Research Roundup: Drug Compliance; Payment Reforms; Hospital Readmissions
Each week, KHN compiles a selection of recently released health policy studies and briefs.
Annals of Internal Medicine:
Association Between Patient-Centered Medical Homes And Adherence To Chronic Disease Medications: A Cohort Study
[Researchers sought to] assess the association between medication adherence and medical homes in a national patient and provider population, given the strong ties between adherence to chronic disease medications and health care quality and spending. ... [They analyzed patients] with common medications for chronic diseases (diabetes, hypertension, and hyperlipidemia) between 2011 and 2013. ... Of 313 765 patients meeting study criteria, 18 611 (5.9%) received care in patient-centered medical homes. Mean rates of adherence were 64% among medical home patients and 59% among control patients. ... Receipt of care in a patient-centered medical home is associated with better adherence, a vital measure of health care quality, among patients initiating treatment with medications for common high-cost chronic diseases. (Lauffenburger et. al, 11/15)
JAMA Cardiology:
Existing And Emerging Payment And Delivery Reforms In Cardiology
Although there is widespread agreement that payment reform is needed, existing programs have significant limitations and the adoption of new programs has been slow. New payment reforms address some of these problems, but many details remain undefined. ... The [fee-for-service] payment model has often generated perverse incentives, and existing and emerging payment models aim to shift the emphasis from volume to value. Early models have not performed as well as hoped. They have imposed substantial administrative burdens, have not been adequately transparent, and have often not delivered clear incentives at the physician level. New approaches are needed that encourage closer collaboration and coordination across the health system. (Farmer et al., 11/15)
JAMA Surgery:
Hospital Factors Associated With Care Discontinuity Following Emergency General Surgery
In an analysis of the 100% Medicare inpatient claims file from January 1, 2008, to November 30, 2011, patients who underwent emergency general surgery and were subsequently readmitted to a nonindex hospital were significantly more likely to have had their index surgery at a large, teaching, safety-net hospital. (Havens et al., 11/16)
JAMA Pediatrics:
Association Between Neighborhood Violence And Biological Stress In Children
A matched, cross-sectional study of 85 children examined whether the rate of violent crime in a neighborhood, rate of reports of domestic violence, and density of liquor or convenience stores were associated with telomere length and cortisol functioning. Each neighborhood stressor was significantly associated with biological stress, with greater exposure associated with shorter telomere length, lower acute cortisol levels and blunted recovery, and steeper diurnal cortisol declines. (Theall et al., 11/14)
JAMA Internal Medicine:
Evaluating The Impact Of Florida’s “Stand Your Ground” Self-Defense Law On Homicide And Suicide By Firearm
Did the implementation of Florida’s “stand your ground” self-defense law have an impact on homicide and homicide by firearm between 2005 and 2014? Findings: This study used an interrupted time series design to analyze changes in rates of homicide and firearm-related homicide. We found that the implementation of Florida’s stand your ground law was associated with a 24.4% increase in homicide and a 31.6% increase in firearm-related homicide. (Humphreys, Gasparrini and Wiebe, 11/14)
The Kaiser Family Foundation:
Where President-Elect Donald Trump Stands On Six Health Care Issues
While health care was not central to the 2016 Presidential campaign, the election’s outcome will be a major determining factor in the country’s future health care policy. A number of issues have garnered media attention, including the future of the Affordable Care Act (ACA), rising prescription drug costs, and the opioid epidemic. President-elect Donald Trump has laid out different approaches to addressing these and other health care issues. Central among these is his position to fully repeal the ACA. (11/9)
