Student URLs April 15, 2016

Sara Sigur

Study finds surprising reason why more black, Latino children aren’t insured
Medicaid and the Children’s Health Insurance Program (CHIP) were developed to give society’s most vulnerable kids a chance at health care. But there’s a catch: In many states, parents must sign their kids up for the programs to receive coverage. And to sign their kids up, parents must know that their kids are eligible in the first place.

Free Clinics Expanding Mission To Help Insured Patients With High Expenses
Denise Johnson works two jobs, but neither of them offers health insurance to part-timers like her. She signed up for a marketplace plan this year, but for routine medical care, Johnson still goes to the free clinic near her Charlottesville, Virginia, home.

AIDS Treatment in Haiti Promising for Developing Nations
One of the first groups of H.I.V. patients in a poor country to get free AIDS drugs has about the same survival rate as their closest counterparts in the United States, according to scientists at Weill Cornell Medical College.

Katherine Crawford

Florida reaches deal to improve healthcare for poor children

The New York Times (4/5, Robles, Subscription Publication) reports Florida health officials agreed to improve access to healthcare for poor children, settling a “long-running class action lawsuit that had accused the state of shortchanging doctors and leaving low-income families to trek long distances to visit specialists.” Lawyers argued in a suit filed in 2005 by pediatric physicians that Florida paid doctors about half of what they received from the Medicaid program, resulting in many doctors refusing to treat the patients. Parents of children who required specialists had to travel long distances or wait months to find a physician who would accept Medicaid.
        The Miami Herald (4/5, Miller) reports that a federal judge in Miami “sided with needy children and their doctors in a 153-page ruling in December 2014, saying state lawmakers had so starved the Florida Medicaid program of funding that it was operating in violation of federal law.” Health administrators and lawyers for the plaintiffs spent months reaching a “settlement with the heads of the state Department, Agency for Health Care Administration and the Department of Children & Families.” Under the settlement, AHCA agreed to create “incentives” for the program’s managed-care plans to boost rates paid to most pediatricians and pediatric specialists.

Cost of insulin increased 200 percent between 2002 and 2013, analysis indicates

Reuters (4/5, Seaman) reports a new study shows the cost of insulin has increased nearly 200 percent between 2002 and 2013. For the study researchers analyzed medical spending data from 27,878 people with diabetes and found that the average price of insulin rose 197 percent from $4.34 to $12.92 per mL, during that time frame.
        STAT (4/5, Silverman) reports that “meanwhile, the amount of money spent by each patient on other diabetes medications fell 16 percent, to $502 from $600.” The analysis “also found that the cost of various widely used oral diabetes drugs either dropped in price or did not rise nearly as significantly as insulin.” For example, Metformin, “which is available as a generic, fell to 31 cents in 2013 from $1.24 per tablet in 2002.” On the contrary, “the newer class of diabetes drugs known as DPP-4 inhibitors rose 34 percent since becoming available in 2006.”

As Rural Hospitals Struggle, Some Opt To Close Labor And Delivery Units

Facilities for delivering babies are costly to run and hard to staff, so some small, rural hospitals are closing them, forcing pregnant women to travel for care. (Michelle Andrews, 2/23) 

Sarah Kleinknecht

Mortality, readmission rates at VA hospitals may be similar to those at other facilities, study finds
A new study on death rates and readmissions indicates VA hospitals “compare pretty favorably with others when it comes to treating older men with three common conditions – heart attacks, heart failure and pneumonia,” the AP (2/9, Tanner) reports. The 2010-2013 study, published in the Journal of the American Medical Association, found the “chances for dying or being readmitted within 30 days of treatment for those conditions varied only slightly for patients hospitalized within the VA system versus at outside hospitals.” These findings “contrast with longstanding concerns about challenges facing veterans and the VA health system, including quality questions and long waits for care.”
        Reuters (2/9, Doyle) also reports on the study, noting while that 30-day mortality rates for heart attack and heart failure were slightly lower at VA hospitals, pneumonia deaths were slightly higher. However, all of the differences were less than one percentage point. Likewise, hospital readmissions for all of the conditions were higher in VA hospitals, but the differences were small.

Childhood leukemia patients from high-poverty areas more likely to suffer early relapse

Among children with acute lymphoblastic leukemia, the most common pediatric cancer, those from high-poverty areas are substantially more likely to suffer early relapse, despite having received the same treatment, according to research. The findings are significant because ALL that relapses early is more difficult to successfully treat. The study is among the first to explore possible factors contributing to outcome disparities among children who received uniform treatment.

Women need more of the HIV drug Truvada than men to prevent infection
Posted: 04 Mar 2016 06:20 AM PST
Women need daily doses of the antiviral medication Truvada to prevent HIV infection while men only need two doses per week due to the way the drug accumulates in different body tissues, according to a new study from pharmacy researchers.


Lauren Clark
Medi-Cal set to expand coverage to undocumented children
A new Medi-Cal policy will offer full coverage to undocumented children.  Most undocumented families can only access medical care on an emergency basis. Immigrants go years without medical treatment for fear of cost, deportation.  The Medi-Cal expansion for undocumented children is exclusively state-funded and is expected to cost the state Department of Health Care Services about $132 million annually. A 2015 study from the Public Policy Institute of California concluded that about half of the state’s undocumented immigrants have incomes low enough to qualify for Medi-Cal.
Huge problems faced by parents of children with autism
Parents of children with Autism Spectrum Disorder (ASD) face severe challenges in accessing adequate services, according to a survey of hundreds of parents in the United Kingdom. Just 11% of parents felt that the NHS professionals they encountered understood their concerns about the behavior and healthcare challenges of their child. The majority, 70 per cent, felt that their child's symptoms were attributed to ASD and seen as something to "get on with," rather than being worthy of further investigation and treatment.
High out-of pocket costs limit access to lifesaving specialty drugs
"Specialty drugs" have become important treatment options for many serious and chronic diseases, and in some conditions like cancer they represent the only chance for long-term survival. But, insurers increasingly require patients to share the high costs of these medications. Two new studies led by researchers at the Perelman School of Medicine at the University of Pennsylvania have found evidence that such cost-sharing arrangements are associated with significant reductions in access to these drugs.


Leah Gregory

Direct primary care practice model growing

The Boston Globe (4/20, McCluskey) reports on the growing practice of “direct primary care” in which physicians do not accept health insurance. Instead, under this model, physicians charge “a flat monthly fee for up to a” certain number of visits per year and provide “e-mail and cellphone” access. But, “monthly fees for direct primary care may be out of reach for many middle- and lower-income families who already pay hundreds of dollars a month for health insurance.” It is estimated that there are some 400 direct primary care practices now operating in the US.

Health Law Benefits Reaching Poor Americans' Wallets, Study Finds
New research shows that many poor Americans' financial woes have been eased by the expansion of Medicaid under the Affordable Care Act, but experts are unable to show if it has made low-income people any healthier.
The Washington Post's Wonkblog: The Big Way Obamacare Helps The Poor Isn’t Really About Their Health 
President Obama's health-care reform law made government health insurance available to more people living in poverty or near poverty by expanding Medicaid. The hope was to improve people's physical health, but new research shows an important effect on financial health: The law has helped many poor Americans pay off the collection agent. The analysis, conducted by a team of university researchers and members of the Federal Reserve Bank of Chicago, estimates that those who signed up for Medicaid under the law reduced their collection balances by $600 to $1,000 each. (Ehrenfreund, 4/20)

Mortality rate of poor children in the US is in decline
Posted: 21 Apr 2016 11:15 AM PDT
Wealthier individuals have a lower mortality rate than poorer people. The common assumption that this effect has intensified in recent years is rebutted now by a new study. Instead of examining life expectancy at birth, the study looks at the mortality rates by age group in different counties in the USA. The study finds that the mortality rates of disadvantaged children and young adults are falling and are approaching the mortality rates in wealthy areas, while the differences among older people continue to be pronounced.

Daniel Njoku

Whites receive more state funding for autism services than other racial/ethnic groups

Whites with autism spectrum disorder (ASD) in California receive more state funding than Hispanics, African Americans, Asians and others, new research from UC Davis Health System has found. The study also showed that state spending on ASD increases dramatically with age.

U.S. Suicide Rate Surges to a 30-Year High

WASHINGTON — Suicide in the United States has surged to the highest levels in nearly 30 years, a federal data analysis has found, with increases in every age group except older adults. The rise was particularly steep for women. It was also substantial among middle-aged Americans, sending a signal of deep anguish from a group whose suicide rates had been stable or falling since the 1950s.

Is Obamacare making Americans healthier?

State Medicaid expansions under Obamacare have improved low-income Americans' insurance coverage, increased their doctor visits and enhanced detection of chronic health conditions, which could lead to improvements in health, a new study suggests.

Sadia Shah

Transgender university and college students are at a significantly higher risk for suicide attempts when their campus experience includes being denied access to bathrooms and gender-appropriate campus housing, a Georgia State University study 

Study finds stress in nurses may affect patient care

NPR  reported on the impacts of “nurse burnout” on patient care and “moral distress.” According to the testimonies of several nurses, a shift may require twelve or more hours without a break in addition to large workloads. The problem has been exacerbated when hospitals are required to cut staffing and lower wages. The American Journal of Respiratory and Critical Care Medicine found that 24 percent of ICU nurses and 14 percent of general nurses tested positive for PTSD symptoms. In 2012, the Center for Disease Control along with the National Institute for Occupational Safety and Health released a review that show
Kids are kids regardless of parenting unit: study comparing same-sex couples to heterosexual couples finds parenting done by Dad and Dad, Mom and Mom, or Mom and Dad equally effective.