Health Insurance In China: After Declining In The 1990s, Coverage Rates Rebounded To Near-Universal Levels By 2011 [Global Health]
We analyzed trends in rates of health insurance coverage in China in the period 1991–2011 and the association of health insurance with hypertension and diabetes based on data from eight waves of the China Health and Nutrition Survey. The rate of coverage fell from 32.3 percent in 1991 to 21.9 percent in 2000, rebounding to 49.7 percent in 2006 and then rapidly climbing to 94.7 percent in 2011. Our study indicated that neither the prevalence of diabetes nor that of hypertension was significantly associated with health insurance coverage. When patients were aware of their condition or disease, those...
Source: Health Affairs - August 7, 2017 Category: International Medicine & Public Health Authors: Li, Y., Malik, V., Hu, F. B. Tags: Insurance Coverage, International Issues Global Health Source Type: research
In Madagascar, Use Of Health Care Services Increased When Fees Were Removed: Lessons For Universal Health Coverage [Global Health]
Despite overwhelming burdens of disease, health care access in most developing countries is extremely low. As governments work toward achieving universal health coverage, evidence on appropriate interventions to expand access in rural populations is critical for informing policies. Using a combination of population and health system data, we evaluated the impact of two pilot fee exemption interventions in a rural area of Madagascar. We found that fewer than one-third of people in need of health care accessed treatment when point-of-service fees were in place. However, when fee exemptions were introduced for targeted medici...
Source: Health Affairs - August 7, 2017 Category: International Medicine & Public Health Authors: Garchitorena, A., Miller, A. C., Cordier, L. F., Ramananjato, R., Rabeza, V. R., Murray, M., Cripps, A., Hall, L., Farmer, P., Rich, M., Orlan, A. V., Rabemampionona, A., Rakotozafy, G., Randriantsimaniry, D., Gikic, D., Bonds, M. H. Tags: Access To Care, Health Reform, International Issues, Rural Health Care Global Health Source Type: research
Geographic Accessibility Of Food Outlets Not Associated With Body Mass Index Change Among Veterans, 2009-14 [Population Health]
In recent years, various levels of government in the United States have adopted or discussed subsidies, tax breaks, zoning laws, and other public policies that promote geographic access to healthy food. However, there is little evidence from large-scale longitudinal or quasi-experimental research to suggest that the local mix of food outlets actually affects body mass index (BMI). We used a longitudinal design to examine whether the proximity of food outlets, by type, was associated with BMI changes between 2009 and 2014 among 1.7 million veterans in 382 metropolitan areas. We found no evidence that either absolute or...
Source: Health Affairs - August 7, 2017 Category: International Medicine & Public Health Authors: Zenk, S. N., Tarlov, E., Wing, C., Matthews, S. A., Jones, K., Tong, H., Powell, L. M. Tags: Health Promotion/Disease Prevention, Public Health, Determinants Of Health Population Health Source Type: research
Widening Disparities In Infant Mortality And Life Expectancy Between Appalachia And The Rest Of The United States, 1990-2013 [Population Health]
Appalachia—a region that stretches from Mississippi to New York—has historically been recognized as a socially and economically disadvantaged part of the United States, and growing evidence suggests that health disparities between it and the rest of the country are widening. We compared infant mortality and life expectancy disparities in Appalachia to those outside the region during the period 1990–2013. We found that infant mortality disparities widened for both whites and blacks, with infant mortality 16 percent higher in Appalachia in 2009–13, and the region’s deficit in life expectanc...
Source: Health Affairs - August 7, 2017 Category: International Medicine & Public Health Authors: Singh, G. K., Kogan, M. D., Slifkin, R. T. Tags: Determinants Of Health Population Health Source Type: research
HITECH Act Drove Large Gains In Hospital Electronic Health Record Adoption [Hospital EHRs]
The extent to which recent large increases in hospitals’ adoption of electronic health record (EHR) systems can be attributed to the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 is uncertain and debated. Because only short-term acute care hospitals were eligible for the act’s meaningful-use incentive program, we used national hospital data to examine the differential effect of HITECH on EHR adoption among eligible and ineligible hospitals in the periods before (2008–10) and after (2011–15) implementation of the program. We found that annual increases in EHR ado...
Source: Health Affairs - August 7, 2017 Category: International Medicine & Public Health Authors: Adler-Milstein, J., Jha, A. K. Tags: Hospitals, Health Information Technology Hospital EHRs Source Type: research
Drugs Cleared Through The FDAs Expedited Review Offer Greater Gains Than Drugs Approved By Conventional Process [FDA Drug Approval]
We investigated whether drugs approved by the Food and Drug Administration (FDA) through expedited review have offered larger health gains, compared to drugs approved through conventional review processes. We identified published estimates of additional health gains (measured in quality-adjusted life-years, or QALYs) associated with drugs approved in the period 1999–2012 through expedited (seventy-six drugs) versus conventional (fifty-nine) review processes. We found that drugs in at least one expedited review program offered greater gains than drugs reviewed through conventional processes (0.182 versus 0.003 QALYs)....
Source: Health Affairs - August 7, 2017 Category: International Medicine & Public Health Authors: Chambers, J. D., Thorat, T., Wilkinson, C. L., Neumann, P. J. Tags: Pharmaceuticals FDA Drug Approval Source Type: research
Offering A Price Transparency Tool Did Not Reduce Overall Spending Among California Public Employees And Retirees [Consumerism & Competition]
We examined the experience of a large insured population that was offered a price transparency tool, focusing on a set of "shoppable" services (lab tests, office visits, and advanced imaging services). Overall, offering the tool was not associated with lower shoppable services spending. Only 12 percent of employees who were offered the tool used it in the first fifteen months after it was introduced, and use of the tool was not associated with lower prices for lab tests or office visits. The average price paid for imaging services preceded by a price search was 14 percent lower than that paid for imaging services...
Source: Health Affairs - August 7, 2017 Category: International Medicine & Public Health Authors: Desai, S., Hatfield, L. A., Hicks, A. L., Sinaiko, A. D., Chernew, M. E., Cowling, D., Gautam, S., Wu, S.-j., Mehrotra, A. Tags: Health Spending, Consumer Issues, State/Local Issues - California Consumerism & amp; Competition Source Type: research
Americans Support Price Shopping For Health Care, But Few Actually Seek Out Price Information [Consumerism & Competition]
The growing awareness of the wide variation in health care prices, increased availability of price data, and increased patient cost sharing are expected to drive patients to shop for lower-cost medical services. We conducted a nationally representative survey of 2,996 nonelderly US adults who had received medical care in the previous twelve months to assess how frequently patients are price shopping for care and the barriers they face in doing so. Only 13 percent of respondents who had some out-of-pocket spending in their last health care encounter had sought information about their expected spending before receiving ...
Source: Health Affairs - August 7, 2017 Category: International Medicine & Public Health Authors: Mehrotra, A., Dean, K. M., Sinaiko, A. D., Sood, N. Tags: Health Spending, Consumer Issues Consumerism & amp; Competition Source Type: research
Patients Are Not Given Quality-Of-Care Data About Skilled Nursing Facilities When Discharged From Hospitals [Consumerism & Competition]
Hospitals are now being held at least partly accountable for Medicare patients’ care after discharge, as a result of regulations and incentives imposed by the Affordable Care Act. However, little is known about how patients select a postacute care facility. We used a multiple case study approach to explore both how patients requiring postacute care decide which skilled nursing facility to select and the role of hospital staff members in this decision. We interviewed 138 staff members of sixteen hospitals and twenty-five skilled nursing facilities and 98 patients in fourteen of the skilled nursing facilities. Most pat...
Source: Health Affairs - August 7, 2017 Category: International Medicine & Public Health Authors: Tyler, D. A., Gadbois, E. A., McHugh, J. P., Shield, R. R., Winblad, U., Mor, V. Tags: Medicare, Quality Of Care, Consumer Issues Consumerism & amp; Competition Source Type: research
Small Cash Incentives Can Encourage Primary Care Visits By Low-Income People With New Health Care Coverage [Consumerism & Competition]
In a randomized controlled trial, we studied low-income adults newly covered by a primary care program to determine whether a cash incentive could encourage them to make an initial visit to a primary care provider. Subjects were randomly assigned to one of four groups: three groups whose members received $10 to complete a baseline survey during an interview and who were randomized to incentives of $50, $25, or $0 to visit their assigned primary care provider within six months after enrolling in the study; and a nonincentivized control group not contacted by the research team. Subjects in the $50 and $25 incentive groups we...
Source: Health Affairs - August 7, 2017 Category: International Medicine & Public Health Authors: Bradley, C. J., Neumark, D. Tags: Access To Care, Health Spending Consumerism & amp; Competition Source Type: research
Medicare Competitive Bidding Program Realized Price Savings For Durable Medical Equipment Purchases [Consumerism & Competition]
From the inception of the Medicare program there have been questions regarding whether and how to pay for durable medical equipment, prosthetics, orthotics, and supplies. In 2011 the Centers for Medicare and Medicaid Services (CMS) implemented a competitive bidding program to reduce spending on durable medical equipment and similar items. Previously, CMS had used prices in an administrative fee schedule to reimburse for these items. We compared prices from Round 1 of the Medicare competitive bidding program, which were established for the periods 2011–13 and 2014–16, to prices paid by national commercial insure...
Source: Health Affairs - August 7, 2017 Category: International Medicine & Public Health Authors: Newman, D., Barrette, E., McGraves-Lloyd, K. Tags: Medicare, Business Of Health Consumerism & amp; Competition Source Type: research
Health Care Reform In The Senates Hands [Eye On Health Reform]
Senate GOP hopes to act on health reform before July 4th were dashed. Meanwhile, a leaked rule would offer broad protections for employers objecting to contraceptive coverage. (Source: Health Affairs)
Source: Health Affairs - August 7, 2017 Category: International Medicine & Public Health Authors: Jost, T. S. Tags: Health Reform Eye On Health Reform Source Type: research
Propping Up Indian Health Care Through Medicaid [Entry Point]
Medicaid expansion in Arizona has helped the Indian Health Service and tribally run health systems improve access. (Source: Health Affairs)
Source: Health Affairs - August 7, 2017 Category: International Medicine & Public Health Authors: Bylander, J. Tags: Access To Care, Health Care Finance, Health Reform, Minority Health Entry Point Source Type: research
Consumerism, Competition, Drug Approval, And More [From The Editor-in-Chief]
(Source: Health Affairs)
Source: Health Affairs - August 7, 2017 Category: International Medicine & Public Health Authors: Weil, A. R. Tags: Health Reform From The Editor-in-Chief Source Type: research
The Affordable Care Act Reduced Socioeconomic Disparities In Health Care Access [Web First]
The United States has the largest socioeconomic disparities in health care access of any wealthy country. We assessed changes in these disparities in the United States under the Affordable Care Act (ACA). We used survey data for the period 2011–15 from the Behavioral Risk Factor Surveillance System to assess trends in insurance coverage, having a personal doctor, and avoiding medical care due to cost. All analyses were stratified by household income, education level, employment status, and home ownership status. Health care access for people in lower socioeconomic strata improved in both states that did expand eligib...
Source: Health Affairs - July 26, 2017 Category: International Medicine & Public Health Authors: Griffith, K., Evans, L., Bor, J. Tags: Medicaid Web First Source Type: research
