Research Roundup: Microcephaly; Insurance Coverage; And Child Mortality
Each week, KHN compiles a selection of recently released health policy studies and briefs.
Pediatrics:
Prevalence And Risk Factors For Microcephaly At Birth In Brazil In 2010
According to the International Fetal and Newborn Growth Consortium for the 21st Century definition, the prevalence of microcephaly (>2 SDs below the mean for gestational age and sex) was higher in SL (3.5%) than in RP (2.5%). The prevalence of severe microcephaly (>3 SDs below the mean) was higher in SL (0.7%) than in RP (0.5%). Low maternal schooling, living in consensual union or without a companion, maternal smoking during pregnancy, primiparity, vaginal delivery, and intrauterine growth restriction were consistently associated with microcephaly. The number of cases of microcephaly is grossly underestimated, with an underreporting rate of ∼90%. (Silva et al., 2/1)
Urban Institute:
Health Insurance Coverage Among Children Ages 3 And Younger And Their Parents In 2016
Using the 2016 American Community Survey (ACS), this brief updates a previous analysis that examined health insurance coverage among children ages 3 and younger and their parents in 2015. High rates of coverage through Medicaid and the Children’s Health Insurance Program (CHIP) continued among young children and their parents in 2016, the third year after implementation of the major coverage provisions of the Affordable Care Act. Uninsurance among both young children and their parents continued to decline, and coverage levels varied across states and metropolitan areas. Estimates for children ages 2 and younger nationally and across states are also presented. (Haley et al., 1/30)
Pediatrics:
Injury And Mortality Among Children Identified As At High Risk Of Maltreatment
Models that predict risk of maltreatment as defined by child protective services substantiation also identify children who are at heightened risk of injury and mortality outcomes. If deployed at birth, these models could help medical providers identify children in families who would benefit from more intensive supports. (Vaithianathan, Rouland, Putnam-Hornstein, 2/1)
JAMA Internal Medicine:
Effect Of In-Hospital Multifaceted Clinical Pharmacist Intervention On Readmission
In a randomized clinical trial of 1467 Danish participants receiving at least 5 medications, a statistically significant reduced rate of readmissions within 30 and 180 days after inclusion was observed in patients randomized to receive an extended pharmacist intervention compared with those who received usual care or a basic pharmacist intervention. (Ravn-Nielsen, Duckert and Lund, 1/29)
Urban Institute:
Delayed Retirement And The Growth In Income Inequality At Older Ages
As concerns about retirement savings have intensified, many older adults have begun working beyond traditional retirement age. By working longer, they can improve their retirement security by increasing their future monthly Social Security payments and shortening the time they must rely on their savings. But does delaying retirement deepen income inequality for older adults by leaving those with health problems behind? (Johnson, 2/1)
New England Journal of Medicine:
Catheter Ablation For Atrial Fibrillation With Heart Failure
Mortality and morbidity are higher among patients with atrial fibrillation and heart failure than among those with heart failure alone. Catheter ablation for atrial fibrillation has been proposed as a means of improving outcomes among patients with heart failure who are otherwise receiving appropriate treatment. ... Catheter ablation for atrial fibrillation in patients with heart failure was associated with a significantly lower rate of a composite end point of death from any cause or hospitalization for worsening heart failure than was medical therapy. (Marrouche, et al., 2/1)
JAMA Surgery:
Association Of The Affordable Care Act Medicaid Expansion With Access To And Quality Of Care For Surgical Conditions
Findings: In this study of patients with 1 of 5 common surgical conditions, Medicaid expansion was associated with a 7.5–percentage point increase in insurance coverage at the time of hospital admission. The policy was also associated with patients obtaining care earlier in their disease course and with an increased probability of receiving optimal care for those conditions. Meaning: The Patient Protection and Affordable Care Act’s Medicaid expansion was associated with increased coverage of patients, earlier presentation with common diagnoses, and improved surgical care. (Loehrer et al., 1/24)
