Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-5 (of 5 Records) |
Query Trace: Ashman JJ[original query] |
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QuickStats: Percentage of emergency department visits* with Medicaid as the primary expected source of payment among persons aged <65 years, by race and ethnicity(†) - National Hospital Ambulatory Medical Care Survey, United States, 2011-2021
Santo L , Schappert SM , Ashman JJ . MMWR Morb Mortal Wkly Rep 2023 72 (31) 853 During 2011–2021, the percentage of ED visits among persons aged <65 years with Medicaid as the primary expected source of payment increased from 34.0% to 45.3%. This pattern was consistent irrespective of race and Hispanic or Latino (Hispanic) origin. ED visits among Hispanic persons increased the most, from 46.3% in 2011 to 62.7% in 2021. The percentage of ED visits among persons with Medicaid as their primary expected source of payment increased from 40.9% in 2011 to 53.4% in 2021 among Black or African American (Black) persons, and from 27.8% to 35.5% among White persons. During the study period, the percentages of ED visits by Black and Hispanic persons with Medicaid as the primary expected source of payment were higher than the percentages of visits by White persons. |
NHAMCS has been a trusted source of data for healthcare disparities research since 1992
Schappert SM , Santo L , Ward BW , Ashman JJ , DeFrances CJ . Public Health Nurs 2023 40 (6) 811-812 The National Center for Health Statistics (NCHS) conducts the National Hospital Ambulatory Medical Care Survey (NHAMCS), a national probability sample survey of visits to U.S. hospital emergency departments (EDs). NCHS staff recently became aware of a Brief Report published in the July 2022 issue of Public Health Nursing (Marye, 2022) which claimed that healthcare disparities research was limited with NHAMCS data; however, the report included inaccuracies about the survey and its data that should be clarified. NHAMCS has been conducted annually since 1992 and has been used for decades to understand the provision of ambulatory medical care at hospitals, as well as disparities in this care. A brief search in the PubMed® database returns hundreds of peer-reviewed research manuscripts using NHAMCS data, with at least 40 focusing on healthcare disparities. Furthermore, NHAMCS continues to be used in various U.S. government reports that focus on health care and health disparities (Agency for Healthcare Research and Quality, 2022; National Center for Health Statistics, 2023). |
Antineoplastic drugs prescription during visits by adult cancer patients with comorbidities: findings from the 2010-2016 National Ambulatory Medical Care Survey
Santo L , Ward BW , Rui P , Ashman JJ . Cancer Causes Control 2020 31 (4) 353-363 PURPOSE: Cancer treatment may be affected by comorbidities; however, studies are limited. The purpose of this study is to examine the frequency of comorbidities at visits by patients with breast, prostate, colorectal, and lung cancer and to estimate frequency of a prescription for antineoplastic drugs being included in the treatment received at visits by patients with cancer and concomitant comorbidities. METHODS: We used nationally representative data on visits to office-based physicians from the 2010-2016 National Ambulatory Medical Care Survey and selected visits by adults with breast, prostate, colorectal, or lung cancer (n = 4,672). Nineteen comorbid conditions were examined. Descriptive statistics were calculated for visits by cancer patients with 0, 1, and >/= 2 comorbidities. RESULTS: From 2010-2016, a total of 10.2 million physician office visits were made annually by adult patients with breast, prostate, colorectal, or lung cancer. Among US visits by adult patients with breast, prostate, colorectal, or lung cancer, 56.3% were by patients with >/= 1 comorbidity. Hypertension was the most frequently observed comorbidity (37.7%), followed by hyperlipidemia (19.0%) and diabetes (12.3%). Antineoplastic drugs were prescribed in 33.5% of the visits and prescribed at a lower percentage among visits by cancer patients with COPD (21.3% versus 34.3% of visits by cancer patients without COPD) and heart disease (22.7% versus 34.2% of visits by cancer patients without heart disease). CONCLUSION: Our study provides information about comorbidities in cancer patients being treated by office-based physicians in an ambulatory setting. |
Multiple chronic conditions among US adults who visited physician offices: data from the National Ambulatory Medical Care Survey, 2009
Ashman JJ , Beresovsky V . Prev Chronic Dis 2013 10 E64 Most research on adults with chronic conditions focuses on a single disease or condition, such as hypertension or diabetes, rather than on multiple chronic conditions (MCC). Our study's objective was to compare physician office visits by adults with MCC with visits by adults without MCC, by selected patient demographic characteristics. We also identified the most prevalent dyads and triads of chronic conditions among these patients. We used the National Ambulatory Medical Care Survey, a nationally representative survey of office visits to nonfederal physicians and used 13 of the 20 conditions defined by the National Strategic Framework on Multiple Chronic Conditions. Descriptive estimates were generated and significant differences were tested. In 2009, an estimated 326 million physician office visits, were made by adults aged 18 years or older with MCC representing 37.6% of all medical office visits by adults. Hypertension was the most prevalent chronic condition that appeared in the top 5 MCC dyads and triads, by sex and age groups. The number of visits by patients with MCC increased with age and was greater for men than for women and for adults with public rather than private insurance. Physicians were more likely to prescribe medications at office visits made by patients with MCC. Physician office visits by adults with MCC were not evenly distributed by demographic characteristics. |
Primary health care in community health centers and comparison with office-based practice
Hing E , Hooker RS , Ashman JJ . J Community Health 2010 36 (3) 406-13 We examine the roles of nurse practitioners (NPs), physician assistants (PAs), and nurse midwives (CNMs) in community health centers (CHCs). We also compare primary care physicians in CHCs with office-based physicians. Estimates are from the National Ambulatory Medical Care Survey, a nationally representative annual survey of nonfederal, office-based patient care physicians and their visits. Analysis of primary care delivery in CHCs and office-based practices are based on 1,434 providers and their visits (n = 32,300). During 2006-2007, on average, physicians comprised 70% of CHC clinicians, with NPs (20%), PAs (9%), and CNMs (1%) making up the remainder. PAs, NPs, and CNMs provided care in almost a third of CHC primary care visits; 87% of visits to these CHC providers were independent of physicians. Types of patients seen by clinicians suggest a division of labor in caring for CHC patients. NPs and PAs were more likely than physicians to report providing health education services. There were no other differences among services examined. Office-based physicians were less likely to work alongside PAs/NPs/CNMs than CHC physicians. CHC staffing is contingent on a variety of providers. CHC staffing patterns may serve as models of primary care staffing for office practices as demand for primary care services nationwide increases. |
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