Pediatric Emergency Medicine Physician | Health Services Researcher
With the Republicans on the verge of dismantling the Affordable Care Act and Medicaid, much of their focus has been on how much healthcare insurance “costs”. I thought it would be timely to revisit a 2015 analysis in the American Journal of Public Health, “Considering Whether Medicaid is Worth the Cost: Revisiting the Oregon Health Study.” (fullContinue reading “What we miss when we look only at the cost of healthcare coverage”
A study published online today in Annals of Emergency Medicine (“Association Between the Opening of Retail Clinics and Low-Acuity Emergency Department Visits”) demonstrated that, contrary to expectations, retail clinics had little effect on rates of low-acuity visits to nearby emergency departments (EDs). This contradicts the popular theory that retail clinics would reduce ED visits. A 2015 report “Building aContinue reading “Retail Urgent Care Clinics Do Not Decrease Emergency Department Visits”
In September, the Pediatric Policy Council (PPC)—a nonpartisan collaboration of the Academic Pediatric Association, the American Pediatric Society, the Association of Medical School Pediatric Department Chairs, and the Society for Pediatric Research dedicated to promoting public policies to advance child health and well-being—developed four general questions related to child health to be sent to theContinue reading “2016 Presidential Candidates’ Positions on Child Health Issues”
An Upshot column “The High Costs of Not Offering Paid Sick Leave” argues that employees and their co-workers may be better off with an incentive to take time off when sick. About 45 percent of the American work force does not have paid sick leave; that’s about 50 million workers. Families with less ability to afford unpaid time off are moreContinue reading “Paid Sick Leave Lowers Costs”
Amidst news of the increasing premiums and decreasing choice of plans in some healthcare markets, the New York Times‘ Upshot column brings us this visual display of the impressive and varied impact of Obamacare on insurance coverage rates from 2013-2016. States that decided to expand their Medicaid programs saw much larger declines in their uninsured ratesContinue reading “Obamacare Succeeds in Expanding Insurance Coverage”
A discussion paper newly released by the National Academy of Medicine–Antibiotic Resistance in Humans and Animals–marks the 40 year anniversary of the first definitive evidence that antibiotic usage in livestock results in the direct spread of antibiotic-resistant bacteria to humans. In releasing the report, the authors pull no punches: Thus, we have known definitively for more thanContinue reading “Waiting for perfect science on antimicrobial resistance is a dangerous excuse for policy inaction”
A new study from the Johns Hopkins Armstrong Institute for Patient Safety and Quality, published in the journal Medical Care, performed a systematic review and meta-analysis of two sets of safety measures used for pay-for-performance and public reporting The measures evaluated in the study are used by several public rating systems, including U.S. News and World Report’s Best Hospitals, Leapfrog’s Hospital Safety Score,Continue reading “AHRQ and CMS Public Reporting Measures Fail to Describe the True Safety of Hospitals”
Today, the Obama administration announces the new National Microbiome Initiative, intended to create scientific tools, discoveries and training techniques related to the human microbiome, the 100 trillion microbes that live in the human body. Tending the human microbiome may help in the treatment of infections, as well as disorders that would seem unrelated to microbes, including obesity andContinue reading “Medical ecology: tending the microbiome”
The Incidental Economist astutely deconstructs the assumptions leading to the failure of the nationwide Hospital-Based Purchasing Program’s pay-for-performance penalties to reduce 30-day mortality. These assumptions include: 30-day mortality is the right outcome measure because it is feasible to measure 30-day mortality is a valid proxy for the quality of inpatient care delivered. As shown with readmissions based penalties and with other payContinue reading “Pay for performance penalties fail again”
A new study in Health Economics shows a temporal association between Britain’s minimum wage law and substantially improved mental health of the low wage workers benefitting from the policy. Source: The Minimum Wage and the Social Determinants of Mental Health
Marion R. Sills, MD, MPH