Research Roundup: Cutting Hospital Readmissions; Using Texts To Fight Smoking

The New England Journal of Medicine: Readmissions, Observation, And The Hospital Readmissions Reduction Program
The Hospital Readmissions Reduction Program ... applies financial penalties to hospitals that have higher-than-expected readmission rates for targeted conditions. Some policy analysts worry that reductions in readmissions are being achieved by keeping returning patients in observation units .... We analyzed data from 3387 hospitals. From 2007 to 2015, readmission rates for targeted conditions declined from 21.5% to 17.8%, and rates for nontargeted conditions declined from 15.3% to 13.1%. ... Stays in observation units for targeted conditions increased from 2.6% in 2007 to 4.7% in 2015, and rates for nontargeted conditions increased from 2.5% to 4.2%. Within hospitals, there was no significant association between changes in observation-unit stays and readmissions after implementation of the ACA. (Zuckerman et al., 2/24)

Health Affairs: Nonprofit Hospitals' Community Benefit Requirements
Public controversy over whether nonprofit hospitals provided community benefits sufficient to justify their favored tax status gave rise to congressional scrutiny during 2005-09 and culminated in the inclusion of new community benefit requirements in the Affordable Care Act (ACA). ... there are disagreements over what should count as a community benefit and to what extent hospitals should be held accountable. ... Hospitals have long considered bad debt and Medicare shortfalls as part of the community benefits they provide, but federal regulations do not .... Data from new community benefit reporting requirements will allow analyses on types and amounts of community benefit expenditures; the impact of increased insurance coverage on reducing demands for charity care ... and geographic variations. (James, 2/25)

JAMA Internal Medicine: Effectiveness of Short Message Service Text-Based Smoking Cessation Intervention Among University Students
[Researchers sought to] determine the effectiveness of a text-based smoking cessation intervention among young people. ... The intervention group then received 157 text messages based on components of effective smoking cessation interventions for 12 weeks. The control group received 1 text every 2 weeks thanking them for participating in the study, with delayed access to the intervention. ... A total of 1590 participants, mainly between 21 and 30 years of age, were randomized into the study .... Eight-week prolonged abstinence was reported by 203 participants (25.9%) in the intervention group and 105 (14.6%) in the control group; 4-week point prevalence of complete cessation was reported by 161 (20.6%) and 102 (14.2%) participants, respectively. (Müssener et al., 2/22)

Health Affairs: Vaccine Pipeline Has Grown During The Past Two Decades With More Early-Stage Trials From Small And Medium-Size Companies
Using a large commercial database, we examined trends in global vaccine research and development and found that the proportion of new vaccine candidates entering all stages of clinical development increased by 3–5 percentage points over the past two decades. Small and medium-size companies accounted for nearly twice as many new Phase I vaccine trials compared to large companies, but late-stage (Phase III) vaccine trials were dominated by large companies. ... Small and medium-size companies, including spin-outs from academic research centers, play an important role in innovative research and discovery. Our findings suggest that policy making targeted at smaller companies, such as prizes or opportunities for public-private partnerships, could support the development of new vaccines. (Hwang and Kesselheim, 2/8)

Pediatrics: Increasing Medication Possession At Discharge For Patients With Asthma: The Meds-In-Hand Project
Many patients recently discharged from an asthma admission do not fill discharge prescriptions. If unable to adhere to a discharge plan, patients with asthma are at risk for re-presentation to care. We sought to increase the proportion of patients discharged from an asthma admission in possession of their medications (meds in hand) from a baseline of 0% to >75%. ... Outpatient pharmacist delivery of discharge medications to patient rooms achieved the project aim of 75% of patients discharged with meds in hand. In a subset of patients for whom all insurance claims were available, those discharged with meds in hand had lower odds of all-cause re-presentation to the emergency department within 30 days of discharge, compared with patients discharged with usual care. (Hatoun et al., 2/24)

The Kaiser Family Foundation: Contraceptive Coverage At The Supreme Court Zubik V. Burwell: Does The Law Accommodate Or Burden Nonprofits’ Religious Beliefs?
Among the most contentious and litigated elements of the Affordable Care Act (ACA) is the requirement that most private health insurance plans provide coverage for ... Food and Drug Administration (FDA) approved prescription contraceptives and services for women. ... over 200 corporations have filed lawsuits claiming that their religious beliefs are violated by the inclusion of that coverage or the “accommodation” offered by the federal government. The legal challenges have fallen into two groups: those filed by for-profit corporations and those filed by nonprofit organizations and both have reached the Supreme Court. ... This brief explains the legal issues raised by the nonprofit litigation, discusses the influence of the Hobby Lobby decision on the current case before the Supreme Court, and the potential impact of a tie decision. (Sobel and Salganicoff, 2/23)

The Kaiser Family Foundation/American Institutes for Research: Payment And Delivery System Reform In Medicare: A Primer On Medical Homes, Accountable Care Organizations, And Bundled Payments
The Affordable Care Act (ACA) established several initiatives to identify new payment approaches for health care that could lead to slower spending growth and improvements in the quality of care. Many of these new delivery system reforms are currently being implemented and tested in traditional Medicare. This Primer describes the framework and concepts of three broad alternative payment models—medical homes, ACOs, and bundled payments—and reviews their goals, financial incentives, size (number of participating providers and beneficiaries affected), and potential beneficiary implications. It also summarizes early results with respect to Medicare savings and quality. (Baseman et al., 2/22)

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

CNN: Study: A Third Of U.S. Adults Don't Get Enough Sleep
You've heard it before, and you'll hear it again: Despite repeated recommendations for adults to sleep at least seven hours each night, a new study shows that more than one-third of us are not getting enough shut-eye. And they've pinpointed which states are the most sleep deprived. The CDC study analyzed data from the 2014 Behavioral Risk Factor Surveillance System to determine whether adults are getting enough sleep. (Manella, 2/18)

The New York Times: HPV Sharply Reduced In Teenage Girls Following Vaccine, Study Says
A vaccine introduced a decade ago to combat the sexually transmitted virus that causes cervical cancer has already reduced the virus’s prevalence in teenage girls by almost two-thirds, federal researchers said Monday. Even for women in their early 20s, a group with lower vaccination rates, the most dangerous strains of human papillomavirus, or HPV, have still been reduced by more than a third. (Hoffman, 2/22)

CBS News: Racial Disparities Persist In Some Types Of Cancer
Cancer deaths have dropped overall for black and white Americans, but disparities still exist, especially when it comes to two of the most common killers -- breast and colon cancer -- a new report shows. (Brophy Marcus, 2/23)

STAT: One In Two Gay Black Men May Contact HIV In Their Lifetimes, New Data Show
One out of every two black men who have sex with men, and one in four Hispanic men who have sex with men, will be diagnosed with HIV at some point in their lives if diagnosis rates remain the same, a new analysis released Tuesday by the Centers for Disease Control and Prevention shows. (Joseph, 2/23)

Reuters: More PET Scans May Not Help Lung, Esophageal Cancer Survivors
Getting expensive radioactive imaging tests to see if a cancer of the lung or esophagus has recurred is not linked to better survival, according to a new study. The likelihood that people with those cancers would be alive two years after their diagnosis was the same whether they went to a hospital that frequently used so-called PET scans or one that used the imaging test less often. (Seaman, 2/23)

Reuters: Mindfulness Program May Ease Chronic Low Back Pain
An eight-week group program focused on mindfulness-based stress reduction may help with short-term function and long-term pain for people with chronic low back problems, according to a new study. “Most people would think mindfulness meditation would help stress,” said lead author Dr. Natalia Morone of the University of Pittsburgh. “They would not typically think it could actually lead to reduced pain or lead them to have less pain interference during their day to day activities.” (Doyle, 2/23)