Research Roundup: Hospital-Acquired Complications; Medicaid Expansion; And Serious Illness In America
Each week, KHN compiles a selection of recently released health policy studies and briefs.
JAMA Internal Medicine:
Measuring Hospital-Acquired Complications Associated With Low-Value Care.
In this cohort study and descriptive analysis of 9330 episodes of low-value use of 7 procedures (ranging from 56 low-value spinal fusions to 3963 low-value knee arthroscopies), depending on the procedure, between 0.2% and 15.0% of patients receiving these low-value procedures developed at least 1 of 16 hospital-acquired complications, the most common being health care–associated infection. (Badgery-Parker, 2/25)
The Henry J. Kaiser Family Foundation:
'Partial Medicaid Expansion' With ACA Enhanced Matching Funds: Implications For Financing And Coverage
The Affordable Care Act (ACA) provides enhanced federal matching funds to states that expand Medicaid to nonelderly adults up to 138% of the federal poverty level (FPL, $17,236/year for an individual in 2019). The ACA enhanced match (93% in 2019, and 90% in 2020 and thereafter) is substantially higher than states’ traditional Medicaid matching rate. A few states have sought Section 1115 demonstration waiver authority from the Centers for Medicare and Medicaid Services (CMS) to receive the substantially higher ACA enhanced match while limiting coverage to individuals at 100% FPL, instead of covering the full 138% FPL ACA group. (Rudowitz and Musumeci, 2/20)
Coping With Serious Illness In America
The luckiest among us have family and friends to lean on when times get tough. For those who develop a serious illness — an often painful and tumultuous experience — family and friends offer crucial emotional support and help with day-to-day activities. A recent survey of the sickest adults in America, conducted by the Harvard T. H. Chan School of Public Health, the New York Times, and the Commonwealth Fund, found that seriously ill adults also rely on their family and friends to organize their health care, helping them navigate an often complex, confusing, and inefficient system. Focus groups and in-depth interviews conducted by the Commonwealth Fund since 2016 revealed that while taking care of a seriously ill family member or friend can bring meaning and satisfaction to caregivers, it also can become a complex and serious responsibility that burdens them. (Lewis et al, 2/21)
JAMA Internal Medicine:
Association Of Adolescent Hypertension With Future End-Stage Renal Disease.
Hypertension is a leading risk factor of cardiovascular morbidity and mortality. The role of nonmalignant hypertension as the sole initiating factor of end-stage renal disease (ESRD) in non–African American populations has recently been questioned. (Leiba, 2/25)
Two-Year Outcomes After Transcatheter Aortic Valve Replacement With Mechanical Vs Self-Expanding Valves: The REPRISE III Randomized Clinical Trial.
In this analysis of the randomized clinical trial, at 2 years, mortality and all stroke were similar between valves. Disabling stroke and paravalvular leak were less while pacemaker requirement and valve thrombosis were more frequent after using the mechanically expanded valve. (Reardon, 2/27)