The October issue of Health Affairs includes several studies relating to the ultimate health care safety net: the emergency department (ED). Additional content in this variety issue focuses on behavioral health, spending, clinician satisfaction, and more. A DataGraphic spotlights aging and health.
US emergency department visits for firearm-related injuries, 2006–14
According to the Centers for Disease Control and Prevention (CDC), firearm-related deaths accounted for more than 36,000 deaths in the United States in 2015. However, due to the politicized environment surrounding gun violence, Congress has yet to appropriate funds to the CDC for firearm-related injury research. As a result, limited data exist on the epidemiological trends and risk factors related to firearm-related death. To better understand US firearm-related injuries, Faiz Gani and coauthors from the Johns Hopkins University School of Medicine analyzed national data for the years 2006–14. Of the 704,916 patients who were alive when they reached the ED with firearm-related injuries, men outnumbered women almost nine to one (45.8 ED visits per 100,000 people versus 5.5 visits per 100,000), and men ages 20–24 were the highest-risk group (see the exhibit below). According to the authors, this little-studied problem accounts for an annual financial burden of approximately $2.8 billion in ED and inpatient charges. Due to the timely nature of this article, Health Affairs has made it paper available to all without a subscription until Monday, October 9.
Another of the ED studies in the issue:
- Freestanding Emergency Departments Preferentially Locate In Areas With Higher Household Income; Cedric Dark of Baylor College of Medicine and coauthors.
DATAWATCH: Low-cost high-volume services drive needless health spending
In the United States, a substantial proportion of health care costs is allocated to low-value care: patient care providing no net health benefit, such as early diagnostic imaging for uncomplicated low-back pain. John Mafi of the University of California, Los Angeles, and coauthors used data for 2014 from Virginia's All Payer Claims Database to examine the cost and use of forty-four low-value health services identified by the Choosing Wisely campaign and other evidence-based guidelines. Of the 1.7 million low-value services provided, the vast majority—93 percent—were also low or very low cost ($538 or less), and these low-cost, high-volume services accounted for 65 percent of spending on low-value care. The more than $586 million spent on low-value services represented 2.1 percent of Virginia's total health care costs that year. The authors conclude that decreasing wasteful health care spending would increase the efficiency of delivery by shifting care from low-value procedures to clinical efforts that improve patient outcomes, and they suggest that in the aggregate, minor actions by key stakeholders can have a sizable impact on reducing unnecessary health care spending.
DATAWATCH: Millennials almost twice as likely as baby boomers to become RNs
Baby-boomer registered nurses (RNs), a group accounting for the largest share of the RN workforce from 1981 to 2012, are starting to retire. This fact would augur a severe future nursing shortage. However, David Auerbach of Montana State University and coauthors, who examined Census Bureau data for the years 1979–2015, have concluded that large national shortages of RNs has likely been averted. This can be partially explained by a surprising surge of interest in nursing among Millennials, in contrast to the case for Generation X professionals. According to the authors, an average Millennial thus far has been nearly twice as likely (186%) to become an RN as an average baby boomer, although they see that these rates of entry are beginning to plateau. The authors forecast that the nursing workforce will be dominated by Millennials in the 2020s. They also project that despite Millennials' brisk rate of entry into nursing, the retirement of baby boomers will dampen (but not erase) the workforce growth in the next decade.
Other October issue studies of interest:
- THE PRACTICE OF MEDICINE: Joy In Medical Practice: Clinician Satisfaction In The Healthy Work Place Trial; Mark Linzer of the Hennepin County (Minnesota) Medical Center and coauthors.
- Health Care In The Suburbs: An Analysis Of Suburban Poverty And Health Care Access; Alina Schnake-Mahl and Benjamin Sommers, both of the Harvard T. H. Chan School of Public Health.
- Effects Of State Insurance Mandates On Health Care Use And Spending For Autism Spectrum Disorder; Colleen Barry of the Johns Hopkins Bloomberg School of Public Health and coauthors.
- Despite Increased Insurance Coverage, Nonwhite Sexual Minorities Still Experience Disparities In Access To Care; Ning Hsieh of Michigan State University and Matt Ruther of the University of Louisville (Kentucky).
from Health Affairs BlogHealth Affairs Blog http://ift.tt/2wtWh2Y
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