Earnings of US Physicians With and Without Disabilities.
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ABSTRACT:
SUBMITTER: Kakara M
PROVIDER: S-EPMC10692836 | biostudies-literature | 2023 Dec
REPOSITORIES: biostudies-literature
Publications
Earnings of US Physicians With and Without Disabilities.
Kakara Mihir M Venkataramani Atheendar S AS
JAMA health forum 20231201 12
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Project description: Not available
| S-EPMC7955270 | biostudies-literature
Project description:ObjectiveCervical cancer is the fourth most prevalent cancer in women worldwide. It is vital to achieve a high cervical cancer screening rate among women. We compared the Pap smear test (PST) used between individuals with disabilities and those without disabilities in Taiwan.MethodsIndividuals registered in the Taiwan Disability Registration File and the National Health Insurance Research Database (NHIRD) were screened for this nationally representative retrospective cohort study. Women aged 30 and above in 2016 and who were still alive in 2016 were matched in a 1:1 ratio via propensity score matching (PSM); 186,717 individuals with disabilities and 186,717 individuals without disabilities were included. Controlling for relevant variables, the odds of receiving PST were compared using conditional logistic regression analysis.ResultsA lower percentage of individuals with disabilities (16.93%) received PST than those without disabilities (21.82%). The odds of individuals with disabilities receiving PST were 0.74 times that of individuals without disabilities (OR = 0.74, 95% CI = 0.73-0.76). Compared to individuals without disabilities, individuals with intellectual and developmental disabilities had the lower odds of receiving PST (OR = 0.38, 95% CI = 0.36-0.40), followed by individuals with dementia (OR = 0.40, 95% CI = 0.33-0.48) or multiple disabilities (OR = 0.52, 95% CI = 0.49-0.54).ConclusionsWe highly recommend that healthcare practitioners recognize the unique needs of individuals with different types of disabilities, especially those with cognitive impairments.
| S-EPMC10217891 | biostudies-literature
Project description:BackgroundPersons with speech, language, and/or voice disabilities (collectively referred to as communication disabilities (CD)) represent 10% of the US population, yet their healthcare outcomes have not been described. Generally, research shows that persons with disabilities have poorer health and healthcare outcomes than their non-disabled peers.ObjectivesTo examine the health and healthcare outcomes of persons with CD compared to persons without CD.DesignRetrospective cohort study of the 2012 National Health Interview Survey, which contained the first supplemental questions on CD. We compared proportional differences in outcomes; logistic and ordered logistic regression assessed the outcome measures across CD categories, controlling for demographics, non-communication disabilities, and chronic conditions. Findings are weighted to permit national inferences.ParticipantsAdults (≥ 18 years old) were divided into 4 mutually exclusive groups: people with voice disabilities only; speech/language disabilities only; speech/language and voice disabilities; and people without CD.Main measuresChronic health conditions; self-rated health; access to care; unmet needs for care; healthcare utilization.Key resultsAdults with CD more frequently had ≥ 1 chronic condition (voice 67.9%, speech/language 68.6%, speech/language and voice 79.9%, no CD 50.1%, p < 0.001) and reported fair/poor health (voice 19.5%, speech/language 32.5%, speech/language and voice 48.3%, no CD 11.2%, p < 0.001) compared to those without CD. Adults with CD more frequently utilized healthcare compared to those without CD. However, persons with CD endorsed greater difficulties accessing care than those without CD, including identifying a usual source of care, trouble finding a physician, and delaying or foregoing care (e.g., delayed due to availability of care: voice 26.1%, speech/language 37.2%, speech/language and voice 30.8% no CD 16.1%, p < 0.001).ConclusionsPersons with CD are medically complex and experience greater challenges accessing healthcare than persons without CD. Healthcare providers need support and tools to provide equitable care that addresses the medical needs of persons with CD.
| S-EPMC6258615 | biostudies-literature
Project description:AIM:To describe and compare the socio-demographic characteristics and community-based participation of children with and without disabilities. METHOD:This cross-sectional study reports data on 1073 children with disabilities (663 males, 410 females) and 11 122 children without disabilities (5617 males, 5505 females) aged 10 to 12 years from the fifth sweep of the Millennium Cohort Study. χ2 was used to explore differences between the two groups. Logistic regression models were used to assess the relationships between childhood disability (dependent variable) and socio-demographic characteristics. Logistic regression models were also used to examine the associations between childhood disability (dependent variable) and participation in community-based activities. RESULTS:Children with disabilities were more likely to be male, have psychosocial and behavioural problems, live in single-parent households, and have a parent with a longstanding illness. Patterns of community-based participation were similar between children with and without disabilities. However, the extent to which the two groups participated differed. Children with disabilities participated with lower frequency in unstructured physical activities (adjusted odds ratio [OR] 2.41; 95% confidence interval [CI]: 1.95-2.99), organized physical activities (adjusted OR 2.29; 95% CI: 1.83-2.86), religious gatherings (adjusted OR 2.08; 95% CI: 1.35-3.20), and getting together with friends (adjusted OR 3.31; 95% CI: 2.61-4.20). INTERPRETATION:Socio-demographic characteristics differed between children with and without disabilities. Children with disabilities had greater restriction in participation compared to peers without disabilities. Participation promoting interventions are required to support the participation of children with disabilities in social and physical activities. WHAT THIS PAPER ADDS:Patterns of community-based participation were similar between children with and without disabilities. Children with disabilities had lower frequency of participation in physical activities, religious gatherings, and getting together with friends.
| S-EPMC7078992 | biostudies-literature
Project description:Evidence exists on the health impacts of the current COVID-19 pandemic on health workers, but less is known about its impact on their work dynamics and livelihoods. This matters, as health workers-and physicians in particular-are a scarce and expensive resource in low- and middle-income countries (LMICs). Our cross-sectional survey set out to explore changes in working hours and earnings during the second year of the pandemic in a representative sample of 1183 physicians in Brazil's São Paulo (SP) and Maranhão (MA) states. Descriptive analysis and inferential statistics were employed to explore differences in working hours and earnings among public and private sector physicians across the two locations. The workloads and earnings of doctors working exclusively in the public sector increased the most in the second year of the epidemic, particularly in MA. Conversely, the largest proportion of private-only doctors in our sample saw a decrease in their working hours (48.4%, 95% CI 41.8-55.0), whereas the largest proportion of public-only doctors in MA saw an increase in their working hours (44.4%, 95% CI 38.0-50.8). Although earnings remained broadly stable in the public sector, a third of public sector-only physicians in MA saw an increase in their earnings (95% CI 24.4-36.2). More than half of private-only doctors across both states saw a decrease in their earnings (52.2%, 95% CI 45.6-58.8). The largest proportion of dual practitioners (the majority in Brazil and in our sample) maintained their pre-pandemic levels of income (38.8%, 95% CI 35.3-42.3). As public-sector doctors have been key in the fight against the pandemic, it is critical to invest in these cadres in order to develop epidemic preparedness in LMICs, and to find new ways to harness for-profit actors to deliver social benefits.
| S-EPMC9408582 | biostudies-literature
Project description:More married couples today consist of two high-earning or two low-earning partners (i.e., earnings homogamy), which leads to greater earnings inequality in married-couple families. Surprisingly few studies have examined this relationship by earnings level, leaving open the question of whether the increase in earnings homogamy at each level of earnings contributes equally to between-couple earnings inequality. I address this question using data on urban China during 1988-2013. Changes in earnings homogamy account for 6% to 11% of the increase in between-couple inequality, but importantly, decomposition reveals that 57% to 68% of the overall impact is driven by the growing earnings homogamy among the top 20% of husbands and their wives. I reach the same finding by replicating the analyses using data from the United States. Two explanations account for this finding: (1) earnings homogamy has increased more among high earners; and (2) all else being equal, increases among high earners are mechanically more influential in shaping the level of between-couple inequality. These findings have important theoretical and policy implications.
| S-EPMC8088775 | biostudies-literature
Project description:The growing economic similarity of spouses has contributed to rising income inequality across households. Explanations have typically centered on assortative mating, but recent work has argued that changes in women's employment and spouses' division of paid work have played a more important role. We expand this work to consider the critical turning point of parenthood in shaping couples' division of employment and earnings. Drawing on three U.S. nationally representative surveys, we examine the role of parenthood in spouses' earnings correlations between 1968 and 2015. We examine the extent to which changes in spouses' earnings correlations are due to (1) changes upon entry into marriage (assortative mating), (2) changes between marriage and parenthood, (3) changes following parenthood, and (4) changes in women's employment. Our findings show that increases in the correlation between spouses' earnings prior to 1990 came largely from changes between marriage and first birth, but increases after 1990 came almost entirely from changes following parenthood. In both instances, changes in women's employment are key to increasing earnings correlations. Changes in assortative mating played little role in either period. An assessment of the aggregate-level implications points to the growing significance of earnings similarity after parenthood for rising income inequality across families.
| S-EPMC8276622 | biostudies-literature
Project description:More than thirty years since the enactment of the Americans with Disabilities Act (ADA), people with disability continue to experience health care disparities. The ADA mandates that patients with disability receive reasonable accommodations. In our survey of 714 US physicians in outpatient practices, 35.8 percent reported knowing little or nothing about their legal responsibilities under the ADA, 71.2 percent answered incorrectly about who determines reasonable accommodations, 20.5 percent did not correctly identify who pays for these accommodations, and 68.4 felt that they were at risk for ADA lawsuits. Physicians who felt that lack of formal education or training was a moderate or large barrier to caring for patients with disability were more likely to report little or no knowledge of their responsibilities under the law and were more likely to believe that they were at risk for an ADA lawsuit. To achieve equitable care and social justice for patients with disability, considerable improvements are needed to educate physicians and make health care delivery systems more accessible and accommodating.
| S-EPMC8740697 | biostudies-literature
Project description:People with disabilities face barriers when attempting to gain access to health care settings. Using qualitative analysis of three physician focus groups, we identified physical, communication, knowledge, structural, and attitudinal barriers to care for people with disabilities. Physicians reported feeling overwhelmed by the demands of practicing medicine in general and the requirements of the Americans with Disabilities Act of 1990 specifically; in particular, they felt that they were inadequately reimbursed for accommodations. Some physicians reported that because of these concerns, they attempted to discharge people with disabilities from their practices. Increasing health care access for people with disabilities will require increasing the accessibility of space and the availability of proper equipment, improving the education of clinicians about the care of people with disabilities, and removing structural barriers in the health care delivery system. Our findings also suggest that physicians' bias and general reluctance to care for people with disabilities play a role in perpetuating the health care disparities they experience.
| S-EPMC9984238 | biostudies-literature
Project description:Background: Prior research has found that women with disabilities are more likely to deliver by cesarean than are women without disabilities. It is not clear whether all of the cesarean deliveries among women with disabilities are medically necessary.Objectives: To examine the associations between maternal disability status and type, mode of delivery, and medical indications for cesarean delivery in California deliveries.Study design: Retrospective cohort study of all nulliparous births in California between 2000 and 2012. We classified births as to whether or not women underwent a trial of labor and determined if medical indications for cesarean delivery were present. Multivariable logistic regression models examined the association of disability with trial of labor and indications for cesarean delivery.Results: Women with disabilities had lower odds of having a labored delivery, compared to women without disabilities (adjusted odds ratio (aOR) = 0.45, 95% confidence interval (CI) 0.41-0.49). In the sample of women who labored (90.5% of total), women with disabilities were more likely to have a medical indication for cesarean delivery (aOR = 1.15, 95% CI 1.10-1.21) and were more likely to have a cesarean delivery (aOR = 1.46, 95% CI = 1.38-1.54). In the subsample of unlabored cesarean deliveries, women with disabilities were less likely to have documented medical indications for cesarean delivery (aOR = 0.45, 95% CI = 0.41-0.50).Conclusions: Women with disabilities were less likely to labor, and these unlabored cesarean deliveries were less likely to have a medical indication for cesarean, compared to women without disabilities.
| S-EPMC7780300 | biostudies-literature