Research Roundup: Marijuana Use; Impact Of HSAs; Medicare Spending On Young And Old

Morbidity and Mortality Weekly Report/CDC: National Estimates Of Marijuana Use And Related Indicators — National Survey On Drug Use And Health, United States, 2002–2014
This report describes national trends for selected marijuana use and related indicators [based on data from the National Survey on Drug Use and Health (NSDUH)] .... In 2014, a total of 2.5 million persons aged ≥12 years had used marijuana for the first time during the preceding 12 months, an average of approximately 7,000 new users each day. During 2002–2014, the prevalence of marijuana use during the past month, past year, and daily or almost daily increased among persons aged ≥18 years, but not among those aged 12–17 years. ... A decrease in the perception of great risk from smoking marijuana combined with increases in the perception of availability (i.e., fairly easy or very easy to obtain marijuana) and fewer punitive legal penalties (e.g., no penalty) for the possession of marijuana for personal use might play a role in increased use among adults. (Azofeifa et al., 9/2)

Employee Benefit Research Institute: The Impact Of An HSA-Eligible Health Plan On Health Care Services Use And Spending By Worker Income
This study examines whether there is variation by worker income on how an HSA [health savings account] eligible health plan affects health care services use and spending. ... HSA-eligible health plan was associated with a decline in (non-preventive) outpatient office visits for workers at all income levels, but the decline was over twice as large for workers and their dependents with incomes less than $50,000 as compared with those with incomes of at least $100,000. ... There was an across-the-board decline in prescription drug fills regardless of worker income. ... The HSA-eligible health plan was associated with a reduction in various preventive services by worker income. For example, lower-income workers reduced their use of influenza vaccinations more than higher-income workers. (Fronstin and Roebuck, 8/30)

Commonwealth Fund: High-Need, High-Cost Patients: Who Are They and How Do They Use Health Care?
[Researchers sought to] examine demographics and health care spending and use of services among adults with high needs, defined as people who have three or more chronic diseases and a functional limitation in their ability to care for themselves or perform routine daily tasks. ... [They used] data from the 2009–2011 Medical Expenditure Panel Survey. ... High-need adults differed notably from adults with multiple chronic diseases but no functional limitations. They had annual health care expenditures that were nearly three times higher ... and out-of-pocket expenses that were more than a third higher .... On average, rates of hospital use for high-need adults were more than twice those for adults with multiple chronic conditions only; high-need adults also visited the doctor more frequently and used more home health care. (Hayes et al., 8/29)

The Kaiser Family Foundation: Similar But Not The Same: How Medicare Per Capita Spending Compares For Younger And Older Beneficiaries
Medicare is most commonly known as a health insurance program for people ages 65 and older, but, since 1973, the program has also provided coverage to millions of people with permanent disabilities who are younger than age 65. ... Contrary to what might be expected based on health status differences between Medicare beneficiaries under age 65 with disabilities and older beneficiaries, average Medicare per capita spending on services covered under Part A and Part B was only moderately higher among those under age 65 than over age 65 in 2014, and was in fact somewhat lower among younger beneficiaries between 2000 and 2011. Total per capita spending began to diverge more widely beginning in 2006 when the Part D prescription drug benefit took effect, with much higher average Part D spending among beneficiaries under age 65. These findings suggest that curtailing rising drug costs would have the effect of reducing the Medicare spending gap between beneficiaries under and over age 65. (Cubanski, Neuman and Damico, 8/16)

Health Services Research Journal/Rand Corp.: Impact Of State Reporting Laws On Central Line–Associated Bloodstream Infection Rates In U.S. Adult Intensive Care Units
We analyzed 2006–2012 adult ICU CLABSI and hospital annual survey data from the National Healthcare Safety Network. The final analytic sample included 244 hospitals, 947 hospital years, 475 ICUs, 1,902 ICU years, and 16,996 ICU months. ... Controlling for the overall time trend, ICUs in states with laws had lower CLABSI rates beginning approximately 6 months prior to the law's effective date ...; this effect persisted for more than 6 1/2 years after the law's effective date. These findings were robust in secondary models and are likely to be attributed to changes in central line usage and/or resources dedicated to infection control. ... Our results provide valuable evidence that state reporting requirements for HAIs improved care. Additional studies are needed to further explore why and how mandatory HAI reporting laws decreased CLABSI rates. (Liu, 7/24)

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

Reuters: Cash May Convince Some Smokers To Quit
Paying smokers to quit and giving them more money the longer they avoid cigarettes might help get more people to kick the habit than cessation advice on its own, a recent study suggests. (Rapaport, 8/25)

Reuters: Online Tools Help People Improve Their Health But Need More Study
Mobile apps and web-based programs do help people reach health goals like exercising more, losing weight and quitting smoking, but studies need to follow-up longer to see how sustainable these interventions are, according to a recent review of existing research. (Kennedy, 8/31)