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Objectives: The COVID-19 pandemic has propelled the use of technology for health care services delivery. Because of inequities in health care and technology access, we investigated the use of telehealth services among racial and ethnic minority groups before and during the COVID-19 pandemic. Methods: For this retrospective study, we examined the electronic health records of privately insured patients in the Healthjump database, provided by the COVID-19 Research Database Consortium. We examined 17.98 million unique visit records of 2.93 million patients from March through December 2019 and 22.17 million records of 3.55 million patients from March through December 2020. We conducted a descriptive analysis and used multiple logistic regression to examine differences in the use of telehealth services among 3 racial and ethnic groups: non-Hispanic White, non-Hispanic Black, and Hispanic people. Results: Telehealth visits before and during COVID-19 accounted for 8.3% and 10.9% of total visits, respectively, with a peak of 15.5% in April 2020. Pre–COVID-19, Hispanic patients had a significantly lower monthly utilization rate (5.3%) than non-Hispanic White patients (8.4%, P <.001) and non-Hispanic Black patients (10.4%, P =.001). During the pandemic study period, Hispanic patients were 41% less likely than non-Hispanic White patients to have a telehealth visit, controlling for age and sex. Conclusions: The likelihood of using telehealth was lower among Hispanic patients than among non-Hispanic White and non-Hispanic Black patients during the pandemic. Culturally sensitive measures are needed to support telehealth use among the Hispanic population. [ABSTRACT FROM AUTHOR]

Background: Maternal and child health (MCH) hospitals play an essential role in providing MCH services in China, while the supply has become increasingly challenging in the past decade, especially among secondary MCH hospitals. In this study we aimed to evaluate the technical efficiency (TE) of secondary MCH hospitals in Hubei province (China) to generate evidence-based decision-making for efficiency improvement. Methods: The data were collected from the Department of Maternal and Child Health of Health Commission of Hubei Province in 2019. A total of 59 out of 74 secondary MCH hospitals were included as our study sample. Four input indicators (number of health professionals, number of beds, number of equipment with value greater than 10,000 RMB Yuan, building area for hospital operations) and three output indicators (number of total diagnostic patients, number of discharged patients, and number of birth deliveries) were selected based on previous literature. TE scores of the sample hospitals were estimated by using Bootstrap-Data Envelopment Analysis (Bootstrap-DEA). Results: After bias-correction with Bootstrap-DEA model, the average TE score of the MCH hospitals was 0.673. 20 (33.89%) MCH hospitals had TE scores below the average. No MCH hospitals achieved excellent efficiency; 16 (27.11%) MCH hospitals reached good efficiency; and 26 (44.06%) MCH hospitals fell into poor and failing efficiency. Besides, 17 MCH hospitals had TE scores of 1 before bias-corrections, while none of them reached 1 after bias correction. Conclusions: Significant capacity variations existed among the secondary MCH hospitals in terms of input and output indicators and their overall TE was low in Hubei of China. For better improvement, the secondary MCH hospitals in Hubei need to improve their internal management and strengthen the construction of their information systems. A series of policy supports are needed from the health and insurance administrations to optimize health resources. Third-party performance evaluation can be piloted to improve efficiency and overall performance of the MCH hospitals. The policy recommendations we raise for MCH hospitals in Hubei can be worth learning for some low- and middle- income countries. [ABSTRACT FROM AUTHOR]

Purpose: A significant body of research indicates that the conflict environment is detrimental to the quality of life and well-being of civilians. This study assesses the health-related quality of life, stress, and insecurity of the West Bank, which has been engaged in conflict for seven decades, in comparison to a demographically and culturally similar population in Jordan, a neighboring nation with no conflict. We expect the Jordanian sample to report better functioning.Methods: We collected 793 surveys from university students (mean age = 20.2) in Nablus, West Bank (398 [50.2%]) and Irbid, Jordan (395 [49.8%]). The survey instrument consisted of the SF-36 to measure HRQoL, the PSS-4 to measure stress, and an insecurity scale, along with demographic characteristics.Results: Our findings indicate that outcomes in the West Bank were not significantly worse than in Jordan, and in some cases represented better functioning, especially in the SF-36 measures.Conclusions: Our counterintuitive results suggest that health and well-being outcomes are dependent on many factors in addition to conflict. For one, it may be that the better perceived health and well-being of the Palestinians is because they have developed a culture of resilience. Additionally, Jordanians are undergoing a period of instability due to internal struggles and surrounding conflicts. [ABSTRACT FROM AUTHOR]

EXECUTIVE SUMMARY: Medicare's Hospital Valued-Based Purchasing (HVBP) program measures hospitals' total performance score (TPS); its measurement strategies have changed regularly since its rollout in 2013. Because the program influences care delivery, it is important to examine how the policy has changed hospitals' behavior and how it may inform future policies. The purpose of this study was to assess the relationship between hospitals' performance on TPS annually from 2013 to 2018 and organizational characteristics. Using the HVBP TPS from 2013 to 2018 and associated hospital characteristics—hospital size, teaching hospital status, system membership, ownership type, urban/rural location, average percentages of patients from Medicare and Medicaid, operating margins, percentages of inpatient revenue as a proportion of total revenue, and case mix index—we conducted a retrospective cohort study of all U.S. hospitals participating in the HVBP program. Regression and panel analyses found that organizations that were expected to have robust and rigid resources were unable to score in the superior category consistently. In addition, organizations were unable to consistently perform positively over time because of changes in the HVBP program measurement and the required organizational responses. Policymakers should consider the ability of organizations to respond to changes to the HVBP program. Likewise, healthcare managers, particularly those in larger organizations, should seek to remove bureaucracy or allow for greater resource slack to meet these changes. [ABSTRACT FROM AUTHOR]

The objective of this study is to explore the relationship between hospitals Health Information Technology (HIT), and financial and quality performance. The study merged the 2017 Centers for Medicare & Medicaid Services (CMS) Healthcare Cost Report Information System, American Hospital Association Annual Survey, and two CMS Hospital Compare datasets. A total of 3002 hospitals were analyzed using multivariate analysis. We found that hospitals with laboratory tracking systems reported better financial performance on five financial performance measures. Policymakers should consider developing policies that facilitate exploration and adoption of various hospital HIT capabilities that measurably improves hospital quality of care. [ABSTRACT FROM AUTHOR]