Research roundup: Unearthing factors in hospital readmissions; dissecting the enrollment surge

May 12 2014

Each week, KHN compiles a selection of recently released health policy studies and briefs. 

Health Affairs: Socioeconomic Status And Readmissions: Evidence From An Urban Teaching Hospital 
Using inpatient data from an urban teaching hospital, we examined how elements of individual characteristics and neighborhood socioeconomic status influenced the likelihood of readmission ... Patients living in high-poverty neighborhoods were 24 percent more likely than others to be readmitted, after demographic characteristics and clinical conditions were adjusted for. Married patients were at significantly reduced risk of readmission, which suggests that they had more social support than unmarried patients. These and previous findings that document socioeconomic disparities in readmission raise the question of whether CMS's readmission measures and associated financial penalties should be adjusted for the effects of factors beyond hospital influence at the individual or neighborhood level, such as poverty and lack of social support (Hu, Gonsahn and Nerenz, May 2014).

University Of Pennsylvania/RWJ Foundation: Deciphering The Data: Final Enrollment Rates Show Federally Run Marketplaces Make Up Lost Ground At End Of Open enrollment
The ACA gave states a number of choices in how to implement the broad coverage changes it required. As such, health reform looks different from state to state, and the impact of the ACA may differ because of these state decisions. This Data Brief examines a number of choices related to the establishment and running of the new health insurance marketplaces, and their impact on enrollment rates to date. ... The final enrollment figures reveal that the federally facilitated marketplaces and some of the troubled state-based ones made up some ground in the last four to six weeks of the open enrollment period (Polsky, Weiner, Colameco, and Becker, May 2014).

Kaiser Family Foundation: Medicare Advantage: Take Another Look
While health policy observers are mainly focused on the number of people enrolled in the new federal and state marketplaces, fewer are keeping a close eye on fairly big changes in the estimates and projections for enrollment in Medicare Advantage plans. The number of Medicare beneficiaries in Medicare private plans reached an all-time high this year of nearly 16 million beneficiaries ... Medicare Advantage enrollment was expected to decrease in response to the reductions in payments to plans that were included in the ACA. ... As Medicare Advantage enrollment increased, monthly premiums actually declined (from an average $44 per month in 2010 to $35 per month in 2014). ... Plans may be looking for ways to tighten their belts and maintain profits, but the changes thus far do not seem to be scaring seniors away (Neuman and Jacobson, 5/7).

JAMA: Prevalence Of Type 1 And Type 2 Diabetes Among Children And Adolescents From 2001 To 2009 
Adjusted for completeness of ascertainment, there was a 21.1% increase in type 1 diabetes over 8 years. In 2001, 588 of 1.7 million youth were diagnosed with type 2 diabetes for a prevalence of 0.34 per 1000. In 2009, 819 of 1.8 million were diagnosed with type 2 diabetes for a prevalence of 0.46 per 1000. ... Significant increases occurred between 2001 and 2009 in both sexes, all age-groups, and in white, Hispanic, and black youth, with no significant changes for Asian Pacific Islanders and American Indians. Adjusted for completeness of ascertainment, there was a 30.5% overall increase in type 2 diabetes (Dabelea et al., 5/7).

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

The Baltimore Sun: Functional Hospital Patients Fare Better
Testing hospital patients on their ability to perform everyday tasks before they are released could go a long way to keeping them from returning to the hospital, new research from Johns Hopkins University suggests. Tasks such as moving from a bed to a chair, eating, using the toilet and communicating are uniformly assessed after patients go to rehabilitation facilities from hospitals, but function isn't always tested in a standardized way before they go. And Hopkins researchers found that low scores on a standardized test of the tasks was a good predictor of hospital readmission (Cohn, 5/5).

Kaiser Health News: Capsules: Chemo Costs In U.S. Driven Higher By Shift To Hospital Outpatient Facilities
The price of cancer drugs has doubled in the past decade, with the average brand-name cancer drug in the U.S. costing $10,000 for a month's supply, up from $5,000 in 2003, according to a new report by IMS Institute for Healthcare Informatics, a health information, services and technology company (Rabin, 5/6).

The Boston Globe: Using Twitter As Tool To Track Side Effects From Drugs
Tracking the safety record of new drugs is a slow and complicated task for the US Food and Drug Administration. Once a drug is on the market, it often takes years before the full range of side effects becomes known, as side effects are reported to the agency mainly by doctors who prescribe the drug. Thousands of patients, however, use Twitter to share symptoms they've developed from their medications, and Boston Children's Hospital researchers have found that such online postings could be a way to identify problems with drugs sooner (Kotz, 5/5). 

Reuters: Youth Diabetes Is On The Rise, Study Suggests
Both type 1 and type 2 diabetes became increasingly common among kids and teens in the U.S. between 2001 and 2009, according to a new study. Though researchers can't say why exactly these rates continue to go up, it is important to monitor them, Dr. Dana Dabelea told Reuters Health (Doyle, 5/5).