Research Roundup: Health Pay Differentials; Lowering Risk Of Falls; The Effect Of CPR
Each week, KHN compiles a selection of recently released health policy studies and briefs.
Health Affairs:
Understanding Pay Differentials Among Health Professionals, Nonprofessionals, And Their Counterparts In Other Sectors
We examined how the wages paid to health-sector employees compared to those paid to workers with similar qualifications in other sectors. Overall, we found that health care workers are paid only slightly more than workers elsewhere ... but the patterns are starkly different for nonprofessional and professional employees. Nonprofessional health care workers earn slightly less than their counterparts elsewhere .... By contrast, the average nurse earns about 40 percent more than the median comparable worker in a different sector. The average physician earns about 50 percent more ... and this differential has increased sharply since 1993. (Glied, Ma and Pearlstein, 6/8)
Health Affairs:
Concentration In Orthopedic Markets Was Associated With A 7 Percent Increase In Physician Fees For Total Knee Replacements
Physician groups are growing larger in size and fewer in number. ... We examined the association between market concentration and physician fees in the case of total knee arthroplasty by calculating market concentration for orthopedic groups practicing in a given market and by analyzing administrative claims data from Marketscan. In the period 2001–10 the average professional fee for total knee arthroplasty was $2,537. During this time, in markets that moved from the bottom quartile of concentration to the top quartile, physician fees paid by private payers increased by $168 per procedure. The increase nearly offset the $261 decline in fees that we observed, absent changes in market concentration. (Sun and Baker, 6/8)
Health Affairs:
Prevention Program Lowered The Risk Of Falls And Decreased Claims For Long-Term Services Among Elder Participants
The LIFT (Living Independently and Falls-free Together) Wellness Program is a multifactorial fall-prevention intervention developed for community-dwelling elders. Its effectiveness was tested in a randomized controlled trial of consenting people who were ages seventy-five and older and who held long-term care insurance policies with one of three major insurers. The study was conducted during 2008–12. In the first year following the intervention, participants in the intervention group had an 11 percent reduction in risk of falling and an 18 percent reduction in risk of injurious falls, compared to participants in the active control group. In the three years after the intervention, participants in the intervention group had a significantly (33 percent) lower incidence of claims for long-term services. (Cohen et al., 6/8)
The New England Journal of Medicine:
Early Cardiopulmonary Resuscitation In Out-Of-Hospital Cardiac Arrest
Out-of-hospital cardiac arrest is a major public health concern, given that there are approximately 420,000 cases in the United States and 275,000 cases in Europe annually. ... in recent years, the value of bystander CPR has been debated in the medical community. ... our primary aim was to assess whether CPR initiated before the arrival of emergency medical services (EMS) was associated with an increase in the 30-day survival rate .... The 30-day survival rate was 10.5% among patients who underwent CPR before EMS arrival, as compared with 4.0% among those who did not .... We also found that if bystander CPR was started before the arrival of EMS, the emergency call was initiated more rapidly, which suggests that bystanders with CPR training are better than bystanders without such training at recognizing that a cardiac arrest is occurring and taking action. (Hasselqvist-Ax et al., 6/11)
The Kaiser Family Foundation:
Medicaid Balancing Incentive Program: A Survey Of Participating States
Eighteen states are currently participating in the Medicaid Balancing Incentive Program (BIP) to increase access to home and community-based services (HCBS) as an alternative to institutional care. Established by the Affordable Care Act, BIP authorizes $3 billion in enhanced federal funding from October 2011 through September 2015. As a condition of participation in BIP, states must implement certain structural changes and reach specific financial benchmarks by September 2015 .... States report that BIP is helping them achieve their goal of rebalancing LTSS [long-term support services] in favor of HCBS. Medicaid LTSS spending on HCBS increased in all 18 BIP states, with 14 states reporting spending growth of 25 percent or more between 2009 and 2014. (O'Malley Watts, Reaves and Musumeci, 6/5)
The Kaiser Family Foundation:
Behavioral Health Parity And Medicaid
Behavioral health parity refers to requirements for health insurers to cover mental health and substance use disorder services on terms that are equal to those offered for medical and surgical services. This issue brief explains how behavioral health parity applies in the Medicaid program, including the major provisions of the Centers for Medicare and Medicaid Services’ (CMS) April 10, 2015 proposed regulations, and identifies key policy issues at the intersection of behavioral health parity and Medicaid. (Musumeci, 6/2)
Here is a selection of news coverage of other recent research:
Reuters:
More Poor Babies Get Checkups When Parents Get Extra Help
Low-income parents may be more likely to get their infants routine checkups and vaccinations when clinics offer extra support navigating healthcare issues and addressing basic needs like food and housing, a U.S. study suggests. Many parents, regardless of income, can face challenges getting babies to the pediatrician, particularly when they struggle to take time off work or arrange care for other children. But poverty can make these obstacles more pronounced. (Rapaport, 6/3)
The New York Times:
With New Study, New Mothers Seeking IUDs Are No Longer Urged To Wait
After childbirth, some new mothers wishing to avoid another pregnancy ask their doctors to provide reversible contraception, like an intrauterine device. But normally, new mothers are told to return for contraception six weeks after giving birth — after fully half of them have already resumed sexual relations. A study, published on Monday in Obstetrics and Gynecology, suggests that this practice should change. (Saint Louis, 6/8)
The Boston Globe:
End-Of-Life Counsel From Doctors Seen As Lacking
Americans routinely tell researchers they don’t want to spend their final days tethered to machines in a hospital, preferring to die at home with less invasive treatments. But that rarely happens. Now, a study from Brigham and Women’s Hospital suggests the biggest reason for that disconnect appears to be the doctors who treat those patients. The physicians, the study suggests, have outsized influence in shaping how patients spend their final days. (Lazar, 6/9)
Reuters:
Tanning Beds Often Available In College Apartment Buildings
Up to half of the apartment housing in close range of two Texas Universities offers free on-site indoor tanning, according to a new survey. Most of the apartment employees interviewed for the survey also reported that minors are allowed to use the tanning facilities, which is outlawed under Texas Administrative Code, the researchers report in JAMA Dermatology. Researchers used google.com, apartmentguide.com, collegestudentapartments.com and daftlogic.com to find apartments within a five-mile radius of The University of Texas at Austin (UT Austin) and Texas A&M University (TAMU) campuses. (Doyle, 6/10)
MinnPost:
Melanoma Rates Will Double (Again) Without Widespread Preventive Efforts, Says CDC
The incidence of melanoma — the deadliest form of skin cancer — has doubled over the past three decades in the United States, and it will continue to increase unless we change our sun-worshipping ways. That’s the sober news from a new Vital Signs study published earlier this week by the Centers for Disease Control and Prevention. (Perry, 6/4)
Medscape:
ADA Moves To Improve Referrals For Diabetes Self-Management
A group of US societies has issued new guidance to doctors on when they should refer patients for diabetes self-management education. "There is confusion as to why diabetes education is needed, when diabetes education should occur, what is needed in diabetes education, and how it should be provided.…This confusion leads to patients not receiving the needed services of diabetes education and support," said lead author of the joint position statement Margaret Powers, PhD, research scientist at the International Diabetes Center at Park Nicollett, Minneapolis, Minnesota, and American Diabetes Association (ADA) healthcare and education president-elect. "Our goal with this paper was to reduce this confusion and provide clear guidelines and expectations for clinicians and for patients," said Dr. Powers. (Tucker, 6/6)
Medscape:
'Food Insecurity' In Low-Income Latinos Thwarts Diabetes Control
In low-income Latino patients with type 2 diabetes who took part in a diabetes education program that was specifically designed for them, those with "food insecurity" — a belief that they could not access adequate food to feed their families — reported eating fewer healthy vegetables at their main meal and had worse initial glycemic control than their peers. (Busko, 6/10)
Reuters:
As Weight Loss Surgery Booms, So Do Surgeries For Hanging Skin
In recent years, as weight loss surgeries have been on the rise, so have procedures like tummy tucks, breast lifts, thigh lifts and upper arm lifts, which are usually associated with significant weight loss, according to new data from the American Society of Plastic Surgery (ASPS). In the 2014 report, they estimate that overall, 1.7 million cosmetic surgical procedures were performed, a slight increase from 2013 but an overall decrease from 2000. Breast augmentation has been the top procedure since 2006. (Doyle, 6/8)
MedPage Today:
'Sleeping In' Doesn't Make Up For Lost Sleep In Teens
Laboratory experiments indicate that adolescents who are deprived of sleep function poorly on school days, and their recovery on the weekend is not enough to make up for burning the midnight oil during the week, researchers said here. Lapses in psychomotor vigilance tests increased ... and subjective scores on the Karolinska Sleepiness Scale increased ... after the adolescents had undergone sleep deprivation -- 5 hours of sleep instead of 10, reported Alex Agostini, a PhD candidate and research assistant at the University of South Australia Centre for Sleep, Adelaide. ... Agostini said that while the young participants said they felt refreshed after having 10 hours of sleep -- and their subjective sleepiness scores returned to baseline, their psychomotor test scores did not recover to baseline levels. (Susman, 6/8)