Morning Briefing
Summaries of health policy coverage from major news organizations
Research Roundup: Transgender Veterans; Public Spending On Children; And Bundled Payments
Transgender people have been able to serve openly in the military since June聽2016. However, the administration of President Donald Trump has signaled its interest in reinstating a ban on transgender military service. In March聽2018 President Trump issued a revised memorandum that stated, in part, that people with a 鈥渉istory or diagnosis of gender dysphoria鈥 who 鈥渕ay require substantial medical treatment, including medications and surgery鈥攁re disqualified from military service except under certain limited circumstances.鈥 Whether and how the health of transgender service members differs from that of cisgender service members (that is, those who identify with their sex assigned at birth) is largely unknown. (Downing et al, 7/9)
How our government spends money鈥攁nd who benefits鈥攔eflects our national priorities, but it鈥檚 not always clear where our tax dollars are going. In these five charts, we take a look at federal and state spending on children through programs and tax reductions. Children can鈥檛 vote or lobby for public resources, but their well-being and development affect the future economic and social health of the country. Investing in their health, education, and stability should be a national priority. So how much are we devoting to the kids鈥 share of public spending. (7/18)
We used Medicare claims from 2013 through 2015 to identify admissions for the five most commonly selected medical conditions in BPCI [Bundled Payments for Care Improvement]: congestive heart failure (CHF), pneumonia, chronic obstructive pulmonary disease (COPD), sepsis, and acute myocardial infarction (AMI). ... At baseline, the average Medicare payment per episode of care across the five conditions at BPCI hospitals was $24,280, which decreased to $23,993 during the intervention period .... Control hospitals had an average payment for all episodes of $23,901, which decreased to $23,503 during the intervention period .... Changes from baseline to the intervention period in clinical complexity, length of stay, emergency department use or readmission within 30 or 90 days after hospital discharge, or death within 30 or 90 days after admission did not differ significantly between the intervention and control hospitals.(Joynt Maddox et al., 7/19)
With less than four months to go until the Congressional midterm general election, a candidate鈥檚 position on continuing protections for people with pre-existing health conditions is at the forefront of the many health care issues on voters鈥 minds, finds the latest Kaiser Family Foundation tracking poll.Continuing pre-existing condition protections ranks first among six other candidate positions on health care issues with 63 percent of voters rating it the 鈥渕ost important鈥 or a 鈥渧ery important鈥 factor. Pre-existing condition protections rank highly across party identification, with majorities of Democratic (74%), independent (64%) and half of Republican (49%) voters saying a candidate鈥檚 position on this issue is either the 鈥渕ost important factor鈥 in their vote or 鈥渧ery important, but not the most important factor.鈥 (7/25)
In this randomized clinical trial that included 300 patients with recent acute coronary syndrome and depression, 24-week treatment with escitalopram compared with placebo resulted in an occurrence of major adverse cardiac outcomes of 40.9% vs 53.6% after a median follow-up of 8.1 years, a difference that was statistically significant. (Kim et al, 7/24)
A single positive CTC assay result 5 years after diagnosis of hormone receptor鈥損ositive breast cancer provided independent prognostic information for late clinical recurrence, which provides proof of concept that liquid-based biomarkers may be used to risk stratify for late recurrence and guide therapy. (Sparano et al, 7/26)