other hospitals.

US Survey of Incidence of and Reasons for Nurse Anesthetists Leaving or Having Considered Leaving Their Jobs.

Many nurse anesthetists changing positions or considering leaving their positions can give the impression that suboptimal quality of anesthesia department leadership exists. To provide nationally accurate benchmark data on annual turnovers of nurse anesthetists to assist chief nurse anesthetists who may be scrutinized for the resignation rate of nurse anesthetists at their hospital, we used the 2018 US National Sample Survey of Registered Nurses. Analyses show that, during 2017, approximately 13.6% (99% CI, 6.6%-25.8%) of survey respondents left the positions that they held as of December 31, 2016. Approximately 37.6% considered leaving but did not resign as of December 31, 2017 (CI, 26.2%-50.6%). Estimates for nurse anesthetists were comparable to those for registered nurses (ie, not unique to nurse anesthetists). With both estimates combined, approximately 53% of nurse anesthetists changed or considered leaving their primary position (CI, 37.3%-68.0%, P=.62 compared with half). The most commonly reported reason was "better pay/benefits" (P≤.0064 vs all other reasons, including burnout). Applying the results, in a department with 37 nurse anesthetists, the national incidence of 13.6% would represent a turnover of 5.0 per year. The 13.6% incidence could also result in 1 of 5 years having as many as 11 nurse anesthetists (30%) leaving.

El copago farmacéutico en España tras la reforma del año 2012 desde la perspectiva del usuario. ¿Evidencias de inequidad? / Pharmaceutical copayment in Spain after the 2012 reform from the user's perspective. Evidence of inequity?

Objetivo: Identificar cuáles son las características que se asocian con aquella parte de la población que manifiesta no poder comprar todos los medicamentos recetados por un médico de la sanidad pública, relacionándolas con los criterios que definen el sistema de copago farmacéutico fijado por el Real Decreto 16/2012, con la finalidad de orientar cambios que eliminen posibles inequidades. Método: Estudio de asociación y relación causal entre la dificultad para comprar medicamentos recetados por la sanidad publica que manifiestan los usuarios a través de la encuesta Barómetro Sanitario y un conjunto de variables que reflejan la capacidad económica, el nivel de necesidad de servicios de salud y que, a su vez, forman parte de los criterios de copago, mediante técnicas de análisis de correspondencias múltiples y de regresión. Resultados: Tras el análisis de las oleadas correspondientes a los años 2013-2017 se ha encontrado evidencia a favor de la hipótesis de que los usuarios más pobres, los activos y los de peor salud manifiestan mayores dificultades para acceder a los medicamentos que les han sido recetados por un médico de la sanidad pública. Conclusiones: Los resultados son compatibles con la hipótesis de que el copago actual es percibido como una barrera de acceso a medicamentos necesarios por parte de algunos sectores de la población. Aunque del trabajo pueden derivarse ciertas acciones dirigidas a reducir dicha barrera, es necesario realizar más investigación que tenga en cuenta la opinión de los usuarios. (AU)

Objective: Identify what are the characteristics of the part of the population that says they cannot buy all the medicines prescribed by a public health doctor, relating them to the criteria that define the pharmaceutical co-payment system established by Royal Decree 16/2012, with the purpose of guiding changes that eliminate possible inequities. Method: Association study and causal relationship between the difficulty to buy prescription drugs that users expressed through the survey called Health Barometer and a set of variables that reflect the degree of need for health services and the economic capacity, that is also part of the co-payment criteria, using multiple correspondence and regression analysis techniques. Results: After the analysis of the data corresponding to the years 2013-2017, evidence has been found in favour of the hypothesis that the poorest users, as well as the working ones and those with worst health show greater difficulties in accessing the medicines which have been prescribed by a public health doctor and, consequently, changes are proposed in the copayment system aimed at eliminating or, at least, reducing such differences. Conclusions: The results obtained are compatible with the hypothesis that the current copayment is perceived as a barrier to access necessary medicines by some sectors of the population. Although certain actions aimed at reducing this barrier can be derived from the work, more research that considers the opinion of the users is needed. (AU)

The Gender Pay Gap in Urology.

INTRODUCTION: Female physicians earn less than males in every medical specialty. We sought to determine whether a pay gap existed in urology and explore potential associated factors. METHODS: We used 2,323 responses to the 2017 American Urological Association census to represent all 12,517 U.S. urologists. We limited analysis to ages 34 to 65 and matched on years in practice. We explored the association between self-reported salary (more than $350,000 vs less than $350,000) and gender using multivariable logistic regression adjusted for age and practice. RESULTS: On bivariate analysis males were more likely to make more than $350,000 (56.9% vs 39.7%, p=0.01). There were no gender differences in weekly clinical (43.1 female vs 46.9 male, p=0.13) or nonclinical hours (7.9 female vs 9.1 male, p=0.23). Men do more inpatient procedures per month (7.8 vs 5.6, p=0.02) and more patient visits per week (78.4 vs. 68.4, p=0.04). Women spent more time with each patient (17.6 vs 14.9 minutes, p <0.01). On unadjusted logistic regression men were more likely to earn more than $350,000 (OR 2.01, p=0.02). On multivariable regression, gender was no longer significant (OR 1.59, p=0.11). Factors associated with earning more than $350,000 include more clinical/fewer nonclinical hours, shorter/more office visits, more inpatient surgeries, private practice, subspecialty training, Northeast location and nonWhite race. CONCLUSIONS: This analysis suggests a gender pay gap. While men and women work equal hours, women urologists are more likely to work in less profitable settings, perform fewer inpatient procedures and see fewer patients. Future research needs to understand whether women choose these practices or whether external factors compel them to do so.

[Pharmaceutical copayment in Spain after the 2012 reform from the user's perspective. Evidence of inequity?] / El copago farmacéutico en España tras la reforma del año 2012 desde la perspectiva del usuario. ¿Evidencias de inequidad?

OBJECTIVE: Identify what are the characteristics of the part of the population that says they cannot buy all the medicines prescribed by a public health doctor, relating them to the criteria that define the pharmaceutical co-payment system established by Royal Decree 16/2012, with the purpose of guiding changes that eliminate possible inequities. METHOD: Association study and causal relationship between the difficulty to buy prescription drugs that users expressed through the survey called Health Barometer and a set of variables that reflect the degree of need for health services and the economic capacity, that is also part of the co-payment criteria, using multiple correspondence and regression analysis techniques. RESULTS: After the analysis of the data corresponding to the years 2013-2017, evidence has been found in favour of the hypothesis that the poorest users, as well as the working ones and those with worst health show greater difficulties in accessing the medicines which have been prescribed by a public health doctor and, consequently, changes are proposed in the copayment system aimed at eliminating or, at least, reducing such differences. CONCLUSIONS: The results obtained are compatible with the hypothesis that the current copayment is perceived as a barrier to access necessary medicines by some sectors of the population. Although certain actions aimed at reducing this barrier can be derived from the work, more research that considers the opinion of the users is needed.

Breaking the Gender Gap: A Two-part Observational Study of the Gender Disparity Among Korean Academic Emergency Physicians.

OBJECTIVES: Despite greater access to training positions and the presence of more women in emergency medicine, it has remained a men-dominated field. This study aims to identify the key issues causing the gender gap in Korea and establish measures to overcome them. METHODS: Using the annual statistical reports of the National Emergency Medical Center and data published on the Korean Society of Emergency Medicine website, cases that listed the current status and positions of members in its organization and its committees were analyzed. Secondary analysis was conducted using data from the 2015 Korean Society of Emergency Survey that included physicians' demographics, academic ranking, years of experience, clinical work hours, training and board certification, core faculty status, position, and salaries. RESULTS: As of September 2019, women account for only 12.7% of the total number of emergency physicians (EP) in Korea; of 119 chair/ vice-chair academic positions, women represented only 9.2%. Women EP were more often assistant professors and fellowship-trained, with fewer in core faculty. However, they worked the same numbers of clinical hours as their men counterparts. The median annual salary of women EP was less than that of men EP after adjusting for academic hospital rank, clinical hours, and core faculty status. CONCLUSIONS: A gender gap still exists among Korean EP, and women earn less than men regardless of their rank, clinical hours, or training. Future studies should evaluate more data and develop system-wide practices to eliminate gender disparities.

Salário de médicos contratados da Estratégia Saúde da Família e contexto municipal: estudo ecológico / Salary of physicians hired by the Family Health Strategy Program and the municipalities context: an ecological study

RESUMO O salário é um importante fator de atração, fixação e satisfação de profissionais médicos na Atenção Primária à Saúde (APS), sobretudo nas regiões mais remotas ou carentes. Este estudo tem o objetivo de identificar características contextuais municipais que estejam associadas ao valor do salário pago a médicos contratados da Estratégia Saúde da Família (ESF). Realizou-se um estudo ecológico e transversal com 78 municípios da Macrorregião de Saúde Norte, Minas Gerais, Brasil. A variável dependente referiu-se ao valor pago aos médicos contratados da ESF. Foram consideradas 22 variáveis independentes contextuais incluindo características sociodemográficas, de localização e indicadores assistenciais e de saúde de cada município, coletados de bases de dados oficiais. Conduziu-se Regressão Linear Múltipla. A média salarial encontrada foi de R$11.188,61 (±R$2.093,71), variando de R$6.388,20 até R$17.000,00. Após ajuste do modelo, somente a Distância ao Centro Regional manteve-se positivamente associada ao desfecho (R2=6,4%). O salário dos médicos não foi determinado por características municipais contextuais mensuráveis. Outros fatores mais subjetivos, de difícil mensuração, podem estar envolvidos na questão. Observa-se a necessidade do estabelecimento de parâmetros claros para definição do valor do salário de médicos contratados para atuação na ESF.

ABSTRACT Salary is an important factor of attraction, fixation and satisfaction of physicians in Primary Health Care (PHC), mainly in the most remote or poor regions. This study aims to identify characteristics related to municipalities that are associated to salaries paid to physicians hired from the Family Health Strategy (FHS) Program. An ecological and cross-sectional study was conducted with 78 municipalities of the Northern Health Macro-region of Minas Gerais State, Brazil. The dependent variable referred to the amount paid to the physicians hired from FHS. Twenty-two contextual independent variables were applied, including sociodemographic characteristics, location and health and care indicators of each municipality, all collected from public databases. Multiple Linear Regression was conducted. The outcome average salary was R$11,188.61 (±R$2,093.71), ranging from R$6,388.20 to R$17,000.00. After adjusting the model, only the variable 'Distance from Regional Center' remained positively associated to the outcome (R2=6.4%). The conclusion is that the salaries of physicians were not determined by measurable contextual municipal characteristics. Other more subjective and difficult to measure factors may be involved in the issue. Therefore, there is need to establish clear parameters so to define the salaries of physicians hired to work for FHS.

Determinants of Salary for Veterinarians Employed in the Field of Shelter Medicine in the United States.

Despite recent growth in the field of shelter medicine, there is a paucity of wage data available. Understanding determinants of salary is helpful for new graduates deciding on a career path as well as employees and employers with regard to budgeting, professional development, and negotiations. An anonymous online survey was distributed via commercial survey platform to shelter veterinarians. Salary was analyzed using multiple linear regression, Kruskall-Wallis equality-of-populations rank-test, and Conover-Iman pairwise comparison. Of the 219 unique respondents, 197 worked as shelter veterinarians, with 157 full-time and 40 part-time. Fifteen respondents worked in academia, and 7 respondents worked in shelter leadership. Full-time shelter veterinarians had a median income of $92,000 [$78,000-110,000], which is the same as the median salary reported for all veterinarians by the AVMA in 2018. Salary depended on years of shelter experience (P = .004), supervision of other veterinarians (P = .015), region (Southwest, P = .010, Mideast, P = .010, and Far West, P = .002) and size of the metropolitan area (>1 million, P = .001 and <250,000, P = .011). Part-time veterinarians had a median income of $60,000 [$44,000-84,000]. The only variable predictive of salary was hours worked, with part-time veterinarians paid a median of $48 [36-66] per hour. Academic veterinarians had a median income of $108,000 [90,000-120,000]. For academics, title (assistant professor, P <.0001 and professor, P = .001), PhD (P = .010), and master's (P= .001) predicted salary. Veterinarians working in leadership positions had a median income of $120,000 [110,000-198,000], and no variable was significant. Veterinarians employed in academia and leadership had a higher salary than veterinarians employed in the shelter. There are predictors of salary for shelter medicine veterinarians, which will help both potential employers and employees, determine reasonable salaries when budgeting, negotiating, or planning personal development.

Surveys of Salary, Benefits, and Job Responsibilities for Veterinarians Employed in the Field of Shelter Medicine in the United States Conducted in 2011 and 2018.

According to American Veterinary Medical Association statistics, veterinarians employed in the not-for-profit sector account for the smallest group by type of employment. However, this group has experienced the greatest amount of change, with an increase of 52% between 2008 and 2013 and 55% between 2013 and 2018. Despite this growth, there has been a paucity of information regarding the salary, benefits, hours, and job duties that come with a career in shelter medicine. An initial survey of shelter medicine salary, benefits, hours, and job duties was conducted in 2011, and a similar survey conducted in 2018. All responses were anonymous. Results from 2018 were compared to 2011 using 2 sample test of proportions (counts) or Mann-Whitney (Wilcoxon rank sum) test (medians). A total of 207 conforming responses were received in 2011, and 219 in 2018. Median salary for all full-time veterinarians in the field of shelter medicine was $75,000 (interquartile range [IQR], 65,000-85,000) in 2011 and $94,500 (IQR, 80,000-110,000) in 2018. Part-time shelter employed veterinarians in 2011 worked a median of 20 hours (IQR 7-28) for an hourly rate of $41 (IQR, 29-56) while they worked a median of 26 hours (IQR, 15-32) for an hourly rate of $48 (IQR, 36-66) in 2018. There was an increase in the provision of all categories of benefits and an increase in veterinarians employed in academia and leadership. Demographics were similar, with the exception of increases in the number of boarded specialists and veterinarians who had completed a residency. Veterinarians reporting that shelter medicine had been offered in their curriculum increased by 44%. Budgets for shelters were reported to be higher, while animal intake and daily count of animals in care was lower. Comparison between surveys of shelter medicine veterinarians in 2011 and 2018 showed a consistent increase in salary, benefits and resources. There were indicators that the field of shelter medicine has matured as a discipline, particularly with regard to the availability of shelter medicine education and increased number of boarded specialists.

A nationwide investigation of the impact of the tipped worker subminimum wage on infant size for gestational age.

Tipped workers, primarily women of reproductive-age, can be paid a "subminimum wage" 71% lower than the federal minimum wage. We estimated the effects of increasing the state-level tipped worker subminimum wage (federally, $2.13 per hour) on infant size for gestational age in the US as infants born small or large are at risk for poor health across the lifecourse. Utilizing unconditional quantile regression and difference-in-differences analysis of data from 2004 to 2016 Vital Statistics Natality Files (N = 41,219,953 mother-infant dyads), linked to state-level wage laws, census, and antipoverty policy data, we estimated the effect of increasing the subminimum wage on birthweight standardized for gestational age (BWz). Smallest and largest infants are defined as those in the 5th and 95th BWz percentiles, respectively. Increases in the subminimum wage affected the BWz distribution. When compared to a static wage of $2.13 for the duration of the study period, wage set to 100% of the federal minimum ($5.15-$7.25) was associated with an increase in BWz of 0.024 (95% CI: 0.004, 0.045) for the smallest infants and a decrease by 0.041 (95% CI: -0.054, -0.029) for the largest infants. Increasing the subminimum wage may be one strategy to promote healthier birthweight in infants.

Wage losses among spouses of women with nonmetastatic breast cancer.

BACKGROUND: The aim of this study was to evaluate the wage losses incurred by spouses of women with nonmetastatic breast cancer in the 6 months after the diagnosis. METHODS: A prospective cohort study of spouses of women diagnosed with nonmetastatic breast cancer who were recruited in 8 hospitals in the province of Quebec (Canada) was performed. Information for estimating wage losses was collected by telephone interviews conducted 1 and 6 months after the diagnosis. Log-binomial regressions were used to identify personal, medical, and employment characteristics associated with experiencing wage losses, and generalized linear models were used to identify characteristics associated with the proportion of usual wages lost. RESULTS: Overall, 829 women (86% participation) and 406 spouses (75% participation) consented to participate. Among the 279 employed spouses, 78.5% experienced work absences because of breast cancer. Spouses were compensated for 66.3% of their salary on average during their absence. The median wage loss was $0 (mean, $1820) (2003 Canadian dollars). Spouses were more likely to experience losses if they were self-employed or lived 50 km or farther from the hospital. Among spouses who experienced wage losses, those who were self-employed or whose partners had invasive breast cancer lost a higher proportion of wages. CONCLUSIONS: Although spouses took some time off work, for many, the resulting wage losses were modest because of compensation received. Still, the types of compensation used may hide other forms of burden for families facing breast cancer.

Supplemental Security Income enrollment and health care and social assistance employment and wages.

We examine the relationship between disabled working-age Supplemental Security Income (SSI) enrollment and health care and social assistance employment and wages. County-level data are gathered from government and other publicly available sources for 3144 US counties (2012 to 2015). Population-weighted linear regression analyses examine associations between each health care and social assistance employment and wage measure and SSI enrollment, controlling for factors associated with health care and social assistance employment and wages. Results show positive associations between county-level percent of the population enrolled in the SSI program and health care and social assistance employment and wages with strong associations identified for social assistance employment. A one standard deviation increase in SSI enrollment is associated with a 5.6% increase in the health care and social assistance sector employment percent compared with the mean and 9.7% and 7.3% increases in health care and social assistance sector employment and wage shares, respectively, when compared with the means. We find working-age adult SSI enrollment is positively associated with employment outcomes, primarily in the social assistance organization subsector and in lower wage paying jobs. Evolving federal disability policy may influence existing and future SSI enrollment, which has implications for health care workforce employment and composition.

Risks of Living Kidney Donation: Current State of Knowledge on Outcomes Important to Donors.

In the past decade, there have been increasing efforts to better define and quantify the short- and long-term risks of living kidney donation. Recent studies have expanded upon the previous literature by focusing on outcomes that are important to potential and previous donors, applying unique databases and/or registries to follow large cohorts of donors for longer periods of time, and comparing outcomes with healthy nondonor controls to estimate attributable risks of donation. Leading outcomes important to living kidney donors include kidney health, surgical risks, and psychosocial effects of donation. Recent data support that living donors may experience a small increased risk of severe CKD and ESKD compared with healthy nondonors. For most donors, the 15-year risk of kidney failure is <1%, but for certain populations, such as young, black men, this risk may be higher. New risk prediction tools that combine the effects of demographic and health factors, and innovations in genetic risk markers are improving kidney risk stratification. Minor perioperative complications occur in 10%-20% of donor nephrectomy cases, but major complications occur in <3%, and the risk of perioperative death is <0.03%. Generally, living kidney donors have similar or improved psychosocial outcomes, such as quality of life, after donation compared with before donation and compared with nondonors. Although the donation process should be financially neutral, living kidney donors may experience out-of-pocket expenses and lost wages that may or may not be completely covered through regional or national reimbursement programs, and may face difficulties arranging subsequent life and health insurance. Living kidney donors should be fully informed of the perioperative and long-term risks before making their decision to donate. Follow-up care allows for preventative care measures to mitigate risk and ongoing surveillance and reporting of donor outcomes to inform prior and future living kidney donors.