Health Policy
Social Needs Resource Connections: A Systematic Review of Barriers, Facilitators, and Evaluation
Healthcare organizations increasingly are screening patients for social needs (e.g., food, housing) and referring them to community resources. This systematic mixed studies review assesses how studies evaluate social needs resource connections and identifies patient- and caregiver-reported factors that may inhibit or facilitate resource connections.Permanent Supportive Housing With Housing First: Findings From a Community Guide Systematic Economic Review
The annual economic burden of chronic homelessness in the U.S. is estimated to be as high as $3.4 billion. The Permanent Supportive Housing with Housing First (Housing First) program, implemented to address the problem, has been shown to be effective. This paper examines the economic cost and benefit of Housing First Programs.Preventing Leading Causes of Death: Systematic Review of Cost-Utility Literature
Heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke are the 5 leading causes of death in the U.S. The objective of this review is to examine the economic value of prevention interventions addressing these 5 conditions.A Systematic Review of the Roles and Contributions of Peer Providers in the Behavioral Health Workforce
Peer providers with lived experiences of mental health and substance use are a growing component of the workforce responsible for the prevention and treatment of behavioral health disorders. This systematic literature review aims to better define the roles of peers and their unique contributions to behavioral health care.Paid Sick Leave and Healthcare Utilization in Adults: A Systematic Review and Meta-analysis
The U.S. is the only industrialized country in the world with no national policy mandating paid sick leave for workers. This study systematically reviews and quantifies the impact of paid sick leave on the use of healthcare services among employed adults.Assessing Rural Health Coalitions Using the Public Health Logic Model: A Systematic Review
Rural communities face unique challenges including fewer healthcare providers and restricted access to nutritious foods, likely leading to poor health outcomes. Community health coalitions are groups of local organizations partnering to address local health needs. Employing such coalitions is one strategy for implementing policy–system–environment changes for improving rural health. However, their success is variable without standardized evaluation. In this review, rural community health coalitions were retrospectively assessed using the W.K.Impact of the Affordable Care Act on Colorectal Cancer Outcomes: A Systematic Review
The Patient Protection and Affordable Care Act increases healthcare access and includes provisions that directly impact access to and cost of evidence-based colorectal cancer screening. The Affordable Care Act's removal of cost sharing for colorectal cancer screening as well as Medicaid expansion have been hypothesized to increase screening and improve other health outcomes. However, since its passage in 2010, there is little consensus on the Affordable Care Act's impact.Economics of Community Health Workers for Chronic Disease: Findings From Community Guide Systematic Reviews
Cardiovascular disease in the U.S. accounted for healthcare cost and productivity losses of $330 billion in 2013–2014 and diabetes accounted for $327 billion in 2017. The impact is disproportionate on minority and low-SES populations. This paper examines the available evidence on cost, economic benefit, and cost effectiveness of interventions that engage community health workers to prevent cardiovascular disease, prevent type 2 diabetes, and manage type 2 diabetes.Immunization Coverage of Children in Care of the Child Welfare System in High-Income Countries: A Systematic Review
Children in care of the child welfare system tend to underutilize preventive health services compared with other children. The purpose of this systematic review was to assess current knowledge regarding immunization coverage levels for children in the child welfare system and to determine barriers and supports to them utilizing immunization services.A Systematic Review of Interventions on Patients’ Social and Economic Needs
Healthcare systems are experimenting increasingly with interventions to address patients’ social and economic needs. This systematic review examines how often and how rigorously interventions bridging social and medical care have been evaluated.Evaluation of School-Based Dental Sealant Programs: An Updated Community Guide Systematic Economic Review
A recently updated Community Guide systematic review of the effectiveness of school sealant programs (SSPs) still found strong evidence that SSPs reduced dental caries among schoolchildren. This follow-up systematic review updates SSP cost and benefit information from the original 2002 review.Challenges in Assessing Mobile Health App Quality: A Systematic Review of Prevalent and Innovative Methods
Mobile apps are poised to become a major source of health guidance; however, concerns about their quality and safety remain. Governments, clinicians, and health researchers are struggling to determine how to adequately evaluate the content and function of mobile health apps to guide consumers toward apps that will effectively and safely support their health. Researchers are both adapting existing research methods, such as those for systematic reviews, and exploring novel methods toward this aim.School-Based Health Centers to Advance Health Equity: A Community Guide Systematic Review
Children from low-income and racial or ethnic minority populations in the U.S. are less likely to have a conventional source of medical care and more likely to develop chronic health problems than are more-affluent and non-Hispanic white children. They are more often chronically stressed, tired, and hungry, and more likely to have impaired vision and hearing—obstacles to lifetime educational achievement and predictors of adult morbidity and premature mortality. If school-based health centers (SBHCs) can overcome educational obstacles and increase receipt of needed medical services in disadvantaged populations, they can advance health equity.Economic Evaluation of School-Based Health Centers: A Community Guide Systematic Review
A recent Community Guide systematic review of effectiveness of school-based health centers (SBHCs) showed that SBHCs improved educational and health outcomes. This review evaluates the economic cost and benefit of SBHCs.Economic Evaluation of Community Water Fluoridation: A Community Guide Systematic Review
A recently updated Community Guide systematic review of the effectiveness of community water fluoridation once again found evidence that it reduces dental caries. Although community water fluoridation was found to save money in a 2002 Community Guide systematic review, the conclusion was based on studies conducted before 1995. Given the update to the effectiveness review, re-examination of the benefit and cost of community water fluoridation is necessary.Obesity-Related Policy/Environmental Interventions: A Systematic Review of Economic Analyses
Policy and environmental changes to support and encourage individual-level nutrition and physical activity behavior are underway in many parts of the U.S. and around the world at national, state, and local levels. Yet, to the authors’ knowledge, no summary of the cost-benefit or cost-effectiveness studies of obesity-related policy/environmental interventions exists.Value of Post-Licensure Data on Benefits and Risks of Vaccination to Inform Vaccine Policy: The Example of Rotavirus Vaccines
In 1999, the first rhesus-human reassortant rotavirus vaccine licensed in the U.S. was withdrawn within a year of its introduction after it was linked with intussusception at a rate of ~1 excess case per 10,000 vaccinated infants. While clinical trials of 60,000–70,000 infants of each of the two current live oral rotavirus vaccines, RotaTeq (RV5) and Rotarix (RV1), did not find an association with intussusception, post-licensure studies have documented a risk in several high and middle income countries, at a rate of ~1–6 excess cases per 100,000 vaccinated infants.Precision Public Health for the Era of Precision Medicine
The Precision Medicine Initiative1 promises a new healthcare era. A proposed 1 million−person cohort could create a deeper understanding of disease causation. Improvements in quality of sequencing, reduction in price, and advances in “omic” fields and biotechnology promise a new era, variably labeled personalized or precision medicine. Although genomics is one driver of precision health care, other factors may be as important (e.g., health information technology).Cost-Utility Analysis of Cancer Prevention, Treatment, and Control: A Systematic Review
Substantial innovation related to cancer prevention and treatment has occurred in recent decades. However, these innovations have often come at a significant cost. Cost-utility analysis provides a useful framework to assess if the benefits from innovation are worth the additional cost. This systematic review on published cost-utility analyses related to cancer care is from 1988 through 2013. Analyses were conducted in 2013–2015.Client and Provider Perspectives on Quality of Care: A Systematic Review
A central premise of the literature on healthcare quality is that improving the quality of care will lead to improvements in health outcomes. A systematic review was conducted to better inform quality improvement efforts in the area of family planning. The objective of this systematic review is to update a previous review focused on the quality of family planning services, namely, the impact of quality improvement efforts and client perspectives about what constitutes quality family planning services.Modeling the Cost Effectiveness of Child Care Policy Changes in the U.S.
Child care facilities influence diet and physical activity, making them ideal obesity prevention settings. The purpose of this study is to quantify the health and economic impacts of a multi-component regulatory obesity policy intervention in licensed U.S. child care facilities.Economics of Mass Media Health Campaigns with Health-Related Product Distribution: A Community Guide Systematic Review
The objective of this systematic review was to determine the costs, benefits, and overall economic value of communication campaigns that included mass media and distribution of specified health-related products at reduced price or free of charge.The Role of Physicians in Promoting Healthier Built Environments
The normal physician treats the problem; the good physician treats the person; the best physician treats the community. —Chinese proverbFinancial Policy Issues for HIV Pre-Exposure Prophylaxis: Cost and Access to Insurance
The costs and access issues related to pre-exposure prophylaxis (PrEP) for HIV prevention have not been adequately explored in health services research or in health policy circles. The dearth of information about the financial aspects of PrEP is a reflection of the unsettled state of this recent HIV prevention strategy. The U.S. Food and Drug Administration (FDA) has approved a drug label change that brings the first antiretroviral combination medication to market for HIV prevention.1 Prior to this decision, there were anecdotal reports that the tenofovir–emtricitabine (TDF–FTC) combination pill Truvada® was already being prescribed and used “off label” as PrEP and that some insurers may have been willing to reimburse PrEP in limited circumstances.A Proposed Framework to Monitor Daily Oral Antiretroviral Pre-Exposure Prophylaxis in the U.S
Safety and substantial efficacy have now been proven for daily antiretroviral pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate (TDF) in combination with emtricitabine (FTC) for HIV-uninfected men who have sex with men (MSM)1 as well as heterosexual men and women.2,3 MSM and heterosexuals (who do not inject drugs) comprised 88% of the estimated new HIV infections in the U.S. in 2009 and have evident need for additional prevention methods to substantially lower the incidence of HIV infections.
