Managed Care Provider Volume

There is considerable evidence that patients that are treated by high volume physicians and hospitals have better health outcomes than patients treated by low volume physicians and hospitals. Thus, as an indirect measure of quality differences between managed care and traditional fee-for-service insurance, we compare the average provider volume of cancer patients covered by these two types of plans. We find that managed care patients tend to be treated by lower volume providers and that the magnitude of the differences varies by the particular cancer and managed care plan.

The Impact of Outness and Lesbian, Gay, and Bisexual Identity Formation on Mental Health

Conflicting literature exists for the relationship between first disclosure, outness, sexual minority identity, and mental health among lesbian, gay, and bisexual (LGB) individuals. That is, while the relationship between LGB identity and mental health has been relatively consistently positive in the literature, the relationship between outness and mental health is more mixed. In addition, the way these constructs differ among race, sex, and sexual orientation are rarely examined. The present study examined the complex relationship between first disclosure, outness, identity, and mental health among 192 lesbian, gay, and bisexual individuals collected from an online sample. The study explored differences on these variables by biological sex, race, age, and sexual orientation. The major findings revealed that bisexual males have less developed sexual minority identities and view their identities less positively than do lesbian, gay, and bisexual female individuals. In addition, bisexual individuals overall are less out and come out later for the first time in comparison to lesbian and gay individuals. In terms of race, Caucasians have a stronger and more positive view of their sexual identity in comparison to individuals of color. It was also found that individuals in later stages of sexual identity development experienced a more positive view of their sexual identity. In terms of mental health, it was revealed that a stronger sexual identity was related to better mental health. Greater degree of outness was found to overall have a moderately positive impact on mental health, though age of first disclosure of sexual minority status was, overall, not associated to measures of identity or mental health. When examined more closely, outness had a more complex, dual impact on mental health. Specifically, outness was found to have both positive and negative consequences for mental health, with identity development accounting for the positive aspects of outness. Directions for future research and implications for clinicians are also discussed

Editorial

Editoria

Espaço público: do urbano ao político

Espaço público: do urbano ao políticoSérgio Luís Abrahão, São Paulo: Annablume/Fapesp, 2008