Research Roundup: ACOs And Non-Medical Needs; Library Health; Retail Clinics And ERs
Each week, KHN compiles a selection of recently released health policy studies and briefs.
Health Affairs:
Housing, Transportation, And Food: How ACOs Seek To Improve Population Health By Addressing Nonmedical Needs Of Patients
Addressing nonmedical needs—such as the need for housing—is critical to advancing population health, improving the quality of care, and lowering the costs of care. Accountable care organizations (ACOs) are well positioned to address these needs. We used qualitative interviews with ACO leaders and site visits to examine how these organizations addressed the nonmedical needs of their patients .... We found that the nonmedical needs most commonly addressed by ACOs were the need for transportation and housing and food insecurity. ACOs identified nonmedical needs through processes that were part of the primary care visit or care transformation programs. (Fraze et al., 11/9)
Health Affairs:
Beyond Books: Public Libraries As Partners For Population Health
Public libraries are ... well positioned to be partners in building a culture of health through programming that addresses the social determinants of health. The Healthy Library Initiative, a partnership between the University of Pennsylvania and the Free Library of Philadelphia (the public library system that serves the city), has undertaken such efforts .... we report findings from an assessment of how ten highly subscribed programs address the social determinants of health, as well as results of interviews with community residents and library staff. Of the 5.8 million in-person Free Library visits in 2015, 500,000 included attendance at specialized programs that addressed multiple health determinants, such as housing and literacy. (Morgan et al., 11/9)
Annals of Emergency Medicine:
Association Between The Opening Of Retail Clinics And Low-Acuity Emergency Department Visits
We assess whether the opening of retail clinics near emergency departments (ED) is associated with decreased ED utilization for low-acuity conditions. We used data from the Healthcare Cost and Utilization Project State Emergency Department Databases for 2,053 EDs in 23 states from 2007 to 2012. ... Among all patients, retail clinic penetration was not associated with a reduced rate of low-acuity ED visits .... Among patients with private insurance, there was a slight decrease in low-acuity ED visits .... For the average ED in a given quarter, this would equal a 0.3% reduction ... in low-acuity ED visits among the privately insured if retail clinic penetration rate increased by 10 percentage points per quarter. (Martsolf et al., 11/10)
Preventing Chronic Disease/CDC:
Disparities In Who Receives Weight-Loss Advice From A Health Care Provider: Does Income Make A Difference?
The US Preventive Services Task Force recommends that all patients be screened for obesity .... However, the prevalence of such advice is low .... This study aimed to describe the determinants of receiving weight-loss advice among a sample with a high proportion of low-income, racial/ethnic minority individuals. Data were collected from a telephone survey of 1,708 households in 2009 and 2010 in 5 cities in New Jersey. ... Of all overweight or obese respondents, 35% reported receiving advice to lose weight. Receiving advice was significantly associated with income in multivariate analysis. Compared with those with an income at or below 100% of the federal poverty level (FPL), those within 200% to 399% of the FPL had 1.60 higher odds of receiving advice ... and those with an income of 400% or more of the FPL had 1.73 higher odds of receiving advice. (Lorts and Ohri-Vachaspati, 10/6)
JAMA Pediatrics:
Survival Rates Following Pediatric In-Hospital Cardiac Arrests During Nights And Weekends
In this national registry-based cohort study of hospitalized children younger than 18 years of age receiving cardiopulmonary resuscitation (CPR), the rate of survival to hospital discharge was 36.2% (4488 of 12 404 children) overall. After adjusting for important potential confounders, we found that the rate of survival to hospital discharge was significantly lower during nights than during days/evenings, but there was no difference between weekends and weekdays. (Bhanji et al., 11/7)
The Kaiser Family Foundation:
Access To Employer-Sponsored Health Coverage For Same-Sex Spouses
Using data collected through the most recent Kaiser Family Foundation and the Health Research & Educational Trust (HRET) Employer Health Benefits Survey, we provide the first national estimates of same-sex spousal health coverage, looking at both the share of firms offering such coverage as well as the share of covered workers with access to spousal benefits. ... In 2016, less than half (43%) of firms offering health insurance coverage to opposite-sex spouses, also provided coverage to same-sex spouses and 16% did not provide this coverage. Another 41% reported they had not encountered this as a benefits issue. ... While the majority of firms in the United States are small, and most do not offer same-sex spousal ESI, the majority of workers are employed by large firms (200 or more workers) (70%), most of whom do offer this benefit. (Dawson, Kates and Rae, 11/2)
The Kaiser Family Foundation:
Health Coverage By Race And Ethnicity: Examining Changes Under The ACA And The Remaining Uninsured
This brief examines changes in health coverage by race and ethnicity under the ACA and reviews characteristics of the remaining uninsured by race and ethnicity and their eligibility for ACA coverage. It is based on Kaiser Family Foundation analysis of Current Population Survey data for the nonelderly population. It finds: People of color have had larger gains in coverage compared to Whites since implementation of the ACA. ... Despite these gains, nonelderly Hispanics, Blacks, and American Indian and Alaska Natives (AIANs) remained more likely than Whites to be uninsured as of 2015. (Artiga et al., 11/4)