Category Archives: Health Care

The Wage and Job Impacts of Hospitals on Local Labor Markets

Source: Anne M. Mandich, Jeffrey H. Dorfman, Economic Development Quarterly, Vol 31, Issue 2, 2017
(subscription required)

From the abstract:
This study examines the impact of hospitals on local labor markets in rural and urban counties. We measure the ability of hospitals, particularly in rural communities, to attract nonhealth-related employment and provide higher wage jobs to residents based on their education level. Results find hospital employees with an associate’s degree can expect a 21.4% wage premium, when compared with alternative opportunities, and those with a bachelor’s degree can earn 12.2% more working in a hospital. Hospitals are shown to be positively related to overall employment as well as exhibit positive employment spillover. For rural counties, a short-term general hospital is associated with 559 jobs in the county, 60 of which are hospital based and 499 are non–health care related. With the positive benefits on wages and non–health care job growth, hospitals have measurable positive labor market outcomes above their primary objective of providing health care access, particularly in rural counties.

Healthy Marketplace Index

Source: Health Care Cost Institute, 2017

The Healthy Marketplace Index measures the economic performance of health care markets across the country. It gives local policymakers, employers, and providers a benchmark as they work to improve health care value and affordability.

Explore Local Prices Using the Map:
– See how health care prices for inpatient, outpatient, and physician services in your local market stack up against a national average
– Understand how local prices for inpatient, outpatient, and physician services have changed over time
– Compare prices in your market to prices in other communities across the country

Do state spending differences create an unequal playing field for children?

Source: Julia B. Isaacs, Urban Institute, April 25, 2017

Some states spend less on their children than others, including public education, health, and social services costs. Arizona, for example, spent less than $4,900 per child in 2013, whereas New York spent slightly more than $12,200 per child (after adjusting for cost of living).

These wide disparities in public investment raise concerns about whether children nationwide are on equal footing when pursuing the American Dream. Though children’s outcomes are affected by many factors, health and education outcomes tend to be better in states that spend more on children.

Differences in K–12 education funding cause most of these differences. New York also spends more per capita than Arizona on Medicaid services for children, cash assistance, child welfare services, the Children’s Health Insurance Program, child care assistance, and child support enforcement. In addition, New York has a state earned income tax credit, but Arizona does not…..
Related:
Unequal Playing Field? State Differences in Spending on Children in 2013
Source: Julia B. Isaacs, Sara Edelstein, Urban Institute, Research Report, April 25, 2017

From the abstract:
For children to thrive and reach their full potential, they need adequate food and shelter, high-quality health care and education, safe environments, and supportive parents and families. Though families play a key role in meeting children’s needs, society also provides resources and services to support children’s healthy development.

Through their funding of public schools, health systems, and social services, state and local governments provide resources and services to support children’s healthy development. Although not all investments translate directly into better child outcomes, a wide disparity in public investments raises concerns about whether children from low-spending states are on equal footing when pursuing the American Dream….

The New Negative Rights: Abortion Funding and Constitutional Law after Whole Woman’s Health

Source: Mary Ziegler, Florida State University – College of Law, Public Law Research Paper No. 832, March 9, 2017

From the abstract:
The Hyde Amendment, a ban on the Medicaid funding of abortion, is once again at the center of the abortion wars. For the most part, critics of the Hyde Amendment argue that it authorizes discrimination against poor women. Using original archival research, this Article show that the amendment has had a far greater impact.

In popular debate, proponents of the Hyde Amendment helped to forge an idea of complicity-based conscience that has recently transformed fights about everything from same-sex marriage to contraceptive access. Constitutionally, the fight for the Hyde Amendment also revolutionized the rights-privilege distinction in constitutional law. In abortion-funding cases, the Court held that there was no constitutional problem with laws that created practical obstacles to abortion access so long as the obstacles themselves were not controlled or created by the state. This approach has resonated outside the context of abortion law.

The Court’s recent decision in Whole Woman’s Health v. Hellerstedt makes a challenge to the Hyde Amendment realistic and compelling. The cases upholding the Hyde Amendment regard as constitutional any burden on a woman’s right to choose that is neither created nor controlled by the government. Whole Woman’s Health explicitly rejected this approach, looking instead at how the formal terms of law interact with forces beyond the government’s control. For this reason, the Article shows that Whole Woman’s Health undermines the core premises of the Hyde Amendment and creates an opening for those seeking to revisit the distinction between negative and positive rights.

NHS research finds ‘direct link’ between staffing levels and death risk

Source: Shaun Lintern, HSJ, April 13, 2017
(subscription required)

….The project looked at staffing levels across 32 general medical and surgical wards at one NHS hospital between April 2012 and March 2015. More than 107,000 patients and almost 700,000 staff shifts were analysed using data from rostering systems and electronic observations, with the number of care hours per patient per day calculated and compared to mortality risks.

Key findings from the research were:
– When patients were exposed to low nursing hours during the first five days of their hospital stay, their risk of death significantly increased.
– For each day of low registered nurse staffing, the risk of death was increased by 3 per cent.
– Patients whose stay included days of high patient turnover in terms of admissions per nurse were associated with a 5 per cent increase in the risk of death.
– High levels of temporary staffing on the ward was associated with increased risk of death.
– When 1.5 or more nurse hours per patient day were provided by temporary staff the risk of death increased by 12 per cent.
– Each additional nurse hour per patient day was associated with a 2 per cent decrease in the chance of vital sign observations being missed…..

Professor Griffiths said the study was due to be published later this year. It will add to a growing body of NHS based research showing links between registered nurse staffing and patient outcomes. In December, a study by Professor Alison Leary found a “calculable” link between nurse numbers and patient outcomes, including 40 separate correlations with staffing levels…..
Related:
Registered nurse, healthcare support worker, medical staffing levels and mortality in English hospital trusts: a cross-sectional study
Source: Peter Griffiths, Jane Ball, Trevor Murrells, Simon Jones, Anne Marie Rafferty, BMJ Open, Volume 6, Issue 2, June 2016

Medical Parole and Aging Prisoners: A Qualitative Study

Source: George Pro, Miesha Marzell, Journal of Correctional Health Care, Online First, First published March 30, 3017
(subscription required)

From the abstract:
The population of geriatric prisoners in the United States will reach unprecedented levels in the coming decades. Geriatric prisoners are at increased risk for deteriorating health and experience the onset of disease earlier than the aging population at large. Medical parole is an underutilized program that allows aging prisoners to transition to community-based health care. This article presents original key informant interview data and analysis of the perceptions of medical parole. Three dominant themes emerged: (1) drugs and nonviolent crimes; (2) politics, costs, and consequences; and (3) quality of health care and sense of security in prison. Participants rejected the possibility that medical care provided is below the clinical standard or is the cause of geriatric prisoners’ deteriorating health and consistently implied that medical care at this prison is better than most Americans receive. Participants perceived their careers more as contributions to public health than criminal justice.

Why there’s more to fixing health care than the health care laws

Source: George Wang, The Conversation, March 29, 2017

….Disease treatment in conventional medicine primarily relies on the use of medications or invasive interventions to treat the dysfunctional body part(s). It generally does not address the health of the whole person at the root level. Such a peripheral approach to health care overlooks the fundamental causes of disease and misses opportunities to realize true healing and health.

To achieve truly successful health care, we need to emphasize the primacy of healing the whole person on a fundamental level. This will catalyze a paradigm shift in the way health care is provided and consumed. Research has shown that such an integrative medicine approach, which considers the mind-body connection, lifestyle choice, social and environmental influence, individuality of body constitution and the therapeutic relationship, not only yields good health outcomes but is cost-effective as well….

2017’s Cities Most Affected by Trumpcare

Source: Richie Bernardo, WalletHub, March 20, 2017

…According to estimates by the nonpartisan Congressional Budget Office, the recently proposed American Health Care Act — unofficially going by the names “Trumpcare” and “Ryancare” — would raise the average health-insurance premium for an individual policyholder by 15 to 20 percent just one or two years from now and lower federal subsidies. In contrast, the CBO projected, average Obamacare premiums would decrease 10 percent by 2026.

In order to gauge the AHCA’s impact on people who buy their own insurance, WalletHub’s analysts compared the differences in premium subsidies that the average households in 457 U.S. cities would receive under Obamacare and Trumpcare. Read on for our findings, commentary from a panel of experts and a full description of our methodology….

Source: WalletHub

The Impact of the Affordable Care Act on Health Coverage for Direct Care Worker

Source: Stephen Campbell, PHI, Issue Brief, March 2017

From the summary:
Direct care workers—nursing assistants, home health aides, and personal care aides who support older Americans and people with disabilities—are among America’s lowest paid workers, often struggling to access health coverage. However, new coverage numbers show that this workforce benefited substantially from the Affordable Care Act (ACA). Between 2010 and 2014, half a million direct care workers gained coverage. At the same time, the uninsured rate across this workforce decreased by 26 percent. As the Trump administration and the new Congress consider the future of the Affordable Care Act (ACA) and Medicaid, it is important to consider the impact of these changes on this critical U.S. workforce.