Suchergebnisse

To determine if the Centers for Medicare and Medicaid Services Hospital Readmission Reduction Program reduced hospital discharges for penalized conditions in minority and low-income communities, we used hospital discharge data for 2006 and 2013 from Arizona, California, Colorado, Florida, New Jersey, New York, North Carolina, and Wisconsin and readmission data from the Medicare Hospital Compare website. Negative binomial regression was used for 6,564 zip codes for each year to estimate the association between the expected penalty for an excess readmission in the hospital service area and the number of hospital discharges for penalized conditions (acute myocardial infarction, congestive heart failure, and pneumonia) for zip codes. The results showed that the expected penalty for excess readmissions had a negative association with the number of discharges for acute myocardial infarction, congestive heart failure, and pneumonia. The negative association increased with the percentage of minority residents but not with the poverty rate.

Abstract
Background
COVID-19 pandemic has immensely impacted the social and personal lives of individuals around the globe. Marginalized-related diminished returns (MDRs) theory suggests that educational attainment shows a weaker protective effect for health and behavioral outcomes for Black individuals compared to White individuals. Previous studies conducted before the COVID-19 pandemic demonstrated diminished returns of educational attainment for Black individuals compared to White individuals.

Objectives
The study has three objectives: First, to test the association between educational attainment and cigarette smoking, e-cigarette vaping, presence of chronic medical conditions (CMC), self-rated health (SRH), depressive symptoms, and obesity; second, to explore racial differences in these associations in the USA during the COVID-19 pandemic; and third, to compare the interaction of race and return of educational attainment pre- and post-COVID-19 pandemic.

Methods
This study utilized data from the Health Information National Trends Survey (HINTS) 2020. Total sample included 1313 adult American; among them, 77.4% (n = 1017) were non-Hispanic White, and 22.6% (n = 296) were non-Hispanic Black. Educational attainment was the independent variable operationalized as years of education. The main outcomes were cigarette smoking, e-cigarette vaping, CMC, SRH, depressive symptoms, and obesity. Age, gender, and baseline physical health were covariates. Race/ethnicity was an effect modifier.

Results
Educational attainment was significantly associated with lower CMC, SRH, depressive symptoms, obesity, cigarette smoking, and e-cigarette vaping. Educational attainment did not show a significant interaction with race on any of our outcomes, suggesting that the health returns of education is similar between non-Hispanic White and non-Hispanic Black individuals.

Conclusion
COVID-19 may have operated as an equalizer of the returns of educational attainment. This observation may be because White may have more to lose; Black communities may be more resilient or have economic and social policies that buffered unemployment and poverty regardless of historical anti-Black oppression.

Abstract
Background
Educational attainment has been linked to reduced risk of health problems such as obesity, but research suggests that this effect may be weaker for non-Hispanic Black individuals compared to non-Hispanic White individuals, a pattern known as minorities' diminished returns (MDRs).

Objectives
This study is aimed at examining the differential association between educational attainment and sustained high body mass index (BMI) among non-Hispanic Black and non-Hispanic White middle-aged and older adults in the USA.

Methods
Using data from the Health and Retirement Study (HRS) spanning 1992–2016, we analyzed a national sample of 35,110 individuals, including 7766 non-Hispanic Black and 27,344 non-Hispanic White individuals. We used logistic regression models to examine the relationship between educational attainment, race, and sustained high BMI, while controlling for age, sex, and marital status at baseline.

Results
Approximately 30.6% of the sample (n = 10,727) had sustained high BMI, while 69.4% (n = 24,383) had sustained low BMI over the period of follow-up. Higher levels of educational attainment were associated with a lower risk of sustained high BMI. We also found, however, that the protective effects of education against sustained high BMI were weaker for non-Hispanic Blacks compared to non-Hispanic Whites.

Conclusion
Our findings suggest that the protective effects of educational attainment against sustained high BMI may be more robust for non-Hispanic Whites than for non-Hispanic Blacks. Further research should explore whether these results are found in other racial and ethnic minorities and whether potential life history experiences may contribute to these disparities.

The aim of this study was to compare the cognitive disorders, processing emotional stimulants and mental reaction in patients with borderline personality disorder and normal individuals. The study was descriptive and scientific-comparative. The study population included all patients with borderline personality disorder who were referred to psychiatric clinics in Tabriz. Among this population, 50 patients with borderline personality disorder were matched with 50 healthy individuals from the general population of the city, who had no history of mental illness, and their demographic variables such as age, sex, educational level and marital status. They were selected by a random sampling technique and had completed the questionnaires on cognitive emotion regulation, mental reaction and the Wisconsin Card Test. In order to analyze the data, the multivariate analysis of variance (MANOVA) was performed with SPSS version 20. Results showed that there is a significant difference between the two groups in preservation error and total error components, as well as the positive and negative components of cognitive regulation, and also in mental reaction (p < 0.001). According to the findings, it can be said that better and more complete understanding of personality disorders, particularly borderline personality disorder, provides more effective and more specialized intervention in the treatment and prevention of recurrence in patients with this disorder.

Nonprofit hospitals provide charity care to financially disadvantaged patients according to their self-designed eligibility policies. The Affordable Care Act may have prompted nonprofit hospitals to adopt more generous eligibility policies, but no prior research has examined the longitudinal trend. The expansion of Medicaid coverage in many states has been found to reduce charity care provision, but it is unclear whether the change in charity care eligibility policies differed between Medicaid expansion and nonexpansion states. Using mandatory tax filings, we found that both hospitals in Medicaid expansion states and hospital in nonexpansion states adopted more generous eligibility policies in 2018 than in 2010, but the change was greater in the former for discounted charity care; while the former provided less charity care regardless of their policy changes, the latter provided more when their policies became more generous. This study has implications for policy discussions on the justification of nonprofit hospitals' tax-exempt status.