Morning Briefing
Summaries of health policy coverage from major news organizations
Research Roundup: Spending On Elderly Patients; Suicide; And Race And Health Coverage
Health Affairs: Explaining The Slowdown In Medical Spending Growth Among The Elderly, 1999–2012
We examined trends in per capita spending for Medicare beneficiaries ages sixty-five and older in the United States in the period 1999–2012 to determine why spending growth has been declining since around 2005. Decomposing spending by condition, we found that half of the spending slowdown was attributable to slower growth in spending for cardiovascular diseases. Spending growth also slowed for dementia, renal and genitourinary diseases, and aftercare for people with acute illnesses. Using estimates from the medical literature of the impact of pharmaceuticals on acute disease, we found that roughly half of the reduction in major cardiovascular events was attributable to medications controlling cardiovascular risk factors. Despite this substantial cost-saving improvement in cardiovascular health, additional opportunities remain to lower spending through disease prevention and control. (Cutler et al, 2/4)
Pediatrics: Parent-Adolescent Agreement About Adolescents’ Suicidal Thoughts
Early identification and intervention hinge on reliable and valid assessment of suicide risk. The high prevalence of parental unawareness and adolescent denial of suicidal thoughts found in this study suggests that many adolescents at risk for suicide may go undetected. These findings have important clinical implications for pediatric settings, including the need for a multi-informant approach to suicide screening and a personalized approach to assessment based on empirically derived risk factors for unawareness and denial. (Jones et al, 2/1)
JAMA Psychiatry: Effect Of Augmenting Standard Care For Military Personnel With Brief Caring Text Messages For Suicide Prevention: A Randomized Clinical Trial
Does a text message-based intervention (Caring Contacts) reduce suicidal thoughts and behaviors among active-duty military personnel? Findings: In this randomized clinical trial of 658 Soldiers and Marines, augmenting standard care with Caring Contacts did not reduce current suicidal ideation or suicide risk events at 12-month follow-up. However, Caring Contacts reduced the odds of having any suicidal ideation (80% vs 88%) and making a suicide attempt (9% vs 15%). (Comtois et al, 2/13)
The Henry J. Kaiser Family Foundation: Changes In Health Coverage By Race And Ethnicity Since Implementation Of The ACA, 2013-2017
The Affordable Care Act (ACA) coverage expansions provided an opportunity to increase coverage and address longstanding racial and ethnic disparities in health coverage.1 This brief examines changes in health coverage by race and ethnicity between 2013 and 2017, providing insight into how coverage has changed since implementation of the ACA. It is based on Kaiser Family Foundation analysis of the nonelderly population using American Community Survey data. (Artiga, Orgera and Damico, 2/13)
JAMA Internal Medicine: Assessment Of Racial/Ethnic And Income Disparities In The Prescription Of Opioids And Other Controlled Medications In California.
In prescription drug monitoring program data from 2011 through 2015, 44.2% of all adults in California in the regions with the lowest-income/highest proportion–white population received at least 1 opioid prescription annually compared with 16.1% in the regions with the highest-income/lowest proportion–white population and 23.6% across California. Opioid overdose deaths were concentrated in lower-income, mostly white regions, with a 10-fold difference in overdose rates across the race/ethnicity–income gradient. (Friedman et al, 2/11)
Health Affairs: Qualifying Conditions Of Medical Cannabis License Holders In The United States
The evidence for cannabis’s treatment efficacy across different conditions varies widely, and comprehensive data on the conditions for which people use cannabis are lacking. We analyzed state registry data to provide nationwide estimates characterizing the qualifying conditions for which patients are licensed to use cannabis medically. We also compared the prevalence of medical cannabis qualifying conditions to recent evidence from the National Academies of Sciences, Engineering, and Medicine report on cannabis’s efficacy in treating each condition. Twenty states and the District of Columbia had available registry data on patient numbers, and fifteen states had data on patient-reported qualifying conditions. (Boehnke, 2/4)
JAMA Psychiatry: Association Of Cannabis Use In Adolescence And Risk Of Depression, Anxiety, And Suicidality In Young Adulthood: A Systematic Review And Meta-Analysis
In this systematic review and meta-analysis of 11 studies and 23 317 individuals, adolescent cannabis consumption was associated with increased risk of developing depression and suicidal behavior later in life, even in the absence of a premorbid condition. There was no association with anxiety. (Gobbi et al, 2/13)
