Archive for the ‘Research Roundup’ Category

Researchers Press For More Action On Health Disparities

As Susan Dentzer, the editor in chief of the journal Health Affairs, was opening a public briefing today on a special issue dedicated to the state of health care disparities in the country, she warned the audience members they “might need a strong dose of Valium” to handle some of the bleak assessments of the racial gap in care.

But panelists, researchers and health care experts say there is light at the end of the tunnel, especially as coverage is expanded under the 2010 health overhaul law. Anne Beal, the president of the Aetna Foundation that helped sponsor the themed issue of the journal, said there is comfort in just knowing how complicated health care disparities can be. “It’s not just race, it’s not just income. … It’s all those things,” she said. “But I think it’s now time for us to collectively stop talking about health care disparities, but really start doing the hard work of achieving health equity.”

Health Affairs Editor in Chief Susan Dentzer introduces a panel on health disparities (Photo by Shefali S. Kulkarni/KHN)

“What we really need, in addition to great research is action,” said Howard K. Koh, assistant secretary of the Department of Health and Human Services. “Unfortunately we have not made enough progress in this area as a nation.”

The briefing provided a number of presentations by researchers with studies in the October issue, all focused on health care disparities. Among the more intriguing studies, Dr. Renee Yuen-Jan Hsia, a professor of Emergency Medicine at the University of California San Francisco, reported that in 2007, 69 million Americans would have needed to travel more than the average patient to reach a trauma facility. Her paper on geographical access to trauma centers revealed that African Americans, people with incomes below the federal poverty level (FPL) and rural residents were deeply affected by emergency center closures.

Stephen Zuckerman presented his work on how changes to Medicare, Medicaid as well as other changes brought on by the health care overhaul could impact illegal immigrants — a group excluded from coverage under the health law. His work suggests that illegal immigrants will continue to use care through safety net operations — such as hospital emergency rooms and community health centers. He points out that the growing population of illegal immigrants could pinch the safety net providers. But he also noted that safety net providers may be better able to handle this increase, because many more of their other patients will be gaining coverage through the health law.

Dentzer told the audience that beyond health care coverage, other factors play a vital role in closing the racial health care gap. “Incomes matter; studies suggest that poverty has a larger effect on health and mortality than tobacco use and obesity,” she said. She pointed to a study by Steven Woolf that looks at how college education can impact health and another by Janice Probst and others showing that great health risks for both rural white and minority populations compared to urbanites because of education, income and health coverage disparities.

“Race and ethnicity clearly matter,” Dentzer said. “One in three whites has hypertension, the leading cause of cardiovascular disease, versus three in five blacks. And place — probably more than race — matters.”

At the meeting, Koh also unveiled the final results Healthy People 2010,  a survey that is taken every 10 years to assess the health of Americans.

Thursday, October 6th, 2011

Majority Of Docs Face Malpractice Claims

Every week, Kaiser Health News reporter Shefali S. Kulkarni compiles a selection of recently released health policy studies and briefs for Kaiser Health News’ Daily Report.

This week in Research Roundup:

  • New England Journal of Medicine explorers the frequency of malpractice claims and cumulative risk of malpractice claims across specialties.
  • The Government Accountability Office examines the Health & Human Services Physicians Feedback Program.
  • Health Affairs looks into how many Medicare Advantage options is too many.
  • The Robert Wood Johnson Foundation and the Urban Institute evaluate the success of efforts to increase the enrollment of children in Medicare and CHIP.

Read more in the Daily Report.

Friday, August 19th, 2011

‘Ankle Phone Call’ Could Save Time And Money In The ER

Got a bum leg?

Well if you do, maybe you should call ahead to the emergency room instead of immediately driving over. A new study by doctors from Massachusetts General Hospital in Boston suggests that hospitals could save time and money if patients with ankle sprains and other lower extremity injuries talk to a health provider first, then schedule an appointments rather than come to the emergency department during regular business hours. Seems simple enough, but research shows that in 2009, lower leg strains and sprains accounted for more than 30 percent of ER visits.

In an effort to combat overcrowded emergency rooms, Dr. David Ring, one of the authors of the study, said that using triage procedures such as special phone lines might help.

“What the data show are that there are alternative methods to provide health care for leg injury because so many of them are relatively minor,” Ring told KHN in an e-mail.

Ring and his colleagues reviewed data on leg injuries from the federal National Electronic Injury Surveillance System — which monitors injuries in emergency rooms  in about 100 hospitals — and conducted follow-up clinical research. They found that most patients with leg injuries evaluated in the ER had relatively minor problems that don’t require an ER visit.  “A sore injured leg certainly feels like it needs immediate attention.  But we know enough about leg injuries that a simple phone triage might allow some patients to avoid the long waits and inconveniences of the ED without any adverse health effects,” Ring said.

Scotland’s national health care system, for example, is looking into conducting a telephone follow up for patients with leg injuries, Ring noted. “These types of things merit additional study—we should explore these opportunities,” he said.

Every week, Kaiser Health News reporter Shefali S. Kulkarni compiles a selection of recently released health policy studies and briefs.  Read more in the Daily Health Policy Report.

Monday, August 15th, 2011

Hospitalists & Health Costs; Treating Substance Abuse

Every week, Kaiser Health News reporter Shefali S. Kulkarni compiles a selection of recently released health policy studies and briefs for Kaiser Health News’ Daily Report.

This week in Research Roundup:

  • The Annals of Internal Medicine weighs the costs and benefits of hospitalist care.
  • The Journal of Cancer Survivorship looks at the out-of-pocket costs of cancer medications for patients covered by Medicare.
  • Health Affairs compares the paperwork burden on doctors in Canada vs. the United States.
  • Health Affairs examines the financial costs of following USDA dietary guidelines.
  • Also in Health Affairs, a look at the effect of the health law on substance abuse treatment.
  • The Journal of General Internal Medicine considers how drug effectiveness statistics are framed in messages to doctors and their patients.

Read more in the Daily Report.

Friday, August 5th, 2011

Social Media Tools Aid Public Health Officials

Dr. Raina M. Merchant, an emergency physician and assistant professor at the Pearlman School of Medicine at the University of Pennsylvania, noticed her patients were becoming far more social media savvy than the health care system they were being treated in.

Photo by Ian Barker via Flickr

She told Kaiser Health News that after reviewing news stories on the use of social media during disasters and seeing her patients turn to Twitter and Facebook for guidance on health issues, “it made a lot of sense to think about how to use these tools before the moment of need.”  Merchant asked,  “Are there lessons to be learned from how people are using Facebook and Twitter and other sites that would allow them to be more prepared?” In a recent paper publish in the New England Journal of Medicine, Mechant and her colleagues write that social media platforms like Twitter, Facebook and Foursquare are playing a more vital role in the public health care system and emergency preparedness. The perspective piece reports that social media sites “provide opportunities for engaging citizens in public health efforts by both ‘pushing’ information to the public and ‘pulling’ information from bystanders.”

Organizations such as FEMA,  the Red Cross and HHS are looking to social media as a way to prepare for emergency and disasters. The NEJM paper highlights recent disasters and public health crises where social media played a crucial role. During the 2010 Haiti earthquake, locals and public health care workers used an open-source Web platform called “Ushahidi” to connect health care providers lacking supplies with those who had them.  In 2009 during the H1N1 influenza epidemic, HHS broadcast a “Mommycast” on YouTube and on iTunes that provided information and prevention tips to one million viewers.

Merchant, who also works as a policy scientist at the Office of the Assistant Secretary for Preparedness and Response under HHS, says it’s important to look at the ways patients and providers share information, because social media “can show us how we, as a health care community, can be more responsive to patients.” Still, the need for accuracy is a big challenge in health care information gleaned from social media. “If we want our patients to get reliable information about health on these outlets,” said Dr. Merchant, “then we [in health care] need to understand how information is transferred and rapidly provide information that’s accurate.”

Every week, Kaiser Health News reporter Shefali S. Kulkarni compiles a selection of recently released health policy studies and briefs.  Read more in the Daily Health Report.

Monday, August 1st, 2011

Restricting Medigap Coverage; Hospital-Acquired Infections

Every week, Kaiser Health News reporter Shefali S. Kulkarni compiles a selection of recently released health policy studies and briefs for Kaiser Health News’ Daily Report.

This week in Research Roundup:

  • Archives of Surgery looks at the clinical and economic burden of hospital-acquired infections.
  • Health Affairs weighs the effects of California’s minimum nurse-to-patient ratio.
  • Health Affairs also examines the relationship between public health spending and mortality rates.
  • The Annals of Internal Medicine conducts a review of health literacy research.
  • The Kaiser Family Foundation compares three potential changes to Medigap coverage.

Read more in the Daily Report.

Friday, July 22nd, 2011

Supermarkets Can’t Alleviate Food Deserts

Even as officials are pushing for more supermarkets to open in produce-starved neighborhoods, a recent study suggests that they might not make the drive-thru line any shorter at fast food restaurants.

Photo by Cami Renfrow via Flickr

The study shows that low-income residents are far more dependent on fast food restaurants than grocery stores and supermarkets  – even if healthier food options are close by. Food deserts — areas with little to no access to healthy food — now make up 10 percent of the U.S., according to the U.S. Department of Agriculture, and most are in urban areas. Health experts have long worried that people in these areas depend too heavily on fast food restaurants, which they say can lead to childhood obesity and other health problems.

In May, the USDA released a Food Desert Locator, an interactive map showing the spread of unhealthy neighborhoods.

In hopes of curbing fast food dependency and childhood obesity and in promoting healthy eating, states such as New York are offering tax-breaks and other incentives to supermarkets to build new stores in major food desert areas. This initiative stems from first lady Michelle Obama’s Let’s Move campaign. The White House also pushed for the Healthy Food Financing Initiative, a collaboration between the USDA and Health and Human Services to get more farmers’ markets, grocery stores and supermarkets to areas without many fresh food outlets.

But according to the study published Monday in the Archives of Internal Medicine, “adding neighborhood supermarkets may have little benefit to diet quality across the income spectrum.” The researchers found that access to a grocery store did not affect residents fruit and vegetable consumption or the overall quality of their diet. The researchers suggest subsidizing the cost of healthy foods and reducing the number of fast food chain restaurants.

Every week, Kaiser Health News reporter Shefali S. Kulkarni compiles a selection of recently released health policy studies and briefs.  Read more in the Daily Health Report.

Friday, July 15th, 2011

Doctors Still Take Medicare

Every week, Kaiser Health News reporter Shefali S. Kulkarni compiles a selection of recently released health policy studies and briefs for Kaiser Health News’ Daily Report.

This week in Research Roundup:

  • JAMA finds the quality of care at rural “critical access hospitals” to be wanting.
  • Health Affairs compares spending in various state Medicaid programs.
  • The National Bureau of Economic Research releases Oregon Health Insurance Experiment findings.
  • Archives of Internal Medicine finds little change in the number of doctors accepting Medicare.
  • The Journal of Head and Face Pain examines real-world costs of migraine treatments.
  • Archives of Pediatric & Adolescent Medicine weighs the effectiveness of childhood obesity screenings.

Read more in the Daily Report.

Friday, July 8th, 2011

Comparing Care In States Vs. Territories … Plus More

Every week, Kaiser Health News reporter Shefali S. Kulkarni compiles a selection of recently released health policy studies and briefs for Kaiser Health News’ Daily Report.

This week, Research Roundup includes:

  • The Archives of Internal Medicine examines care in U.S. states vs. U.S. territories.
  • The Journal of General Internal Medicine looks at the use of social media by doctors.
  • The National Institute For Health Care Management takes a deeper dive into which health care costs are driving growth.
  • The Kaiser Family Foundation surveys insurance options for the unemployed.
  • The Center of Budget and Policy Priorities and the Kaiser Family Foundation review the various online application procedures states have adopted for CHIP and Medicaid.

Read more in the Daily Report.

Kaiser Health News is an editorially-independent program of the Kaiser Family Foundation.

Friday, July 1st, 2011

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