Research Roundup: Readmission Rates At Safety Net Hospitals; Asthma Cases; Cataract Surgery

Health Affairs: Understanding Medicare Hospital Readmission Rates And Differing Penalties Between Safety-Net And Other Hospitals
Since the implementation of Medicare’s Hospital Readmissions Reduction Program in 2012, concerns have been raised about the effect its payment penalties for excess readmissions may have on safety-net hospitals. ... We examined the extent to which the program’s current risk-adjustment factors, measures of patient socioeconomic status, and hospital-level factors explain the observed differences in readmission rates between safety-net and other hospitals. Our analyses suggest that patient socioeconomic status can explain some of the difference in readmission rates but that unmeasured factors such as hospitals’ performance may also play a role. We also found that safety-net hospitals have experienced only slightly higher readmission penalties under the program than other hospitals have. (Sheingold, Zuckerman and Shartzer, 1/5)

Health Affairs: Formerly Homeless People Had Lower Overall Health Care Expenditures After Moving Into Supportive Housing
In this pilot study we used a mixture of survey and administrative claims data to evaluate outcomes for formerly homeless people who were living in a supportive housing facility in Oregon between 2010 and 2014. Results from the claims analysis showed significantly lower overall health care expenditures for the people after they moved into supportive housing. Expenditure changes were driven primarily by reductions in emergency and inpatient care. Survey data suggest that the savings were not at the expense of quality: Respondents reported improved access to care, stronger primary care connections, and better subjective health outcomes. (Wright et al., 1/5)

JAMA/The Kaiser Family Foundation: Recent Trends In Employer-Sponsored Health Insurance Premiums
This Visualizing Health Policy infographic charts recent trends in employer-sponsored health insurance premiums. Between 1999 and 2015, premiums increased by 203%, outpacing both inflation and workers’ earnings. However, growth of premiums for family coverage slowed toward the end of that time period, from an average of 11% per year between 1999 and 2005 to 5% per year between 2005 and 2015. Between 2014 and 2015, the average premium for single and family coverage increased 4%, and over the past 5 years, deductibles increased faster than both premiums and wages. (Long et al., 1/5)

Pediatrics: Changing Trends In Asthma Prevalence Among Children
Overall, childhood asthma prevalence increased from 2001 to 2009 followed by a plateau then a decline in 2013. From 2001 to 2013, multivariate logistic regression showed no change in prevalence among non-Hispanic white and Puerto Rican children and those in the Northeast and West; increasing prevalence among 10- to 17-year-olds, poor children, and those living in the South; increasing then plateauing prevalence among 5- to 9-year-olds, near-poor children, and non-Hispanic black children; and increasing then decreasing prevalence among 0- to 4-year-olds, nonpoor, and Mexican children and those in the Midwest. Non-Hispanic black-white disparities stopped increasing, and Puerto Rican children remained with the highest prevalence. (Akinbami, Simon and Rossen, 1/1)

JAMA Ophthalmology: Geographic Variation In The Rate And Timing Of Cataract Surgery Among US Communities
[Researchers sought to] assess the extent of geographic variation in patient age at initial cataract surgery [by analyzing] a [r]etrospective cross-sectional study of 1 050 815 beneficiaries older than 40 years of age with cataracts who were enrolled in a nationwide managed-care network during the period from 2001 to 2011. ... A total of 243 104 patients with cataracts (23.1%) underwent 1 or more surgical procedures (55.1% were female patients). Communities with the youngest and oldest patients at initial surgery differed in age by nearly 20 years (59.9-60.1 years in Lansing, Michigan, and Aurora, Illinois, vs 77.0-79.6 years in Marquette, Michigan; Rochester, New York; and Binghamton, New York). (Kauh et al., 12/30)

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

Reuters: Better Results Offset Costs Of Prostate Surgery At Specialty Centers
Men who get prostate cancer surgery at hospitals that do a lot of these procedures may have better results, and those better outcomes might help offset the added cost of care at specialized facilities, a U.S. study suggests. (Rapaport, 1/1)

Los Angeles Times: More Than 90% Of People Who Overdosed On Prescription Painkillers Can Still Get Refills, Study Says
Even after overdosing on opioid medications, more than nine out of 10 patients continued to get prescriptions for the powerful painkillers, according to a new study. As a result, some went on to suffer another overdose. The findings, published Monday in Annals of Internal Medicine, are “highly concerning,” the study authors wrote. (Kaplan, 12/28)

Reuters: U.S. May Lack Resources To Treat Kids In Disasters
In the event of a natural disaster, epidemic or terrorist attack, the U.S. may not have enough medical resources to aid affected children, according to a report from the American Academy of Pediatrics. Children are particularly vulnerable to illness and injuries during these emergency situations and their distinct needs – such as special drug formulations or dosing and pint-size medical devices – mean supplies set aside for adults may not work for them. To start fixing the problem, the U.S. needs more investment in treatments that are appropriate for children, including research to develop age-appropriate therapies as well as investments to increase the nation’s stockpile of remedies already made for kids, according to the report from AAP’s Disaster Preparedness Advisory Council. (Rapaport, 1/5)

The New York Times: Can Too Much Exercise Harm The Heart?
With many of us contemplating marathons or other prolonged endurance events in 2016, we, our spouses and other family members most likely have wondered whether such strenuous training could be harmful to our hearts. Could any of us, in making ambitious resolutions, exercise too much? A newly published scientific review offers both reassurance and some caution. It found that while most athletes’ hearts can withstand most exercise, there are exceptions. (Reynolds, 12/30)

Reuters: Extra Care Required When Dying Parents Have Young Kids
End-of-life care for parents of young children may need to include additional support services that help the entire family cope with terminal illness, a recent study suggests. While all families may struggle when a loved one is dying, parenting duties can create an added layer of emotional stress and complicate efforts to comfort patients at the end of life, researchers note in the journal BMJ Supportive and Palliative Care. (Rapaport, 1/1)