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Abstract: This paper analyzes the effect of a change in the status of housing equity as a protected asset for Medicaid long‐term care payment eligibility. A difference‐in‐difference‐in‐differences strategy is employed to estimate the effect of the policy on the housing equity holdings of potentially treated individuals. Using a panel of unmarried homeowners, the policy induced treated individuals who were likely to require long‐term care to hold less housing equity by values of $82,000 to $193,000 relative to control individuals. This equates to relative reductions of 12 to 29 percent for treated individuals after the policy change. Similar effects are not observed when considering health measures less predictive of long‐term care services and for a sample of married households who were unlikely affected by the policy. These estimates confirm the importance of the housing asset as a shelter for Medicaid eligibility. [ABSTRACT FROM AUTHOR]

This paper explores the issue of identifying prescription opioid abuse in the healthcare setting and potential strategies to address this nationwide problem. In particular, this article examines existing literature focusing on opioid abuse and possible prevention methods to address this epidemic in the U.S. Using literature reviews accompanied by interviews from healthcare professionals who shared their experiences about the problems they face in their practices, this study found that the complexity of opioid abuse requires a more universal approach and some form of intervention from the outside. One inspiration for a solution comes from the Mandatory Reporting of abuse for children implemented by many professionals in California. This paper suggests a variation of the Mandatory Reporting, adapted for opioid abuse that involves education and public involvement, harsher consequences for professionals for failure to report opioid abuse, as well as involvement from the federal government in the form of legislation. [ABSTRACT FROM AUTHOR]

A majority of married couples in the USA take advantage of the fact that employers often provide health insurance coverage to spouses. When older spouses become eligible for Medicare, however, many of them can no longer provide their younger spouses with coverage. In this paper, we study how spousal eligibility for Medicare affects the health insurance and health care access of younger spouses. We find that spousal eligibility for Medicare results in younger spouses no longer having employers pay for their insurance and being less likely to have employer-sponsored coverage. Instead, younger spouses switch to privately purchased coverage, which tends to be worse than what they had before their spouses became eligible for Medicare. We also find suggestive evidence that younger spouses are less likely to use health care services after their older spouses become eligible for Medicare. [ABSTRACT FROM AUTHOR]

Background: Preparing nursing students for practice is supported by developing a global perspective of health care delivery models. However, many schools of nursing and students lack the resources for study abroad. Method: Using a virtual stay-in place model, 42 international students applied an evidenced-based approach to study statistics, research, transitions in care, and elder care models that supported collaboration among peers from Austria, Switzerland, Chile, the United Kingdom, and the United States. Students explored social, economic, and reimbursement factors not encountered in the typical classroom. Results: Student beliefs and perspectives changed after completing a program with global peers. Survey results and themes in reflection papers indicated increased ability to conceptualize content in new ways, including holistic elder care, cultural practices and reimbursement options, and effects on future practice. Conclusion: Virtual international learning experiences are an effective education innovation that allows student to connect and learn from one another using a stay-in place model. [J Nurs Educ. 2023;62(11):647–649.] [ABSTRACT FROM AUTHOR]

Purpose: Self-direction–also known as participant direction, personalization and self-directed care–is a service delivery model that enables people to manage their personal budget and purchase services and supports tailored to their needs based on a person-centered plan. This paper, the outcome of an international learning exchange on self-direction, describes approaches across four countries' successful strategies, unresolved questions and recommendations to enhance self-direction globally. Design/methodology/approach: The findings are a product of discussions at the 2019 International Initiative for Mental Health Leadership and International Initiative for Disability Leadership Exchange on Advances in Self-Direction. Participants included people who are self-directing, providers and caregivers who support people who are self-directing, advocates, fiscal agents and public managers who administer self-direction from the United States, England, Australia and New Zealand. Findings: In all four countries, people who self-direct exercise high levels of choice and control and are able to individualize their services and supports to promote a good life in the community. The exchange also revealed challenges and possible solutions to improve and expand self-direction. Practical implications: The results of the meeting provide guidance for public managers, providers and advocates for initiating and expanding self-direction. Originality/value: This international meeting was a unique opportunity to compare self-direction across four different countries and across multiple perspectives, including people with disabilities, caregivers, providers and administrators. [ABSTRACT FROM AUTHOR]

Editorial. Comments on the aging of the population and the implications for medical care and health care systems. How the demographic trend will affect health care and society; Specific problems that the U.S. faces which are related to aging; Invitation to authors to submit manuscripts on topics such as disease interventions, dementia, incontinence, diabetes, cancer and others.

This paper considers the availability of data for addressing questions related to health insurance and health care and the potential contribution of a new household panel study. The paper begins by outlining some of the major questions related to policy and concludes that survey data on health insurance, access to care, health spending, and overall economic well-being will likely be needed to answer them. The paper considers the strengths and weaknesses of existing sources of survey data for answering these questions. The paper concludes that either a new national panel study, an expansion in the age range of subjects in existing panel studies, or a set of smaller changes to existing panel and cross-sectional surveys, would significantly enhance our understanding of the dynamics of health insurance, access to health care, and economic well-being. [ABSTRACT FROM AUTHOR]

The article offers the author's comment on the article "Why the Geographic Variation in Health Care Spending Cannot Tell Us Much about the Efficiency or Quality of Our Health Care System" by Louise Sheiner. The author compares the variable used by Sheiner in the study with the ones used by Jack Wennberg and colleagues. He says that Sheiner looks only at acute care. An overview of the paper is also offered.

Unlike most industrialized nations, the United States has a highly fragmented healthcare system in which patient information is not typically shared across different providers. In recent years, however, the federal government has attempted to foster the development of health information exchanges (HIEs) by making funds available to states and local governments. As this paper seeks to demonstrate, what is most critical is not the economic business model chosen, but the degree to which system designers are able to generate value for the main actors involved. This paper will analyze the characteristics of the successfully implemented Indiana Health Information Exchange through alignment theory and enactment frameworks, highlighting its ability to meet the expectations of its most important users, embedded within the specific historical, organizational, and cultural environment, and how this interaction of factors has augmented its prospects of long-term sustainability. [ABSTRACT FROM AUTHOR]

In the present paper, I focus on the main determinants of health workforce conduct, the challenges encountered in honing human resources for health, and the grave shortage of human resources for health. The objective of this paper is to emphasize the setting up, production and supervision of human resources forhealth, the health workforce requirements of the population, and the drivers of health employee performance. The literature on the provision of health employees to underserved territories, the impact of the health employees on health outcomes and expenditures, and relevant matters influencing the functioning of health systems is relevant to this discussion. [ABSTRACT FROM AUTHOR]

Over the past few decades, healthcare expenditures in the United States have increased due to a variety of different factors. Depending on their insurance plans, Americans have varying levels of health insurance coverage and may need to make co-payments or pay fully for specific health services. According to multiple studies, health insurance does appear to increase the utilization of healthcare services, except emergency services. Demographic factors such as age, citizenship, and race/ethnicity, as well as the type of health service demanded, all appear to influence the consumption of healthcare in the United States. However, many existing studies conducted in this area are not experimental or randomized, which may result in a lack of validity of the estimated relationship between insurance and healthcare utilization due to confounding variables. A new experimental study, similar to the RAND HIE study, is needed to provide insight into the current relationships between insurance and healthcare utilization, taking into consideration changes in legislation. [ABSTRACT FROM AUTHOR]

To provide medical and social services to underserved communities, many health care organizations across the United States have expanded the role of emergency medical services to include mobile integrated health and community paramedicine (MIH-CP). Although MIH-CP programs differ in structure and setting, many share the common goal of improving health through home-based, patient-centered care management models. Ideally, these innovative programs reduce use of health care services, including 911 (US emergency system) calls and emergency department visits. In 2018 a large, urban academic medical center partnered with the city's fire department to establish an MIH-CP program to support patients as they transition in their first 30 days at home after hospitalization. Prior to launch, a multidisciplinary team developed a logic model to guide development, implementation, and evaluation of this complex and innovative program. This paper describes the team's structured process for developing a logic model. It also describes key components of the initial logic model and the Transitional Health Support program structure, as well as subsequent revisions to both. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has been stressful for many, increasing levels of anxiety, depression and other mental health concerns worldwide. With the spread of the virus, many youth found themselves physically isolated from their peers and confined to their homes, and medical and mental health services previously provided in person had to adapt by providing virtual sessions. The transition to virtual care created many new challenges for clinicians and patients, including some specific to transgender youth and their families. Pre-pandemic, transgender youth comprised a marginalized and vulnerable population, with elevated risk for adverse mental health outcomes. However, community support, strong group identification and family affirmation can serve as important mitigating factors. In this paper, we will discuss unique challenges encountered in working with the parents and caregivers of transgender youth during virtual visits that have the potential to interfere with development of a therapeutic alliance and the movement toward increased family acceptance. We will provide clinical case examples and propose methods through which to address difficulties and improve care. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has presented a formidable challenge to care continuity for community mental health clients with serious mental illness and for providers who have had to quickly pivot the modes of delivering critical services. Despite these challenges, many of the changes implemented during the pandemic can and should be maintained. These include offering a spectrum of options for remote and in-person care, greater integration of behavioral and physical healthcare, prevention of viral exposure, increased collaborative decision-making related to long-acting injectable and clozapine use, modifying safety plans and psychiatric advance directives to include new technologies and broader support systems, leveraging natural supports, and integration of digital health interventions. This paper represents the authors' collaborative attempt to both reflect the changes to clinical practice we have observed in CMHCs across the US during this pandemic and to suggest how these changes can align with best practices identified in the empirical literature. [ABSTRACT FROM AUTHOR]

Context Few qualitative findings have been published that explore and identify the challenges experienced by independent abortion providers during the COVID‐19 pandemic in the United States (US). In this paper, we explore these themes while expanding the concept of "abortion exceptionalism" beyond its original legal meaning to address the impact of abortion stigma. Methods: Twenty abortion providers from independent abortion clinics throughout the US South and Midwest participated in semi‐structured interviews in June and July 2020. Interviews explored the challenges of providing abortion care in the wake of the COVID‐19 pandemic and sought to identify how clinics strategized and amended their clinical practices to continue providing abortion care during this time. Results: All providers we spoke to noted significant challenges to providing abortion care in the early days of COVID‐19. In addition to experiencing the same concerns as other health care institutions, abortion clinics also faced additional, unique burdens that can only be attributed to the politics of abortion exceptionalism. Examples of this abortion exceptionalism include abrupt orders to close clinics, the need to rely on traveling physicians, legislature‐imposed limits on telemedicine, heightened activities of protesters, and non‐evidence‐based regulation of medication abortion. Conclusion: Despite major challenges and differential treatment, independent abortion clinics in the US persevered to continue to provide abortion care throughout the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

[This paper examines how an African country, Zambia, reproduces patterns of health care delivery system of the West characterized by U.S. The replication of pattern of health discriminates against the poor, and rural inhabitants. First, a brief theoretical analysis of underdevelopment is provided. Secondly, the structure of the present U.S. health care delivery system is provided highlighting the role of the academic-medical component. The analysis shows how health care resources are distributed among socioeconomic, racial groups and between urban and rural areas. The major part of the paper examines health care delivery system in Zambia, outlining those areas that are replicated. The paper emphasizes that this should serve as lessons for Africa. This replication is made possible by the indigenous African middle class through which Western values are transmitted. This class (elites) is in control of state machinery and makes decisions on the distribution, and consumption of health resources. In conclusion, I recommend a radical economic and political transformation of these societies if resources have to be distributed equitably.] [ABSTRACT FROM AUTHOR]

The article presents comments to the article entitled "Measuring the Health of the U.S. Population," by David M. Cutler and Elizabeth Richardson. According to Theodore E. Keeler, the paper opens up a new way of looking at health in economic terms, both over time and across populations. He also thinks the use of the National Health Interview Survey Data to determine the effects of chronic illness on well-being is clever. According to Douglas Staiger, the authors are very clear about what is being measured. He also emphasizes the importance of the specifics of the health capital calculation.

Background: In 2010, the first comprehensive National HIV/AIDS Strategy for the United States was released and included three goals: (1) reducing the number of people who become infected with HIV, (2) increasing access to care and improving health outcomes for people living with HIV, and (3) reducing HIV-related health disparities and health inequities. In 2013, as part of its effort to help address the National HIV/AIDS Strategy, the National Institute on Drug Abuse (NIDA) funded a type 2 effectiveness-implementation hybrid trial titled the Substance Abuse Treatment to HIV Care (SAT2HIV) Project. Aim 1 of the SAT2HIV Project tests the effectiveness of a motivational interviewing-based brief intervention (MIBI) for substance use as an adjunct to usual care within AIDS Service Organizations (ASOs) as part of its MIBI Experiment. Aim 2 of the SAT2HIV Project tests the effectiveness of implementation and sustainment facilitation (ISF) as an adjunct to the Addiction Technology Transfer Center (ATTC) model for training staff in motivational interviewing as part of its ISF Experiment. The current paper describes the study protocol for the ISF Experiment. Methods: As part of a multisite randomized controlled trial, individuals with comorbid HIV/AIDS and problematic substance use are randomized to receive either the ASOs'; usual care (control condition) or usual care plus a MIBI for substance use (experimental condition) delivered by trained ASO case-management staff. Primary outcome measures are reductions in days of primary substance use, number of substance-related problems, times engaging in risky behaviors, days of non-adherence to HIV medications, and increases in substance use treatment. As part of this paper, we describe the trial protocol in accordance with the Standard Protocol Items: Recommendations for Interventional Trials guidelines. Discussion: If successfully able to implement MIBI as an effective adjunct to usual care, the current trial may have a significant impact on increasing the capacity of ASOs to address problematic substance use among individuals living with HIV/AIDS. Reducing the prevalence of problematic substance use among individuals living with HIV/AIDS within the United States may lead to significant improvements on key performance measures (i.e., the HIV Care Continuum and the 90-90-90 target). [ABSTRACT FROM AUTHOR]

The 2010 Affordable Care Act (ACA) increased healthcare access for many Americans. But, its exclusion of most noncitizens and imperfect state-level implementation stratified coverage by documentation status, place, income level, race, and ethnicity across the U.S.A. Drawing from the sociological literature on boundaries, this paper argues that these demographic boundaries facilitate de jure and de facto stratification for immigrants and low-income Americans of various ethnoracial backgrounds. Using existing survey research regarding national ACA implementation and a qualitative study of ACA implementation in Boston, MA, this paper shows how such stratification may worsen existing disparities in healthcare coverage and access among the U.S. population. Implications regarding President Donald Trump and conservative lawmakers’ plans to repeal the ACA are also discussed. The paper contributes to researchers’ understanding of how public policies produce boundaries by place, documentation status, race, ethnicity, and income that facilitate inequality. [ABSTRACT FROM AUTHOR]

Despite nearly universal health-care coverage for older Americans, the quality of care for the sickest and frailest remains sub-optimal. Understanding why requires analysis of the medical ecosystem. This paper considers the role of four of the principal actors in this system: physicians, hospitals, drug companies, and Medicare. Physicians spend more time in the office addressing diabetes and hypertension than they do evaluating falls and impaired cognition because of their training and their interests. Hospital administrators affect the hospital experience by investing in procedural specialties at the expense of low-tech, high-touch care. Pharmaceutical companies affect the medications older patients take by direct-to-consumer advertising and marketing to physicians. Medicare affects the patient's experience by prospective payment for hospitals, resulting in the burgeoning of post-acute care to accommodate early hospital discharges. Determining how to improve the quality of care for older people requires identifying a lever that affects the entire system. Medicare is uniquely positioned to serve this role. Reforming Medicare by introducing cost-effectiveness criteria for reimbursement of expensive devices, by instituting requirements that medical resident training programs include exposure to multidisciplinary team care, and by introducing a new benefit package for the frail elderly could improve American geriatric care. [ABSTRACT FROM AUTHOR]

Objectives To prioritize research topics relevant to the care of the growing population of older adults with multiple chronic conditions ( MCCs). Design Survey of experts in MCC practice, research, and policy. Topics were derived from white papers, funding announcements, or funded research projects relating to older adults with MCCs. Setting Survey conducted through the Health Care Systems Research Network ( HCSRN) and Claude D. Pepper Older Americans Independence Centers ( OAICs) Advancing Geriatrics Infrastructure and Network Growth Initiative, a joint endeavor of the HCSRN and OAICs. Participants Individuals affiliated with the HCSRN or OAICs and national MCC experts, including individuals affiliated with funding agencies having MCC-related grant portfolios. Measurements A 'top box' methodology was used, counting the number of respondents selecting the top response on a 5-point Likert scale and dividing by the total number of responses to calculate a top box percentage for each of 37 topics. Results The highest-ranked research topics relevant to the health and healthcare of older adults with MCCs were health-related quality of life in older adults with MCCs; development of assessment tools (to assess, e.g., symptom burden, quality of life, function); interactions between medications, disease processes, and health outcomes; disability; implementation of novel (and scalable) models of care; association between clusters of chronic conditions and clinical, financial, and social outcomes; role of caregivers; symptom burden; shared decision-making to enhance care planning; and tools to improve clinical decision-making. Conclusion Study findings serve to inform the development of a comprehensive research agenda to address the challenges relating to the care of this 'high-need, high-cost' population and the healthcare delivery systems responsible for serving it. [ABSTRACT FROM AUTHOR]

Compared with policy related to child abuse, older adult protection policy developed later and made slower progress in the United States of America. Few studies have addressed older adult protection policy. This paper compares the two policies and provides implications about how to improve older adult protection policy by emulating child protection policy. The Dimensions of Choice Framework was utilised to illuminate the differences between child protection and older adult protection policies (i.e. allocation, provisions, delivery and finance), while Advocacy Coalition Framework theory was used to explain why these differences exist (i.e. the contentions between ally and opposite coalitions). The Dimensions of Choice Framework refined the descriptive comparison of the two policies while the Advocacy Coalition Framework unfolded the efforts and struggles between advocacy coalitions that result in policy changes; and the conceptual combination further provides a cross-disciplinary link between social work and public policy studies. Findings indicated that, compared to child protection policy, older adult protection policy lacked federal legislative and administrative direction, well-developed diagnosis and evaluation tools, a national data system, sufficient federal funds and a comprehensive response mechanism. This was the case because older adult protection advocates presented a more controversial argument regarding the role of government intervention in protecting victims while respecting individual autonomy, lower public and government awareness, and weaker efforts from ally coalitions. [ABSTRACT FROM AUTHOR]

This paper examines the presence of contagion in health care fraud across jurisdictional boundaries. Using state‐level data for the United States, we find evidence of contagion in medical fraud. There are also spillovers from border corruption on medical fraud, but no evidence of spillovers from international borders. In other findings, greater urbanization, greater elderly population, and higher hospital occupancy positively contribute to medical fraud, while nursing employment has a mitigating effect. Further, it is economic inequality rather than economic prosperity that seems relevant. The main findings are robust to consideration of simultaneity, but dependent upon the prevalence of fraud across states. [ABSTRACT FROM AUTHOR]

The origins of pharmacy specialization has its beginning in the efforts of Harvey A. K. Whitney, Sr. through his leadership in establishing progressive hospital pharmacy services and hospital‐focused programs and policies within the nation's professional pharmacy organizations. Later, Donald Francke spoke of specialization in the hospital pharmacy setting as a natural outgrowth of practice activities that required more time and specialized expertise. A broader national discussion and eventual codification of specialty recognition and attendant certification within pharmacy began in 1971 with a policy statement approved by the APhA House of Delegates that led to the creation of a Task Force on Specialties in Pharmacy followed by the creation of the Board of Pharmaceutical Specialties (BPS). Given that specialization in any health profession is primarily a function of the reality of ever‐increasing scientific and technological developments, debate regarding the need, types, and value of specialization in pharmacy seem destined to be driven not by intra‐ or inter‐professional debates within pharmacy, but by the needs, expectations, and values of patients and health care systems. [ABSTRACT FROM AUTHOR]

A transformation in the way in which primary care is delivered is underway in the US. Across the country primary care practices are grappling with how to change from the traditional physician-directed model to a more patient-centred collaborative style as part of the effort to curb the rise of chronic disease. To date, few tools or techniques exist to help the individual primary care provider make this difficult and complex transformation. One such tool that has arisen is the shared care plan (SCP). As defined in the Taking Action for Learning and Knowledge Management to improve Diabetes Mellitus (TALK/DM) study (a NIDDK funded pilot project to implement SCPs in primary care), the SCP of primary care becomes the product of collaboration between the practice and the patients. The SCP is created by combining knowledge management (KM) techniques and motivational interviewing (MI) health counselling methods to form a new knowledge object. This paper focuses on this aspect of the TALK/DM study and takes a case study approach to explore how one primary care practice is implementing the SCP as knowledge object (both a paper document and an electronic record in the EMR system) in its organisation. This study adds nuance and insight into how knowledge objects such as the SCP can serve as a tool for collaboration in primary care. [ABSTRACT FROM AUTHOR]

This article reports on the coverage of the U.S. healthcare crisis by newspapers in 2006. The crisis received a little attention from the press. The reasons for this observation are indicated. Moreover, this article states the position of physicians on the crisis and some actions they are taking to address it.

Objectives: The United States health system is challenged to improve patient and population health, enhance patients' experience of care, and reduce health care costs. Value-based health care (VBHC) models are proposed to address these issues. Medical health systems are making strides toward VBHC, whereas dental care systems lag behind. The aims of this paper are to a) present study findings of an interprofessional practice model integrating oral health and primary care in a dental practice setting, and b) discuss practice and research implications for advancing VBHC approaches in oral health.Methods: A nonexperimental research method was employed to evaluate the Nurse Practitioner-Dentist Model for Primary Care (NPD Model) at the Harvard Dental Center. Pretest/post-test design was used to assess clinical patient outcomes for a convenience cohort of Medicare beneficiaries (n = 31) with a reported diagnosis of hypertension and/or type 2 diabetes. Clinical outcome measures included: blood pressure, weight, body mass index (BMI), and Hemoglobin A1c.Results: Positive and significant improvements in biometrics (blood pressure, body weight, BMI, HbA1c) were found.Conclusions: The NPD Model is an early prototype for interprofessional VBHC in oral health and holds promise for improving patient and population health outcomes. Integration of interprofessional VBHC in oral health is an imperative for achieving the Triple Aim to improve the overall health of our nation. [ABSTRACT FROM AUTHOR]

A trauma-informed, thematic analysis that identified stress-related themes evident in 39 personal abortion narratives from the Tennessee Stories Project in the United States is presented in this paper. Using the Braun and Clarke model of thematic analysis, guided by the trauma-informed social work framework, researchers examined these narratives to identify stress related themes. Findings: An overall theme of stress and traumatic stress was found to be present throughout the abortion narratives. These themes were categorized into subthemes, including: (a) existing life stressors preceding the abortion experience, (b) stressors while trying to access abortion services, (c) stressors while obtaining abortion services, and (d) stressors arising after the procedure. Applications: These results suggest that stress and traumatic stress were reflected in these abortion narratives throughout the abortion seeking experience. This finding supports the need for social work practice responses that are designed to address and eliminate stress during the process of seeking and obtaining an abortion in the United States. A trauma-informed framework is recommended for guiding social work education about abortion, social worker interactions with clients who are seeking abortions, and the development of abortion policy in the United States in order to better align the abortion seeking experience with the principles of trauma-informed care. [ABSTRACT FROM AUTHOR]

This paper outlines the current ethical guidelines for electronic therapy services, and the sufficiency and implications of these guidelines in a culturally diverse population as found in the United States. The paper limits the discussion of ethical deliberations to: what is considered adequate competency to practice mental health therapy electronically; the disclosure and identity verification requirements; confidentiality issues when different social norms exist; the social responsibility of public institutions or individuals; and issues that relate to miscommunication due to different cultural or educational backgrounds. It concludes that since E-Therapy helps to reach underserved populations and significantly reduces costs associated with mental health services, compliance with ethical guidelines must be enforced to benefit from the latest communication technologies. This paper is relevant for various professions related to psychology and psychotherapy, including pastors and pastoral counselors, because various forms of E-therapy are emerging in the 21st century and can serve as resources for 'E-pastoral counseling.' [ABSTRACT FROM AUTHOR]

The relationship between subjective wellbeing and in-migration is explored in this paper. The wellbeing of a state is considered an incentive for in-migration to that state as the wellbeing in that state increases. A cross-sectional, multiple regression on the contiguous states in the United States was used to determine if there is any relationship. A significant and positive relationship was found between state-level subjective wellbeing and net in-migration when controlling for economic and non-economic variables typically associated with in-migration. The positive relationship indicates that as a state's wellbeing increases its appeal as a destination for internal migrants increases as well. It is recommended for policymakers to focus on improving the subjective wellbeing of their state's residents not only to retain and attract new residents, but as a general measure of successful administration. Future studies are needed to verify the link between a state's wellbeing and in-migration to that state. This study serves as a first step in this literature. [ABSTRACT FROM AUTHOR]

Big Data promises to heal many of the complex problems in healthcare. Departing from conventional ways of thinking about what constitutes relevant health data and how to analyze it, data-intensive resourcing entails different practices of collecting, sorting, circulating, and interpreting data, while making it available to multiple users. In the process, big data and the infrastructures instilled to support it are creating new forms of value and reordering relationships as distinctions between medical and nonmedical data and research and care are blurred. This paper situates big data in healthcare within social-political and economic conditions in the U.S., and charts emerging assemblages in order to make visible the cultural work that big data does in healthcare. [ABSTRACT FROM AUTHOR]

Hospice social workers face many challenges in attempts to replicate or supplement the holistic support and unique services hospice provides for individuals discharged alive. This discontinuity in care can impact the types of supports needed by individuals and caregivers, which may or may not be accessible within their community. Patients and families who have access to community-based palliative care programs following a discharge generally tend to navigate the process with fewer challenges. This qualitative study (N = 24) explored both the challenges of the live discharge process and the opportunities within social work practice in the US. Results from this study emphasize the need for a framework to better approach a live discharge to ensure appropriate supports are accessible for all patients and caregivers. Specifically, results highlight both the concrete and psychosocial challenges in live discharges as a result of tension between current eligibility requirements and individual feelings and needs. Social workers also provided suggestions to improve the live discharge process, including attention to communication and preparation. This paper outlines specific challenges of live discharge from hospice, a framework for understanding presented challenges, and implications for policy and practice. [ABSTRACT FROM AUTHOR]