“A book lying idle on the shelf is wasted ammunition.” – Henry Miller, The Books in My Life (1952) The Medical Care Blog is home to many strong opinions. In the last year, contributors have written provocatively about the political determinants of health, highlighted the per-mile cost of President Trump’s wall in numbers of children who… Read More »
Physicians and other providers are the gatekeepers for prescription medicines; they decide who, under what circumstances, and for how long someone takes one – or several – medicines. But how do physicians stay abreast of the latest research about the safety and efficacy of the medicines they prescribe? We set out to understand how they… Read More »
Although the term health equity is widely used, a common understanding of this term is lacking. Viewing health equity through the lenses of allostatic load and intersectionality could help. This blog post considers three case scenarios, all of which are composites of actual cases that have occurred within the United States, to explore ideas of… Read More »
Why do we care about unintended pregnancies? Rates of unintended pregnancy “indicate the extent to which women and couples can determine freely whether and when they have children,” as stated by Finer and Zolna. There is some evidence that women and girls who have unintended pregnancies have a higher likelihood of other risk factors, such as… Read More »
Individuals experiencing homelessness are among the most medically, socially, economically, and politically vulnerable in our society. Because of this, patterns of service use by these individuals can often serve as indicators of the safety net capacity and overall wellness of the systems of care we have in place – like “canaries in the coal mine.”… Read More »
It’s a new season. The federal government re-opened this week after a record-breaking shut-down. Democrats gained control of the U.S. House of Representatives, feeling newly emboldened after the dispute about a border wall. A gaggle of 2020 presidential hopefuls has revealed themselves in recent weeks, lining up to be, arguably, the most liberal class of… Read More »
Do you use social media? If so, how many social media platforms (e.g., Facebook, Twitter, Instagram, Pinterest, LinkedIn) are you a member of? With about 40% of the world’s population already on some form of online social media, even if you don’t use it, you’ve probably heard of it. Devoting several hours each day to… Read More »
In 2019, mental health and opioid use disorders remain major public health issues. The most recent estimates suggest that 40 million adults experience mental illness in the U.S. and nearly 8 million adults experience both mental and substance use disorders at the same time. Individuals with mental illness also face higher risks of co-occurring chronic health conditions and… Read More »
Primary care sensitive (PCS) emergency department (ED) use is a measure that highlights the connection between primary and emergency care. The right care, for the right person, in the right place, at the right time is a reasonable goal of a high-quality health system. In the US, however, many people go to the emergency department… Read More »
President Trump wants $5 billion right now for his border wall, and another $7 billion (or maybe $13 billion) later on to finish the project. What else could we do with that kind of money? Here’s an idea: with $12 billion we could cover ALL 3.9 million uninsured children in the US today, and still have a… 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 »
This will be the last post of 2018 for us here at The Medical Care Blog. We would like to take this opportunity, as we do every year, to recognize YOU – our reader – as well as our contributors. We are really proud of the work we’ve done this year, and we hope you’ve… Read More »
The December edition of Health Wonk Review is now up at Health System Ed. In case you missed it, our contribution for this month comes from Jess Williams and covers some interesting new collaborative work on what research topics should be prioritized according to people with diabetes and/or obesity and researchers specializing in the fields.… Read More »
There are approximately 61 million women of reproductive age (15-44 years) in the United States, and at any given time, 70% of them are at risk of unintended pregnancy—that is, they are sexually active but do not want to become pregnant. About 72% of women who currently use contraception use non-permanent methods, such as the… Read More »
If you have a question, how do you find the answer? Many of us do a quick Google search or search out the answer at a library. However, people with Autism Spectrum Disorder (ASD) and their families face many challenges and barriers when trying to locate information. A recent episode of the (highly recommended) podcast… Read More »
The burden of homelessness on the health of those afflicted continues to be a major global public health concern. Last year, the United States recorded an increase in the number of homeless for the first time since 2010. On any given night in 2017, there were 553,742 people in the U.S. experiencing homelessness. In terms of… Read More »
Patients are increasingly involved in shaping research in health care, especially since the advent of the federal Patient-Centered Outcomes Research Institute (PCORI). PCORI actively promotes the engagement of patients and other stakeholders (clinicians, caregivers, purchasers, etc.) in the research process. As we discussed in an earlier entry on this blog, research terminology alone can be a… Read More »
Greetings from San Diego, where we’re just wrapping up the 2018 meeting of the American Public Health Association. It’s been a whirlwind stretch of great presentations, engaging conversations, and electric scooters! Have you seen these things? I was surprised at how many of my public health colleagues were willing to ride without a helmet… But… Read More »
Going to the hospital is more than a drag. For patients, it can be a frightening experience, dangerous to one’s health, a burden on family and caregivers, and very expensive. Policies to reduce preventable return visits to the hospital are good for patients – and good for Medicare’s bottom line. Medicare’s Hospital Readmission Reduction Program… Read More »
Engaging patients and families in their care has been a longstanding goal for quality improvement. Engaging patients and communities in research is an emerging field of work and collaboration, and a recent Medical Care article discusses some similarities and differences between engaging patients and communities. Why do we engage communities and patients in research? To create… Read More »
APHA 2018 starts November 10! Thousands of public health practitioners, students, scholars, and activists will descend on San Diego, CA on Saturday for our annual conference. As in previous years, your faithful co-editors will be there, live-tweeting about sessions! So be sure to follow @MedCareBloggers for real-time updates. The program is looking great, and we are excited about… Read More »
A relatively undiscussed and unconsidered form of discrimination continues to plague our health care institutions. It’s about time we talk about it. Insurance-based discrimination is the prejudicial treatment of a patient based on his/her insurance status. This type of discrimination mostly affects the 28.9 million Americans who have no health insurance coverage, although there is… Read More »
The October edition of Health Wonk Review is now up at Joe Paduda’s Managed Care Matters blog. This month, our featured post is the excellent commentary by new contributor Dr. Ranit Mishori titled The Social Determinants of Health? What about the Political Determinants of Health? Enjoy!
A few weeks ago, a headline in the Chicago Tribune grabbed my attention: “Millennials are trading primary care doctors for faster, cheaper alternatives.” This headline fits the rather unfortunate stereotype of millennials as impatient, job-hopping, financially-struggling, digital natives. But if this is true, then millennials are bound to “swipe left” to health care delivered in a… Read More »
Welcome to Point-Counterpoint – the BLOG Edition! In this series — as in the series by the same name in the journal — authors stake out positions on current issues, highlighting the pros and cons. In this Point-Counterpoint, we discuss the new Apple Watch’s electrocardiogram (ECG) technology, launched with the Apple Watch Series 4. The… Read More »
The concept that health comes with significant social determinants is everywhere we turn. This idea – that health and health inequities are driven by “the conditions in which people are born, grow, live, work and age [and are] shaped by the distribution of money, power and resources” – is increasingly the focus of articles, research… Read More »
This month’s Health Wonk Review, by Andrew Sprung at xpostfactoid, is called Map of Malfunction. Andrew describes this month’s edition as “a smorgasbord of smart takes on the morphing ACA marketplace; various dysfunctions (and one or two functions) of U.S. health care; and political wars over Medicare and the ACA.” The round-up features Red Thaddeus Miguel’s first… Read More »
Are you happy with your healthcare provider? Most people are happy, even if they’re unhappy with the health care system as a whole. But if you’re unhappy with your doctor or your care, how likely are you to say so or search out a new healthcare provider? Visiting your doctor can be intimidating; so much so,… Read More »
Over a third of all Americans are at an increased risk for chronic conditions such as heart attack, stroke, cancer, and diabetes due to their lack of sleep. Key disorders, such as obstructive sleep apnea, which now afflicts 30 million adults in the United States, are some of the primary causes of the morbidity and… Read More »
Welcome to the Bang for the Buck series! In this series, we will look at the most recent cost and cost-effectiveness research on public health methods and technology and discuss their potential for policy and implementation within the current health care system. As the costs of treating diseases continue to rise faster than inflation, prevention… Read More »
Last Tuesday I saw eight patients in my morning clinic; I felt like I did a lot. I saw Ms. S, a sixty-two-year-old lady with high blood pressure and diabetes; we chatted about her cats while I checked her feet and titrated her insulin. I treated my 9:30 am patient with some antibiotics for a… Read More »
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 »
We have been contributing to the Health Wonk Review, a longstanding roundup of “the best of the best” in health policy-related blog posts, on an irregular basis for some time. Starting this month, we’re pleased to announce that we’ll be participating more regularly. We will post a notice and link to the latest edition every… Read More »
Title X, a program that provides federal dollars to be used for family planning services, is under siege. The public comment period ended July 31, 2018, and now we wait to see how funding changes for Title X unfold. Title X is a critical program that provides essential reproductive health services to women, created by… Read More »
We are in the midst of a national epidemic concerning opioid misuse and abuse, and lawmakers are rushing to address this concerning situation. However, a recent report finds that only a few states are successfully implementing a balanced approach to curbing opioid misuse and abuse while maintaining access to pain relief for patients in need.… 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 »
Medication non-adherence can be a tricky issue for healthcare providers, patients, and pharmacists to solve. In addition to cost, there are many other factors that influence whether someone takes their medication(s) as prescribed. As discussed in the literature, side effects, confusion about medications, and the general human tendency to forget may all play a role.… Read More »
This year, we’ve seen more than 2,000 children separated from their parents, who were legally seeking asylum in the US. Most were from Central American countries in which crime and unrest place many at risk for violence. These children were taken from their families by US government employees between April 19 and May 31, 2018,… 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 »
In India, cardiovascular diseases (CVDs), specifically coronary heart disease and congestive heart failure, are leading causes of disability and death. The large projected population of patients with CVDs in the coming years poses one of the biggest threats to this fast developing nation’s future. The crushing magnitude of the problem is exacerbated in rural areas where… Read More »
Many women in the United States will be sexually assaulted during their lifetimes. And the aftermath of sexual assault impacts women health long after the assault itself. Survivors of sexual assault have been shown to have a greater increase in psychiatric disorders directly after their assaults than patients who have not been assaulted. Other research… 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 »
Readers of The Medical Care Blog know that the United States spends more money than any other country on healthcare. Currently, the US spends about 18% of its gross domestic product on health care, and it is predicted to grow to nearly 20% by 2026 [PDF]. While the growth rate in spending remains near historical… Read More »
As the older population in the US continues to grow, simultaneously increasing the need for healthcare services and providers, patients these days might be more likely to see a physician assistant (PA) or a nurse practitioner (NP), as opposed to an physician (MD); but what’s the difference? Let’s start out with some key facts: how… Read More »
Reproductive rights have been a topic for policy making and legal jurisprudence throughout much of the past century. As the healthcare system of the United States continues to evolve, women’s health and reproductive rights remain central to the debate. I previously authored a post here at The Medical Care Blog which discussed religion-restricted healthcare and… Read More »
In the new US consumer marketplace, doing good for society is powerful. Choices that people are making about how their food is grown, how companies test household products and reduce their impact on the environment, and how companies make their profits are driving new business models. Farmers are changing their pest and weed-control methods, manufacturers are… Read More »
In a recent letter to state Medicaid directors, officials at the Centers for Medicare and Medicaid Services (CMS) encouraged states to implement work requirements in Medicaid, writing that “a growing body of evidence suggests that targeting certain health determinants, including productive work and community engagement, may improve health outcomes.” In response, 10 Republican-led states have… Read More »
Fibromyalgia is a debilitating centralized pain condition experienced by millions of Americans. “Centralized” refers to origination or amplification of pain by a sufferer’s central nervous system. It is, in a true sense, pain that is “in one’s head” — but nevertheless as real and noxious as any other pain. Ultimately, pain is always something experienced… Read More »
Reactions to the opioid crisis are affecting patients in need of hospice and end-of-life care in the United States. Hospice providers have been largely exempt from the increasing regulation of opioid and narcotic prescriptions, as most recent laws and regulations affecting opioid prescribing specifically exempt individuals receiving cancer treatment, palliative care, or those nearing their end-of-life. However,… Read More »