Research Briefs and Snapshots

Impact of Sweetened Beverage Tax on Chain Retailers in Philadelphia

Research Brief
Jul. 2, 2019

On January 1, 2017, Philadelphia became the second U.S. city to tax the distribution of sweetened beverages. The 1.5 cent per ounce tax applies to the distribution of sugar- and artificially sweetened beverages. Similar taxes have been passed in several other cities and are being considered at the state level. The authors examined the effect of the tax on beverage prices and sales at chain retail stores in Philadelphia.

Contributors to Post-injury Mental Health in Urban Black Men with Serious Injuries

Research Brief
Jun. 21, 2019

Factors over the life course affect the mental health of urban black men with serious injuries.  Childhood adversity, pre-injury physical and mental health conditions, and intentional injury (violence) are risk factors for post-injury depression and posttraumatic stress. Clinicians should expand assessment beyond the acute injury event to identify those patients at risk for poor mental health outcomes.

College Affirmative Action Bans and Health Risk Behaviors

Jun. 19, 2019

College affirmative action bans were associated with higher rates of smoking and drinking in underrepresented minority 11th and 12th graders, and these students continued to smoke at higher rates into young adulthood. Policymakers should consider unintended public health consequences of proposals, such as affirmative action bans, that may limit socioeconomic opportunities.

Expanding Access to Naloxone: A Review of Distribution Strategies

Issue Brief
May. 29, 2019

Amidst an ongoing opioid crisis that claimed 47,600 lives in 2017, increasing the availability of the rescue medication naloxone is a high priority. Naloxone reverses an opioid overdose when given intranasally or intramuscularly. But to be effective, naloxone must be available at the time of overdose. Naloxone distribution to laypeople can save a life when first responders are not immediately available, or when people witnessing overdoses are unwilling or unable to call 911. Naloxone is increasingly available through some pharmacies under a standing order; however, even when available, cost and stigma barriers persist. This Issue Brief reviews recent evidence on the outcomes and cost-effectiveness of naloxone distribution strategies in community, pharmacy, and other health care settings.

Outcomes Associated With Good Hospital Work Environments for Nurses

May. 14, 2019

Hospital work environments that promote nurse leadership, encourage nurse participation in hospital governance and decision-making, assure adequate resources and staffing, and foster collaboration between doctors and nurses are consistently associated with better patient, quality, safety, and job outcomes. The work environment offers a powerful target for improvement efforts and warrants the resources and attention of health care administrators.

Five-Year Cost of Dementia: Medicare

Research Brief
Apr. 29, 2019

[dropcap]A[/dropcap]bout 5.5 million older adults are living with dementia, a chronic, progressive disease characterized by severe cognitive decline. This number will likely grow significantly as the U.S. population ages, which has cost implications for the Medicare program. A full accounting of these additional expenses will help policymakers plan for them in their Medicare budgets. In this study, Norma Coe and colleagues examined survival and Medicare expenditures in older adults with and without dementia to estimate dementia’s incremental costs to Medicare in the five years after diagnosis.

The Effect of Predictive Analytics-Driven Interventions on Healthcare Utilization

Research Brief
Apr. 3, 2019

Among high-risk Medicare Advantage members with congestive heart failure, a proactive outreach program driven by a claims-based predictive algorithm reduced the likelihood of an emergency department (ED) or specialist visit in one year by 20% and 21%, respectively. The average number of visits dropped as well, with a 40% reduction in the volume of ED visits and a 27% reduction in the volume of cardiology visits after the first year.

The Burden of Health Care Costs for Working Families

Issue Brief
Apr. 1, 2019

Growing concern about the affordability of health care and the cost burden imposed on working families frequently appears in public debate about the next phase of health care reform. In this second brief of our affordability series, Penn LDI and United States of Care adapt a national-level affordability index to provide state-level data on the cost burden faced by working families who have employer-sponsored insurance (ESI). We examine how this burden varies across states, and how it has changed within states from 2010 to 2016.

Assessing First Visits By Physicians To Medicare Patients Discharged To Skilled Nursing Facilities

Research Brief
Kira Rysinka, MD
Apr. 1, 2019

In this study of postacute care, more than 10% of Medicare skilled nursing facility (SNF) stays included no visit from
a physician or advanced practitioner. Of stays with visits, about half of initial assessments occurred within a day of
admission, and nearly 80% occurred within four days. Patients who did not receive a visit from a physician or advanced
practitioner were nearly twice as likely to be readmitted to a hospital (28%) or to die (14%) within 30 days of SNF
admission than patients who had an initial visit.

U.S. Emergency Room Department Encounters for Firearm Injuries, 2009-2014

Mar. 28, 2019

Substantial opportunities exist to prevent recurrent firearm injury. Current models must expand beyond patients presenting at trauma centers with firearm assault injuries. Evidence-based prevention programs – including firearm counseling and safe storage interventions – should be adopted across a broad range of EDs and firearm injuries.

Patient Outcomes After Hospital Discharge to Home with Home Health Care vs to a Skilled Nursing Facility

Research Brief
Mar. 11, 2019

In this study of more than 17 million Medicare hospitalizations between 2010 and 2016, patients discharged to home
health care had a 5.6 percent higher 30-day readmission rate than similar patients discharged to a skilled nursing facility
(SNF). There was no difference in mortality or functional outcomes between the two groups, but home health care was
associated with an average savings of $4,514 in total Medicare payments in the 60 days after the first hospital admission.

Consumers' Responses to Surprise Medical Bills in Elective Situations

Research Brief
Mar. 4, 2019

A surprise medical bill is a bill from an out-of-network provider that was not expected by or not chosen by the patient.To see whether consumers are more likely to switch hospitals after receiving a surprise bill, Benjamin Chartock and Sarah Schutz, and their co-author Christopher Garmon, analyzed nationwide employer-sponsored health insurance claims for labor and delivery services. Mothers who received a surprise out-of-network bill for their first delivery had 13% greater odds of switching hospitals for their second delivery compared to those who did not get a surprise bill.

Detecting BS in Health Care 2.0

Issue Brief
Feb. 11, 2019

In our initial report “Detecting BS in Health Care,” we identified our top ten BS concepts and trends within the health care industry, and encouraged our readers to hone their “BS detection skills.” Many of you have let us know that we “left some BS on the table.” This time around, we make bolder assertions about other possible forms of BS—including some sacred cows—that might make some readers uncomfortable.

Proposed Work Requirements in Pennsylvania Medicaid: Characterizing Eligible Beneficiaries

Issue Brief
Feb. 8, 2019

To help the Pennsylvania Department of Human Services understand the likely impact of a proposed Medicaid work requirement, we analyzed the demographic, economic and health characteristics of working-age, non-disabled adults who receive Medicaid, and any issues or barriers this population may face in obtaining and maintaining employment.

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