(Press-News.org) Bottom Line: Full implementation of the Affordable Care Act's (ACA) national health insurance expansion could result in many more discretionary surgical procedures in the next few years based on how utilization changed after an earlier insurance reform in Massachusetts.
Author: Chandy Ellimoottil, M.D., of the University of Michigan, Ann Arbor, and colleagues.
Background: The potential effect of the ACA on surgical care is not well known. The authors examined its possible effect by analyzing the Massachusetts insurance expansion and utilization of discretionary and nondiscretionary surgical procedures.
How the Study Was Conducted: The authors used state inpatient databases from Massachusetts and two control states (New Jersey and New York) to identify adults who underwent discretionary procedures (e.g. elective procedures such as joint replacement and back surgery) and nondiscretionary procedures (e.g. cancer surgery and hip fracture repair) from 2003 through 2010. The transition point for insurance reform was July 2007.
Results: A total of 836,311 surgical procedures were identified during the study period. Insurance expansion was associated with a 9.3 percent increase in discretionary surgery in Massachusetts and a 4.5 percent decrease in nondiscretionary surgery. Authors estimate the ACA could yield an additional 465,934 discretionary surgical procedures by 2017.
Discussion: "Our collective findings suggest that insurance expansion leads to greater utilization of discretionary inpatient procedures that are often performed to improve quality of life rather than to address immediately life-threatening conditions. Moving forward, research in this area should focus on whether greater utilization of such procedures represents a response to unmet need or changes in treatment thresholds driven by patients, providers or some combination of the two."
INFORMATION:
(JAMA Surgery. Published online July 2, 2014. doi:10.1001/jamasurg.2014.857. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor's Note: An author made a conflict of interest disclosure. This study was supported by a grant from the Agency for Healthcare Research and Quality and other sources. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Media Advisory: To contact corresponding author David C. Miller, M.D., M.P.H., call Shantell Kirkendoll at 734-764-2220 or email smkirk@umich.edu
Study estimates effect on surgery following national health insurance expansion
2014-07-02
ELSE PRESS RELEASES FROM THIS DATE:
Trial examines treatment for psychogenic nonepileptic seizures
2014-07-02
Bottom Line: A clinical trial found a reduction in seizures and improvement in related symptoms, including depression and anxiety, in patients with psychogenic nonepileptic seizures (PNES) who were treated with cognitive behavioral therapy informed psychotherapy (CBT-ip) with and without the medication sertraline.
Authors: W. Curt LaFrance, Jr., M.D., M.P.H., of Brown University, Rhode Island Hospital, Providence, R.I., and colleagues.
Background: PNES is not responsive to standard treatment and can be made worse by antiepileptic medications. Up to 20 percent of civilians ...
SDSC assists researchers in novel wildlife tracking project
2014-07-02
A team including researchers from the U.S. Geological Survey (USGS) and the San Diego Zoo's Institute for Conservation Research has developed a novel methodology that for the first time combines 3D and advanced range estimator technologies to provide highly detailed data on the range and movements of terrestrial, aquatic, and avian wildlife species.
A paper detailing the project, called 'Movement-based Estimation and Visualization of Space Use in 3D for Wildlife Ecology and Conservation', was published July 2 in the PLOS ONE online science journal. A video of the project ...
Noninvasive advanced image analysis could lead to better patient care
2014-07-02
PHOENIX, Ariz. — July 2, 2014 — Lung cancer patients could receive more precise treatment, and their progress could be better tracked, using a new high-tech method of non-invasive medical imaging analysis, according to a study published today by the journal PLOS ONE.
Genetic changes increasingly are recognized as driving cancer development. But obtaining evidence of these changes usually requires a biopsy, which can be problematic for sensitive regions of the body such as the lungs.
Based on a review of 48 patients with non-small cell lung cancer (NSCLC), the study ...
Researchers invent 'meta mirror' to help advance nonlinear optical systems
2014-07-02
Researchers at the Cockrell School of Engineering at The University of Texas at Austin have created a new nonlinear metasurface, or meta mirror, that could one day enable the miniaturization of laser systems.
The invention, called a "nonlinear mirror" by the researchers, could help advance nonlinear laser systems that are used for chemical sensing, explosives detection, biomedical research and potentially many other applications. The researchers' study will be published in the July 3 issue of Nature.
The metamaterials were created with nonlinear optical response ...
A million times better
2014-07-02
This news release is available in German.
Lasers have a fixed place in many fields of application. Yet, there are still wavelengths for which either no systems exist, or at best only large and expensive ones. On the other hand remote sensing and medical applications call for compact laser systems, for example with wavelengths from the near infrared to the Terahertz region.
A team of researchers at the Technische Universitaet Muenchen (Germany) and the University of Texas Austin (USA) has now developed a 400 nanometer thick nonlinear mirror that reflects frequency-doubled ...
Scientists can now screen for stem cells that enhance corneal regrowth
2014-07-02
A Boston-based scientific collaborative, led by Harvard Stem Cell Institute (HSCI) researchers, has discovered a way to collect the best cell type for regenerating a damaged cornea—the clear membrane that covers the pupil and directs light into the back of the eye. The investigators report in the journal Nature that purified human stem cells can be used to improve long-term vision in mice. The team is now pursuing FDA-approval for the technique before moving on to patient clinical trials.
The study, lead by co-senior investigators Natasha Frank, MD, and Markus Frank, ...
Die-offs of band-tailed pigeons connected to newly discovered parasite
2014-07-02
A new pathogen has been discovered by scientists investigating major
die-offs of pigeons native to North America, according to studies led
by the University of California, Davis, and the California Department
of Fish and Wildlife.
Scientists were able to implicate this new parasite, along with the
ancient parasite Trichomonas gallinae, in the recent deaths of
thousands of Pacific Coast band-tailed pigeons. The die-offs occurred
during multiple epidemics in California's Central Coast and Sierra
Nevada mountain ranges. Scientists named the new pathogen Trichomonas
stableri.
Avian ...
Computer-automated, time-lapse embryo photography may increase success of IVF
2014-07-02
PHILADELPHIA - Using computer-automated, time‐lapse photography of embryos in the laboratory during in-vitro fertilization may improve embryo selection, potentially increasing the chances of pregnancy among women undergoing the procedure, according to new research from the Perelman School of Medicine at the University of Pennsylvania and five other fertility centers. Results of the study were presented this week at the 30th annual European Society of Human Reproduction and Embryology (ESHRE) meeting in Munich, Germany.
The researchers at Penn and their collaborators ...
Novel intravaginal ring shows promise for HIV prevention
2014-07-02
A novel intravaginal ring implanted with anti-retroviral drug tablets, or pods, demonstrated sustained and controlled drug release and safety over 28 days, according to a paper published ahead of print in Antimicrobial Agents and Chemotherapy. The ring, designed to prevent transmission of HIV, was tested in pig-tailed macaque monkeys, and is engineered to be inexpensive, all the better for use in developing countries, says corresponding author Marc Baum.
One of the two drug combinations tested in the ring had been shown in three clinical trials to prevent HIV—some of ...
Veterans with muscle injuries and mental health conditions more likely to end service
2014-07-02
ANN ARBOR, Mich. — Sixty percent of U.S. Army soldiers who were unable to return to a military career after an Iraq deployment couldn't do so because of a muscle, bone or joint injury and nearly half had a mental health diagnosis, according to a new study from the University of Michigan and VA Ann Arbor Healthcare System.
Lower rank, which indicated socioeconomic status, was also a predictor of poor health outcomes among service members, according to the research that appears in the Journal of Bone and Joint Surgery and was led by a former Army Major who served in ...