Research Roundup: Costly Mental Health Care; Doctors And Prices; Effects Of Health Coaching

Health Affairs: Mental Disorders Top The List Of The Most Costly Conditions In The United States: $201 Billion
Estimates of annual health spending for a comprehensive set of medical conditions are presented for the entire US population and with totals benchmarked to the National Health Expenditure Accounts. ... In 1996 the most costly medical condition, by far, was heart conditions, at $105 billion, with mental disorders a distant second at $79 billion. They had equal spending in 2004 ($131 billion each; data not shown), and by 2013 spending on mental disorders had moved far ahead—reaching $201 billion versus $147 billion spent on heart conditions. [Spending for mental disorders at a] 5.6 percent average annual growth rate was about average for all personal health spending. Instead, what stands out is the 2 percent growth in spending on heart conditions over this period, which was more than 2 percentage points slower than GDP growth. (Roehrig, 5/18)

The American Journal of Managed Care: Physician Perceptions of Choosing Wisely and Drivers of Overuse
[Researchers surveyed] clinicians practicing at Atrius Health, the largest ambulatory care provider in Massachusetts. We analyzed 584 responses (72% response rate). ... After adjusting for covariates, almost all physicians agreed that doctors need to limit unnecessary tests (96.8%), have a responsibility to control costs (92.2%), and should be aware of and adhere to clinical guidelines (97.9%). Approximately one-third felt it unfair to ask physicians to be both cost-conscious and concerned with welfare (33.0%), thought there is too much emphasis on costs (30.7%), try not to think about costs (33.9%), and thought that doctors are too busy to worry about costs (27.8%); these proportions did not differ across specialties. Less than half of respondents (36.9%) reported having a firm understanding of the costs of tests and procedures to the healthcare system. (Colla et al., 5/17)

Pediatrics: Effect Of Patient-Centered Medical Home On Preventive Services For Adolescents And Young Adults
[Researchers sought to] determine the association between enrollment in patient-centered medical homes (PCMHs) and the receipt of preventive services among adolescents and young adults [by using a] retrospective cohort study including patients ... at the Hennepin County Medical Center, Minnesota. ... Overall, 21 704 patients [aged 10 to 24] were included. ... Adjusted odds ratios ... comparing the receipt of preventive services of patients enrolled in PCMHs to youth who did not receive these services were as follows: (1) preventive visits 1.10 ...; (2) influenza 0.89 ..., meningococcal 1.53 ..., and human papillomavirus vaccinations 1.53 ...; (3) screening for sexually transmitted infections 1.69 ...; (4) prescription of any type of contraception 2.18 ... and long-acting reversible contraceptives 2.66 ...; and (5) cervical cancer screening 1.14. (Garcia-Huidobro et al., 5/16)

Annals of Family Medicine: What Happens After Health Coaching? Observational Study 1 Year Following A Randomized Controlled Trial
Health coaching is effective for chronic disease self-management in the primary care safety-net setting, but little is known about the persistence of its benefits. We conducted an observational study evaluating the maintenance of improved cardiovascular risk factors following a health coaching intervention. ... Results support the conclusion that most improved clinical outcomes persisted 1 year after the completion of the health coaching intervention. (Sharma et al., 5/16)

Here is a selection of news coverage of other recent research:

Medscape: Critical Access Hospitals Perform Well On Common Surgeries
Patients who undergo common surgical procedures at small, rural (critical access) hospitals have similar 30-day mortality rates, lower serious complication rates, and lower Medicare expenditures compared with those who undergo the procedures at non-critical access hospitals, a new study shows. (Brown, 5/18)

Stat: Female Scientists Report Pervasive Gender Bias, Sexual Harassment
A study published Tuesday in the Journal of the American Medical Association found that two-thirds of female biomedical researchers reported having personally experienced “gender bias in professional advancement.” And one-third reported experiencing sexual harassment, overwhelmingly in the form of sexist remarks and coercive behavior. (Samuel, 5/17)

Reuters: More Physical Activity Linked To Less Risk For Cancer
Higher levels of leisure-time activity may boost protection against a wide range of cancers, according to a new analysis of research from the U.S. and Europe. Based on data from 12 previous studies involving a total 1.44 million people, researchers found that with few exceptions, high versus low amounts of moderate to vigorous activity meant lowered risk for 13 out of 26 types of cancer. (Hand, 5/17)

Reuters: How Much Palliative Care Breast Cancer Patients Get May Depend On Race
When women have advanced breast cancer, the amount of comfort-oriented care they receive at the end of life may depend on the color of their skin, a small U.S. study suggests. ... Black women were 49 percent less likely to receive certain medications for symptom relief than white patients, and they were also 14 percent less likely to get hospice care aimed at improving quality of life in their final days, the study found. (Rapaport, 5/12)

Spectrum: Atlas Of Brain Connectivity Can Flag Attention Problems
A new set of charts shows how brain connections can change as children grow, and indicates that people with attention problems have altered patterns of brain connections. ... Pediatricians routinely rely on normative growth charts — showing how height, weight and head circumference change with age — to identify children with developmental delay. The new work creates charts for the maturation of connections in the brain. In the study, published in April in JAMA Psychiatry, researchers relied on brain scans from 519 people between 8 and 22 years old, including 25 with ADHD. (Zeliadt, 5/18)