Quality of Care in the United States Territories, 1999–2012

Nuti, Sudhakar V.; Wang, Yun; Nuñez-Smith, Marcella; Normand, Sharon‐Lise T.; Murugiah, Karthik; Rodríguez-Vilá, Orlando; Ross, Joseph S.; Krumholz, Harlan M.

doi:10.1097/mlr.0000000000000797

Cited by 5 publications

(2 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…22 One study of Medicare benefi ciaries in U.S. territories found lower reimbursement for hospitalizations and higher 30-day mortality rates compared with Medicare benefi ciaries in the states. 14 Worse quality of care has also been reported when Hispanic Medicare benefi ciaries in Puerto Rico are compared with Hispanic Medicare benefi ciaries in the U.S. states. 15 Medicare enrollees in Puerto Rico are also more likely to report lower patient satisfaction.…”

Section: Discussionmentioning

confidence: 99%

Breast Cancer Screening in Puerto Rico and Other US Territories: Findings from the 2016 Behavioral Risk Factor Surveillance System Survey

López¹,

Miles²,

Flores³

et al. 2020

Journal of Health Care for the Poor and Underserved

View full text Add to dashboard Cite

Initial studies suggest that women living in U.S. territories may experience barriers to appropriate breast cancer diagnosis and treatment. Our purpose was to evaluate mammography screening engagement in U.S. territories compared with U.S. states. Women aged 50-74 years in the 2016 Behavioral Risk Factor Surveillance System survey without personal history of breast cancer were included. Proportions of women reporting mammography use were calculated. Multivariable logistic regression models were used to compare self-reported mammography use in U.S. territories with all U.S. states. Our total study population included 131,320 women. Of this group, 2,481 were from U.S. territories. In our adjusted analyses, women in the U.S. Virgin Islands were less likely to report mammography use (OR 0.52) compared with women in the U.S. states. Women in other U.S. territories reported mammography at similar rates to U.S. states. Targeted interventions accounting for unique, territory-specifi c barriers are likely required to improve screening engagement.

show abstract

Section: Discussionmentioning

confidence: 99%

Breast Cancer Screening in Puerto Rico and Other US Territories: Findings from the 2016 Behavioral Risk Factor Surveillance System Survey

López¹,

Miles²,

Flores³

et al. 2020

Journal of Health Care for the Poor and Underserved

View full text Add to dashboard Cite

show abstract

“…For this analysis, we excluded births from US territories because the healthcare systems in these areas likely differ from States and the District of Columbia in meaningful ways (n = 29,851) [17][18][19] (Fig 1). In an effort to isolate the effect of HCV on maternal health, we include records of women between the ages of 15-49 with a live birth following a first singleton pregnancy.…”

Section: Datamentioning

confidence: 99%

Maternal hepatitis C virus infection and three adverse maternal outcomes in the United States

Hood,

Miller,

Shoben

et al. 2023

PLoS ONE

View full text Add to dashboard Cite

Background Hepatitis Virus C (HCV) infection rates have trended upwards among pregnant people in the USA since 2009. Existing evidence about HCV infections and maternal outcomes is limited; therefore, we used birth certificate data to investigate the association between HCV infection and maternal health outcomes. Methods We used the 2017 US birth certificate dataset (a cross-section of 1.4 million birth records) to assess the association between prevalent HCV infection and gestational diabetes, gestational hypertension, and eclampsia. Potential confounding variables included prenatal care, age, education, smoking, presence of sexually transmitted infections (STIs), body mass index (BMI), and weight gain during pregnancy. We restricted our analysis to only women with a first singleton pregnancy. Odds ratios were estimated by logistic regression models and separate models were tested for white and Black women. Results Only 0.31% of the women in our sample were infected with HCV (n = 4412). In an unadjusted model, we observed a modest significant protective association between HCV infection and gestational diabetes (Odds ratio [OR]: 0.83; 95% CI: 0.76–0.96); but this was attenuated with adjustment for confounding variables (Adjusted odds ratio [AOR]: 0.88; 95% CI: 0.76, 1.02). There was no association between HCV and gestational hypertension (AOR: 1.03; 95% CI: 0.91, 1.16) or eclampsia (AOR: 1.15; 95% CI: 0.69, 1.93). Results from the race stratified models were similar to the non-stratified summary models. Conclusion We observed no statistically significant associations between maternal HCV infection with maternal health outcomes. Although, our analysis did indicate that HCV may lower the risk of gestational diabetes, this may be attributable to confounding. Studies utilizing more accurately measured HCV infection including those collecting type and timing of testing, and timing of infection are warranted to ensure HCV does not adversely impact maternal and/or fetal health. Particularly in the absence of recommended therapy for HCV during pregnancy.

show abstract