Research Roundup: Hospital-Employed Doctors; Community Health Center Services For Kids

Annals of Internal Medicine: Changes In Hospital–Physician Affiliations In U.S. Hospitals And Their Effect On Quality Of Care
[Researchers used a] retrospective cohort study of U.S. acute care hospitals between 2003 and 2012 [to examine employment relationships with their physicians]. ... In 2003, approximately 29% of hospitals employed members of their physician workforce, a number that rose to 42% by 2012. Relative to regionally matched controls, switching hospitals were more likely to be large (11.6% vs. 7.1%) or major teaching hospitals (7.5% vs. 4.5%) and less likely to be for-profit institutions (8.8% vs. 19.9%) .... Up to 2 years after conversion, no association was found between switching to an employment model and improvement in any of 4 primary composite quality metrics. (Scott et al., 9/20)

Pediatrics: Federally Qualified Health Center Access And Emergency Department Use Among Children
[Researchers sought to] determine whether increasing access to federally qualified health centers (FQHCs) in California was associated with decreased rates of emergency department (ED) use by children without insurance or insured by Medicaid. ... [They found] Increased geographic density of FQHC sites was associated with ≤18% lower rates of ED visits among Medicaid-insured children and ≤40% lower ED utilization among uninsured children .... However, the percentage of Medicaid-insured and uninsured children seen at FQHCs was not associated with any significant change in ED visit rates among Medicaid-insured or uninsured children. (Nath et al., 9/22)

JAMA Internal Medicine: Effects Of Subsidies And Prohibitions On Nutrition In A Food Benefit Program
[Researchers sought to] evaluate whether the proposed policy of incentivizing the purchase of fruits and vegetables and prohibiting the purchase of less nutritious foods in a food benefit program improves the nutritional quality of participants’ diets. ... A food benefit program that pairs incentives for purchasing more fruits and vegetables with restrictions on the purchase of less nutritious foods may reduce energy intake and improve the nutritional quality of the diet of participants compared with a program that does not include incentives or restrictions. (Harnack, 9/19)

Morbidity and Mortality Weekly Report/CDC: Falls and Fall Injuries Among Adults Aged ≥65 Years — United States, 2014
In 2014, 28.7% of older adults reported falling at least once in the preceding 12 months, resulting in an estimated 29.0 million falls. Of those who fell, 37.5% reported at least one fall that required medical treatment or restricted their activity for at least 1 day, resulting in an estimated 7.0 million fall injuries. ... Although falls are common, approximately half of older adults who fall do not discuss it with their health care provider. However, older adult falls are largely preventable. Health care providers can play an important role in fall prevention by 1) screening older adults for fall risk, 2) reviewing and managing medications linked to falls, and 3) recommending vitamin D where appropriate for improved bone, muscle, and nerve health. (Bergen, Stevens and Burns, 9/23)

The Kaiser Family Foundation: Medicare Advantage Plan Switching: Exception Or Norm?
This analysis focuses on enrollees in Medicare Advantage plans with prescription drug coverage (MA-PDs) who change plans when given the opportunity. ... Relatively few Medicare Advantage enrollees, roughly one in ten, voluntarily switch from one MA-PD to another MA-PD each year, suggesting that plan switching among seniors is more the exception than norm. The takeaway from this analysis for beneficiaries is not entirely clear. On the one hand, our analysis shows some price sensitivity among Medicare Advantage enrollees: switching rates were higher among the minority of enrollees with relatively big premium increases. On the other hand, the findings confirm that the vast majority of enrollees do not change plans, and that plan “stickiness” may come at a cost, in terms of higher premiums and higher out-of-pocket spending limits. (Jacobson, Neuman and Damico, 9/20)

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

Reuters: Disease-Related Malnutrition Costs U.S. $15.5 Billion Annually: Study
The United States could save at least $15.5 billion in annual healthcare spending if malnutrition caused by chronic diseases is better addressed, according to a study. The study, conducted by Abbott Laboratories' nutrition division and the University of Illinois, noted one in three patients who arrive at a U.S.-hospital suffer from malnutrition. A further one-third become malnourished during their stay. (Grover, 9/21)

The New York Times: Stress May Counteract Effects Of A Healthful Diet
Stress may counteract the beneficial effects of a healthful diet, a study in Molecular Psychiatry suggests. ... Among women who had low levels of stress, markers of inflammation tended to be higher after eating the meal containing high levels of saturated fat than after the low saturated fat meal. But for women who had high levels of stress, those differences disappeared — they had high levels of inflammation even after the meal that was low in saturated fats. (Bakalar, 9/22)

Reuters: Yes, Virginia, There Is A Weight Gain Over Christmas
A new study has confirmed what your waistband has told you all along -- you gain weight during the holidays. It also concluded that people who weigh themselves frequently seem to lose those extra pounds faster. ... Within 10 days of Christmas, the average weight increased 0.4 percent among Americans and 0.6 percent among the Germans. For the Japanese, a 0.3 percent increase came during Golden Week in May, which includes an aggregation of four holidays. For a 150-pound person, that's less than a pound. But one of the authors of the study published in the New England Journal of Medicine, Dr. Brian Wansink, told Reuters Health in a telephone interview that the increase was so low because the people using the scales were unusual. (Emery, 9/21)

Medscape: Conflicting Interpretation Of Cancer Genetic Test Results Common
The results of multiplex genetic cancer tests are being interpreted in different ways at different laboratories, even when they are Clinical Laboratory Improvement Amendments (CLIA)–approved commercial laboratories. A new study has found considerable variation: In some cases, genetic mutations were interpreted as pathogenic or likely pathogenic by some labs but were considered to be of unknown significance by others. These variations could have implications for medical management decisions, the authors comment. (Brooks, 9/22)