Research roundup: Arthritis racial disparities, hospital mortality data, voters on long-term care

Apr 24 2010

Centers for Disease Control and Prevention: Differences In The Prevalence And Impact Of Arthritis Among Racial/Ethnic Groups In The United States, National Health Interview Survey, 2002, 2003, and 2006 - "Blacks and Hispanics were approximately 1.3 times as likely as whites to have activity limitation, 1.8 to 1.9 times as likely to have severe joint pain, and 1.6 to 1.7 times as likely to have work limitation," caused by arthritis. Multiracial or respondents who classified themselves a 'other' "were 1.7 times as likely as whites to report activity limitation, 1.9 times as likely to report severe joint pain, and 2.2 times as likely to report work limitation.

"Hispanics and blacks report less access to health care than do whites and may be less likely to be diagnosed with arthritis, resulting in an underestimate of the prevalence of arthritis in these populations" (Bolen et al., May 2010).

British Medical Journal: Using Hospital Mortality Rates To Judge Hospital Performance: A Bad Idea That Just Won't Go Away - "Hospital mortality rates are a poor diagnostic test for quality and SMRs [standardised mortality ratios] do not identify preventable deaths," write the authors of this analysis that details challenges associated with using such evidence to determine the accountability of health care providers, as reflected in recent studies. Instead, the authors propose quality measurements focus on "non-mortality outcomes [that] are heavily influenced by the quality of care—rates of hospital acquired bloodstream infection, for example" (Lilford and Pronovost, 4/20).

SCAN Foundation/UCLA Center For Health Policy: Fifty-eight percent of California voters, 40 and older, report feeling unprepared to pay for long-term care, such as nursing home or in-home care services, if they needed it, according to a this recent survey (.pdf). Additionally, "[w]hen presented with average costs, a majority of voters 40 and older say they could not afford long-term care for longer than three months if they needed," the authors report. About two-thirds of respondents did not know that Medicare does not cover long-term care. The majorities were true across party and racial lines. The survey was conducted March 5 - 22, and has a margin of error of +/- 2.8 percentage points (4/21). (Note: The Scan Foundation funds some of KHN's aging coverage.)

Health Services Research: Implications Of The Nurse Staffing Mandate For Other States - This study compared the impact of state-mandated minimum nurse-to-patient ratios in California to New Jersey and Pennsylvania - two states without such legislation. Based on surveys with over 22,000 staff nurses from the three states and state hospital discharge databases from 2006 - two years after the start of mandatory ratios in California - the authors report, "California hospital nurses cared for one less patient on average than nurses in the other states and two fewer patients on medical and surgical units. Lower ratios are associated with significantly lower mortality." Additionally, "[w]hen nurses' workloads were in line with California-mandated ratios in all three states, nurses' burnout and job dissatisfaction were lower, and nurses reported consistently better quality of care," the authors write (Aiken et al., 4/9).

KHN summarized news coverage of the Health Services Research study (4/22).

Kaiser Family Foundation/Health Management Associates: CHIP Enrollment: June 2009 Data Snapshot - This report, "based on survey responses and data provided by CHIP directors in all 50 states and the District of Columbia, finds that CHIP ... reached a historically high monthly enrollment of 5 million children in June 2009," during which a total of 4.96 million children were enrolled - "an increase of 130,400 children (2.7 percent) from June 2008." The brief provides a breakdown of CHIP enrollments by state between June 2004 and June 2009, and highlights key CHIP policy changes that took place in several states (Smith, Roberts, Rousseau and Schwartz, April 2010).

The Kaiser Family Foundation also features explainers on the COBRA subsidy and elements of the new health law, including the requirement for insurance companies that offer dependent coverage to children to cover young adults up to age 26 on their parents' insurance, and the creation of a temporary national high-risk pool that will offer insurance to individuals with pre-existing conditions that have been uninsured for over six months (4/20).