Rytterstraarup8749

This study aims to evaluate the impact of war on Syrian refugees' life in Bekaa/Lebanon, focusing on psychological and physical symptoms, and to assess the prevalence of the most common symptoms of posttraumatic stress disorder (PTSD) in affected patients recruited in the study.

This observational study was conducted over a period of 1 month-June 2019-in three main camps in the Bekaa region. After taking approval, a total number of 108 Syrian refugees were interviewed and asked about their quality of life and health conditions in camps, after leaving their country. A validated questionnaire was filled by field researchers to gather information on refugees' psychological distresses, physical symptoms, and future perspective.

During the 4 weeks of study, 108 refugees completed the questionnaire; psychological assessment showed 73.8% of refugees who were exposed to the fighting atmosphere, suffered from one or more psychological symptoms related to PTSD. In addition, 50.5% of the refugees were <30 years old, and among those, 83.5% believed that they have no future for themselves and their families, while 15.4% lost hope in a better life. Seventy-four percent reported at least one physical symptom in the past 4 weeks that is related to PTSD. Furthermore, 64.3% strongly agreed that there is lack of awareness and medical care including psychological and mental health, while 56.1% strongly agreed on the important role of pharmacists and other healthcare professionals in providing advice to patients on their overall health and mental health.

Syrian refugees at the assessed camps suffered from psychological distress that requires urgent attention. Current medical and psychological support is absent, and further assessment is needed.

Syrian refugees at the assessed camps suffered from psychological distress that requires urgent attention. Current medical and psychological support is absent, and further assessment is needed.

Independent freestanding emergency departments (IFEDs) have proliferated over the last decade, largely in Texas. We examined the IFED physician workforce composition and changes in emergency physician workforce supply across states and in rural Texas over the period of IFED proliferation following a 2009 legislation allowing the licensing of these sites.

IFED websites, Texas Medical Board lookup tool, National Plan & Provider Enumeration System (NPPES), Provider Enrollment and Chain/Ownership System (PECOS), Medicare Physician Shared Patient Patterns, CareSet DocGraph Hop Teaming, Healthcare Provider Database.

Descriptive analysis of the IFED physician workforce; quasi-experimental difference-in-difference analysis of Texas emergency physician movement into and out of the state; and difference-in-difference-in-difference analysis of the change in emergency physician supply between rural and urban areas in Texas compared with other states.

Using the NPIs obtained through Texas IFED websites and Texnderserved workforce and access challenges.

New models of health care organizations such as IFEDs have workforce implications that may further exacerbate rural and underserved workforce and access challenges.

To provide the first plausibly causal national estimates of health outcomes for older dual-eligible recipients of Medicaid HCBS relative to nursing home care and to explore possible mechanisms for the effect.

We use 2005 and 2012 Medicaid Analytic eXtract (MAX), a national compilation of Medicaid claims, merged with Medicare claims to identify hospital admissions, our main outcome variable.

We model the effects of HCBS using a longitudinal instrumental variables framework. To address the endogeneity of HCBS receipt, we instrument for it using the county percentage of nonelderly long-term care users who receive HCBS. VX-770 supplier The percentage of nonelderly users is highly predictive of HCBS use for an elderly beneficiary, but because the instrument was derived from a separate population, the exclusion restriction is unlikely to be violated.

1,312,498 older adults (65+) dually enrolled in Medicaid and Medicare and are using long-term care. We also examine heterogeneity of effects by race/ethnicity and the presence to HCBS, while well-motivated, results in the unintended consequence of substantially higher hospitalization rates for older dual eligibles. The quality and/or quantity of services may be inadequate for some HCBS recipients. Hospitalizations are costly to Medicare but also to the HCBS recipient in terms of stress and risks. Although consumer preferences to remain at home may outweigh poor outcomes of HCBS, the full costs and benefits need to be considered. HCBS outcomes-not just expansion-need more attention.

To describe the cost of using evidence-based implementation strategies for sustained behavioral health integration (BHI) involving population-based screening, assessment, and identification at 25 primary care sites of Kaiser Permanente Washington (2015-2018).

Project records, surveys, Bureau of Labor Statistics compensation data.

Labor and nonlabor costs incurred by three implementation strategies practice coaching, electronic health records clinical decision support, and performance feedback.

Personnel time spent on these strategies was estimated for five broad roles (a) project leaders and administrative support, (b) practice coaches, (c) clinical decision support programmers, (d) performance metric programmers, and (e) primary care local implementation team members.

Implementation involved 286 persons, 18131 person-hours, costing $1587139 or $5 per primary care visit with screening or $38 per primary care visit identifying depression, suicidal thoughts and/or alcohol or substance use disorders, in a single year. The majority of person-hours was devoted to project leadership (35%) and practice coaches (34%), and 36% of costs were for the first three sites.

When spread across patients screened in a single year, BHI implementation costs were well within the range for commonly used diagnostic assessments in primary care (eg, laboratory tests). This suggests that implementation costs alone should not be a substantial barrier to population-based BHI.

When spread across patients screened in a single year, BHI implementation costs were well within the range for commonly used diagnostic assessments in primary care (eg, laboratory tests). This suggests that implementation costs alone should not be a substantial barrier to population-based BHI.