Research Roundup: Patient Safety; Opioid Use; And Marketplace Premiums
Each week, KHN compiles a selection of recently released health policy studies and briefs.
Nurses’ And Patients’ Appraisals Show Patient Safety In Hospitals Remains A Concern
The Institute of Medicine concluded in To Err Is Human in 1999 that transformation of nurse work environments was needed to reduce patient harm. We studied 535 hospitals in four large states at two points in time between 2005 and 2016 to determine the extent to which their work environments improved, and whether positive changes were associated with greater progress in patient safety. Survey data from thousands of nurses and patients showed that patient safety remains a serious concern. (Aiken et al, 11/5)
The Pew Charitable Trusts:
Innovative Approaches Can Help Improve Availability Of Opioid Use Disorder Treatment
The number of people with opioid use disorder (OUD)—which is marked by a dependence on opioids, including prescription pain relievers and illicit drugs such as heroin—far exceeds the treatment capacity across the country. In 2017, more than 450,000 individuals with OUD were unable to access treatment. (Rising, Connolly and Duncan, 11/9)
Are Marketplace Premiums Higher In Rural Than In Urban Areas?
Researchers found urban-area premiums were associated with lower marketplace premiums in both 2016 and 2017, for the second-least expensive silver plan, which covers at least 70 percent of health care costs. Although urban areas tend to have health care systems that are more expensive, they also have large populations that invite competition among plans and spread the financial risk associated with health care coverage among more people, thus lowering premium prices. Rural areas, in contrast, typically have a lower cost of living, but fewer people spread out over a greater area, which can discourage competition among health plans. (Wengle, Blumberg and Holahan, 11/15)
JAMA Internal Medicine:
Effect Of Exercise Intervention On Functional Decline In Very Elderly Patients During Acute Hospitalization: A Randomized Clinical Trial
Functional decline is prevalent among acutely hospitalized older patients. Exercise and early rehabilitation protocols applied during acute hospitalization can prevent functional and cognitive decline in older patients. ... Functional decline is prevalent among acutely hospitalized older patients. Exercise and early rehabilitation protocols applied during acute hospitalization can prevent functional and cognitive decline in older patients. (Martinez-Velila, 11/12)
The Henry J. Kaiser Family Foundation:
Potential Changes To Medicaid Long-Term Care Spousal Impoverishment Rules: States’ Plans And Implications For Community Integration
To financially qualify for Medicaid long-term services and supports (LTSS), an individual must have a low income and limited assets. In response to concerns that these rules could leave a spouse without adequate means of support when a married individual needs LTSS, Congress created the spousal impoverishment rules in 1988. Originally, these rules required states to protect a portion of a married couple’s income and assets to provide for the “community spouse’s” living expenses when determining nursing home financial eligibility, but gave states the option to apply the rules to home and community-based services (HCBS) waivers. (Musumeci and O'Mailey Watts, 11/14)