One hundred and sixty-one Americans died of an opioid overdose each day in 2016, and early 2017 data suggest this trend is continuing. The medical and public health community knows from decades of research that providing individuals suffering from opioid use disorder with specific medications can save lives. Our public policies governing opioid use disorder,… Read More »
In this post, we describe five principles that guided the development of Positive Health Check, a clinic-based digital health intervention for HIV-positive patients, aimed at making it acceptable and feasible in a clinic setting.
Prisoners have a fundamental right to receive health care while incarcerated, a right that is mandated by the US Supreme Court. However, negligent care in prisons persists and is often an issue of limited access due to cost mitigating policies. Since the 1990’s, prison systems have integrated managed care strategies, like co-payments, to mitigate increasing… Read More »
Activity tracker technology has come a long way. The first Fitbit released in 2009 only measured movement, sleep, and calories burned. In contrast, the Fitbit Ionic smartwatch released in 2017 has a much broader range of functions, including heart rate monitoring, personal coaching, and built-in GPS. Consequently, with this change in functionality comes a change in potential uses for… Read More »
Each year, millions of people around the world are victims of human trafficking. In the US, the National Human Trafficking Hotline, which maintains one of the most extensive data sets, received 13,897 calls in 2017, with 4,460 human trafficking cases reported. Of the 4,460 cases reported, 3,186 cases were of sex trafficking and 689 cases were… Read More »
Improving the overall patient care experience is an essential focus for organizations as healthcare delivery continues to evolve. The US Department of Health & Human Services Agency for Healthcare Research and Quality (AHRQ) notes patient experience as an integral component of healthcare quality, which includes “several aspects of healthcare delivery that patients value highly when… Read More »
Over the last few decades, cigarette smoking has become a health burden concentrated primarily among low-income individuals in the U.S. In our recently published research study, Medicaid coverage expansions and cigarette smoking cessation among low-income adults, we sought to determine the relationship between recent expansions of Medicaid coverage and smoking cessation for low-income adults. Demographics… Read More »
American Indians (AIs) typically have poorer health outcomes than any other racial or ethnic minority group in the United States. This includes an increased risk for cancer, diabetes, injury related mortality, and infant mortality. AIs tend to have the highest rates of poverty and low rates of insurance coverage. Much of the AI population uses the Indian… Read More »
“Neonatal abstinence syndrome” (NAS) sounds deceptively innocuous, given that it is literally infant drug withdrawal. It is usually caused by prenatal exposure to opioids but can also result from maternal consumption of other substances, like alcohol and antianxiety medications. Common symptoms include excessive high-pitched crying, fever, sweating, irritability, vomiting, diarrhea, rapid breathing, sleep disturbances, and poor… Read More »
October is here, so along with the fall foliage, prepare yourself for a deluge of pink ribbons, umbrellas, bumper stickers, and billboards: it’s Breast Cancer Awareness Month. Started as a well-intentioned campaign to raise awareness about breast cancer and fundraise for breast cancer research, some have said that the movement commodifies a deadly disease at… Read More »
Medicine, alongside achievements in sanitation and public health, remains one of the major achievements of modern society. The reduction (or eradication) of many infectious diseases from the developed world, breakthroughs in anesthesiology and surgery, and advances in the care of chronic diseases (including HIV) are just a few of the multitudes of achievements. But these… Read More »
What do you use your cell phone for on a daily basis? Many people would say using social media, texting, and placing phone calls– but have you ever considered your smartphone as a tool to improve medication adherence? Our phones are an integral part of our lives, and consequently, researchers, clinicians, and patients have all… Read More »
Annual routine check-ups, flu shots, and mammograms are among the basic preventive services for which the Patient Protection and Affordable Care Act of 2010 established a mandate for insurance plans: full coverage, with no out-of-pocket costs. In making it a little easier for some parts of the US population to access basic services, did the… Read More »
The pursuit of health equity – ensuring equal access to opportunities that enable all communities to lead healthy lives – is a critical task for the U.S. The direct and indirect medical costs associated with sickness and premature death resulting from health care inequities are enormous (estimated to be $230 billion and $1.24 trillion, respectively,… Read More »
Opiate overdose is now the leading cause of accidental death in the United States, killing more than 50,000 people in 2015. About 20,000 of those deaths were attributed to the use of prescription opiate medications. As a physician, I want to alleviate my patients’ pain, but I have also taken an oath to do my… Read More »
Reproductive rights have been a topic for policy making and legal jurisprudence throughout much of the past century. As the healthcare system of the United States continues to evolve, women’s health and reproductive rights remain central to the debate. A recent policy update by Aishwarya Rajagopalan and Lisa Lines here at The Medical Care Blog discusses… Read More »
Despite a rapid expansion in the use of buprenorphine-naloxone (bup-nx) as a treatment for opioid use disorder, there is little understanding of the patterns of treatment. In a newly published-ahead-of-print Medical Care article, Brendan Saloner and colleagues from Johns Hopkins used an all-payer claims database to investigate what factors predict the duration of treatment, dosage, and continuity of treatment for… Read More »
Smoking cessation is not innovative or trendy or even particularly exciting, but as a primary care doctor, in most cases helping a patient quit smoking is the best thing that I can do to help that patient over their lifetime. Without question. And for that reason, I always make it a priority to talk about it… Read More »
I’ll never forget the time Granddaddy tried to eat my hand. At least that’s how it seemed to me at age six. In reality, he’d simply confused my hand with the straw sticking out of the milkshake we’d brought to him at the nursing home. By that point in his early-onset Alzheimer’s disease, the Granddaddy… Read More »
Violence against women and girls is an international concern that cuts across all sectors of society. The United Nations defines violence against women as “any act of gender-based violence that results in, or is likely to result in, physical, sexual or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary… Read More »
Republican Congressional leaders are currently debating how to repeal the Affordable Care Act (ACA) as part of the budget reconciliation process. Much of the debate over the ACA has focused on the individual mandate (and here) and the affordability (here and here) of coverage in the state-based marketplaces. The House version of the legislation, however,… Read More »
This post is the third in our series focusing on presentations that were delivered at a special panel session at APHA16 on the childhood roots of health inequity [part 1, part 2]. Our third presenter, Kerith Conron, ScD, MPH, is currently the Blachford-Cooper Distinguished Scholar and Research Director at The Williams Institute of UCLA’s School… Read More »
Adequacy of healthcare for transgender patients has recently come to light, particularly with the increased discussion of trans persons in the media. Trans individuals identify their gender differently from their assigned sex at birth. Trans healthcare is an emerging field of research, and this increased focus continues to uncover the lack of knowledge amongst providers… Read More »
Private practitioners are busy people between caring for their patients, recording and documenting data, going to meetings, keeping up with new treatment modalities, and running a practice group. They follow a tight schedule, have multiple sources of pressure, and suffer from burnout. Stress occurs when a person is drained of energy, but can recover. In the case of… Read More »
Children who grow up in stressful environments, without adequate adult support, are at much greater risk of developing heart disease, cancer, and many other diseases as adults. This is partly because of the coping behaviors that people use to deal with stress, but also because of the cumulative effects of toxic stress. Thus, many of… Read More »
Posters and banners declaring “Creating the Healthiest Nation: Ensuring the Right to Health” were hung throughout the Colorado Convention Center in downtown Denver last month, celebrating the theme of the American Public Health Association’s (APHA) 144th Annual Meeting and Expo. As a first time attendee, one of approximately 11,600 people, I was a bit overwhelmed;… Read More »
After a whirlwind APHA 2016 in Denver, we are back with a quick summary of the meeting and Medical Care Section events. There were about 11,600 conference registrants overall. We were impressed with the great turnout for Medical Care Section events. We had standing room only for the Special Invited Panel Session: The Childhood Roots of Health Inequity, a… Read More »
With the mania of the presidential election in full tilt and the election just days away, it’s hard to have a rational public discussion about health care. Supporters of the two presidential candidates have drawn a deep and divisive line (or rather a tectonic fissure) in the sand about health care reform. This is due, in great part, to the bombastic, and ultimately… Read More »
Who treats Medicaid patients? And is the quality of care provided by these individuals the same as you might expect from a clinician who takes only private insurance? An article in the April 2016 issue of Medical Care sought to answer these questions.
Although more than 92% of physicians reported seeing at least one Medicaid patient in 2011, the median proportion of Medicaid patients, for both PCPs and specialists, was less than 6%. This suggests that a small group of providers is responsible for seeing the majority of patients with Medicaid coverage…
As a current medical student, this research struck a nerve, particularly because of the emphasis on IMGs and medical school ranking. … What is more important to me is to understand what I, as a future primary care provider, can do. How do I ensure that people with Medicaid coverage get timely and appropriate referrals to specialty care? How can I expand my provider network to better equip them with the tools they need to ensure their long-term, lasting health?
The presidential primaries are in full swing and health care is an issue for both parties. The candidates have left themselves plenty of wiggle room, but there is enough information in the public domain to make some predictions about what the different approaches (and they are different) would mean for the health care system. This… Read More »
Earlier this month, the Department of Housing and Urban Development (HUD) released a proposed federal rule to implement smoke-free public housing. The proposed rule would affect all living units, common areas, outdoor areas up to 25 feet away from the housing areas, and administrative offices. The change would affect over 700,000 units no later than… Read More »