Blockchain use is usually associated with the finance industry, but the healthcare industry is actually outpacing finance’s adoption [pdf]. There are so many opportunities for blockchain in healthcare that some cite it as the perfect use case. In this two-part blog post, we will describe the implications of blockchain-based health information technology from the patient,… Read More »
Value-based care is all the rage in health care system transformation. Promising in concept, value-based care initiatives aim to reward value over volume, shifting our understanding and practice of delivery and payment reform. These efforts received governmental support in 2015 via the Medicare Access and CHIP Reauthorization Act (MACRA), which launched a myriad of quality… Read More »
Health and health care disparities are frustratingly persistent. This is widely known, in great part, because of the landmark report Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care that then spurred the Agency for Healthcare Research and Quality (AHRQ) to track and report on disparities for 250 measures since the early 2000s. The… Read More »
A 14-year-old girl came to my primary care clinic with abdominal pain, similar to abdominal pain she’s had intermittently for years. As with all women of reproductive age, I checked a urine pregnancy test, and it was positive. I returned to the patient’s room to talk with her about the result, and her first question… Read More »
Homelessness and housing are issues of public health significance. This month, we published a Special Commentary about homelessness in Medical Care, informed by the 2017 policy statement we co-authored for the American Public Health Association (APHA) about homelessness and how federal, state, and local authorities can use evidence-based solutions to help bring an end to… Read More »
Health information and communications technologies, such as electronic medical records and telemedicine, have the potential to increase access to healthcare in rural areas. This potential was one of the main drivers of the Health Information Technology for Economic and Clinical Health (HITECH) Act that was passed 10 years ago. HITECH gave the Centers for Medicare… Read More »
Patients want to be healthy. They want to live longer, function better and have higher wellbeing. How patients feel is best measured by asking them. Few cancer patients these days have not been asked to fill out standardized questionnaires about their symptoms, functioning, and well-being. While these patient-reported outcomes (PROs) are not new to healthcare… Read More »
Access to care facilitates better health, and much of the work in Medical Care analyzes policy changes that affect insurance coverage both for the population as a whole and for disadvantaged groups (see examples, here, here, and here). Unfortunately, even as governments and researchers work on existing problems, technology is enabling new barriers. Wellness programs… Read More »
Hepatitis C treatment has gone through a revolution in the last 5 years. Treatment durations have dropped from 48 to 12 weeks, and success rates have improved dramatically. However, treatment costs have sky-rocketed accordingly, and access to care has become a significant issue, particularly for lower socioeconomic individuals and groups. Eligible veterans should have access… Read More »
My second child – a daughter – was born 3 days before I was to begin year two of medical school. Already in my 30s, in the first stage of a second career, I decided to push through, and not take any time off. For a year, it worked out, as I had the support… Read More »
For months, I’ve been keenly interested in trying to explore where the field of primary care research stands. It’s daunting to pull your head up from your own research, take stock of what your colleagues (both known and unknown) are doing and try to assess where the field is advancing. Doing this every now and… Read More »
The risk of having a stroke has gone down over the past 25 years among older people in the US, according to new research by Yao and colleagues published this month in Medical Care. The study combined data from several different nationally representative data sources, including Medicare claims and survey data from NHANES and MCBS.… Read More »
I have been lucky enough in my career so far to visit communities around the United States to support public health efforts. While every community is different, one experience has remained the same: I am an outsider, and often a privileged one at that. Working across so many communities has given me a lot of… Read More »
Vaping and the use of e-cigarettes, especially among teenagers, has been in the news frequently in recent months. But what does the research-based evidence have to say about these new devices? I sat down with Jessica Pepper, PhD, MPH, a top published author in the field of e-cigarette research, to learn more about the prevalence… Read More »
“One foot in the grave,” he said. “Is that how you feel?” I asked. “No, it’s how I live.” Unsheltered for 38 years, he had lived primarily behind a dumpster floating in and out of the medical, social and judicial system. In the month before the new Keck School of Medicine of the University of… Read More »
Tailoring the primary care medical home model improves the care experience for US Department of Veterans Affairs (VA) patients with homelessness experience, according to a recent study by Dr. Audrey Jones and colleagues in the journal Medical Care. Researchers from the VA’s Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center and Center for Health Equity Research… Read More »
How happy are you? That’s a tricky question and there’s a lot that can impact your answer. According to a 2016 article in The Economist, these include factors like your financial status, health, relationships and education. One factor that might also have a big influence on your answer is your age. As a society, we… Read More »
“A book lying idle on the shelf is wasted ammunition.” – Henry Miller, The Books in My Life (1952) The Medical Care Blog is home to many strong opinions. In the last year, contributors have written provocatively about the political determinants of health, highlighted the per-mile cost of President Trump’s wall in numbers of children who… Read More »
Physicians and other providers are the gatekeepers for prescription medicines; they decide who, under what circumstances, and for how long someone takes one – or several – medicines. But how do physicians stay abreast of the latest research about the safety and efficacy of the medicines they prescribe? We set out to understand how they… Read More »
Although the term health equity is widely used, a common understanding of this term is lacking. Viewing health equity through the lenses of allostatic load and intersectionality could help. This blog post considers three case scenarios, all of which are composites of actual cases that have occurred within the United States, to explore ideas of… Read More »
Why do we care about unintended pregnancies? Rates of unintended pregnancy “indicate the extent to which women and couples can determine freely whether and when they have children,” as stated by Finer and Zolna. There is some evidence that women and girls who have unintended pregnancies have a higher likelihood of other risk factors, such as… Read More »
It’s a new season. The federal government re-opened this week after a record-breaking shut-down. Democrats gained control of the U.S. House of Representatives, feeling newly emboldened after the dispute about a border wall. A gaggle of 2020 presidential hopefuls has revealed themselves in recent weeks, lining up to be, arguably, the most liberal class of… Read More »
Do you use social media? If so, how many social media platforms (e.g., Facebook, Twitter, Instagram, Pinterest, LinkedIn) are you a member of? With about 40% of the world’s population already on some form of online social media, even if you don’t use it, you’ve probably heard of it. Devoting several hours each day to… Read More »
In 2019, mental health and opioid use disorders remain major public health issues. The most recent estimates suggest that 40 million adults experience mental illness in the U.S. and nearly 8 million adults experience both mental and substance use disorders at the same time. Individuals with mental illness also face higher risks of co-occurring chronic health conditions and… Read More »
Primary care sensitive (PCS) emergency department (ED) use is a measure that highlights the connection between primary and emergency care. The right care, for the right person, in the right place, at the right time is a reasonable goal of a high-quality health system. In the US, however, many people go to the emergency department… Read More »
President Trump wants $5 billion right now for his border wall, and another $7 billion (or maybe $13 billion) later on to finish the project. What else could we do with that kind of money? Here’s an idea: with $12 billion we could cover ALL 3.9 million uninsured children in the US today, and still have a… Read More »
This post is for the measurement methodologists in the house. Although, the study results have a real impact for anyone reading macro-level studies of health care services and economics. Sure, this is a bit of inside baseball, but it involves a fundamentally important issue at the center of healthcare research and policy that relies on… Read More »
This will be the last post of 2018 for us here at The Medical Care Blog. We would like to take this opportunity, as we do every year, to recognize YOU – our reader – as well as our contributors. We are really proud of the work we’ve done this year, and we hope you’ve… Read More »
The December edition of Health Wonk Review is now up at Health System Ed. In case you missed it, our contribution for this month comes from Jess Williams and covers some interesting new collaborative work on what research topics should be prioritized according to people with diabetes and/or obesity and researchers specializing in the fields.… Read More »
If you have a question, how do you find the answer? Many of us do a quick Google search or search out the answer at a library. However, people with Autism Spectrum Disorder (ASD) and their families face many challenges and barriers when trying to locate information. A recent episode of the (highly recommended) podcast… Read More »
The burden of homelessness on the health of those afflicted continues to be a major global public health concern. Last year, the United States recorded an increase in the number of homeless for the first time since 2010. On any given night in 2017, there were 553,742 people in the U.S. experiencing homelessness. In terms of… Read More »
Patients are increasingly involved in shaping research in health care, especially since the advent of the federal Patient-Centered Outcomes Research Institute (PCORI). PCORI actively promotes the engagement of patients and other stakeholders (clinicians, caregivers, purchasers, etc.) in the research process. As we discussed in an earlier entry on this blog, research terminology alone can be a… Read More »
Greetings from San Diego, where we’re just wrapping up the 2018 meeting of the American Public Health Association. It’s been a whirlwind stretch of great presentations, engaging conversations, and electric scooters! Have you seen these things? I was surprised at how many of my public health colleagues were willing to ride without a helmet… But… Read More »
APHA 2018 starts November 10! Thousands of public health practitioners, students, scholars, and activists will descend on San Diego, CA on Saturday for our annual conference. As in previous years, your faithful co-editors will be there, live-tweeting about sessions! So be sure to follow @MedCareBloggers for real-time updates. The program is looking great, and we are excited about… Read More »
The October edition of Health Wonk Review is now up at Joe Paduda’s Managed Care Matters blog. This month, our featured post is the excellent commentary by new contributor Dr. Ranit Mishori titled The Social Determinants of Health? What about the Political Determinants of Health? Enjoy!
A few weeks ago, a headline in the Chicago Tribune grabbed my attention: “Millennials are trading primary care doctors for faster, cheaper alternatives.” This headline fits the rather unfortunate stereotype of millennials as impatient, job-hopping, financially-struggling, digital natives. But if this is true, then millennials are bound to “swipe left” to health care delivered in a… Read More »
Welcome to Point-Counterpoint – the BLOG Edition! In this series — as in the series by the same name in the journal — authors stake out positions on current issues, highlighting the pros and cons. In this Point-Counterpoint, we discuss the new Apple Watch’s electrocardiogram (ECG) technology, launched with the Apple Watch Series 4. The… Read More »
The concept that health comes with significant social determinants is everywhere we turn. This idea – that health and health inequities are driven by “the conditions in which people are born, grow, live, work and age [and are] shaped by the distribution of money, power and resources” – is increasingly the focus of articles, research… Read More »
This month’s Health Wonk Review, by Andrew Sprung at xpostfactoid, is called Map of Malfunction. Andrew describes this month’s edition as “a smorgasbord of smart takes on the morphing ACA marketplace; various dysfunctions (and one or two functions) of U.S. health care; and political wars over Medicare and the ACA.” The round-up features Red Thaddeus Miguel’s first… Read More »
Are you happy with your healthcare provider? Most people are happy, even if they’re unhappy with the health care system as a whole. But if you’re unhappy with your doctor or your care, how likely are you to say so or search out a new healthcare provider? Visiting your doctor can be intimidating; so much so,… Read More »
Over a third of all Americans are at an increased risk for chronic conditions such as heart attack, stroke, cancer, and diabetes due to their lack of sleep. Key disorders, such as obstructive sleep apnea, which now afflicts 30 million adults in the United States, are some of the primary causes of the morbidity and… Read More »
Chlamydia and gonorrhea are among the most common sexually transmitted infections (STIs) in the United States, and research shows that 50% of sexually active individuals will contract an STI by 25 years old. Though chlamydia and gonorrhea are often asymptomatic in women, screening is important in order to prevent complications, such as pelvic inflammatory disease… Read More »
Title X, a program that provides federal dollars to be used for family planning services, is under siege. The public comment period ended July 31, 2018, and now we wait to see how funding changes for Title X unfold. Title X is a critical program that provides essential reproductive health services to women, created by… Read More »
We are in the midst of a national epidemic concerning opioid misuse and abuse, and lawmakers are rushing to address this concerning situation. However, a recent report finds that only a few states are successfully implementing a balanced approach to curbing opioid misuse and abuse while maintaining access to pain relief for patients in need.… Read More »
For two years in a row, the United States has experienced a decrease in life expectancy, which researchers have largely attributed to the opioid epidemic. Life expectancy for the United States population was 78.6 years in 2016, a decrease of 0.1 year from 2015 [PDF]. Age-specific death rates between 2015 and 2016 increased for younger… Read More »
Medication non-adherence can be a tricky issue for healthcare providers, patients, and pharmacists to solve. In addition to cost, there are many other factors that influence whether someone takes their medication(s) as prescribed. As discussed in the literature, side effects, confusion about medications, and the general human tendency to forget may all play a role.… Read More »
This year, we’ve seen more than 2,000 children separated from their parents, who were legally seeking asylum in the US. Most were from Central American countries in which crime and unrest place many at risk for violence. These children were taken from their families by US government employees between April 19 and May 31, 2018,… Read More »
The New York Times recently posted an article about the return on investment around public health interventions and how American life expectancy at birth increased by 30 years in the time from 1900 to 1999. The article went on to stress that these additional years of life can largely be attributed to advances in public… Read More »
In India, cardiovascular diseases (CVDs), specifically coronary heart disease and congestive heart failure, are leading causes of disability and death. The large projected population of patients with CVDs in the coming years poses one of the biggest threats to this fast developing nation’s future. The crushing magnitude of the problem is exacerbated in rural areas where… Read More »
It’s summer! In my world, that means road trips and beach days. One of my favorite ways to pass the time on a road trip or long lazy day at the beach is to catch up on podcasts. Podcasts — the name derives from iPod + broadcast — are audio or video transmissions, often produced… Read More »