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Ensaios Clínicos como Assunto , Aprovação de Drogas , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Política de Saúde , Humanos , Aprovação de Drogas/legislação & jurisprudência , Aprovação de Drogas/métodos , Política de Saúde/legislação & jurisprudência , Japão , Ensaios Clínicos como Assunto/legislação & jurisprudência , Ensaios Clínicos como Assunto/métodosRESUMO
In this Medical News article, JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS, and Alondra Nelson, PhD, the Harold F. Linder Professor at the Institute for Advanced Study, discuss effective AI regulation frameworks to accommodate innovation.
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Inteligência Artificial , Pesquisa Biomédica , Política de Saúde , Invenções , Legislação Médica , Educação de Pós-Graduação em Medicina , Medicina , Inteligência Artificial/legislação & jurisprudência , Política de Saúde/legislação & jurisprudência , Invenções/legislação & jurisprudência , Pesquisa Biomédica/legislação & jurisprudênciaAssuntos
Registros Eletrônicos de Saúde , Política de Saúde , Governo Estadual , Pesquisa Biomédica/métodos , Análise de Dados , Atenção à Saúde/métodos , Atenção à Saúde/normas , Registros Eletrônicos de Saúde/legislação & jurisprudência , Registros Eletrônicos de Saúde/normas , Registros Eletrônicos de Saúde/provisão & distribuição , Registros Eletrônicos de Saúde/tendências , Política de Saúde/legislação & jurisprudência , Política de Saúde/tendências , HumanosRESUMO
This study evaluates changes in medical exemptions and geographic distribution of kindergarteners in California not up to date on vaccination after changes to state legislation.
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Política de Saúde , Instituições Acadêmicas , Cobertura Vacinal , Vacinação , California/epidemiologia , Política de Saúde/legislação & jurisprudência , Instituições Acadêmicas/legislação & jurisprudência , Instituições Acadêmicas/provisão & distribuição , Vacinação/legislação & jurisprudência , Vacinação/estatística & dados numéricos , Humanos , Pré-Escolar , Cobertura Vacinal/legislação & jurisprudência , Cobertura Vacinal/estatística & dados numéricosAssuntos
Neoplasias Colorretais , Detecção Precoce de Câncer , Política de Saúde , Medicare , Idoso , Humanos , Colonoscopia , Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/normas , Detecção Precoce de Câncer/tendências , Programas de Rastreamento , Medicare/legislação & jurisprudência , Estados Unidos , Política de Saúde/legislação & jurisprudênciaRESUMO
Importance: Professional medical organizations recommend that adults receive routine postpartum care. Yet, some states restrict public insurance coverage for undocumented immigrants and recently documented immigrants (those who received legal documentation status within the past 5 years). Objective: To examine the association between public insurance coverage and postpartum care among low-income immigrants and the difference in receipt of postpartum care among immigrants relative to nonimmigrants. Design, Setting, and Participants: A pooled, cross-sectional analysis was conducted using data from the Pregnancy Risk Assessment Monitoring System for 19 states and New York City including low-income adults with a live birth between 2012 and 2019. Exposure: Giving birth in a state that offered public insurance coverage for postpartum care to recently documented or undocumented immigrants. Main Outcomes and Measures: Self-reported receipt of postpartum care by the category of coverage offered (full coverage: states that offered publicly funded postpartum care regardless of immigration status; moderate coverage: states that offered publicly funded postpartum care to lawfully residing immigrants without a 5-year waiting period, but did not offer postpartum care to undocumented immigrants; no coverage: states that did not offer publicly funded postpartum care to lawfully present immigrants before 5 years of legal residence or to undocumented immigrants). Results: The study included 72â¯981 low-income adults (20â¯971 immigrants [29%] and 52â¯010 nonimmigrants [71%]). Of the 19 included states and New York City, 6 offered full coverage, 9 offered moderate coverage, and 4 offered no coverage; 1 state (Oregon) switched from offering moderate coverage to offering full coverage. Compared with the states that offered full coverage, receipt of postpartum care among immigrants was 7.0-percentage-points lower (95% CI, -10.6 to -3.4 percentage points) in the states that offered moderate coverage and 11.3-percentage-points lower (95% CI, -13.9 to -8.8 percentage points) in the states that offered no coverage. The differences in the receipt of postpartum care among immigrants relative to nonimmigrants were also associated with the coverage categories. Compared with the states that offered full coverage, there was a 3.3-percentage-point larger difference (95% CI, -5.3 to -1.4 percentage points) in the states that offered moderate coverage and a 7.7-percentage-point larger difference (95% CI, -10.3 to -5.0 percentage points) in the states that offered no coverage. Conclusions and Relevance: Compared with states without insurance restrictions, immigrants living in states with public insurance restrictions were less likely to receive postpartum care. Restricting public insurance coverage may be an important policy-driven barrier to receipt of recommended pregnancy care and improved maternal health among immigrants.
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Emigrantes e Imigrantes , Política de Saúde , Acesso aos Serviços de Saúde , Cobertura do Seguro , Medicaid , Cuidado Pós-Natal , Adulto , Feminino , Humanos , Gravidez , Estudos Transversais , Emigrantes e Imigrantes/legislação & jurisprudência , Emigrantes e Imigrantes/estatística & dados numéricos , Acesso aos Serviços de Saúde/legislação & jurisprudência , Acesso aos Serviços de Saúde/estatística & dados numéricos , Cobertura do Seguro/legislação & jurisprudência , Cobertura do Seguro/estatística & dados numéricos , Seguro Saúde/legislação & jurisprudência , Seguro Saúde/estatística & dados numéricos , Medicaid/legislação & jurisprudência , Medicaid/estatística & dados numéricos , Cuidado Pós-Natal/legislação & jurisprudência , Cuidado Pós-Natal/estatística & dados numéricos , Política Pública/legislação & jurisprudência , Estados Unidos/epidemiologia , Política de Saúde/legislação & jurisprudência , Pobreza/estatística & dados numéricos , Imigrantes Indocumentados/legislação & jurisprudência , Imigrantes Indocumentados/estatística & dados numéricosRESUMO
This Viewpoint details how and why improved oversight of private equity acquisition of physician practices and hospitals is needed to mitigate the effects on health care costs, clinicians' jobs, and patients' access to care.
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Atenção à Saúde , Equidade em Saúde , Política de Saúde , Setor Privado , Atenção à Saúde/legislação & jurisprudência , Atenção à Saúde/organização & administração , Equidade em Saúde/legislação & jurisprudência , Política de Saúde/legislação & jurisprudência , Setor Privado/legislação & jurisprudênciaRESUMO
OBJECTIVE: Government alcohol sales data were used to investigate associations between estimates of per capita age 15+ alcohol consumption, policy restrictiveness, and area-level deprivation. METHOD: We analyzed weekly consumption data (expressed as per capita age 15+ Canadian standard drinks [13.45 g of pure ethanol]) collected from all 89 local health areas in British Columbia, Canada, between April 2017 and April 2021. Our analyses were stratified by outlet type (total, on-premise, and off-premise). Our intervention was alcohol policy restrictiveness (operationalized by the Restrictiveness of Alcohol Policy Index), and our moderator was area-level deprivation (Canadian Index of Multiple Deprivation). The Restrictiveness of Alcohol Policy Index included hours of trading, the number of people permitted on site for on-premise venues, the proportion of outlets in operation, and the extent of permissible home delivery. RESULTS: Higher policy restrictiveness was associated with decreased consumption across all outlet types (ps < .001): when the most restrictive policies were implemented, consumption was reduced by 9% and 100% in off- and on-premise outlets, respectively. Area-based deprivation level modified the effect of policy restriction on per capita alcohol consumption (ps < .007): for total and off-premise consumption, the decrease was greatest among more economically deprived areas (ps < .001); for on-premise outlets, areas with a high proportion of racial and ethnic minorities increased their consumption (ps < .001). CONCLUSIONS: Alcohol-specific policy restrictions implemented in response to the COVID-19 pandemic were associated with reduced consumption. However, the magnitude and direction of change was moderated by area-based deprivation level, albeit inconsistently across various deprivation measures.
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Consumo de Bebidas Alcoólicas , COVID-19 , Comércio , Etanol , Política de Saúde , Quarentena , COVID-19/epidemiologia , Etanol/economia , Consumo de Bebidas Alcoólicas/economia , Consumo de Bebidas Alcoólicas/epidemiologia , Colúmbia Britânica/epidemiologia , Comércio/estatística & dados numéricos , Humanos , Adolescente , Adulto Jovem , Adulto , Quarentena/legislação & jurisprudência , Política de Saúde/legislação & jurisprudência , Pessoa de Meia-IdadeAssuntos
Prisioneiros , Prisões , Saúde Pública , Política Pública , Justiça Social , Humanos , Política de Saúde/legislação & jurisprudência , Prisioneiros/legislação & jurisprudência , Prisões/legislação & jurisprudência , Política Pública/legislação & jurisprudência , Saúde Pública/legislação & jurisprudênciaRESUMO
BACKGROUND: In February 2022, Massachusetts rescinded a statewide universal masking policy in public schools, and many Massachusetts school districts lifted masking requirements during the subsequent weeks. In the greater Boston area, only two school districts - the Boston and neighboring Chelsea districts - sustained masking requirements through June 2022. The staggered lifting of masking requirements provided an opportunity to examine the effect of universal masking policies on the incidence of coronavirus disease 2019 (Covid-19) in schools. METHODS: We used a difference-in-differences analysis for staggered policy implementation to compare the incidence of Covid-19 among students and staff in school districts in the greater Boston area that lifted masking requirements with the incidence in districts that sustained masking requirements during the 2021-2022 school year. Characteristics of the school districts were also compared. RESULTS: Before the statewide masking policy was rescinded, trends in the incidence of Covid-19 were similar across school districts. During the 15 weeks after the statewide masking policy was rescinded, the lifting of masking requirements was associated with an additional 44.9 cases per 1000 students and staff (95% confidence interval, 32.6 to 57.1), which corresponded to an estimated 11,901 cases and to 29.4% of the cases in all districts during that time. Districts that chose to sustain masking requirements longer tended to have school buildings that were older and in worse condition and to have more students per classroom than districts that chose to lift masking requirements earlier. In addition, these districts had higher percentages of low-income students, students with disabilities, and students who were English-language learners, as well as higher percentages of Black and Latinx students and staff. Our results support universal masking as an important strategy for reducing Covid-19 incidence in schools and loss of in-person school days. As such, we believe that universal masking may be especially useful for mitigating effects of structural racism in schools, including potential deepening of educational inequities. CONCLUSIONS: Among school districts in the greater Boston area, the lifting of masking requirements was associated with an additional 44.9 Covid-19 cases per 1000 students and staff during the 15 weeks after the statewide masking policy was rescinded.