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Clinician Type and Care Setting for Treatment of Medicare Beneficiaries With Dementia
03-27-25
Standardizing and improving the treatment that Medicare beneficiaries living with dementia receive requires understanding the settings where they are receiving care, the types of clinicians providing that care, and whether clinicians recognize the diagnosis of dementia in their encounters with...
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Palliative Care Services in Long-Term Acute Care Hospitals: A National Survey Study
03-25-25
Each year, long-term acute care hospitals (LTACHs) care for over 70,000 individuals with complex and serious illness requiring prolonged inpatient care for weeks or months following a short-stay hospitalization. While LTACHs are most distinct from other post-acute care settings for their expertise...
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Impact of COVID-19 on Trends in Physician Payments from Traditional Medicare from 2017-2021
03-11-25
Physicians, especially in primary care, likely faced substantial revenue loss during the COVID-19 pandemic due to decreases in patient volume and deferred healthcare utilization. While studies have focused on projections and limited surveys, the impact of the pandemic on physician revenue is...
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Relationship Between Nurse Staffing During Labor and Cesarean Birth Rates in US Hospitals
03-01-25
Highlights:
The U.S. cesarean birth rate was 32.4% in 2023 and continues to increase each year.
Avoiding morbidity and mortality risk associated with cesarean birth is critical.
RN staffing during labor and birth is linked to cesarean rates.
RN staffing aligned with national standards...
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Relationship Between Safety-net Oral Health Care Practices and Income Among American Indian/Alaska Native, Black, and Hispanic/Latino Dentists
02-19-25
Background. American Indian/Alaska Native (AI/AN), Black (B), and Hispanic/Latino (H/L) people are underrepresented in dentistry, yet disproportionately constitute the safety-net dental workforce. We examined the relationship between serving as safety-net providers (SNPs) and self-reported income...
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An Unclear Partnership: Key Questions about Physician and Advanced Practice Provider Collaboration in Primary Care
01-17-25
More than 83 million people in the United States live in primary care shortage areas. As the US healthcare system faces a contracting primary care physician workforce, advanced practice providers are playing an increasingly important role in the delivery of primary care services. In parallel,...
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Training Standards for Personal Care Aides Across States: An Assessment of Current Standards and Leading Examples
01-15-25
As the largest occupational group in the United States (combined with home health aides), personal care aides (PCAs) provide care for millions of Americans. Despite the size of the workforce, PCAs still struggle with unaddressed job quality challenges – inadequate training being primary among them...
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Policies and Initiatives Impacting Medi-Cal Dental Care: 2014 - 2023
01-09-25
Access to dental care for millions of Californians is tied to coverage by California’s Medicaid (Medi-Cal) Dental insurance program. While child dental coverage is federally mandated, adult dental coverage is optional. In 2009, adult dental coverage was mostly eliminated but was partially...
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Tribal Community Health Representatives (CHR): Home Care Workforce Insights, Experiences, and Recommendations for Elder Care.
01-06-25
The Community Health Representative (CHR) Program was established by Congress in 1968 to provide an outreach component meeting the specific healthcare needs of tribes and tribal communities. This program predates the official recognition of non-tribal Community Health Workers (CHWs) by the American...
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Spotlighting the Experiences of the Home Care Workforce Caring for Older Adults Living with Dementia
12-31-24
Medicaid Home and community-based services (HCBS) and home-based clinical care (i.e., Medicare home health care) aim to support independence and well-being in the community, especially for older adults living with disability and complex health conditions, such as dementia. Many older adults receive...
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Clinician Type and Setting of Care Delivered to Medicare Beneficiaries with Dementia in the US
12-31-24
Improving care coordination for people living with dementia (PLWD) requires understanding of the types of clinicians delivering care and the settings in which they practice.
We identified all beneficiaries with dementia in traditional Medicare in 2019. We used the Medicare Carrier file — i.e.,...
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Navigating Hostile Workplaces and Educational Spaces Within Health Services and Policy Research
12-16-24
Advancing health equity requires acknowledging and attending to inequities within the health policy and services research (HSPR) workforce. Although HSPR racial and ethnic diversity has been increasing, the profession still has considerable unfinished work: in 2021, Black, Hispanic, and Indigenous...
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Nurse Practitioner Race and Ethnicity and Interest in Independent Primary Care Practice and Serving Medicaid Enrollees
12-15-24
Nurse practitioners (NPs) are important providers of primary care to underserved populations, particularly in areas with lower physician supply. In 2023, California implemented new regulations aimed at improving access to care, especially primary care services, by providing a pathway for NPs to...
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“My Voice Does Not Matter…” A Qualitative Analysis of Clinician Experiences with Psychological Safety, the Work Environment, and Burnout
11-27-24
Clinician burnout remains prevalent, exacerbated by factors such as inadequate staffing, a lack of organizational support, devaluation, and poor interpersonal relations. Amidst provider shortages, the nurse practitioner (NP) workforce is expanding, paralleling high rates of burnout. This study,...
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Physicians’ Perspectives on Using Direct Observation to Assess Non-English Language Proficiency for Clinical Practice: A Qualitative Study
11-20-24
Communication barriers are known to adversely affect patient safety. Yet few health systems assess and track physician non-English language proficiency for use in clinical settings. Barriers to current assessments (usually simulated clinician oral proficiency interviews) include time constraints...
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Cancer Registrar Workload and Staffing Study: Guidelines for Hospitals Cancer Registry Programs
10-30-24
Cancer registrars are vital to cancer surveillance -- the work includes collecting, coding, reporting, and curating national cancer data that are used to create national statistical data about cancer epidemiology and treatment.
However, cancer registrars are often considered a nonrevenue-producing...
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Understanding California’s Midwife Workforce
10-22-24
Midwives are licensed clinicians who play a key role in the maternity care workforce. In California, licensed midwives (LMs) and nurse-midwives (NMs) provide comprehensive, person-centered care focused on pregnancy, childbirth, and the postpartum period.
To better understand the midwife workforce...
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Health Workforce Research Centers Annual Report, 2024
10-07-24
Important health workforce research that we undertake here is part of a national effort to monitor and plan for the health care needs of US residents. The UCSF Health Workforce Research Center on Long-Term Care (UCSF HWRC), housed at Healthforce Center, is a dynamic hub of policy-oriented research...
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California’s Nurse Practitioner Workforce: Understanding Demographics, Education, and Scope of Practice
09-27-24
Nurse practitioners — often referred to as NPs — are the largest group of nonphysician primary care providers and play a growing role in filling gaps in health care provision in both primary care and behavioral health across California. NPs are registered nurses who have completed additional...
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Health Insurance Matters: Insurance Coverage and Health Service Use Among Direct Care Workers in the US
08-30-24
Objectives: Direct care workers (DCWs) play a central role in supporting individuals' health and well-being across care settings, yet may face barriers to accessing health care themselves, particularly because of high rates of uninsurance.
Design: An observational study using pooled National...
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Association Between Self-Direction and Personal Care Aide Wages
08-26-24
The supply of personal care aides (PCAs), who assist people receiving home care, is a growing concern. PCA shortages result, in part, from the low wages earned by these workers. State policies have had some effect on wages. Self-direction (SD) may be associated with wages because SD allows home...
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Psychological Safety Is Associated with Better Work Environment and Lower Levels of Clinician Burnout
07-17-24
Burnout is attributed to negative work environments and threatens patient and clinician safety. Psychological safety is the perception that the work environment is safe for interpersonal risk-taking and may offer insight into the relationship between the work environment and burnout.
In this...
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Policy at Healthforce Design Workshop Pre-work June 2024
06-15-24
As part of our commitment to a process that is community informed, we invited anyone interested in shaping our health workforce policy priorities to participate in design workshops. In August and September, Policy at Healthforce held two online workshops (each with the same content) for people to...
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Policy at Healthforce: Learnings and Progress from Year One
06-14-24
Policy at Healthforce is a collective effort that prioritizes systems and policy changes to advance the diversity and skills of workers to produce better economic opportunity and, ultimately, better health for communities of color, statewide public health, and individual health equity.
Guided by...
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Nurse Practitioner Care, Scope of Practice, and End-of-Life Outcomes for Nursing Home Residents with Dementia
05-10-24
Is nurse practitioner (NP) care associated with end-of-life outcomes for nursing home residents with Alzheimer disease and related dementias (ADRD), and do these associations differ between states with full versus restrictive NP scope of practice regulations?
The results of this cohort study...
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The Social Ecology of Burnout: A Framework for Research on Nurse Practitioner Burnout
05-03-24
The US health system is burdened by rising costs, workforce shortages, and unremitting burnout. Well-being interventions have emerged in response, yet data suggest that the work environment is the problem. Nurse practitioner (NP) burnout is associated with structural and relational factors in the...
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Authorization Status of Dental Therapists by State, 2024
04-30-24
Dental therapists (DTs) are primary dental care practitioners that have been deployed in many countries around the world. There is increasingly strong evidence supporting the safety and effectiveness of DTs, including their ability to promote community-based services and enhance oral health equity...
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Systematically Assessing the Quality of Dental Electronic Health Record Data for an Investigation into Oral Health Care Disparities
04-24-24
Objectives: This work describes the process by which the quality of electronic health care data for a public health study was determined. The objectives were to adapt, develop, and implement data quality assessments (DQAs) based on the National Institutes of Health Pragmatic Trials Collaboratory (...
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Moral Injury Awareness and Prevention in Healthcare Organizations: A Blueprint Informed by the COVID-19 Pandemic
04-19-24
Moral injury is lasting psychological and spiritual distress that stems from violating one’s values or feeling betrayed by a trusted institution or authority. Moral injury is associated with post-traumatic stress (PTSD), depression, anxiety, substance use, functional impairments, and suicide risk....
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Patients’ Experiences of Dental Diagnostic Failures: A Qualitative Study Using Social Media
04-15-24
Objective: Despite the many advancements made in patient safety over the past decade, combating diagnostic errors (DEs) remains a crucial, yet understudied initiative toward improvement. This study sought to understand the perception of dental patients who have experienced a dental diagnostic...