Chlamydia and gonorrhea are among the most common sexually transmitted infections (STIs) in the United States, and research shows that 50% of sexually active individuals will contract an STI by 25 years old. Though chlamydia and gonorrhea are often asymptomatic in women, screening is important in order to prevent complications, such as pelvic inflammatory disease… Read More »
For two years in a row, the United States has experienced a decrease in life expectancy, which researchers have largely attributed to the opioid epidemic. Life expectancy for the United States population was 78.6 years in 2016, a decrease of 0.1 year from 2015 [PDF]. Age-specific death rates between 2015 and 2016 increased for younger… Read More »
The New York Times recently posted an article about the return on investment around public health interventions and how American life expectancy at birth increased by 30 years in the time from 1900 to 1999. The article went on to stress that these additional years of life can largely be attributed to advances in public… Read More »
It’s summer! In my world, that means road trips and beach days. One of my favorite ways to pass the time on a road trip or long lazy day at the beach is to catch up on podcasts. Podcasts — the name derives from iPod + broadcast — are audio or video transmissions, often produced… Read More »
Direct-to-consumer advertisements for prescription drugs have been legal in the United States since 1985, but are illegal in almost every other country. The history of consumer-directed ads in this country is that of private companies replacing public agencies as the purveyors of information on prescription drugs to the people. It has left us in a… Read More »
Ironically, many healthcare providers–doctors, nurses, physician and medical assistants–are not trained in “health” at all but in “medicine” instead. Often, as providers, our instinct is to first reach for a pill bottle or a procedure and forget about lifestyle changes that could be safer and more financially feasible for our patients. As the burden of… Read More »
On this page, we feature collections of posts and special series of posts. The Childhood Roots of Health Inequity In 2015, the Health Equity Committee of the APHA Medical Care Section organized a special invited panel session at the APHA Annual Meeting in Denver. We then produced a special series of blog posts about each… Read More »
As the City of Worcester Commissioner of Health and Human Services, I have developed city-wide initiatives and worked on policy change to address three primary health issues prevalent in our community, those being addiction, mental health, and homelessness, which all tend to occur hand in hand. Addiction is the largest public health and public safety… Read More »
October is here, so along with the fall foliage, prepare yourself for a deluge of pink ribbons, umbrellas, bumper stickers, and billboards: it’s Breast Cancer Awareness Month. Started as a well-intentioned campaign to raise awareness about breast cancer and fundraise for breast cancer research, some have said that the movement commodifies a deadly disease at… Read More »
Every physician fears being sued. Almost half of primary care doctors are subject to a malpractice lawsuit at some point in their careers. In some quarters, physicians are fatalistic about this fact. I have heard colleagues say: “It’s going to happen at some point, I know it.” But since the publication of the Institute of… Read More »
One of the challenges in delivering efficient medical care is identifying people who are at risk of a negative outcome, so we can focus our efforts on screening and treating those at elevated risk. We do this in individual face-to-face encounters through clinical, diagnostic processes: taking a patient’s history, performing a physical examination, recording signs… Read More »
Medical claims data are collected for payment purposes. However, these data are often used for other purposes such as studying quality of care, assessing provider performance, and measuring health. These data are a rich resource for health services research, but when they do not include key pieces of information we can find ourselves bending over… Read More »
Smoking cessation is not innovative or trendy or even particularly exciting, but as a primary care doctor, in most cases helping a patient quit smoking is the best thing that I can do to help that patient over their lifetime. Without question. And for that reason, I always make it a priority to talk about it… Read More »
In the era of value-based care, caregivers and policymakers alike are intensely interested in strategies to reduce 30-day hospital readmissions. Researchers continue to offer up helpful tools in this effort. Recently published online ahead of print in Medical Care, Burke and colleagues make an important contribution with their article The Hospital Score Predicts Potentially Preventable 30-Day Readmissions… Read More »
The year 2016 was a big one for The Medical Care Blog: in February, we moved from our old publisher-hosted location and launched this new domain and design. We’ve published 61 posts here since then – a little more than one a week. We’ve added many new contributors and broadened our audience. Thank you for reading!… Read More »
In my medical practice, lacking the tools to communicate meaningfully with other providers who are caring for my patients is a daily frustration. This is only magnified when it comes to caring for my most vulnerable patients who have difficulty communicating for themselves, such as those suffering from substance use disorders (SUDs), so I was… Read More »
With the mania of the presidential election in full tilt and the election just days away, it’s hard to have a rational public discussion about health care. Supporters of the two presidential candidates have drawn a deep and divisive line (or rather a tectonic fissure) in the sand about health care reform. This is due, in great part, to the bombastic, and ultimately… Read More »
In just a few days, thousands of public health practitioners, students, scholars, and activists will descend on Denver, Colorado for APHA 2016. This year, your faithful co-editors will be there, live-tweeting about sessions! So be sure to follow @MedCareBloggers for real-time updates. Here are just a few of the sessions we’re looking forward to this year:… Read More »
According to the 2013 Medical Expenditure Panel Survey, hospital inpatient expenses account for a large portion (nearly 30%) of total health care expenses and health care spending is highly concentrated among a relatively small proportion of individuals. The top 1% of spenders accounted for 21.5% of total expenditures while the lower 50% accounted for just… Read More »
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 »
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 »
Meet Our Current Editors Lisa M. Lines, PhD, MPH has been a member of the Medical Care Editorial Board since 2013 and co-founded The Medical Care Blog in 2014. She is a senior health services researcher at RTI International, an independent, non-profit research institute. She is also Assistant Professor of Population and Quantitative Health Sciences… Read More »
As our country’s diverse populations grow, the variety in the numbers of spoken languages and dialects is also on the rise. In 2013, approximately 25.1 million individuals were considered Limited English Proficiency (LEP), which is a term that refers to individuals ages 5 and older who report speaking English less than very well as per… Read More »
“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 »
Support for patient-centered medical homes (PCMH) has been growing in recent years. A typical PCMH model includes a primary care physician supported by a multidisciplinary team, coordinated care, measurements of quality and safety, and enhanced access to same-day appointments. Preliminary program evaluations have shown that PCMHs can improve access and quality, but to date, there… Read More »
Competition between hospitals in a given market should provide incentives to ensure quality while also lowering costs. Over the past two decades, hospital markets have increasingly consolidated. This consolidation reduces competition and increases the comparative leverage that hospitals and associated health systems have. While there are some theoretical advantages of increased consolidation such as potential… Read More »
From The Medical Care Blog: A special consensus statement on climate change and public health In 2021, more than 250 of the world’s leading medical and public health journals released a joint statement about climate change and public health. Published simultaneously, editorial boards of the journals declared climate change to be the “greatest threat” to… Read More »
What comes to mind when you hear the word “weathering”? Perhaps you think of erosion, depletion, and wearing down. Or maybe enduring, surviving, and withstanding. All of these associations accurately describe what happens to our bodies in response to chronic stress. This particular type of physiological stress affects the brain and other parts of the… Read More »
In this post, we examine how the COVID-19 pandemic affected frequencies of diagnoses and claims costs in the Affordable Care Act (ACA) marketplaces in 2020 and 2021. The ACA marketplaces are critical sources of coverage for millions of Americans and were increasingly so during the COVID-19 pandemic due to job losses and coverage disruptions. The… Read More »
Ben King is joining our editorial team at The Medical Care Blog! Dr. King (he/him) is currently an Assistant Professor of Population Health at the new Tilman J Fertitta Family College of Medicine at the University of Houston. He has additional appointments in the Department of Behavioral and Social Sciences, with the UH-Humana Integrated Health… Read More »
This month’s topic focuses on suicide and social determinants of health (SDoH) Welcome to the Healthy Intersections podcast for October, 2023. Today’s podcast focuses on the links between suicide and social determinants of health in the United States. Suicide is one of the causes of deaths of despair, along with deaths from drugs and alcohol.… Read More »
Hi everyone! We’re excited to share the August edition of our Healthy Intersections Podcast with you. This month, we hosted Dr. Amanda Onwuka, a social epidemiologist and health services researcher at RTI International, as well as Jeremy Ney, author of American Inequality. We talk about the epidemic of drug overdose deaths in the US, mental… Read More »
Eli Lilly & Co.’s announcement that it is slashing prices for its major insulin products could make life easier for some diabetes patients while easing pressure on Big Pharma. It also casts light on the profiteering methods of the drug industry’s price mediators — the pharmacy benefit managers, or PBMs — at a time when… Read More »
An Opportunity to Get Ahead of the Overdose Crisis For many Americans, drug use ‘prevention’ conjures memories of early public health campaigns using fearsome imagery and catchy slogans to deter substance use. Campaigns implored youth to “just say no” to drugs, and the public received stark warnings: “this is your brain on drugs.”
As California settles into a third year of pandemic, covid-19 continues to pose a serious threat of death. But the number of people dying — and the demographics of those falling victim — has shifted notably from the first two years. Given the collective immunity people have garnered through a combination of mass vaccination and… Read More »
On this month’s episode of the Healthy Intersections Podcast, Samy Anand from the Medical Care Section recaps last month’s blog posts and preview’s June’s issue of the Medical Care journal. Some great articles to check out for your summer reading list. Next, Lisa Lines, co-editor of the blog and podcast, interviews Dr. Pia MacDonald, an… Read More »
During the pandemic, telemedicine demonstrated it’s power. As we begin to make the shift back to in-person clinical care in a post-pandemic world, it’s important to look at the lessons learned during the pandemic. This will help guide us in how to move forward and improve telemedicine delivery. The History The use of telemedicine is… Read More »
Part 1 of this two-part series laid out arguments for and shortcomings of imputing race/ethnicity from the perspective of health equity. In this post, we’ll talk about gaps in the evidence and a few alternatives to imputation, including approaches involving population-level and neighborhood-level data. Imputation is a common solution to deal with “the missing-data problem.”… Read More »
In military medicine, exercises, such as a mass vaccination points-of-dispensing (POD) scenario, test preparedness capacity, and drill for potential real-world public health emergency scenarios. Exercises are designed to challenge medical teams to work under pressure and problem solve according to conditions presented in the exercise scenario. A benefit of medical exercises in the military is… Read More »
Over 30% of Black, Latinx, and Indigenous populations in the US are enrolled in Medicaid programs; more than half of all Medicaid enrollees are people of color. As such, Medicaid policies disproportionately affect populations of color. As more institutions reckon with historical and current injustices due to centuries of racism and racist policies, understanding how… Read More »
The pandemic has consistently exposed the underlying inequities and effects of systemic racism on American Indian (AI) and other marginalized communities. The health equity challenge of 2021 is around COVID-19 vaccine equity. Over the first months since the vaccine has become available, communities of color are not getting shots in the arm at the same… Read More »
This past year at The Medical Care Blog has been quite an adventure. Like the rest of humanity, we were thrown into a whole new reality with the COVID-19 pandemic. Our first posts about SARS-CoV-2 (the novel coronavirus) and COVID-19 (the disease it causes) began in mid-March and haven’t stopped since. All told — across… Read More »
Current healthcare reimbursements may create incentives for excess use of ventilators to treat COVID-19 patients. Recent research has shown that healthcare providers, including hospitals, have experienced substantial financial losses as a result of the COVID-19 pandemic. Alternative, less-invasive treatments for critically ill COVID-19 patients could potentially improve patient outcomes. But these approaches expose hospitals to… Read More »
Over the past two decades, research has helped identify ways to reduce complications among people with diabetes and laid the foundation for primary prevention. However, prevention and treatments are still unequally applied, and social, economic, and age-related disparities persist. The June 2020 supplement issue of Medical Care argues for and presents the results of natural… Read More »
While working as a nurse, I remember one instance of caring for two patients who were twins. Along with the same birthday and the same last name, they both had very similar first names. The twins were roughly around the same height, the same weight, and also had the same hair color. At first glance… Read More »
The rapid emergence of COVID-19 reminds us of the importance of the public health system. Local health departments (LHDs) play a central role in emergency preparedness and response. Effective epidemic response rests on the performance of the essential public health activities— assessment, policy development, and assurance—by LHDs. Evidence suggests that LHDs can improve population health… Read More »
Welcome to the final post in our series on patient portals – an attempt to imagine the future. Part 1 of this series summarized the latest data on who is using portals. Part 2 explained some of the barriers to use as well as what factors increase use. Evidence of Increased Patient Engagement and Other… Read More »
This year, teachers striking across the country have found common ground on a priority outside of typical debates around salaries or pensions. Educators in three major cities–Los Angeles, Oakland, and Chicago–among others, have been calling for more school counselors, librarians, nurses, psychologists, and social workers to support their students’ development beyond academic benchmarks. These public… Read More »
The codes of the International Classification of Diseases (ICD) serve as the backbone for billing, payment, and surveillance programs across the entire healthcare system – nationally and globally. Recent research published in Medical Care by Alexander Mainor and colleagues from the Dartmouth Institute for Health Policy & Clinical Practice has shown that the transition of… Read More »
This post is for the measurement methodologists in the house. Although, the study results have a real impact for anyone reading macro-level studies of health care services and economics. Sure, this is a bit of inside baseball, but it involves a fundamentally important issue at the center of healthcare research and policy that relies on… Read More »