Enrollment Trends Research Articles

Abstract B036: Trends in disparities in clinical trial accrual: An analysis of National Cancer Institute (NCI)-sponsored early phase clinical trials over the last 22 years

Abstract Using the NCI Cancer Therapy Evaluation Program (CTEP)-sponsored early phase oncology clinical trials database, we evaluated trends in disparities in patient enrollment over the last 22 years. Counts and percentages of enrolled patients were calculated directly from the full population of patients enrolled to CTEP-sponsored Phase 1, 2, and 1/2 trials during 2000-22. Trends in enrollment were assessed based on single-year data, four-year periods, and using a three-year rolling average. Analyses of patient residential ZIP code were restricted to patients residing and enrolled at institutions within the United States. Geographical data corresponding to patient ZIP codes was obtained using the zipcodeR package, including geographical region and median household income corresponding to each ZIP, and distance between patient residential and enrolling institution ZIPs. A total of 14,877 patients were enrolled in CTEP-sponsored early phase trials evaluated during 2000-22, with 14,342 residing and enrolled within the US. The proportion of patients aged 40-64 at enrollment decreased from 59.8% in 2000-03 to 47.5% in 2020-22, with corresponding increases in ages 65-74 (24.2% to 32.9%) and 75-84 (5.9% to 12.3%). There were fluctuations in gender, most likely based on the specific agents being studied in clinical trials enrolling at a given time. In 2020-22, 72.9% of the population was non-Hispanic white when compared to 2000-03 when enrollment of non-Hispanic whites was 83.7%. Hispanic/Latino population enrollment increased from 4.2% in years 2000-03 to 6.9% in years 2020-22. Asian/Pacific Islander population increased from 2.5% in 2000-03 to 5.4% in 2020-22. Enrollment of non-Hispanic Black patients increased slightly over the last 20 years (6.3% to 7.1%), as did the proportion with unknown or unspecified race/ethnicity (3.3% to 7.6%). Trial enrollment trends by geographic regions revealed that enrollment in South and West overall increased (29.1% to 40.9%; 7.9% to 18.2%), Northeast representation remained static (23.9% to 20.8%) and Midwest representation decreased (24.4% to 19.4%) from 2000-03 to 2020-22. Most early phase participants in our database were from localities with a moderate median household income ($52,200 - $156,600; 51.9% to 59.4%), with an increase in representation from low-income localities (income < $52,000; 31.1% to 37.7%) over the last 22 years. We observed an overall increase in patients enrolling within a 50-mile radius of their residence over the 22-year period (46.5% to 64.5%) and an overall decrease in patients traveling over 200 miles to enroll in clinical trials (16.1% to 8.3%). We also examined trends in disparities during the COVID-19 pandemic and saw no significant differences in trial enrollment by race/ethnicity and gender when compared to pre-pandemic enrollment. Disparities in patients enrolled in early-phase clinical trials have marginally improved over the span of two decades, and outreach and inclusion efforts for enrollment of underrepresented patients should be continued to sustain these observed trends. Citation Format: Maria Farooq, Elad Sharon, Naoko Takebe, Ana F. Best, Shanda Finnigan. Trends in disparities in clinical trial accrual: An analysis of National Cancer Institute (NCI)-sponsored early phase clinical trials over the last 22 years [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B036.

Do Declining Enrollments Predict Teacher Turnover in Music?

The purpose of this study was to investigate the potential relationship between student enrollment trends in elective secondary music ensembles and music ensemble teacher job turnover. Although student enrollment is widely accepted as an important concern for music educators and a crude proxy measure of music teacher quality, these normative beliefs have not been thoroughly examined empirically. This study tested these beliefs using data from a State Longitudinal Data System to link statewide high school student ensemble enrollment data to teacher workforce data for the academic years 2012 to 2013 through 2019 to 2020. Two-way fixed effects estimators with logistic and multinomial logistic regression showed that decreasing enrollments in high school music ensembles predict music teachers’ departure from the profession. A comparative interrupted time-series analysis showed that a change in music teacher does not significantly affect the future enrollment trend of a high school music ensemble program. An exploratory analysis examining the postteaching careers of former high school music teachers showed that the majority of music teachers who exited the profession earned considerably higher wages in their new careers. The authors conclude by discussing the implications of the results for music teachers, music administrators, music teacher education, and future research.

Linking Response to Intervention and Identification of a Specific Learning Disability

We investigated state and national trends in the enrollment of students ages 6 to 21 under the specific learning disability (SLD) category across 15 consecutive school years (2005–2006 to 2019–2020). We used multi-level modeling to estimate the effects of state and time on SLD enrollment and conducted a policy analysis of three states (Rhode Island, Kansas, and New Mexico) to examine changes in SLD policy (including Response to Intervention) in conjunction with trends in enrollment. Results indicate significant differences in SLD enrollment between states in the initial year and significant decreases in SLD enrollment over time, but no significant differences in the change in SLD enrollment between states. Results from the policy analysis suggest that the state policy context (including legal requirements in the SLD evaluation process), type of RTI model, and method of SLD evaluation can affect SLD enrollment. We discuss these results within the context of increased variability in RTI models.

Gender Disparities in Nephrology Trials: A Meta-Analysis of Enrollment Trends between 2000 and 2021.

Gender disparities in the incidence and complications of kidney diseases are well described. However, analysis to elucidate gender disparities in enrollment in nephrology randomized clinical trials (RCTs) has not been performed. We performed a systematic review and meta-analysis of high impact nephrology RCTs published between 2000-2021. We. included RCTs enrolling participants age ≥18 in the following categories: 1) chronic kidney disease (CKD); 2) acute kidney injury (AKI); 3) glomerulonephritis (GN); 4) maintenance dialysis; and 5) kidney transplantation. We summarized trial characteristics according to reporting and enrollment of participants, enrollment site, publication year, trial category, and intervention type. Outcomes of interest include the proportion of enrolled male and female participants overall and according to trial category. Additionally, we compared enrollment trends in the United States and globally to estimates of kidney disease prevalence. The majority of qualifying trials (373/380, 98%) reported the distribution of male and female participants. Enrollment was imbalanced overall with male participants accounting for 62% (n=215,850) of the enrolled participants and female participants for just 38% (n=133,082). Male participants formed the majority of trial cohorts in AKI (65%), CKD (62%), Dialysis (55%) and transplant trials (65%), whereas women were majority enrollees in glomerulonephritis trials (61%). CKD trials under-represented women in both US trials and worldwide. Women are under-represented in high impact nephrology trials with the exception of GN trials. This imbalance may contribute to disparities in outcomes and gaps in the care of women with kidney disease.

Navigating Transitioning Experiences: A Review of Ethnic Minority First-generation College Students in Chinese Higher Education

Since the 1980s, educational opportunity programs aimed at reducing the disparities between ethnic minority groups and the Han have been implemented in China. In reflection of the policies, the China College Student Survey (CCSS) finds a positive trend of enrollment from first-generation college students with rural backgrounds in the past ten years. An increasing number of scholarly works have also investigated the effects of policies on ethnic minority college students and proposed recommendations for improving policies to assist individuals in adapting to college life. This paper considers the importance of resilience in transitional experiences on both academic and life outcomes and reviews both quantitative and qualitative studies on ethnic minority university students experiences in Han-dominant urban areas. Through Tummala-Narras multicultural resilience framework, this paper concludes three dimensions of resilience employed by ethnic minority individualsresilience as active capital accumulation, resilience as hope and empowerment, and resilience as social supportand finds that to ensure well-being in the Chinese context, individuals most likely find resilience from their personal abilities and interactions with mainstream culture, while downplaying the role of community and family support. In the future, cross-sectional, periodic, and longitudinal data can be introduced to the topic as waves of cultural, economic, and policy shifts engender different experiences for each cohort generation and the diverse pool of ethnic minority students. Considering the fluidity and context-dependent nature of resilience, future studies could probe into how resilience functions in multicultural workspaces post-college and how identities concerning race and ethnicity shape economic relations.

A demographic profile of high school music courses in New York

ABSTRACT Previous scholarship has provided a broad overview of demographic trends in secondary school music enrolment across the United States. However, there exists a gap in the literature in how students with disabilities are represented in school music, and the demographics of students enrolled in experiences outside of band, orchestra, and choir. Therefore, the purpose of this study was to examine demographic trends in music courses across New York, which has implemented a variety of course offerings that exist outside of band, orchestra, and choir. Using data obtained from the State Department of Education’s Student Information Repository System (SIRS), this article provides a profile of school music in the state. Results demonstrate how students with disabilities are underrepresented in school music programmes and differences in participation by race, gender, socioeconomic status, and native language across a variety of traditional and non-traditional school music experiences. Specific music experiences, such as Guitar and Piano, help to balance the demographic profile of school music programmes with disproportionately White and more affluent large ensemble courses.

AACSB accreditation and student demand

AbstractWe ask whether Association to Advance Collegiate Schools of Business (AACSB) accreditation has a meaningful impact on higher education admissions. To do this, we use the Synthetic control Method to explore 19 U.S. institutions which first achieved this certification recently. We, first, restrict attention to business school enrollment. While initial evidence suggests that the accreditation is associated with a decrease in enrollments, we show that this is complicated by non‐parallel trends prior to accreditation. Compared to their peers, institutions who seek out accreditation were experiencing flatter business enrollments. Correcting for the non‐parallel trends, we fail to find evidence that AACSB accreditation halts this negative undergraduate enrollment trend. We do find potential benefits to graduate business enrollment. Second, considering institution‐wide effects, we fail to find an impact on undergraduate applications, first‐year enrollment, price, or quality of the incoming student body.

Insufficient Reporting of Race and Ethnicity in Breast Cancer Clinical Trials.

Reporting race and ethnicity in clinical trial publications is critical for determining the generalizability and effectiveness of new treatments. This is particularly important for breast cancer, in which Black women have been shown to have between 40 and 100% higher mortality rate yet are underrepresented in trials. Our objective was to describe changes over time in the reporting of race/ethnicity in breast trial publications. We searched ClinicalTrials.gov to identify the primary publication linked to trials with results posted from May 2010-2022. Statistical analysis included summed frequencies and a linear regression model of the proportion of articles reporting race/ethnicity and the proportion of non-White enrollees over time. A proportion of 72 of the 98 (73.4%) studies that met inclusion criteria reported race/ethnicity. In a linear regression model of the proportion of studies reporting race/ethnicity as a function of time, there was no statistically significant change, although we detected a signal toward a decreasing trend (coefficient for quarter = -2.2, p = 0.2). Among all studies reporting race and ethnicity over the study period, the overall percentage of non-White enrollees during the study period was 21.9%, [standard error (s.e.) 1.8, 95% confidence interval (CI) 18.4, 25.5] with a signal towards a decreasing trend in Non-White enrollment [coefficient for year-quarter = -0.8 (p = 0.2)]. Our data demonstrate that both race reporting and overall representation of minority groups in breast cancer clinical trials did not improve over the last 12 years and may have, in fact, decreased. Increased reporting of race and ethnicity data forces the medical community to confront disparities in access to clinical trials. This may improve efforts to recruit and retain members of minority groups in clinical trials, and over time, reduce racial disparities in oncologic outcomes.

The Origin and Evolution of an Anomalous Academic Credential: The Ontario College Advanced Diploma

The Ontario College Advanced Diploma requires three years of post-secondary education and the attainment of learning outcomes like those of a three-year baccalaureate degree. Except for one other Canadian province, no similar academic credential is awarded by colleges in Canada or the United States. For these reasons it has been viewed by some as an anomalous academic credential. This article relates how Ontario colleges came to offer such a rare credential and how the credential survived for over half a century. Employing the concept of path dependence, the origins of the advanced diploma are traced back to the institutes of technology that were first established in Ontario in the 1940s. The article employs a mix of historical inquiry, document analysis, enrolment trend analysis, and literature review methodologies.

Descriptive Analysis of University Enrollment Trends in Colombia between 2014 and 2022

During the study period between 2014 and 2022, a 9.5% increase in the number of university students enrolled in Colombia was observed, with a total of 419,940 new enrollees. The objective of this research was to analyze trends and cycles in university enrollments, focusing on the impact of the COVID-19 pandemic and the growth of the virtual modality. The methodology included analyzing data from the National Higher Education Information System (SNIES) and performing calculations to evaluate variations in enrollments over the years. The results allowed visualizing the enrollment cycles between private and official sector universities, highlighting that the pandemic generated a significant decrease in enrollments in 2020, mainly affecting private universities. An increase in the gap between enrollment in the official and private sector was observed, with the latter losing ground. The virtual modality experienced exponential growth in the last 8 years and as a result of the pandemic became an important factor in the university enrollment market, especially in graduate programs in the private sector and undergraduate programs in the formal sector. In summary, the study reveals the transformation of the university enrollment landscape in Colombia, due to changes in student preferences between sector and mode of study. These findings may be valuable for decision making in educational institutions and provide a deeper understanding of trends in higher education in the Colombian context.

An Empirical Study on the Growth in Enrolment of Additional Skill Acquisition Programme in Kerala

Objective: The study's purpose is to evaluate the efficacy and impact of the Additional Skills Acquisition Programme (ASAP) initiated by the Kerala government in India. The research questions focus on understanding the enrolment trends and assessing the impact of skills development across various sectors. Theoretical Framework: The research is grounded in the understanding of the pivotal role of higher education and skill development in driving economic and social growth. It proposes the essentiality of knowledge and skill-based education in catering to the requirements of a globalized economy and society. Method: The methodology employed for this study involves using secondary data gathered from the official website of ASAP, Government of Kerala, for the period 2014-15 to 2018-18. The data was analysed using ANOVA tests and Time Series Analysis to discern patterns and trends. Results and Conclusion: The analysis unveils a consistent enrolment of approximately 2500-2700 students in the ASAP program during the examined period, with a steady composition of students across B.Com, B.Sc, and BA. However, the study recommends implementing stringent measures to further boost enrolment. Implications of the research: The study highlights the need for an effective skill development framework to achieve global competitiveness and economic growth. It provides recommendations to capitalize on India's demographic dividend through apt skill development. Originality/Value: This research contributes to the understanding of the practical implementation and outcomes of a government-led skill development program, and its impact on economic and social development, particularly in the context of a rapidly globalizing economy.

The Impact of Implementation of Free Tuition on Access to Education in Public Day Secondary Schools in Njoro Sub-County, Kenya

The implementation of Free Primary Education (FPE) in the year 2003 stemmed from the huge admission of children to primary schools. The Kenyan administration introduced the initiative in 2008 as a mechanism purposed to check on the issues emanating from the FPE. Worries have conversely been noticed over the impact of free tuition programs on access. The exploration determination was to assess the influence of free tuition on access to education in public day secondary schools in Njoro Sub-County Nakuru County in relation to enrolment trends. The investigation utilized a descriptive review research plan. The objective populace was 528 respondents, which incorporated 40 head educators, 487 instructors and one sub-region training officer in Njoro Sub-County. The sample size was 106 respondents, made up of 8 head educators, 97 instructors, and one Sub-County Education Officer. Proportionate sampling was embraced in the selection of the head teachers and teachers, while purposive sampling was applied in the selection of the Sub-County Education Officer. The instrument for collecting data was mainly questionnaires which were used on the head teachers and teachers, while an interview schedule was applied in gathering data from the Sub-county Education Officer. From the findings, it is recommended that for enrolment to be enhanced, the government should introduce a mechanism to support parents in meeting other initial costs, such as uniforms and buying books in public day secondary schools in Njoro Sub-County.

1012-P: Trends in Enrollment in Medicare Advantage Plans among Older Adults with Diabetes, 2015–2020

Existing literature has found an increase in the proportion of older adults that enroll in Medicare Advantage (MA) plans relative to those enrolling in traditional Medicare (TMed). Similarly, previous studies have shown that individuals with diabetes are more likely to enroll in MA plans than those without diabetes. Our objective was to determine whether trends for enrollment in MA plans among adults with diabetes followed a similar trend to those without diabetes. We used the Medicare Current Beneficiary Survey (MCBS) to calculate the proportion of the Medicare-eligible population enrolling in MA vs. TMed each year from 2015 - 2020. We stratified these rates by diabetes diagnosis (any diabetes vs. no diabetes), and further by diabetes type (Type 1 vs. Type 2). Like previously published literature, we found that those with diagnosed diabetes has higher rates of MA enrollment than those without diabetes. MA enrollment trends followed a similar pattern among those with diabetes compared to those without. Among those without diabetes, MA enrollment rates increased from 34.2% in 2015 to 40.5% in 2020. Among those with Type 1 and Type 2 Diabetes, MA enrollment rates increased from 38.8% to 46.9% and from 38.4% to 45.8%, respectively. In relative terms, MA enrollment increased by 20.9% among those with Type 1 Diabetes, 13.9% among those with Type 2 Diabetes, 15.9% with other diabetes, and 18.3% without diabetes. Disclosure J.M.Weinstein: Research Support; Dexcom, Inc. R.Muthukkumar: None. L.A.Young: Research Support; Novo Nordisk, Rhythm Pharmaceuticals, Inc., Eli Lilly and Company, Jaeb Center for Health Research, Sanofi, Boehringer-Ingelheim. A.R.Kahkoska: None. Funding National Institutes of Health (KL2TR002490, UL1TR002489)

Student perceptions: How virtual student-led talking circles promote engagement, social connectedness, and academic benefit

Many expect upward trends in online college course enrollment to continue. Despite perceived improvements in online pedagogical practice and advantages afforded by virtual platforms, most students and professors still perceive social interaction, engagement, and overall learning to be more challenging online than in person. More than 3 in 10 college students are less willing to participate in discussions online compared to in person. More than 7 in 10 professors report needing help with strategies for keeping students engaged online. As such, we must identify strategies that cater to students’ academic, and social-emotional needs in an online environment. Breakout rooms have often been implemented to promote discussion and collaboration, however, when not well-structured, they often increase social discomfort instead. In this mixed methods study, using surveys, interviews and class observations, we examine student-led talking circles in an undergraduate adolescent development course ( N = 61), in which student discussion leaders prepared questions and facilitated small group conversations using structured turn-taking protocols. Nearly 95% of students felt talking circles increased peer connectedness, 92% felt they improved content learning, and 90% felt they increased engagement. Students largely attributed these benefits to specific elements of the talking circle format. Regression results revealed significant associations between peer connectedness and perceived academic benefit, after accounting for demographics, basic psychological needs, dispositional factors, and norms of communication.

Patterns of diversity in cancer clinical trial enrollment at a New York City academic health system, 2018-2022.

e18630 Background: Mitigation of cancer clinical trial (CT) enrollment disparities is increasingly prioritized in healthcare, but disparity metrics are inconsistently published by individual health systems. We aimed to assess health-system-level trends in CT enrollment by race, ethnicity, sex, and treatment location (network vs main hospital) during the COVID-19 pandemic, as well as to evaluate county-level disparities in CT accrual fraction (AF) over a five-year period. Methods: This was a cross-sectional study of the population enrolled on therapeutic cancer CTs in a New York City academic health system (AHS) from 2018-2022. Demographics were descriptively analyzed and compared with most recent public NCI-reported therapeutic trial accrual data. New York County 5-year cancer incidence was estimated for each demographic subgroup using age-adjusted cancer incidence rates from public SEER/NPCR data and US Census data. Primary endpoint was AF, defined as proportion of patients accrued relative to cancer incidence. Results: Of 2,533 patients enrolled on CTs over the 5-year period, 51% were White, 18% Black, 17% Hispanic, 9.8% Asian, 0.08% American Indian/AK Native, 0% Pacific Islander, and 3.9% Multiple/unknown race; 47% were female. Minority accrual proportion was higher than that of NCI accrual data (45% vs 25%, p =< 0.001). Annual enrollment fell from maximum 571 patients in 2019 to 457 in 2020, then increased to 499 by 2022. Meanwhile, the proportion of minority enrollment increased to a peak of 49.2% in 2020 and fell to 45% in 2022. Female enrollment of 49% in 2018 decreased to 42% in 2021, increasing sharply to 51% in 2022. On multivariate analysis, Black and Asian patients were more likely to be enrolled after the start of the pandemic than White patients (ORs 1.3, 95% CI 1.1-1.6; 1.4, 1.03-1.8). Black, Asian, and female patients were more likely to be enrolled at network hospital locations than White or male patients, respectively (ORs 1.9, 95% CI 1.3-2.7; 2, 1.2-3.1; 14, 8.6-21). Relative to county-level estimated cancer incidence, Black patients had a higher AF than White patients (0.96% vs 0.77%, OR 1.3, 95% CI 1.1-1.4), while Hispanic patients had a lower AF (0.55%, OR 0.72, 95% CI 0.64-0.8). Women had a lower AF than men (0.66% vs 0.74%, OR 0.9, 95% CI 0.83-0.97). Conclusions: Minority accrual at this AHS was higher than nationally reported. Despite decreased total accrual numbers in 2020 due to the COVID-19 pandemic, high accrual diversity was maintained. County-level AF disparities among women and Hispanic patients suggest opportunities for improvement in community outreach, and greater diversity of clinical trial enrollees at network hospitals may reflect successful outreach to the communities they serve.

Enrollment Trends, Motivations, and Future Aspirations of Female Undergraduate Students in STEM Courses at Federal University Gusau - Nigeria

This study aimed to investigate the enrollment trends, motivations, and future aspirations of female undergraduate students in Science, Technology, Engineering, and Mathematics (STEM) courses at the Federal University Gusau in Nigeria. A survey design was employed, and a 36-item questionnaire was used to collect data from a sample of 350 female undergraduate students studying STEM courses at the university. The questionnaire had three sections focusing on demographic information, motivations and future career aspirations of the respondents in STEM fields. The questionnaire was validated and reliability coefficient of 0.72 was obtained using Cronbach alpha. The data collected were analyzed using mean and standard deviation. The results showed that female students' overall enrollment in STEM courses was relatively low. However, there were variations across disciplines, with some courses having as high as 50.70% (Biotechnology) and 49.43% (Microbiology), and as low as 8.36% (Physics), 9.06% (Geology) and 11.06% (Mathematics) of female enrollment. The overall enrollment rose from 23% in the 2014/2015 academic year to 31.4% in the 2019/2020. The study also found that personal interest, background knowledge, and academic success in STEM-related subjects were the key motivators for females to pursue STEM courses. On the other hand, lack of family and community support, lack of confidence in problem-solving, and the need for role models and mentors were significant barriers. It is recommended among others that, universities and policymakers provide more resources and support to female students in STEM fields, such as mentorship programmes, scholarships, and initiatives to promote gender equity.

Using Supplemental Instruction through the EMPOWER Program to Increase Diversity in STEM Fields

The underrepresentation of women and racial minorities in science, technology, engineering and math (STEM) fields is of national concern. Despite recent increases, females continue to be underrepresented in math, physical science, and engineering related fields compared to their male counterparts. There is also evidence showing a troubling inequity trend in enrollment of most graduate and all post graduate degrees in STEM fields. These factors ultimately impact the workforce with women less likely than men with similar degrees to actually be employed in these fields, constituting 23% of the science and engineering labor force and only 10 % of employed physicists. Well-structured interventions are needed to support African American women in overcoming barriers to increase their representation in STEM. What is Needed to Make a Difference? Extracurricular instruction in the form of supplemental educational programming is needed to identify, engage and retain African American female students to ensure their level of post-secondary education STEM success and beyond. The R25 Summer Research Education Program is designed to support education activities that complement and or enhance the training of a workforce to meet the nation’s biomedical, behavioral, and clinical research needs. Methods: The Engaging Multidisciplinary Professional Opportunities for Women in Environmental Research (EMPOWER) program was created to address the diversity in STEM. This summer research experience program was developed to educate high school science teachers in tandem with outstanding African American and Hispanic women from metro Atlanta high schools in the research approaches and competencies required for a deeper understanding of how to measure and assess environmental exposures, including air and water in the urban environment and link them to health effects. Results/Discussion: Students and teachers participated in a four-week summer program. The primary objectives of EMPOWER were two-fold including:1) Enhance teaching capacity within the sciences and assist in the development of public and environmental health curriculum along with in class activities intended to promote interest in STEM. 2) Provide African-American and LatinX women opportunities to engage in faculty lead research projects, obtain hands-on training in tandem with professional and soft skill development. EMPOWER’s major contribution will be to continue to enhance STEM education in high schools leading to higher quality post-secondary opportunities and greater workforce diversity. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Enrollment And Characteristics Of Dual-Eligible Medicare And Medicaid Beneficiaries In Integrated Care Programs.

Integrated care programs (ICPs) are meant to make Medicare and Medicaid coverage for dual-eligible beneficiaries work more seamlessly. Evidence is limited on ICP enrollment trends and the characteristics of dual-eligible beneficiaries who enroll in these programs-specifically, the Program of All-Inclusive Care for the Elderly, Medicare Advantage (MA) Fully Integrated Dual-Eligible Special Needs Plans, and state demonstration Medicare-Medicaid plans. Using national data, we evaluated changes in ICP enrollment between 2013 and 2020 and compared the demographic characteristics of beneficiaries in these programs relative to the characteristics of beneficiaries not in them. The proportion of dual-eligible beneficiaries in ICPs increased from 2.0percent in 2013 to 9.4percent in 2020. However, nonintegrated or partially integrated coordination-only MA plans experienced the plurality of growth in enrollment of dual-eligible beneficiaries. Relative to non-ICP fee-for-service Medicare, beneficiaries in ICPs were more likely to be Black and Hispanic versus White and were less likely to be rural, younger, or disabled. Policy makers should diligently monitor growth in ICPs and less integrated dual-eligible plans in MA while also evaluating their impact on equity, spending, and quality of care.

Trends in Premiums, Claims, and Enrollment for Fully Insured Large Group, Small Group, and Individual Health Plans From 2011 to 2021

This economic evaluation compares trends in premiums, claims, and enrollment among fully insured large group, small group, and individual health plans in the US from 2001 to 2021.

ANALYSIS OF THE STRUCTURE OF PARTICIPANTS OF EDUCATION IN THE FIELD OF INTEGRATING MOVEMENT IN WORK WITH CHILDREN

The aim of this research is to determine the profile of preschool teachers who have enrolled in the education for Leader of Kinesiological Activities for Early and Preschool Children at the Faculty of Teacher Education of the University of Rijeka, as well as to predict it for future cycles. As many as 171 preschool teachers who completed their education for Leader of Kinesiological Activities for Early and Preschool Children, i.e. lifelong training programme, participated in the research. The basic descriptive parameters were calculated, and to determine the correlation between certain variables the Spearman’s correlation coefficient was used, the differences were determined by the Student’s t-test for independent samples, and to predict the future preschool teachers’ profile the linear regression analysis was used. The results indicate that the attendants were statistically significantly different (p<0.00) according to the criterion of completed study, i.e. preschool teachers with a completed graduate study are averagely seven years younger and have almost seven years of working experience less. A further trend of enrolment anticipates preschool teachers with less years of service and a completed graduate study. The greatest contribution offered by this research lies in the proven need of the participants for further training on the topic of integrated movement, while the large age span indicates a huge interest of preschool teachers with more, but also fewer years of service.