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Decision-making errors such as present bias (PB) can have important consequences for health behaviors, but have been largely studied in the financial domain. We conducted a mixed-method study on PB in the context of ART adherence among clinic-enrolled adults in Uganda (n = 39). Specifically, we quantified PB by asking about preferences between medication available sooner to minimize headaches versus available later to cure headaches. We describe demographic similarities among PB participants and qualitatively explored how participants reflected on their PB (or absence thereof) in the context of health. Participants reporting PB were predominantly male, single/unmarried, older, had higher levels of education and income and more advanced HIV progression. Three common reasons for more present-biased choices provided were: (1) wanting to avoid pain, (2) wanting to return to work, and (3) fear of one's health worsening if s/he did not address their illness immediately. While PB in the financial domain often suggests that poorer individuals are more likely to prefer immediate rewards over their wealthier counterparts, our results suggest poor health is potentially a driving factor of PB. Further research is needed to build on these finding and inform how programs can frame key messages regarding ART adherence to patients displaying PB. Trial registration: ClinicalTrials.gov identifier: NCT03494777. [ABSTRACT FROM AUTHOR]

Purpose: To investigate whether rural‐urban differences in quality of care for Medicare Advantage (MA) enrollees vary between females and males. Methods: Data for this study came from the 2019 Healthcare Effectiveness Data and Information Set. Linear regression was used to investigate urban‐rural differences in individual MA enrollee scores on 34 clinical care measures grouped into 7 categories, and how those differences varied by sex (through evaluation of statistical interactions). Findings: Across all 7 categories of measures, scores for rural residents were worse than scores for urban residents. For 4 categories—care for patients with (suspected) chronic obstructive pulmonary disease, avoiding prescription misuse, behavioral health, and diabetes care—the average difference across measures in the category was greater than 3 percentage points. Across all 34 measures, there were 15 statistically significant rural‐by‐sex interactions that exceeded 1 percentage point. In 11 of those cases, the deficit associated with living in a rural area was greater for males than for females. In 3 cases, the deficit associated with living in a rural area was larger for females than for males. In 1 case involving Follow‐up After Hospitalization for Mental Illness, rural residents had an advantage, and it was larger for males than for females. Conclusions: Interventions may help address patient‐ (eg, health literacy and patient activation), provider‐ (eg, workforce recruitment and retention), and structural‐level issues contributing to these disparities, especially for rural males. [ABSTRACT FROM AUTHOR]

We examined peer-reviewed publications analyzing data from the English GP Patient Survey (GPPS), U.S. National Health Interview Survey (NHIS), and California Health Interview Survey (CHIS) to explore how the health of sexual minority populations varies across settings and subgroups. We searched for English language articles published 2011–2022, screening abstracts (n = 112), reviewing full text (n = 97), and extracting data (n = 85). We conducted a content analysis to identify patterns across settings for sexual minority people compared with heterosexual counterparts and each other. Across all settings, sexual minority adults had poorer health care access, worse health outcomes and patient experiences, more detrimental health behaviors, and greater health care services utilization (reflecting risk awareness and need). When subgroup data were reported, differences were greater among women, except for HIV and related cancers, which were most prevalent among sexual minority men. Sexual minority people generally reported significantly worse health access, outcomes, and behaviors in all three settings. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Medicare beneficiaries dually eligible for Medicaid are a low-income group who are often in poor health. Little research has examined sex differences in patient experience by dual/low-income subsidy (LIS) status. STUDY DESIGN: Cross-sectional comparison by sex and low-income status. METHODS: We used linear regression to compare 6 case mix--adjusted patient experience measures (on a 0-100 scale) by sex within non--dual/LIS and dual/LIS beneficiary groups among 549,603 respondents 65 years and older to the 2016-2017 Medicare Consumer Assessment of Healthcare Providers and Systems surveys of beneficiary experience with Medicare (mail with telephone follow-up of nonrespondents, 42% response rate). RESULTS: Dual/LIS male beneficiaries reported worse patient experiences on all 6 measures than female beneficiaries, with scores 1 to 2 percentage points lower for 3 measures and less than 1 percentage point lower for the other 3 measures. For 4 of the 6 measures, sex differences among dual/LIS beneficiaries were significantly larger than those among non--dual/LIS beneficiaries. In all 4 instances, the gaps between men and women among dual/LIS beneficiaries favored women; P < .05 for all differences discussed. CONCLUSIONS: Low-income male Medicare beneficiaries are more likely to report poor patient experiences, possibly because of lower health literacy, less patient activation, and smaller social networks, along with provider responses to these characteristics. Efforts to address these patient-level factors should happen in parallel with structural-level approaches to train and prepare providers to ensure attentive, respectful patient-centered care for all patients. Additionally, targeted use of ombudsmen and interventions may help reduce inequities. [ABSTRACT FROM AUTHOR]