Access & Equity

In JAMA Pediatrics, Amanda Kreider and colleagues, including Benjamin French, Jaya Aysola, Brendan Saloner, Kathleen Noonan and David Rubin, compare health care access, quality and cost outcomes by insurance type for children in low or moderate income households. Using family-reported measures from the National Surveys of Children’s Health, the authors examined children’s access to preventive and specialty care and caregiver satisfaction with insurance coverage, and also characterized unmet health needs and out-of-pocket costs over the last decade. The analysis revealed that...

In Academic Radiology, Hanna Zafar and colleagues, including Peter Groeneveld, compare differences in total Medicare costs among asymptomatic elderly patients in the year after initial computed tomographic colonography (CTC) or initial optical colonoscopy (OC). In 2009, the Centers for Medicare and Medicaid Services stopped covering CTC screening among asymptomatic individuals based on the scarcity of data regarding differences in outcomes and costs between patients who received CTC and OC. Zafar and colleagues performed a retrospective cohort study of asymptomatic Medicare...

In 2013, before the ACA’s health insurance marketplaces opened, more than 10 million people purchased insurance in the individual market. In the American Journal of Health Economics, Mark Pauly, Scott Harrington, and Adam Leive estimate how the ACA affected the prices these buyers faced in 2014.  Before taking any federal subsidies into account, they find that the impact of the ACA on total average price was relatively modest.

They looked at the effects of the ACA on premiums, expected out-of-pocket payments, and total expected price paid by these former buyers. They...

In the JAMA Surgery, Mark Neuman and Rachel Werner explore the association between marital status and chances of survival after major surgery. The authors used data from the University of Michigan Health and Retirement Study, a longitudinal panel survey that enrolled adults 50 years of age or older. Among the adults included in these data, those who were divorced, separated or widowed had greater odds of dying or developing a new functional disability during the first two years after cardiac surgery compared with their married counterparts. These findings extend prior work...

In Pediatrics, Jo Ann D’Agostino and colleagues, including Scott Lorch, evaluate to what extent premature infants adhere to the American Academy of Pediatric’s (AAP) health supervision visit schedule, what factors affect adherence, and how adherence associates with receiving suggested preventive care. The AAP recommends periodic health supervision visits throughout childhood to monitor growth and development, and to screen for illnesses.  Using data from a 30-site primary care network, the authors find less than half of the infants received all expected health supervision visits....