Research Roundup: Home Care; Opioids; And Medicare Data
Each week, KHN compiles a selection of recently released health policy studies and briefs.
Health Affairs:
The Financial Burden Of Paid Home Care On Older Adults: Oldest And Sickest Are Least Likely To Have Enough Income
Paid home care can significantly improve the lives of older adults with disabilities and their families, but recipients often incur substantial out-of-pocket spending. We simulated the financial burden of paid home care for a nationally representative sample of non-Medicaid community-dwelling adults ages sixty-five and older. (Johnson and Wang, 6/3)
Health Affairs:
Home Health Care For Children With Medical Complexity: Workforce Gaps, Policy, And Future Directions
With the medical and surgical advances of recent decades, a growing proportion of children rely on home-based care for daily health monitoring and care tasks. However, a dearth of available home health care providers with pediatric training to serve children and youth with medical complexity markedly limits the current capacity of home health care to meet the needs of patients and their families. (Foster, Agrawal and Davis, 6/3)
JAMA Internal Medicine:
Association Of Opioid Overdose With Opioid Prescriptions To Family Members
In this case-control study, prior opioid dispensing to family members was associated with 2.89-fold higher odds of individual overdose, which persisted in young children and increased with greater quantities of opioid medications dispensed to family members. (Khan et al, 6/24)
Pediatrics:
Outpatient Prescription Opioid Use In Pediatric Medicaid Enrollees With Special Health Care Needs
Although potentially dangerous, little is known about outpatient opioid exposure (OE) in children and youth with special health care needs (CYSHCN). We assessed the prevalence and types of OE and the diagnoses and health care encounters proximal to OE in CYSHCN. (Feinstein, 6/3)
JAMA Internal Medicine:
Assessment Of Strategies For Managing Expansion Of Diagnosis Coding Using Risk-Adjustment Methods For Medicare Data
Since the passage of the Affordable Care Act (ACA) in 2010, many studies have used national Medicare data to examine associations between national hospital pay-for-performance programs and quality and costs of care. In January 2011, as the ACA was being implemented, the Centers for Medicare & Medicaid Services increased the number of available diagnosis billing codes from a maximum of 9 diagnosis codes (the primary diagnosis plus 8 comorbidities; a tenth code was reserved for coding external causes of injury and usually left blank) to 25 diagnosis codes (the primary diagnosis plus 24 comorbidities). (Tsugawa et al, 6/26)
