Research Roundup: Marketplace Competition; Rural Health IT; HIV Testing; Abortion Coverage

Rand Corp./Brookings: Early Assessment Of Competition In The Health Insurance Marketplace
This report ... analyzes competition in the Health Insurance Marketplaces ... in six states (Alaska, Florida, Kansas, North Carolina, Ohio, and Texas) ... states that had one or more potential indicators of “insufficient competition”—such as few insurers offering plans, low enrollment, high premiums, inadequately informed consumers, or sparsely populated rural areas .... Across the six states, respondents consistently said consumers have difficulty understanding health insurance and purchasing and retaining marketplace coverage. State research teams also reported a lack of outreach initiatives .... The ability of insurers to create effective, affordable provider networks was a key determinant to success in many states. ... State researchers also found that the population size and density was one of the main determinants of insurer participation. (Eibner and Rivlin, 1/19)

Health Affairs: Variation In Rural Health Information Technology Adoption And Use
While rural hospitals and physicians have adopted health information technology at the same, or greater, rates as their urban counterparts, meaningful-use attestation varies dramatically among rural providers. Also, rural providers are more likely to skip a year of declaring that they have met meaningful-use requirements, putting them at a financial disadvantage compared to urban providers. (Heisey-Grove, 1/20)

Pediatrics: HIV Testing Among US High School Students And Young Adults
We analyzed National Youth Risk Behavior Survey (YRBS) and Behavioral Risk Factor Surveillance System (BRFSS) data to assess HIV testing prevalence among high school students and young adults aged 18 to 24. ... During the study periods, an average of 22% of high school students (17% of male and 27% of female students) who ever had sexual intercourse and 33% of young adults reported ever being tested for HIV. Among high school students, no change was detected in HIV testing prevalence during 2005–2013, regardless of gender or race/ethnicity. Among young adult males, an average of 27% had ever been tested, and no significant changes were detected overall or by race/ethnicity during 2011–2013. Significant decreases in testing prevalence were detected during 2011–2013 among young adult females. (Van Handel et al., 1/19)

The Kaiser Family Foundation: Coverage For Abortion Services In Medicaid, Marketplace Plans And Private Plans
Although the number [of] women gaining access to health insurance coverage is rising, an increasing share of women are facing limitations in the scope of that coverage when it comes to abortion services. The impact of the abortion coverage restrictions disproportionately affects poor and low-income women who have limited ability to pay for abortion services with out-of-pocket funds. Today over half of women on Medicaid have abortion coverage that is limited to pregnancies resulting from rape, incest, or life endangerment. While millions of women have gained health insurance coverage as a result of the ACA insurance expansions, many are enrolled in plans that restrict the circumstances in which abortion services will be covered. (Salganicoff et al., 1/20)

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

HealthDay: New Approach Might Boost HIV Testing Rates
Telling people they'll be screened for HIV unless they decline to be tested -- an approach known as "opt-out" testing -- could significantly increase the number of patients who agree to be tested, new research suggests. Other approaches to HIV screening, such as leaving it up to patients to specifically ask to be tested, could have the opposite effect, researchers said. (Dallas, 1/20)

HealthDay: Study: Frailty In Seniors Raises Mortality Risk Related To Elective Surgery
Physical frailty among older people who have elective surgery is linked to a greater risk of death one year later, a new study suggests. Canadian researchers found the one-year death rate for frail older patients having certain surgeries was at least one death for every five people. To make an informed treatment decision, doctors, patients and their families should be aware of this heightened risk, the team advised. (1/21)

Reuters: Drug Shortages In U.S. Emergency Rooms On The Rise
U.S. emergency rooms are increasingly running short on medications, including many that are needed for life-threatening conditions, a recent study documents. Since 2008, the number of shortages has risen by more than 400 percent, researchers found. Half of all emergency room shortages were for life-saving drugs, and for one in 10 there were no available substitutes, they report in Academic Emergency Medicine. Half of the individual shortage incidents had no explanation, the authors found. The rest had a variety of systemic causes that add up to a U.S. drug supply too low to meet public demand. (Kennedy, 1/15)

Reuters: Cardiac Arrest Survival Gets Less Likely The Higher Up You Live
In a study of residential high-rise buildings, people who suffered cardiac arrest had a better chance of survival if they lived on lower floors, and survival odds decreased as floor number increased. "We thought there might be something here because once somebody collapses into cardiac arrest, their chance of survival decreases really quickly,” said lead author Ian Drennan, a paramedic with York Region Paramedic Services and a researcher with Li Ka Shing Knowledge Institute at St. Michael's Hospital in Toronto. (Doyle, 1/18)

Medscape: Physical, Occupational Therapy Ineffective In Parkinson's
Patients with mild to moderate Parkinson's disease don't appear to benefit much from physical therapy (PT) or occupational therapy (OT), a new study shows. The study, comparing PT and OT with no therapy, showed that these interventions were not associated with clinically meaningful improvements in activities of daily living or quality of life. (Anderson, 1/19)

Reuters: Sleeping In On Weekends May Help Reduce Diabetes Risk
Getting too little sleep during the week can increase some risk factors for diabetes, but sleeping late on weekends might help improve the picture, a small U.S. study suggests. Researchers conducted a sleep experiment with 19 healthy young men and found just four nights of sleep deprivation were linked to changes in their blood suggesting their bodies weren’t handling sugar as well as usual. (Rapaport, 1/18)

Reuters: Skin Cancer More Deadly When Caught During Pregnancy
Melanoma may be even more dangerous when it’s diagnosed in women during pregnancy or within a year of giving birth, a U.S. study suggests. Among women under 50 with malignant melanoma, those diagnosed during or soon after pregnancy were significantly more likely to have tumors spread to other organs and tissues, and were also much more likely to have the cancer recur after treatment, the study found. (Rapaport, 1/20)

Reuters: Sexual Trauma Raises Suicide Risk Among Veterans
Men and women veterans who experienced sexual assault or repeated, threatening sexual harassment while serving in the military are at heightened risk of suicide, according to a recent U.S. study. Researchers with the department of Veterans Affairs found that men with a history of what the VA calls military sexual trauma (MST) are 70 percent more likely than fellow vets without such experience to commit suicide, and women veterans with MST are more than twice as likely as other female vets to do so. (Nelson, 1/20)