Research Roundup: Medicaid Eligibility, ICU Infection Rates, Heartburn Drugs’ Side Effects, And More

Urban Institute: Quickly Expanding Medicaid Eligibility As An Urgent Response To The Coronavirus Pandemic
Economists believe that a global recession is unavoidable amidst the Coronavirus crisis, and there are already reports of large spikes in unemployment. Since the health insurance of many Americans is tied to their employment, the US is likely to also see large increases in uninsured people with newly lower incomes. The 15 states that have not yet expanded Medicaid eligibility under the Affordable Care Act are least prepared to assist the many workers expected to simultaneously lose their jobs and their health insurance coverage. Medicaid enrollment is not limited to a narrow open enrollment period (as is the case with most private insurance), so eligible people can enroll at any time during the year. (Blumberg and Mann, 3/24)

JAMA Internal Medicine: Association Between Medicaid Expansion And Rates Of Opioid-Related Hospital Use
In this difference-in-differences study evaluating institutions in 46 states and the District of Columbia, the post-2014 Medicaid expansions were associated with a statistically significant 9.7% reduction in the rate of opioid-related inpatient hospitalizations. There did not appear to be any associations between the pre-2014 or post-2014 Medicaid expansions on the rate of opioid-related emergency department visits. (Wen et al, 3/23)

CIDRAP: Multinational ICU Study Finds High Rate Of Infection, Antibiotic Use
A high prevalence of suspected or proven infections, with a substantial risk of in-hospital mortality for infected patients. The results of the multinational point-prevalence study, published yesterday in JAMA, found that, over a 24-hour period, 54% of ICU patients in 88 countries had a suspected or proven infection, with gram-negative bacterial infections accounting for more than two thirds of those infections. The in-hospital mortality rate was 30% among patients with infections, with the risk of death higher for patients with certain antibiotic-resistant pathogens. (Dall, 3/25)

The New York Times: Heartburn Drugs Tied To Bone Fractures In Children
Proton pump inhibitors — the widely used heartburn drugs — may slightly increase the risk for bone fractures in children, a new study suggests. P.P.I.’s are approved for use in children over a year old for treating gastroesophageal reflux disease, the persistent regurgitation of food and stomach acid. Using Swedish government health records, researchers studied 231,866 children, half of whom had been prescribed P.P.I.’s. (Bakalar, 3/23)

CIDRAP: Hopeful Results From Trials Of Dengue Vaccine Candidate
Phase 2 and 3 randomized, controlled clinical trials of Takeda’s tetravalent (four-strain) dengue vaccine candidate show that it is safe, produces immunity in children, and protects against the disease—regardless of previous exposure to different strains of the virus, according to studies published in yesterday’s The Lancet.In the phase 3 double-blind trial, 20,099 children 4 to 16 years old at 26 centers in endemic areas of Asia and Latin America were randomly assigned to receive two doses of the live TAK-003 vaccine or two doses of placebo 3 months apart from September 2016 to August 2017. (Van Beusekom, 3/18)

Urban Institute: Estimates Of The Implications Of Public Option And Capped Provider Payment Rate Reforms
In this report, Urban Institute researchers estimate the coverage and spending implications of various forms of a public health insurance option introduced as an alternative to private plans currently available to consumers. The public option would be a plan structured the same as private insurance plans currently available in the applicable markets, but it would also share some characteristics with the traditional Medicare fee-for-service plan. Its actuarial value, covered benefits, and cost-sharing structure would reflect the private options in the market in which it was introduced (e.g., a Marketplace qualified health plan in the nongroup market or a typical plan in the employer market). However, a public option would have a broad network, like the traditional Medicare plan, and would pay providers at Medicare rates or some multiple thereof that would set prices between Medicare’s payment rates and those of commercial insurers today. (Blumberg, Holahan, McMorrow and Simpson, 3/18)