Pressure ulcers: risk factors and the power of policy

Medical Care has recently published two papers on the topic of pressure ulcers — costly, painful, largely preventable infections associated with poorer quality care. In the first, from researchers at the University of Manitoba, York University, and the University of British Columbia, lead author Malcolm Doupe, PhD and colleagues focus on the risk of developing stage… Read More »

The Impact of Gasoline Costs on the Healthcare Industry

The higher the cost of gasoline, the higher the healthcare costs for the treatment of injuries caused by motorcycle crashes. In an article published ahead of print in Medical Care this week, He Zhu and colleagues discuss the association between gas prices in the United States, hospital costs, and utilization for both motorcycle and non-motorcycle related injuries. Remember… Read More »

Death is not always an adverse event

Quality in healthcare can be a slippery concept. But in general, our medical system treats mortality as the ultimate adverse event. Higher mortality is thought to indicate poorer quality care. But what if death were the appropriate and preferred outcome for an individual? Consider the hypothetical case of an 87-year-old man named Philip. Philip has a living… Read More »

Factors associated with better performance on quality indicators for ACOs

Accountable Care Organizations (ACOs) are groups of health care providers, including doctors, hospitals, and other service providers, who provide coordinated care, reducing the need for patients to manage coordination of their own care. These organizations receive incentives from Medicare when they deliver care to patients efficiently. Providers make more money if they keep their patients healthy. Medicare… Read More »

The Health Plans of the Democratic Presidential Candidates and How They May Affect Primary Care

Nearly halfway through the primaries, the Democratic primary contest between Hillary Clinton and Bernie Sanders continues. And perhaps nothing sets these candidates further apart in the progressiveness of their agenda than their approaches to health care. In this post, let’s take a look at the vastly different approaches to health care proposed by candidates Clinton and Sanders, with a particular focus on primary care.

Who Treats Medicaid Patients?

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?

Racial and Ethnic Disparities after the ACA: Good News and Bad

The major goal of the Affordable Care Act was to expand health insurance coverage. The Department of Health and Human Services will tell you that the Affordable Care Act is working: more Americans are insured. About 16.4 million people gained insurance in the past five years. What do these numbers mean for racial and ethnic minorities who… Read More »

The Use of Clinical Preventive Services under the Affordable Care Act

Increased use of recommended clinical preventive services among adults, such as colorectal and breast cancer screening and influenza vaccination, may save up to 100,000 lives per year and vastly improve life expectancy among the US population. Despite these benefits, recommended preventive services have been underused. In this post, I focus on colorectal cancer screening among adults… Read More »

Measuring Cost-related Medication Burden

As readers of Medical Care are no doubt aware, prescription drug expenditures for Medicare beneficiaries are high – nearly $90 billion in 2012.  There is some evidence that Medicare Part D has reduced financial burdens, at least among some beneficiaries, but recent surveys suggest that around 4.4% of individuals ages 65 and older (including those not on… Read More »

Racial Disparities in Ambulatory Care Sensitive Admissions

Using 2003-2009 Agency for Healthcare Research and Quality (AHRQ) hospital discharge data from 6 geographically and demographically diverse states, Mukamel and colleagues found that African Americans continue to experience poorer quality primary care, especially for chronic conditions.

Welcome to The ^new!^ Medical Care Blog

Welcome! We are so happy you have joined us on our new domain and platform. This move is one that we hope will allow our blog to grow its reach and readership. Our archives remain mostly at the old site. We hope you will share these posts with your colleagues, students, and fellow researchers and practitioners. Comments… Read More »

What might be hindering patient portal usage?

Personally, I find patient portals to be convenient. It’s an easy way to send healthcare-related questions to my provider such as, “does this medication have any side effects?” or, “can you please refill my prescription?”  I perceive the primary benefit as not having to schedule an appointment or wait on hold for 15 minutes to… Read More »

The intersection of physician gender and quality of care

According to data out this month from the Kaiser Family Foundation, there are 2 male doctors for every 1 female in practice in the US. This translates to about 300,000 fewer women than men in practice today. This gender difference is a disparity that many in health care may think has resolved, but in fact… Read More »

Smoke-free Public Housing: A Rule Whose Time Has Come

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 »

Breaking the Fee-for-Service Addiction: Don’t Throw the Baby Out with the Bathwater

“Breaking The Fee-For-Service Addiction: Let’s Move To A Comprehensive Primary Care Payment Model,” a recent Health Affairs blog post by Rushika Fernandopulle of Iora Health, argues for replacing FFS payment with risk-adjusted comprehensive payments for primary care. We agree. However, the post portrays sponsors’ continuing to require submission of “dummy claims” as an unproductive addiction… Read More »