Research Roundup: Quality And Patient Satisfaction; Trauma Centers And Kids; Effects Of Medicaid

JAMA Surgery: Relationship Between Hospital Performance On A Patient Satisfaction Survey And Surgical Quality
[The federal] Value-Based Purchasing program ... ties financial incentives to hospital performance on a range of quality measures. However, it remains unclear whether patient satisfaction is an accurate marker of high-quality surgical care. ... [The researchers studied 180 hospitals and grouped them] by quartile based on their performance on the Hospital Consumer Assessment of Healthcare Providers and Systems survey. ... those at the highest quartile had significantly lower risk-adjusted odds of death, ... failure to rescue ... and minor complication .... we demonstrated a significant association between patient satisfaction scores and several objective measures of surgical quality. Our findings suggest that payment policies that incentivize better patient experience do not require hospitals to sacrifice performance on other quality measures. (Sacks et al., 6/24)

JAMA Surgery: Mortality Among Injured Children Treated At Different Trauma Center Types
Whether pediatric trauma centers (PTCs), mixed trauma centers (MTCs), or adult trauma centers (ATCs) offer a survival benefit compared with one another when treating injured children is controversial. ... [In a retrospective cohort study, the researchers] identified 175,585 injured children. ... After adjustment, children had higher odds of dying when treated at ATCs ... and MTCs ... compared with those treated at PTCs. In stratified analyses, young children had higher odds of death when treated at ATCs vs PTCs, but there was no association between center type and mortality among older children ... and adolescents .... [The study recommends that] quality improvement initiatives geared toward ATCs and MTCs are required to provide optimal care to injured children. (Sathya et al., 6/24)

JAMA/Kaiser Family Foundation: Health Care Coverage And Access For Men, 2013-2015
This Visualizing Health Policy infographic provides a snapshot of men’s health care and insurance coverage issues, including health status, access to care, and use of services. It compares the uninsured rates of men and women; their cost barriers to care; their connection to clinicians; and their use of prescription drugs, screening, and counseling services. Fewer men than women gained coverage between October 2013 and March 2015, and the uninsured rate continues to be higher for men than women. Although men are less likely than women to experience cost barriers to care, uninsured men are twice as likely as all men to report cost barriers resulting in delayed care or reduced prescription medication use. Men are also are less likely to have seen a health care provider in the past 2 years and to seek screening services or discuss their sexual health with providers. (Kurani et al., 6/23)

Morbidity and Mortality Weekly: Patterns of Health Insurance Coverage Around the Time of Pregnancy Among Women With Live-Born Infants — Pregnancy Risk Assessment Monitoring System, 29 States, 2009
In 2009, before passage of the 2010 Patient Protection and Affordable Care Act (ACA), approximately 20% of women aged 18–64 years had no health insurance coverage. In addition, many women experienced transitions in coverage around the time of pregnancy. Having no health insurance coverage or experiencing gaps or shifts in coverage can be a barrier to receiving preventive health services and treatment for health problems that could affect pregnancy and newborn health. With the passage of ACA, women who were previously uninsured or had insurance that provided inadequate coverage might have better access to health services and better coverage .... data from 2009 can be used as a baseline to measure the incremental impact of ACA on the continuity of health care coverage for women around the time of pregnancy. (D'Angelo et al., 6/19)

The Commonwealth Fund: Does Medicaid Make a Difference?
As millions of Americans gain Medicaid coverage under the Affordable Care Act, attention has focused on the access to care, quality of care, and financial protection that coverage provides. This analysis uses the Commonwealth Fund Biennial Health Insurance Survey, 2014, to explore these questions .... The survey findings suggest that Medicaid coverage provides access to care that in most aspects is comparable to private. Adults with Medicaid coverage reported better care experiences on most measures than those who had been uninsured during the year. Medicaid beneficiaries also seem better protected from the cost of illness than do uninsured adults, as well as those with private coverage. (Blumenthal, Rasmussen, Collins and Doty, 6/24)

Health Affairs: The FDA's Menu-Labeling Rule
The Affordable Care Act (ACA) mandated that many chain restaurants and other "similar" food establishments list the calorie count of the food they sell. The requirement will take effect nationwide in December 2015 .... The law might seem relatively straightforward, but a close reading of the final rule makes clear that virtually every word in section 4205 of the ACA--the statutory basis for the FDA rule--was ... subject to vigorous debate. ... Cost was also a hotly debated factor. The supermarket industry had said it might have to spend up to a billion dollars to implement the new labeling requirements; the restaurant industry said that number was a gross exaggeration. ... A larger, existential question is whether calorie and other nutrition labeling actually makes a difference in how many calories people consume. ... One of the major unresolved issues involving the new rules is determining who will enforce them. (Goldman, 6/25)

The Kaiser Family Foundation: How Does Gaining Coverage Affect People's Lives? Access, Utilization, And Financial Security Among Newly Insured Adults
This report, based on the 2014 Kaiser Survey of Low-Income Americans and the ACA, aims to understand the impact that gaining coverage has had on the lives of the “newly insured” adult population. ... Most newly insured adults are in working families, many with a part-time worker. Despite concerns about adverse selection into coverage, about half of newly insured adults are under age 35 (similar to those who remained uninsured) .... While some newly insured adults changed where they regularly go for care and most see private doctor’s offices for their regular care, many continue to seek services from community clinics and health centers, which ... may be the most available source of care in their area. Still, survey findings show that newly insured adults face some access barriers compared to adults who were insured before 2014. (Garfield and Young, 6/19)

Morbidity and Mortality Weekly Report: Opioid Overdose Prevention Programs Providing Naloxone to Laypersons — United States, 2014
For many years, community-based programs have offered opioid overdose prevention services to laypersons who might witness an overdose, including persons who use drugs, their families and friends, and service providers. Since 1996, an increasing number of programs provide laypersons with training and kits containing the opioid antagonist naloxone hydrochloride (naloxone) to reverse the potentially fatal respiratory depression caused by heroin and other opioids. ... From 1996 through June 2014, surveyed organizations provided naloxone kits to 152,283 laypersons and received reports of 26,463 overdose reversals. (Wheeler et al., 6/19)

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

Reuters: Many With Early Breast Cancer Have Too Many Imaging Tests
Nearly nine in 10 women with early breast cancer have imaging exams to see if the cancer has spread, despite official recommendations against such tests, a new study suggests. The American Society of Clinical Oncology and the National Comprehensive Cancer Network recommend against looking for metastatic cancer in women with stage I or II breast cancer. That’s because less than two percent of these women will have metastases, and there’s a high risk that the tests will be falsely positive, leading to unnecessary extra testing, delays and anxiety. (Doyle, 6/22)

The Sacramento Bee: Study Finds Early Autism Treatment Has Long-Term Gains
The long-term success of an early autism treatment codeveloped by a University of California-Davis researcher was validated recently by a national study soon to be published in the Journal of the American Academy of Child & Adolescent Psychiatry. The Early Start Denver Model is a nonmedical treatment for children age 12-48 months who show symptoms of autism, a developmental disorder that can affect social skills, movement, attention span and intellectual ability. While autism is usually diagnosed in children between the ages of 2 and 3, a growing body of research suggests that diagnosing it early and intervening with one-on-one, parent-led treatment can reduce symptoms in the long run. (Caiola, 6/21)

The Associated Press: Study: Scant Evidence That Medical Pot Helps Many Illnesses
Medical marijuana has not been proven to work for many illnesses that state laws have approved it for, according to the first comprehensive analysis of research on its potential benefits. The strongest evidence is for chronic pain and for muscle stiffness in multiple sclerosis, according to the review, which evaluated 79 studies involving more than 6,000 patients. Evidence was weak for many other conditions, including anxiety, sleep disorders, and Tourette's syndrome and the authors recommend more research. (Tanner, 6/23)

The Hill: Study: E-Cigs More Popular Among Youth Than Traditional Smokes
The popularity of electronic cigarettes and hookahs has overtaken traditional cigarettes among youths, according to a new study from the federal government. The Food and Drug Administration, and Centers for Disease Control and Prevention found e-cigarettes are the most popular tobacco product among middle and high school students. (Devaney, 6/23)

Reuters: In Old Age, Current And Former Smokers Face Early Lung Disease
There may be 35 million older Americans with undiagnosed lung disease due to cigarette smoking, a new study suggests. They don't meet the criteria for a diagnosis of chronic obstructive pulmonary disease, but they still suffer significant lung disease and impairment, the researchers report in JAMA Internal Medicine. (Seaman, 6/22)

MinnPost: Underage Drinking Has Declined Significantly, Study Finds
Efforts by community groups, schools, parents and government agencies to reduce underage drinking appear to be paying off, both nationally and here in Minnesota. Significantly fewer teens — especially at the lower ages — are using alcohol than did so a decade ago, according to a report released earlier this month by the Substance Abuse and Mental Health Services Administration (SAMHSA). Experts stress, however, that the decline needs to be viewed with caution. (Perry, 6/22)

Reuters: 'Virtual Reality' Treatment Shows Promise For Alcoholism
A form of "virtual reality" therapy might help treat alcohol addiction, suggests a preliminary study from South Korea. The study involved only 10 patients with alcohol dependence. But senior researcher Dr. Doug Hyun Han of Chung-Ang University Hospital in Seoul and colleagues think the approach might be promising, in part because it puts patients in situations similar to real life and requires their active participation. (Doyle, 6/24)