Vulnerable Populations

MTPPI has longstanding interest in access to care, health care utilization, and outcomes among vulnerable populations. Given the fragmented nature of the U.S. healthcare system, the lack of universal insurance, and high rates of poverty among minorities and disadvantaged populations, MTPPI has joined many members of the health services research community who are concerned about the health care of vulnerable populations. Many of MTPPI’s intramural projects have examined such populations, the most prominent issues include the following:

• Exclusion from the Medicare program of persons with end-stage renal disease who do not qualify based on administrative requirements;
• Complexity and coordination of care required by persons with a serious chronic medical condition or multiple conditions;
• Access to cadaveric kidney transplantation based on insurance status;
• Access to expensive life-long immunosuppressive regimens for transplant recipients after their eligibility to Medicare expires three years post-transplant;
• Rates of uninsurance among immigrant foreign-born populations in the U.S.;
• Implications of the Orphan Drug Act for persons with an ‘orphan’ medical condition who require extremely expensive drug therapy that may use up their lifetime maximum cap;
• Excess of asthma morbidity and mortality found among minorities in urban areas;
• Extent and adequacy of psychiatric treatment among persons suffering from one or more chronic medical condition.

Publications

Recent publications prepared by the Institute in this field are:

Physician Prescribing for Peptic Ulcer Disease

Excluded from Universal Coverage: ESRD Patients Not Covered by Medicare

The Cost of Medicaid-Covered Services Provided to Disabled Adults With Neurologic Disorders: Implications for Managed Care

Unequal Access to Cadaveric Kidney Transplantation in California Based on Insurance Status

Health Insurance Coverage among Foreign-Born US Residents: The Impact of Race, Ethnicity, and Length of Residence

A Cross-National Comparison of Orphan Drug Policies: Implications for the U.S. Orphan Drug Act

Psychiatric Illness in Patients with End-Stage Renal Disease

Race, Income, Urbanicity, and Asthma Hospitalization in California

Influence of the NIH Consensus Conference on Helicobacter Pylori on Physician Prescribing Among a Medicaid Population

The Effect of Insurance Status on Use of Recombinant Erythropoietin Therapy Among End-Stage Renal Disease Patients in Three States

Drug Use Concomitant With Cyclosporine Immunosuppressive Therapy for 3 Years After Renal Transplantation

Diagnostic Imaging & Child Abuse: Technologies, Practices & Guidelines

Public and private health insurance of US foreign-born residents: implications of the 1996 welfare reform law.

 

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