Biomedical subjects

Arleen A Leibowitz

Publications and source records attributed to Arleen A Leibowitz.

6 recordsLinked to original sources

PubMed2005

Psychotropic medication use in a national probability sample of children in the child welfare system.

OBJECTIVES: The aim of this study was to estimate the point prevalence of psychotropic medication use, and to describe relationships between child-level characteristics, provider type, and medication use among children in the child welfare system. METHODS: The National Survey of Child and Adolescent Well-Being is the first nationally representative study of children coming into contact with the child welfare system. We used data from its baseline and 12-month follow-up waves, and conducted weighted bivariate analyses on a sample of 3114 children and adolescents, 87% of whom were residing in-home. RESULTS: Overall, 13.5% of children in child welfare were taking psychotropic medications in 2001-2002. Older age, male gender, Caucasian race/ethnicity, history of physical abuse, public insurance, and borderline scores on the internalizing and externalizing subscales of the Child Behavior Checklist were associated with higher proportions of medication use. African-American and Latino ethnicities, and a history of neglect, were associated with lower proportions of medication use. CONCLUSIONS: These national estimates suggest that children in child welfare settings are receiving psychotropic medications at a rate between 2 and 3 times that of children treated in the community. This suggests a need to further understand the prescribing of psychotropic medications for child welfare children.

Adolescent↗

PubMed2005

A socioeconomic profile of older adults with HIV.

The objective of this study was to assess the socioeconomic circumstances of older patients with HIV and acquired immunodeficiency syndrome (AIDS). The investigators compared subjects from a national probability sample of 2,864 respondents from the HIV Cost and Services Utilization Study (HCSUS, 1996) with 9,810 subjects from Wave 1 (1992) of the Health and Retirement Survey (HRS). Bivariate analyses compare demographic characteristics, financial resources, and health insurance status between older and younger adults and between older adults with HIV and the general population. It was found that nearly 10% of the HIV-positive population is between the ages of 50 and 61 years. Older whites with HIV are mostly homosexual men who are more well educated, more often privately insured, and more financially stable than the HIV population as a whole. In contrast, older minorities with HIV possess few economic resources in either absolute or relative terms. The success of new drug therapies and the changing demographics of the HIV population necessitate innovative policies that promote labor force participation and continuous access to antiretroviral therapies.

Female↗

PubMed2004

The demand for health and health concerns after 30 years.

Michael Grossman's seminal model stressed that health production requires both goods and time. Yet recent empirical health research focuses primarily on personal medical care to the exclusion of other inputs to health. Future research should place greater emphasis on the roles of non-medical consumption goods, population level inputs and time in producing health capital. Improved information technology will allow researchers to dissect how education promotes efficiency in combining goods and time to produce health. Economic analyses of child health, which is the antecedent of adult health, must proceed in tandem with medical advances in understanding health development in childhood.

Child↗

PubMed2004

Rapid HIV testing: issues in implementation.

With the approval of rapid HIV testing and the expected broader use of this technology, community-based organizations incorporating its use face both opportunities and challenges. The primary advantage of rapid testing is the ability to dramatically increase the number of individuals who become aware of their HIV status. Individuals will be able to test for HIV and learn their results in the same session. Many challenges exist, however, for those agencies considering offering rapid HIV testing. For example, given the potential for an increase in the number of individuals seeking rapid testing, there will be a need to ensure that the individuals who are at highest risk for HIV are being tested. In addition, given that rapid testing will be done in a single session, it will be necessary to consider how to effectively address a client's behaviors and attitudes concerning high-risk activities. New types of referrals may also need to be developed, such as for individuals who receive a preliminary positive HIV test result and who will need to return for a confirmatory result. In addition, those receiving confirmatory positive results will require immediate linkages to a variety of services, including medical, mental health, and social services. Also, counselors providing immediate test results may need additional skills and support to address the stress associated with implementing this new technology. Community agencies will need to utilize this technology in a way that maximizes its potential to identify cases of HIV and links individuals as quickly as possible to needed services.

AIDS Serodiagnosis↗

PubMed2004

Employee responses to health insurance premium increases.

OBJECTIVE: To determine the sensitivity of employees' health insurance decisions--including the decision to not choose health maintenance organization or fee-for-service coverage--during periods of rapidly escalating healthcare costs. STUDY DESIGN: A retrospective cohort study of employee plan choices at a single large firm with a "cafeteria-style" benefits plan wherein employees paid all the additional cost of purchasing more generous insurance. METHODS: We modeled the probability that an employee would drop coverage or switch plans in response to employee premium increases using data from a single large US company with employees across 47 states during the 3-year period of 1989 through 1991, a time of large premium increases within and across plans. RESULTS: Premium increases induced substantial plan switching. Single employees were more likely to respond to premium increases by dropping coverage, whereas families tended to switch to another plan. Premium increases of 10% induced 7% of single employees to drop or severely cut back on coverage; 13% to switch to another plan; and 80% to remain in their existing plan. Similar figures for those with family coverage were 11%, 12%, and 77%, respectively. Simulation results that control for known covariates show similar increases. When faced with a dramatic increase in premiums--on the order of 20%--nearly one fifth of the single employees dropped coverage compared with 10% of those with family coverage. CONCLUSIONS: Employee coverage decisions are sensitive to rapidly increasing premiums, and single employees may be likely to drop coverage. This finding suggests that sustained premium increases could induce substantial increases in the number of uninsured individuals.

Adult↗

PubMed2003

Insurance status of HIV-infected adults in the post-HAART era: evidence from the United States.

In the United States, universal public insurance is only available for the elderly. But unlike most other major diseases, HIV/AIDS predominantly affects the nonelderly. The result is that insurance availability and public programme participation are linked to disease progression in a complicated way. This paper uses data from a unique, nationally representative sample of HIV-infected adults receiving medical care, to describe the relationship between disease progression and insurance coverage in the United States. We find that public insurance is the predominant source of coverage for those in care for HIV, and that coverage increases as disease progresses. Those with public coverage have substantial work experience and earnings capacity, but do not work. This suggests that reforms allowing HIV positive (+) patients to maintain public coverage while returning to work could increase employment and earnings significantly. More speculatively, it suggests that the United States system for financing health care is not well-equipped to deal with epidemics that afflict a population in its prime work years.

Adult↗