Research roundup: Addressing disparities in cancer diagnosis time, Medicare open season awareness

Oct 13 2012

KHN reporters Ankita Rao and Alvin Tran compiled a selection of recently released health policy studies and briefs.

Cancer Epidemiology, Biomarkers, & Prevention: Boston Patient Navigation Research Program: The Impact Of Navigation On Time To Diagnostic Resolution After Abnormal Cancer Screening – Researchers tested the effectiveness of using patient navigation programs with women who have abnormal breast or cervical cancer screenings. These programs aim to facilitate treatment by such things as arranging financial support, transportation to appointments, child care or interpreter services.  Researchers found that women with abnormal cervical or breast cancer screenings who received patient navigation had a significant decrease in time to diagnosis. They conclude: "Patient navigation may address cancer health disparities by reducing time to diagnosis following an abnormal cancer-screening event" (Battaglia et al., 10/2012).

Archives Of Internal Medicine: Variation In Use Of High-Cost Diabetes Mellitus Medications In The VA Healthcare System – To determine if the Veterans Affairs (VA) hospital system "may serve as a model of efficient use of prescription drugs," researchers "examined national VA data for over 1 million outpatients with diabetes mellitus (DM) to understand how prescribing of high-cost medications varies across facilities." They found substantial variations across 139 facilities. According to the authors, factors specific to each VA facility may be the root of the variations in the use of high-cost drugs (Gellad et al., 10/8).

Georgetown University Health Policy Institute/The Commonwealth Fund: Child-Only Coverage And The Affordable Care Act: Lessons For Policymakers -- The authors of this analysis write: "The Affordable Care Act prohibited insurers from denying or limiting coverage for children under the age of 19 in 2010. In response, some insurers ceased to offer coverage to children in need of individual health insurance, known as a 'child-only' policy." They found that 22 states and the District of Columbia have taken action to promote child-only coverage.  Kentucky, for example, saw 268 children enrolled in child-only coverage in 2012 after requiring insurers to offer the policies during open season. The authors say the findings "suggest the need for meaningful regulatory incentives to avoid market disruption in successfully implementing broader reforms in 2014" (Keith, Lucia and Corlette, 10/2012).

The Kaiser Family Foundation: Senior's Knowledge And Experience With Medicare's Open Enrollment Period And Choosing A Plan -- Researchers surveyed seniors about Medicare's 2013 open enrollment period, Oct. 15 - Dec. 7. "During this time, the Medicare program encourages beneficiaries to review their benefits and coverage options, including traditional Medicare, private Medicare Advantage plans, and Medicare Part D prescription drug plans." They found that "one in four seniors say they are unaware of this annual opportunity to review and change their Medicare coverage, with even larger shares who say they unaware of Medicare's open enrollment period among blacks and Hispanics and those seniors in fair or poor health, with low incomes, and without a high-school diploma" (Cubanski and Damico, 10/10).

Here is a selection of news coverage of other recent research:

Medscape: Racial Disparity in HIV Mortality Hits Less Educated Hardest
Blacks with a high school education or less continue to die from HIV at much higher rates than whites of any education level, despite the emergence of treatment that has reduced overall mortality, according to a study published online October 8 in the Archives of Internal Medicine. Edgar P. Simard, PhD, MPH, senior epidemiologist, Surveillance Research Program, American Cancer Society, and colleagues looked at National Vital Statistics System records of 91,307 HIV deaths among people aged 25 to 64 years between 1993 and 2007 (Laidman, 10/8).

Medscape: Obesity Medicine Certification Needed, Endocrinologists Say
The American Association of Clinical Endocrinologists (AACE) has released a position statement in which it calls for specialized education in obesity medicine, a certification program, and shared strategies to combat obesity. Jeffrey I. Mechanick, MD, a clinical professor of medicine, endocrinology, diabetes, and bone disease at the Mt. Sinai Hospital in New York City, and colleagues presented the position statement in an article published online October 9 in Endocrine Practice. More than simply an excess of body fat, obesity is a primary disease state, the authors write (Brown, 10/10).

Medpage Today: Hospital Scores: Change Formula, Change Rank
Hospital rankings on readmissions and early deaths are strongly influenced by the calculation methods that are used, researchers found. Changing just two key factors -- adjustment for patient case mix and number of admissions per patient included -- led to a variation in individual hospital rankings by an average 29% of the total score, Carl van Walraven, MD, MSc, of the Ottawa Hospital Research Institute and University of Ottawa in Ontario, and colleagues reported online in CMAJ (Phend, 10/11).

Medpage Today: Post-Hospital Choice Can Save Medicare Billions
Directing Medicare beneficiaries into the most cost-efficient setting possible after a hospital stay could save the program $35 billion to $100 billion over the next decade, the Alliance for Home Health Quality and Innovation, a home care trade association, reported Wednesday. "This isn't a silver bullet to fix Medicare but it could make a difference," Rep. David McKinley (R-W.Va.) said at a press conference where the report was issued. "Better post-acute care leads to less frequent hospital readmissions, plain and simple" (Frieden, 10/10).

Reuters: Climate Linked To California ER Visits
The risk of heading to the emergency room for certain conditions, such as heart disease, diabetes, stroke, kidney disease and low blood pressure rises slightly as temperature and humidity increase, according to a new study from California. Researchers also found that for a few conditions, including aneurysm and high blood pressure, higher temperatures were tied to a drop in ER visits (Grens, 10/5).