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For the last four decades, policymakers have attempted to control the United States's high health care costs by reducing patients' demand for care (e.g., by imposing managed-care restrictions or high costs on patients at the time of use). Yet studies based mostly on data from the public Medicare program, which covers mostly elderly Americans, suggest that supply (e.g., number of physicians or hospital beds) rather than demand drives aggregate service use and, hence, costs. Using variation between U.S. states in per enrollee Medicare spending versus per capita spending of all other (non-Medicare) individuals, we find that greater supply boosts costs for the entire population. Furthermore, we find that factors that suppress demand in the non-Medicare population do reduce non-Medicare health care spending, but simultaneously increase Medicare spending. This suggests that for a given supply of medical resources, suppressing demand for one group of patients may produce a compensatory increase in provision of care to those whose demand has not been suppressed. Health planning to assure adequate medical resources where they are needed while preventing excess supply where it is duplicative and wasteful is likely a more effective cost control strategy than the imposition of managed-care restrictions or imposing higher costs onto patients seeking care. [ABSTRACT FROM AUTHOR]

Rationale: Early-life exposures may precipitate asthma, but their contribution to disparities in asthma is less clear. Objective: To elucidate racial, ethnic, and socioeconomic status (SES) disparities in the age trajectory of asthma burden among U.S. children. Methods: We analyzed three datasets: 1) 2016–2021 National Children's Health Survey (n = 223,551), 2) 2015–2017 Child Asthma Call-Back Survey (n = 4,289), and 3) 2018–2019 National Inpatient Sample (n = 23,713 children with asthma). We examined cumulative asthma prevalence by individual year of age and children's race and ethnicity or SES (National Children's Health Survey); mean age at asthma diagnosis by race and ethnicity and SES, unadjusted and adjusted for confounders (Asthma Call-Back Survey); and asthma hospitalization rates overall and per child with asthma by individual year of age and race and ethnicity (National Inpatient Sample). Results: Among White children, cumulative asthma prevalence increases gradually through childhood to 6.6% at age 5 years and 16.1% by age 17 years. Prevalence increases more sharply in early childhood among Black children, reaching 17.6% at age 5 years (risk ratio, 2.6; 95% confidence interval, 1.9–3.8), but plateaus after age 9 years, with a consequent decrease in Black–White relative disparities into adolescence. Disparities according to SES follow a similar trajectory, emerging early and subsequently narrowing. Similarly, Black, Hispanic, and low-income children with asthma are diagnosed at an earlier age than White (or high-income) children. The asthma hospitalization rate increases in the first years of life among all children, but most rapidly among Black children, with a peak absolute Black–White gap at age 4 years; the relative gap remains wide throughout childhood and peaks at age 10 years. However, per child with asthma, relative White–Black disparities in hospitalizations increase through age 15 years. Conclusions: Disparities in asthma prevalence emerge in early childhood and then narrow, suggesting that reducing early-life adverse environmental exposures may be key to asthma prevention. Policies to improve the social determinants of health during gestation and childhood, e.g., environmental equity and family income support, are needed. [ABSTRACT FROM AUTHOR]

This study assesses changes in hospitals' capital assets after private equity acquisition. [ABSTRACT FROM AUTHOR]

A study published in the Annals of Internal Medicine analyzed data from the 2019 to 2022 National Health Interview Survey to examine the impact of the COVID-19 pandemic on asthma disparities in the United States. The study found that the pandemic led to a decrease in chronic airway disease exacerbations, which may have narrowed asthma disparities. However, there were still differences in asthma outcomes among racial and ethnic groups. The study suggests that further research is needed to understand the underlying factors contributing to these disparities. The data presented in the document shows that asthma prevalence, attacks, and emergency department visits vary among different racial and ethnic groups. Black children have higher asthma prevalence and attacks compared to White children, while there is no significant difference between White and Hispanic children. Hispanic children have higher asthma emergency department visits compared to White children. Among adults, asthma prevalence increased slightly among White adults, while Hispanic adults had the lowest prevalence and Black adults had the highest. Asthma attack rates decreased among Black adults, and asthma emergency department visit rates decreased among Black and White adults. Among children, asthma prevalence remained stable but was consistently highest among Black children. Asthma attack rates slightly decreased and then increased, particularly among White children. Overall, asthma emergency department visit rates decreased, primarily among Black and Hispanic children. The study suggests that there may be opportunities to address the factors contributing to asthma and its exacerbations. [Extracted from the article]