Morning Briefing
Summaries of health policy coverage from major news organizations
Research Roundup: Transgender Veterans; Public Spending On Children; And Bundled Payments
Health Affairs: Transgender And Cisgender US Veterans Have Few Health Differences
Transgender people have been able to serve openly in the military since June 2016. However, the administration of President Donald Trump has signaled its interest in reinstating a ban on transgender military service. In March 2018 President Trump issued a revised memorandum that stated, in part, that people with a “history or diagnosis of gender dysphoria” who “may require substantial medical treatment, including medications and surgery—are disqualified from military service except under certain limited circumstances.” Whether and how the health of transgender service members differs from that of cisgender service members (that is, those who identify with their sex assigned at birth) is largely unknown. (Downing et al, 7/9)
Urban Institute: Public Spending On Children In Five Charts
How our government spends money—and who benefits—reflects our national priorities, but it’s not always clear where our tax dollars are going. In these five charts, we take a look at federal and state spending on children through programs and tax reductions. Children can’t vote or lobby for public resources, but their well-being and development affect the future economic and social health of the country. Investing in their health, education, and stability should be a national priority. So how much are we devoting to the kids’ share of public spending. (7/18)
The New England Journal of Medicine: Evaluation Of Medicare’s Bundled Payments Initiative For Medical Conditions
We used Medicare claims from 2013 through 2015 to identify admissions for the five most commonly selected medical conditions in BPCI [Bundled Payments for Care Improvement]: congestive heart failure (CHF), pneumonia, chronic obstructive pulmonary disease (COPD), sepsis, and acute myocardial infarction (AMI). ... At baseline, the average Medicare payment per episode of care across the five conditions at BPCI hospitals was $24,280, which decreased to $23,993 during the intervention period .... Control hospitals had an average payment for all episodes of $23,901, which decreased to $23,503 during the intervention period .... Changes from baseline to the intervention period in clinical complexity, length of stay, emergency department use or readmission within 30 or 90 days after hospital discharge, or death within 30 or 90 days after admission did not differ significantly between the intervention and control hospitals.(Joynt Maddox et al., 7/19)
The Henry J. Kaiser Family Foundation: Most Americans – Across Parties – Say 2018 Candidates’ Position On Pre-Existing Condition Protections Will Matter To Their Vote; Do Not Want Supreme Court To Overturn These ACA Protections
With less than four months to go until the Congressional midterm general election, a candidate’s position on continuing protections for people with pre-existing health conditions is at the forefront of the many health care issues on voters’ minds, finds the latest Kaiser Family Foundation tracking poll.Continuing pre-existing condition protections ranks first among six other candidate positions on health care issues with 63 percent of voters rating it the “most important” or a “very important” factor. Pre-existing condition protections rank highly across party identification, with majorities of Democratic (74%), independent (64%) and half of Republican (49%) voters saying a candidate’s position on this issue is either the “most important factor” in their vote or “very important, but not the most important factor.” (7/25)
JAMA: Effect Of Escitalopram Vs Placebo Treatment For Depression On Long-Term Cardiac Outcomes In Patients With Acute Coronary Syndrome: A Randomized Clinical Trial
In this randomized clinical trial that included 300 patients with recent acute coronary syndrome and depression, 24-week treatment with escitalopram compared with placebo resulted in an occurrence of major adverse cardiac outcomes of 40.9% vs 53.6% after a median follow-up of 8.1 years, a difference that was statistically significant. (Kim et al, 7/24)
JAMA Oncology: Association Of Circulating Tumor Cells With Late Recurrence Of Estrogen Receptor–Positive Breast Cancer: A Secondary Analysis Of A Randomized Clinical Trial
A single positive CTC assay result 5 years after diagnosis of hormone receptor–positive breast cancer provided independent prognostic information for late clinical recurrence, which provides proof of concept that liquid-based biomarkers may be used to risk stratify for late recurrence and guide therapy. (Sparano et al, 7/26)
