Research Roundup: Improve screening for colon cancer; disparities in cardiac care; the effect of Medicaid expansion on cities -
Each week, KHN compiles a selection of studies and health policy briefs published recently.
Urban Institute and Robert Wood Johnson Foundation: ACA and American cities: Uninsured Less and More Federal Dollars
This report estimated the effect of the Affordable Care Act (ACA) on 14 large and diverse cities: Los Angeles, Chicago, Houston, Philadelphia, Phoenix, Indianapolis, Columbus, Charlotte, Detroit, Memphis, Seattle, Denver, Atlanta and Miami. Among the seven cities in states that expanded Medicaid, the ACA will likely decrease the number of uninsured by an average of 57 percent. ... Of the seven cities in states not Medicaid expansion, the ACA will likely decrease the number of uninsured by an average of 30 percent. ... If Medicaid eligibility were expanded in these cities, the number of uninsured would fall by an average of 52 percent (Buettgens and Dev, 6/19).
JAMA Internal Medicine: comparative effectiveness of a Multifaceted Intervention To improve adherence annual colorectal cancer screening in community health centers
Colorectal cancer (CRC) screening rates are lower among Latinos and people living in poverty. ... However, the ability of [fecal occult blood testing] to reduce CRC mortality depends on high levels of adherence to annual screening. ... Our multifaceted intervention [including computerized reminders, standing orders for medical assistants to give patients home fecal immunochemical tests (FIT), and clinician feedback on CRC screening rates] ... greatly increased adherence to annual screening CRC; most projections were carried out without personal calls. It is possible to improve the annual CRC screening for vulnerable populations with relatively low-cost strategies that are facilitated by the Health Information Technology
Circulation (Baker et al, 6/16). . The first results of the Massachusetts Healthcare Reform on racial, ethnic disparities and socioeconomic in cardiovascular care
insured adults receive invasive cardiovascular procedures more frequently than uninsured adults. We examined the impact of the reform of health care in Massachusetts on the use of coronary revascularization procedures and hospital and 1-year mortality by race / ethnicity, education and sex. ... Using data on requests from the hospital, we compared the differences in coronary revascularization (coronary artery bypass grafting or percutaneous coronary intervention) and hospital mortality .... The reduction of barriers to insurance on receipt of coronary revascularization procedures has not eliminated existing demographic and educational disparities in access to these procedures
Employee Benefit Research Institute (Albert et al, 6/17.) :. consumer engagement Among HSA and HRA Enrollees
HRA [health reimbursement arrangements] and HSA [health savings accounts] are very similar, but there are some key differences that can provide different incentives related to the use of health care services, and therefore, different experiences of consumer engagement. An HSA is owned by the individual with the high deductible health plan and is completely portable. There is no rule of annual use-it-or-lose-it associated with HSA .... However, an HRA is a health plan funded by the employer reimburses employees for eligible medical expenses . ... Of Leftover funds at the end of each year can be carried forward for future use (at the discretion of the employer) .... Adults with HSA were more likely than those with an HRA to present a number of anxious behaviors associated costs of using health care services (Fronstin, 6/19)
The Kaiser Family Foundation. potential Supreme Court: Who will cover "? loads "
The Supreme Court is expected to rule [in the Hobby Lobby and Conestoga Wood Specialties cases] by the end of June 2014. ... If the Court decides that Hobby Lobby has to comply with [health law] contraceptive coverage requirement, Hobby Lobby will probably choose to stop providing health insurance .... If, however, the Hobby Lobby Supreme Court exempts from the requirement that they include all FDA approved contraceptives prescribed as the ACA requires certain employees and dependents ... women may either have to go without their favorite contraceptive method, pay out of pocket, or ask subsidized services in a clinic funded by the government. ... It would be easy to imagine that other companies religious objections to the full range of contraceptives would eliminate coverage (Sobel, Salganicoff and Nisha Kurani, 6/18)
This is a selection of news coverage of other recent research.
AARP blog: diabetes, Alzheimer Top 2 Areas drug Research
diabetes, Alzheimer's disease, arthritis and heart disease topped the list for most new drugs in development to treat chronic diseases common for older Americans, according to a new drug industry report. The report by the Pharmaceutical Research and Manufacturers of America (PhRMA), a trade association for the industry, said 435 drugs that primarily target older people are currently either in clinical trials or under review by the Food and Drug Administration (FDA) (Sagon, 6/16)
Reuters. Needle biopsies can be underutilized for breast cancer patients
most women must undergo a needle biopsy for breast cancer diagnosis, but some surgeons opt for a more invasive procedure instead, according a new study [in the Journal of Clinical Oncology]. The difference may be a matter of experience of the surgeon, the researchers say, so many women could benefit if surgeons were trained and encouraged to opt for the needle method more often (Doyle, 6/15).
Journal of the American Medical Association: Researchers focus on recovery in schizophrenia
prospects for people diagnosed with schizophrenia, once considered a devastating disease that only worsens over time, has improved in recent decades. Antipsychotic medications and psychosocial treatments have allowed many with the disease to achieve a certain degree of recovery, managing residual symptoms and lead productive lives. However, further efforts are needed to consolidate those improvements and help more patients achieve these goals. ... These approaches are described in a new report, "Schizophrenia: time for the change in policy," written by [Stephen Marder, MD, professor of psychiatry at the University of California, Los Angeles] and others (Friedrich, 6/18)
NewsWorks.: study :. one in five inmates in prisons Pa hepatitis C
Nearly one in five inmates entering prisons of Pennsylvania hepatitis C, according to a study published in the June issue of the American Journal of public Health. Since 03, Pennsylvania has examined everyone entering prison for hepatitis C, unless a detainee chooses to withdraw from the race. of the more than 100,000 people who were tested when entering between 04 and 2012, about 18 percent tested positive for the virus. "There is an incredibly high rate," said lead author Sarah Larney, a member of the research Center alcohol at the University of New South Wales and National Drug and a research associate at Brown University (Gordon, 6/16).
MinnPost: Few doctors discuss the planning end of life with heart failure patients, Mayo Study Finds
About 5 million Americans have heart failure, a chronic condition in which the heart's pumping action weakens slowly. There is no cure. Treatment -; medications and lifestyle changes -; can help people with the condition live longer and lead more active lives, but half of heart failure patients die within five years of their diagnosis. However, despite the prognosis, few doctors discuss end of life planning with patients with heart failure and their families, according to a recent study by researchers at the Mayo Clinic in Rochester (Perry, 6/18).
Reuters: SDM still missing for screening cancer
regarding cancer screening, doctors often do not discuss adequately the balance of advantages and disadvantages with their patients , a new study suggests. ... According to the concerned test, between 69 and 93 percent of study participants chose to get tested, and most said they would do it again the same decision, the authors write in American Journal of Preventive Medicine (Pittman, 6/19).
MedPage Today: Racial Disparity In Stroke Grows In South Carolina
In South Carolina, the rate of stroke hospitalizations increased in recent years among young and middle-aged blacks , but no other groups, resulting in a widening disparity, the researchers found. Among black individuals under 65, the rate per 100,000 increased from 121 in 01 to 142 in 2010, a relative increase of 17.3%, according to Wayne Feng, MD, of the Medical University Stroke Center South Carolina in Charleston, and colleagues. However, the Stroke hospitalization rates declined in black and white people 65 and over and remained stagnant in whites young, they reported in the July issue of Stroke: Journal of the American Heart Association (Neale, 6/19).
Modern Healthcare: Black, Hispanic Dialysis patients usually admitted for infections
black and Hispanic patients on dialysis for end stage renal disease had significantly higher rates of infection-related hospitalizations and were less likely to have visited a specialist in pre-treatment care, a new study. hospitalizations for infection were approximately 20% higher for blacks of all ages, and about 30% higher for older Hispanics, compared to white patients, said co-author Dr. Keith Norris of school David Geffen UCLA medical (Rice, 19.06.)
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