Lifetime prevalence of prescription opioid misuse was 9.5%. Misusers of prescription opioid drugs generally reported lower ratings of perceived harm as compared to individuals not reporting misuse of prescription opioid drugs. Primary reasons for misuse of prescription opioid drugs was to relieve pain (33.9%), "to feel good/get high" (23.2%) and experimentation (21.4%). Lifetime misuse of a prescription opioid drug for physical or emotional pain was reported by 8.1% and 2.2% of respondents, respectively. Primary reasons for misuse for physical pain included because pain was temporary, immediate relief was needed, and no health insurance/financial resources. Primary reasons for misuse for emotional pain included not wanting others to find out, embarrassment and fear. Conclusions/Importance: Reasons for misuse of prescription opioid drugs vary by type of prescription opioid drug. Reasons for not seeking treatment that ultimately lead to misuse, vary by type of pain being treated and may be important considerations in the effort to stem the misuse of prescription opioid drugs among college students.
BackgroundThe Patient Protection and Affordable Care Act established the Hospital Readmission Reduction Program (HRRP) to penalize hospitals with excessive 30-day hospital readmissions of Medicare enrollees for specific conditions. This policy was aimed at increasing the quality of care delivered to patients and decreasing the amount of money paid for potentially preventable hospital readmissions. While it has been established that the number of 30-day hospital readmissions decreased after program implementation, it is unknown whether this effect occurred equally between not-for-profit and proprietary hospitals. The aim of this study was to determine whether or not the HRRP decreased readmission rates equally between not-for-profit and proprietary hospitals between 2010 and 2012.MethodsData on readmissions came from the Dartmouth Atlas and hospital ownership data came from the Centers for Medicare and Medicaid Services. Data were joined using the Medicare provider number. Using a difference-in-differences approach, bivariate and regression analyses were conducted to compare readmission rates between not-for-profit and proprietary hospitals between 2010 and 2012 and were adjusted for hospital characteristics.ResultsIn 2010, prior to program implementation, unadjusted readmission rates for proprietary and not-for-profit hospitals were 16.16% and 15.78%, respectively. In 2012, following program implementation, 30-day readmission rates dropped to 15.76% and 15.29% for proprietary and not-for-profit hospitals. The data suggest that the implementation of the Hospital Readmission Reduction Program had similar effects on not-for-profit and proprietary hospitals with respect to readmission rates, even after adjusting for confounders.ConclusionsAlthough not-for-profit hospitals had lower 30-day readmission rates than proprietary hospitals in both 2010 and 2012, they both decreased after the implementation of the HRRP and the decreases were not statistically significantly different. Thus, this study suggests that the Hospital Readmission Reduction Program was equally effective in reducing readmission rates, despite ownership status.
BackgroundThe Title X family planning program provides affordable access to a range of sexual and reproductive health services, with a priority for low-income people. The disproportionate burden of unintended pregnancy, breast and cervical cancer, and sexually transmitted diseases among minority groups, teens, and young adults in the US underscore the need for affordable access to such services. However, increased access to sexual and reproductive health services, resulting from the Affordable Care Act (ACA) create questions regarding the continued need for this program.MethodsA study was conducted to assess clients’ perceptions of Title X-funded family planning clinics and their preferences for these clinics for a range of sexual and reproductive health services. An anonymous, self-administered, paper-and-pencil survey was administered to 696 clients who received services from one of eight Title X-funded family planning clinics in Northeast Ohio.ResultsThe majority of participants stated very positive perceptions of the Title X-funded clinics; that they “Always” go to the Title X-funded clinic for birth control, STD/HIV testing, and pregnancy testing; and that the Title X-funded clinic was their regular source of health care. Females were more likely than males to prefer the Title X clinic for birth control, physical exams, pregnancy testing, and health information and more teens under the age of 18 preferred to use the Title X clinic for STD/HIV testing, physical exams, pregnancy testing, and health information.ConclusionsFindings indicate that these Title X-funded family planning clinics successfully reached populations in need of sexual and reproductive health services and suggest that these facilities can help play an important role in reducing disparities even after full implementation of the Affordable Care Act. However, more research is needed to fully quantify the need and value of Title X-funded family planning clinics and its relation to the changing health care environment in the US.
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