Research Roundup: Pediatric ACOs; High-Deductible Health Plans; Zika And Women

JAMA Pediatrics: Effect Of Attribution Length On The Use And Cost Of Health Care For A Pediatric Medicaid Accountable Care Organization
Little is known about the effect of pediatric accountable care organizations (ACOs) on the use and costs of health care resources, especially in a Medicaid population. ... [Researchers used a] retrospective study of Medicaid claims ... for patients attributed from September 1, 2013, to May 31, 2015. ... Among the 28 794 pediatric patients receiving treatment ..., continuous attribution to the ACO for more than 2 years was associated with a decrease ... of 40.6% ... in inpatient days but an increase ... of 23.3% ... in office visits, 5.8% ... in emergency department visits, and 15.3% ... in the use of pharmaceuticals. These changes in the use of health care resources combined resulted in a cost reduction of 15.7%. (Christensen and Payne, 2/2)

Health Affairs/Robert Wood Johnson Foundation: High-Deductible Health Plans
High-deductible health plans (HDHPs) are increasing in prevalence in both the group and individual markets. ... The central debate over HDHPs is whether or not the plans reduce health care costs and use in a way that could negatively affect health. The Institute of Medicine estimates that 30 percent of health spending is waste. HDHPs are designed to reduce unnecessary use. There is mounting evidence that HDHPs are successful at reducing costs and care use, but results are mixed on the impact of this reduced care use on health status. ... Health care costs have slowed in recent years but are growing once again. Forecasting predicts that health spending will continue to grow faster than the GDP, at a rate of 5.8 percent from 2014 to 2024, and will rise to 19.6 percent of the GDP by 2024. As health care spending climbs, the prevalence of high-deductible plans will likely continue to increase. (Dolan, 2/4)

The New England Journal of Medicine: The Role Of Risk-Reducing Surgery In Hereditary Breast And Ovarian Cancer
In this review, we address issues related to the care of women in families with hereditary breast and ovarian cancer syndrome who have not had cancer. We discuss risk assessment for breast and ovarian cancers according to the woman’s age, the efficacy of risk-reducing surgery, the complications and psychosocial effects of these procedures, alternative strategies for risk management, and the best ways to facilitate individual decision making. (Hartmann and Lindor, 2/4)

The Kaiser Family Foundation: Zika Virus: The Challenge for Women
Active Zika transmission is now reported in 18 countries in Latin America and the Caribbean, as well as several other territories, and the World Health Organization (WHO) predicts it could affect 4 million people across the Americas this year alone. ... Of particular concern is the association between Zika infection and microcephaly, a severe birth defect of the newborn brain. ... The United States government may have an important role to play in addressing health access and rights for women in Zika-affected countries, both through its direct health and development assets as well as its diplomatic engagement and public health expertise. To understand more about where these issues are likely to be more acute, we examine available country-level data on access to contraception, abortion policies, and the US government’s foreign assistance and global health presence in Zika-affected countries. (Kates, Michaud and Valentine, 2/1)

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

CNN: Study Links Eating Fish With Healthier Brains, Regardless Of Mercury
Eating at least one serving of seafood a week could help stave off Alzheimer's disease, according to a study. A strong case has been building for the role that omega-3 fatty acids found in fish could play in protecting against Alzheimer's and other forms of dementia. But questions remained about whether these benefits could be canceled out by the mercury in fish, which at high enough levels can be toxic to the brain. The new study suggests that is not the case. (Storrs, 2/2)

The New York Times: Whooping Cough Booster Shot May Offer Only Short-Term Protection
The rapidly fading effectiveness of the pertussis booster vaccine may help explain recent widespread outbreaks of whooping cough. The United States stopped using a whole-cell pertussis vaccine in the 1990s and began using an acellular version called DTaP. Five vaccinations are given during childhood, and a booster vaccine, called the Tdap, is given to adolescents and adults. Researchers looked at 1,207 pertussis cases among children who had had the acellular vaccine in childhood. The study, in Pediatrics, found that when these children got the Tdap booster, it was 69 percent effective after the first year, then dropped to less than 9 percent two to three years later. (Bakalar, 2/5)

CNN: New Vaccines For HPV, Meningitis Recommended For Kids And Adults
New vaccines for meningococcal type B and HPV and are among the updates to the immunization schedule published for children and adults. The Advisory Committee on Immunization Practices, known as ACIP, makes the updates every year. ACIP is a part of the Centers for Disease Control and Prevention. A number of medical groups, including the American College of Obstetricians and Gynecologists and the American Academy of Family Physicians, have endorsed the new schedules. (Storrs, 2/4)

JAMA Medical News: US Infant Mortality Rate Declines But Still Exceeds Other Developed Countries
The newest federal data on US infant mortality in 2014 can be viewed as a glass half full or a glass half empty. The good news from the Centers for Disease Control and Prevention’s (CDC’s) National Center for Health Statistics (NCHS) is that the 2014 infant mortality rate of 582 deaths per 100 000 live births—23 215 infant deaths—is a 2.3% decrease from the 2013 rate. It’s also the lowest recorded US infant mortality rate. ... The bad news is that the US infant mortality rate, which the CDC defines as death before 1 year of age, still far outstrips infant death rates in other developed countries, such as Finland and Iceland, both of which had a 2013 infant mortality rate of 180 deaths per 100 000 births. (Jacob, 2/2)

Forbes: Health On-Demand Attracts $1B In Investments
The move to make the healthcare system a digital-first industry as Uber and Lyft have done for U.S. transportation will trigger a quadrupling to $1 billion the projected venture capital investment in on-demand health products this year. A new report from Accenture says on-demand healthcare investment will grow from $250 million today to more than $1 billion by 2017. (Japsen, 2/2)

Reuters: An Ethical Way To Choose Which Kids Get Chemo During A Shortage?
When chemotherapy is in short supply, doctors should choose kids to receive treatment based on which patients have the best odds of being cured by the drugs, argues a group of oncologists. Shortages of life-saving cancer medicines for children are frequent and can complicate typical treatment protocols, creating substantial ethical challenges, the doctors write in the Journal of the National Cancer Institute. (Rapaport, 1/29)

Reuters: Dietary Fiber In Teen Years May Lower Later Breast Cancer Risk
For girls and young women, getting a lot of fiber could pay off decades later with lowered risk of developing breast cancer, according to a large U.S. study. Researchers analyzed data on more than 44,000 women participating in a long-term study and found those who ate the most fiber during high school and early adulthood were about 20 percent less likely to develop breast cancer by middle age than those who ate the least fiber in their youth. (Doyle, 2/1)