(Press-News.org) GAINESVILLE, Fla. -- UF Health researchers have found that care linked to heart attacks and chronic obstructive pulmonary disease, or COPD, among disabled adults covered by Medicaid has improved with the expansion of a new health care program in Texas over the last decade.
This approach to health care delivery is growing in popularity across the country, with the number of states implementing similar programs increasing from eight in 2004 to 18 in 2014. These programs have two components: managed care and home- and community-based health services. Managed care is reputed to be more cost effective and patient oriented than traditional models because it allows enrollees to receive coordinated services across a provider network. Home- and community-based health services offer disabled adults assistance with a variety of issues, such as bathing, food preparation and medication management.
"As more and more states look to adopt this model, it is crucial that we examine whether vulnerable populations, like disabled adults, are receiving the type of high-quality care that will promote their health and well-being," said Elizabeth A. Shenkman, Ph.D., chair of the department of health outcomes and policy in the UF College of Medicine and co-author of the study.
The research team examined aspects of enrollees' care under a program called STAR+PLUS that combines managed care and home- and community-based services in 28 Texas counties. The new program stems from a Medicaid policy change that allows for alternatives to traditional care, called managed care waivers. Specifically, the team examined care for certain chronic conditions among disabled enrollees ages 21 to 64 enrolled in the STAR+PLUS program.
Many aspects of routine care for chronic conditions like diabetes, asthma and high cholesterol remained the same between the traditional health care delivery model and the new approach to health care delivery, according to findings published in the journal Medical Care in July. However, care associated with acute events, such as heart attacks and worsening of COPD, adhered more closely to recommended standards of care for people with chronic conditions under the new approach to health care delivery compared with the traditional model.
"Receiving quality care not only helps patients with chronic conditions manage their diseases more effectively, it also enhances their ability to remain in their homes," said Martin Wegman, an M.D.-Ph.D. student in the UF College of Medicine and lead author of the article. "More than one-third of adults with disabilities covered by Medicaid have three or more chronic conditions, and they are more likely to have psychiatric illness and substance abuse issues than other Medicaid enrollees, making this population particularly vulnerable and in need of purposeful and competent care to support their health management."
In particular, 32 percent more patients who had heart attacks received a standard medication for controlling heart rhythms and reducing high blood pressure after being discharged. In addition, 28.5 percent more enrollees received the appropriate medication after their COPD worsened, compared to those in counties that remained under the traditional model.
To ensure these results stemmed only from implementing the new program, the research team studied the implementation of STAR+PLUS, using data from 2006 to 2010, and compared those findings to baseline measurements before the program took effect and to counties that had not yet implemented the program.
The researchers believe there are a few reasons why some aspects of care improved under the new program while others did not. The positive findings could stem from the fact that care is generally more coordinated within managed care, with follow-up care integrated after acute events in almost real time. Improvements were not observed in care for patients with diabetes or in managing high cholesterol, but it may take longer to observe improvements in these areas because they are not always associated with acute health care events.
"This study shows that disabled adults covered by Medicaid are more likely to receive improved care for serious health events with this new model, but more research is needed to identify the mechanisms by which these improvements occur," said Wegman. "More importantly, we need to know whether that improved care actually translates into improved health and quality of life for this vulnerable population."
INFORMATION:
Toxic is bad. Or is it? New studies of seagrasses reveal that they are surprisingly good at detoxifying themselves when growing in toxic seabed. But if seagrasses are stressed by their environment, they lose the ability and die. All over the world seagrasses are increasingly stressed and one factor contributing to this can be lack of detoxification.
Seagrass meadows grow along most of the world's coasts where they provide important habitats for a wide variety of life forms. However in many places seagrass meadows have been lost or seriously diminished and in several places, ...
Increasing the number of female speakers at a scientific conference can be done relatively quickly by calling attention to gender disparities common to such meetings and getting more women involved in the conference planning process, suggests a Johns Hopkins Bloomberg School of Public Health researcher.
Reporting online Aug. 4 in the journal mBio, Arturo Casadevall, MD, PhD, professor and chair of the W. Harry Feinstone Department of Molecular Microbiology and Immunology at the Bloomberg School, lays out how the American Society of Microbiology General Meeting was able ...
COLUMBUS, Ohio - New mothers take a close look at their personal relationship with their husband or partner when deciding how much they want him involved in parenting, new research finds.
The study found that mothers limited the father's involvement in child-rearing when they perceived their couple relationship to be less stable. Mothers also limited fathers who were less confident in their own ability to raise children.
The bottom line is that new mothers are assessing their partners' suitability to be a parent, said Sarah Schoppe-Sullivan, co-author of the study and ...
When it comes to courting, one common spider species is quick to learn, and that learning process involves eavesdropping on the visual cues of rivals to win their mate. The latest discovery in a research partnership represented by Alma College, The Ohio State University at Newark and the University of Cincinnati is the featured article in the August issue of the international research journal Animal Behaviour.
Previous studies by the researchers explored how brush-legged wolf spiders (Schizocosa ocreata) used visual eavesdropping to try to outdo a male rival's leg-tapping ...
Cholera is a diarrhoeal disease that is caused by an intestinal bacterium, Vibrio cholerae. Recently an outbreak of cholera in Haiti brought public attention to this deadly disease. In this work, the goal of our differential equation model is to find an effective optimal vaccination strategy to minimize the disease related mortality and to reduce the associated costs. The effect of seasonality in pathogen transmission on vaccination strategies was investigated under several types of disease scenarios, including an endemic case and a new outbreak case. This model is an extension ...
WASHINGTON -- Chronic marijuana use by teenage boys does not appear to be linked to later physical or mental health issues such as depression, psychotic symptoms or asthma, according to a study published by the American Psychological Association.
Researchers from the University of Pittsburgh Medical Center and Rutgers University tracked 408 males from adolescence into their mid-30s for the study, which was published in Psychology of Addictive Behaviors.
"What we found was a little surprising," said lead researcher Jordan Bechtold, PhD, a psychology research fellow ...
HIV can continue to grow in patients who are thought to be responding well to treatment, according to research by the University of Liverpool.
During treatment for HIV the virus hides in blood cells that are responsible for the patient's immune response. The virus does this by inserting its own genetic information into the DNA of the blood cells, called CD4 Tlymphocytes.
The study by the University's Institute of Infection and Global Health measured the levels of integrated HIV in the CD4 cells of patients undergoing uninterrupted treatment for up to 14 years, and ...
A super-dense star formed in the aftermath of a supernova explosion is shooting out powerful jets of material into space, research suggests.
In a study published today, a team of scientists in the Australia and the Netherlands has discovered powerful jets blasting out of a double star system known as PSR J1023+0038.
It was previously thought that the only objects in the Universe capable of forming such powerful jets were black holes.
PSR J1023+0038 contains an extremely dense type of star astronomers call a neutron star, in a close orbit with another, more normal ...
Flight simulators for the training of air pilots are well known. But what about riding simulators? Although the first horse simulator was used at the French National Equestrian School in Saumur already in the 1980s, riding simulators for dressage, show jumping, polo or racing, have become available only recently. They look like horses and respond to the aids of the rider via sensors which measure the force exerted by the reins and the rider's legs. Via a screen in front of the simulator, the rider immerses himself into a virtual equestrian world.
Simulators are aimed ...
Scientists first had to re-think death before they could develop a way of testing the potential harm to the environment caused by thousands of chemicals humankind uses each day.
Researchers led by Dr Roman Ashauer, of the Environment Department at the University of York, refined the technique of survival analysis used routinely by toxicologists, biologists, medical researchers and engineers. The research could pave the way for testing the estimated 15,000 substances discovered daily.
Survival analysis which helps to predict a huge range of functions such as the survival ...
