Dataset Information

Health Insurance Programs, Extended Social History Taking, and Resources to Overcome Health Care Barriers: Introduction for Medical Students.

ABSTRACT:

Introduction

Recognizing social determinants of health and addressing barriers to health care are an essential part of medical practice for which students' formal training is inadequate. The majority of medical students feel a professional responsibility to understand health policy, but their knowledge of health care legislation and health insurance is lacking, and their primary information sources are outside the medical education setting. This resource provides an easily implemented tool kit to begin to fill these educational gaps.

Methods

During their first inpatient medicine clerkship, fourth-year students in a 6-year BA/MD program participated in a classroom activity that included instruction on taking a comprehensive social history and a lecture regarding government insurance. Through an interactive case-based discussion, students developed a list of specific resources and then compiled information to share with their classmates.

Results

Thirty-seven students participated in this learning activity during a brief pilot period. Comparison of preclass and postclass survey data showed that students increased their knowledge regarding insurance programs. Students also increased their self-perceived skills in identifying barriers and arranging resources for patients. The majority of students (94%) intended to apply these skills and knowledge during future clinical rotations.

Discussion

This resource provides a tool for introductory, interactive learning about health insurance, social history taking, and addressing barriers to health care, and requires minimal resources. The amount of time devoted to the activity, references, and discussion topics can be customized to fit within a school's specific learning goals and overall curriculum on health disparities.

SUBMITTER: Haury E

PROVIDER: S-EPMC7809925 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Health Insurance Programs, Extended Social History Taking, and Resources to Overcome Health Care Barriers: Introduction for Medical Students.

Haury Emily E

MedEdPORTAL : the journal of teaching and learning resources 20210107

<h4>Introduction</h4>Recognizing social determinants of health and addressing barriers to health care are an essential part of medical practice for which students' formal training is inadequate. The majority of medical students feel a professional responsibility to understand health policy, but their knowledge of health care legislation and health insurance is lacking, and their primary information sources are outside the medical education setting. This resource provides an easily implemented to ...[more]

PMID: 33473375

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Project description:BackgroundMedical schools worldwide are accelerating the introduction of digital health courses into their curricula. The COVID-19 pandemic has contributed to this swift and widespread transition to digital health and education. However, the need for digital health competencies goes beyond the COVID-19 pandemic because they are becoming essential for the delivery of effective, efficient, and safe care.ObjectiveThis review aims to collate and analyze studies evaluating digital health education for medical students to inform the development of future courses and identify areas where curricula may need to be strengthened.MethodsWe carried out a scoping review by following the guidance of the Joanna Briggs Institute, and the results were reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. We searched 6 major bibliographic databases and gray literature sources for articles published between January 2000 and November 2019. Two authors independently screened the retrieved citations and extracted the data from the included studies. Discrepancies were resolved by consensus discussions between the authors. The findings were analyzed using thematic analysis and presented narratively.ResultsA total of 34 studies focusing on different digital courses were included in this review. Most of the studies (22/34, 65%) were published between 2010 and 2019 and originated in the United States (20/34, 59%). The reported digital health courses were mostly elective (20/34, 59%), were integrated into the existing curriculum (24/34, 71%), and focused mainly on medical informatics (17/34, 50%). Most of the courses targeted medical students from the first to third year (17/34, 50%), and the duration of the courses ranged from 1 hour to 3 academic years. Most of the studies (22/34, 65%) reported the use of blended education. A few of the studies (6/34, 18%) delivered courses entirely digitally by using online modules, offline learning, massive open online courses, and virtual patient simulations. The reported courses used various assessment approaches such as paper-based assessments, in-person observations, and online assessments. Most of the studies (30/34, 88%) evaluated courses mostly by using an uncontrolled before-and-after design and generally reported improvements in students' learning outcomes.ConclusionsDigital health courses reported in literature are mostly elective, focus on a single area of digital health, and lack robust evaluation. They have diverse delivery, development, and assessment approaches. There is an urgent need for high-quality studies that evaluate digital health education.

Project description:ObjectivesNational health insurance is now common in most developed countries. This study reviews the evidence and synthesizes the cost-effectiveness information for national health insurance or disability insurance programs across high-income countries.Data sourcesA literature search using health, economics and systematic review electronic databases (PubMed, Embase, Medline, Econlit, RepEc, Cochrane library and Campbell library), was conducted from April to October 2015.Study selectionTwo reviewers independently selected relevant studies by applying screening criteria to the title and keywords fields, followed by a detailed examination of abstracts.Data extractionStudies were selected for data extraction using a quality assessment form consisting of five questions. Only studies with positive answers to all five screening questions were selected for data extraction. Data were entered into a data extraction form by one reviewer and verified by another.Evidence synthesisData on costs and quality of life in control and treatment groups were used to draw distributions for synthesis. We chose the log-normal distribution for both cost and quality-of-life data to reflect non-negative value and high skew. The results were synthesized using a Monte Carlo simulation, with 10,000 repetitions, to estimate the overall cost-effectiveness of national health insurance programs.ResultsFour studies from the United States that examined the cost-effectiveness of national health insurance were included in the review. One study examined the effects of medical expenditure, and the remaining studies examined the cost-effectiveness of health insurance reforms. The incremental cost-effectiveness ratio (ICER) ranged from US$23,000 to US$64,000 per QALY. The combined results showed that national health insurance is associated with an average incremental cost-effectiveness ratio of US$51,300 per quality-adjusted life year (QALY). Based on the standard threshold for cost-effectiveness, national insurance programs are cost-effective interventions.ConclusionsAlthough national health insurance programs have been introduced in most developed countries, only a few studies have examined their cost-effectiveness. All the selected studies revealed strong evidence to support health insurance programs or health reforms in the United States. The average ICER in this study is below the standard threshold for cost-effectiveness used in the US. The small number of relevant studies is the main limitation of this study.

Dataset Information

Health Insurance Programs, Extended Social History Taking, and Resources to Overcome Health Care Barriers: Introduction for Medical Students.

Introduction

Methods

Results

Discussion

Publications

Health Insurance Programs, Extended Social History Taking, and Resources to Overcome Health Care Barriers: Introduction for Medical Students.

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