In the Journal of Rehabilitation Research & Development, Margaret Stineman and colleagues compare outcomes of postacute stroke patients provided with comprehensive rehabilitation with those provided with consultative rehabilitation services. Of the nearly 3000 patients in the study, 23 percent received comprehensive rehabilitation while the remaining patients received consultative services. The researchers found that those who received comprehensive rehabilitation compared with consultative gained on average 12.8 more points of physical independence on a 78-point scale and...
As a recipient of the Alice Hersh Scholarship, I had the privilege of attending AcademyHealth’s 2015 National Health Policy Conference in Washington D.C. In addition to many interesting sessions, I had the opportunity to meet many leaders in the health care space, from health services researchers and policy makers to providers and business leaders.
Healthcare System Supports for Young Adult Patients with Pediatric Onset Chronic Conditions: A Qualitative Study
In the Journal of Pediatric Nursing, Dava Szalda and colleagues examine how adult primary care teams can facilitate the transition and ongoing care of adults with pediatric onset chronic illness. Currently, over 90% of pediatric patients with chronic medical conditions are living into adulthood. For some pediatric onset chronic conditions there are more adults living with an illness than children. This qualitative study explores practice supports and barriers to care for this population, comparing them to other patients with chronic illness in order to identify facilitators that...
Lessons for Providers and Hospitals from Philadelphia’s Obstetric Services Closures and Consolidations, 1997-2012
In Health Affairs, Scott Lorch and colleagues suggest that the way in which hospitals respond to disruptions caused by the closure of nearby facilities could influence patient outcomes. They look at the example of obstetric services in Philadelphia, where 13 of 19 hospital obstetric units closed between 1997 and 2012. This led to a "severely strained obstetric care system," according to interviews with key informants in hospitals with units still open. The authors conclude that policymakers need to do more to anticipate reductions in supply and monitor patient outcomes.
A version of this article was originally published by The Children’s Hospital of Philadelphia.
(An edited version of this post appeared in Philly.com)
US health care spending has never grown as slowly as it did last year.
Dwight D. Eisenhower was in the Oval Office when the US government began recording health care spending in 1960. Since that time, growth in health care spending has never been lower than the 3.6% annual rate reported by researchers from the Centers for Medicare and Medicaid Services a few weeks ago in the journal Health Affairs.
Association of the 2011 ACGME Resident Duty Hour Reforms With Mortality and Readmissions Among Hospitalized Medicare Patients
In the Journal of the American Medical Association, Mitesh Patel, Kevin Volpp and colleagues evaluate patient outcomes associated with 2011 limits on resident work hours, and find no change in 30-day mortality rates or 30-day all-cause readmission rates. See the LDI blog post on this study.
The existence of a primary care physician shortage, even prior to the ACA, is not universally accepted. A new report by the Institute on Medicine found “no credible evidence” that the nation faces a looming physician shortage in primary care specialties. There is greater consensus about a maldistribution of physicians, in terms of specialty, geography, and practice settings.
A new LDI/INQRI Research Brief, written by Mark Pauly, PhD, Mary Naylor, RN, PhD, and me, reviews the evidence of an existing or looming primary care shortage in the wake of the ACA. Will the combined effects of an aging population, an increase in coverage and demand for care, and a decrease in the number of physicians going into primary care create widespread gaps in access? Who will treat the newly insured, and will this exacerbate existing workforce shortages?