COVID-19 has had a major impact on U.S. nursing homes, resulting in a large and disproportionate share of COVID-19 deaths. Starting in April 2020, nursing homes were required to report COVID-19 cases to their state health department. Linking these reports to Medicare quality data, the authors examined the characteristics of 8,943 nursing homes in 23 states and Washington, D.C. Using data collected between April 22 and 29, they described the differences between facilities that reported COVID-19 cases (34%) and those that did not report cases.
One in five U.S. children has a mental health condition, but little is known about their health care use and spending. The authors looked at 2016 Medicaid claims for approximately 775,000 children (ages 3-17) with a mental health diagnosis and at least 11 months of continuous Medicaid coverage. They compared utilization and spending of "top spenders" (patients who spent the most overall on health care, or the top 1%) and "typical spenders" (patients with more usual spending, the remaining 99%).
Opioid overdose deaths have been called “deaths of despair” because of their possible connection to individual and community distress. This study looks at how proximity to auto plant closures — which represent large, traumatic, and culturally significant shocks to economic opportunity — affected opioid deaths among working age adults between 1999 and 2016.
Thirteen states limit alcohol purchases to state-run stores. Washington was among these states until 2011, when voters passed Initiative 1183,
which privatized liquor sales and imposed taxes and fees on them. As a result, the number of retail sites increased dramatically, and the cost of
liquor went up. The authors compared the amount of alcohol purchased by households in Washington metropolitan areas to the amount purchased by households in 10 states that retained monopoly control of alcohol sales, before and after privatization.
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.
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.
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.