Research Roundup: Graduate Medical Ed; Health Care For Moms; Premium Hikes
Each week, KHN compiles a selection of recently released health policy studies and briefs.
Annals of Internal Medicine:
Financing U.S. Graduate Medical Education: A Policy Position Paper Of The Alliance For Academic Internal Medicine And The American College Of Physicians
In this position paper, the Alliance for Academic Internal Medicine and the American College of Physicians ... make a series of recommendations to reform the current funding system to better align [graduate medical education] GME with the needs of the nation's health care workforce. These recommendations include using Medicare GME funds to meet policy goals and to ensure an adequate supply of physicians, a proper specialty mix, and appropriate training sites; spreading the costs of financing GME across the health care system; evaluating the true cost of training a resident and establishing a single per-resident amount; increasing transparency and innovation; and ensuring that primary care residents receive training in well-functioning ambulatory settings that are financially supported for their training roles. (Butkus et al. 5/3)
Urban Institute:
How Are Moms Faring Under The Affordable Care Act? Evidence Through 2014
The number of uninsured mothers fell from 7.5 million in 2013 to 5.9 million in 2014, as the uninsurance rate for mothers reached its lowest point since 1997. The largest declines in uninsurance were found among low- and moderate-income mothers who were targeted by the ACA’s Medicaid expansion and the introduction of subsidized Marketplace coverage, respectively. ... Despite these gains in coverage, nearly one in six mothers remained uninsured in 2014, and these mothers were disproportionately young, low-income, Hispanic, noncitizens, less educated, not married, and living in the South. (Karpman et al., 5/5)
Kaiser Family Foundation:
What To Look For In 2017 ACA Marketplace Premium Changes
Insurers are gaining experience under the ACA and are in a better position than in previous years to project the health and claims of their enrollees. Some have realized that their enrollees are less healthy on average than they had anticipated, and for these insurers, relatively large premium increases are likely. ... Other factors influencing premium changes for all insurers for 2017 include increasing prices and service use, the end of the federal reinsurance program (which reduced premiums in previous years), and the one-year waiver of the federal health insurance tax. ... Given the highly competitive nature of the Marketplaces in much of the county, as well as the uncertainty insurance companies faced in the early years of ACA implementation, it’s not surprising that premium increases may be higher in 2017. (Claxton and Levitt, 5/5)
National Bureau of Economic Research:
Impacts Of The Affordable Care Act On Health Insurance Coverage In Medicaid Expansion And Non-Expansion States
This paper estimates the causal effects of the ACA on health insurance coverage using data from the American Community Survey. ... Our preferred specification suggests that, at the average pre-treatment uninsured rate, the full ACA increased the proportion of residents with insurance by 5.9 percentage points compared to 3.0 percentage points in states that did not expand Medicaid. Private insurance expansions from the ACA were due to increases in both employer-provided and non-group coverage. The coverage gains from the full ACA were largest for those with incomes below the Medicaid eligibility threshold, non-whites, young adults, and unmarried individuals. We find some evidence that the Medicaid expansion partially crowded out private coverage among low-income individuals. (Courtemanche, 4/25)
Public Citizen:
Infant Formula Marketing In Public Hospitals: An Outdated And Unethical Practice
The results of our analysis of the largest public hospitals in the United States are consistent with our previous research on top-ranked hospitals in the United States. The vast majority of public hospitals are also following best practices in public health by supporting breastfeeding and ending the distribution of company-sponsored formula discharge bags and other promotional materials. ... Of the 62 hospitals from which we received responses, 95 percent (59 out of 62) are completely free of all forms of infant-formula marketing. (Strader and Kehres, 4/26)
Here is a selection of news coverage of other recent research:
Reuters:
Return Visits To The ER More Likely For Patients With Limited English
Patients in the emergency room who don't speak English well are slightly more likely to return within days, suggesting their care the first time was not as good as it could have been, researchers say. In a study in one New York hospital, about 4 percent of English speakers made an unplanned return to the ER within three days, compared to 5 percent of people with limited English. (Doyle, 4/29)
The Tampa Bay Times:
Dental Care In The ER Is Costing Us Millions — And Not Helping Patients
Dental problems are driving a growing number of Floridians to the emergency room — and costing taxpayers millions of dollars, according to a new study published in the Journal of Public Health Dentistry. The study found the number of dental-related visits to Florida emergency departments surged from 104,642 in 2005 to 163,900 in 2014, an increase of about 57 percent. (McGrory, 5/5)
Reuters:
Mental Health Risks Aren't Equal Among All Gay, Bisexual Men
While gay and bisexual men are at higher risk for mental health issues than their straight counterparts, the risk is particularly high for young gay and bisexual men, a new study has found. On the other hand, high levels of education, income and living with a man were among the factors that seemed to protect gay and bisexual men of all ages against depression, anxiety and other mental health problems. (Seaman, 4/29)
Reuters:
Flu Strikes Fewer Infants When Pregnant Women Get Vaccinated
Infants have a much lower risk of getting influenza when their mothers are vaccinated against the virus during pregnancy, a U.S. study confirms. Doctors recommend flu vaccinations for pregnant women because the virus is linked to complications like preterm births, and because it helps protect babies from catching the flu before they’re able to get vaccinated at six months of age. (Rapaport, 5/3)
Reuters:
Lower Odds Of Lung Cancer Surgery For Blacks In Segregated Neighborhoods
African American lung cancer patients who live in segregated, low-income neighborhoods are less likely than their peers in more affluent communities to get surgery that can add years to their lives, a U.S. study suggests. Compared to black patients living in the least segregated areas, residents of the most segregated communities were at least 60 percent less likely to receive surgery for non-small cell lung cancer, the most common form. (Rapaport, 5/4)