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This Week in Managed Care: November 16, 2018
November 16, 2018

What We're Reading: Long-Acting Contraceptives; Heart Surgery and Opioids; Undocumented and Seeking Care

AJMC Staff
Of US women between the ages of 15 and 49, 64.9% use some form of contraception, and the use of long-acting reversible contraceptives is increasing; people with prolonged opioid use have an increased risk for cardiovascular problems, but they are also more likely to develop major surgery complications; there are an estimated 11 million undocumented immigrants in the United States, and they struggle to receive basic medical care.

More Women Are Turning to Long-Acting Contraceptives

Of US women between the ages of 15 and 49, 64.9% use some form of contraception, and the use of long-acting reversible contraceptives (LARCs) is increasing. According to The New York Times, more than 10% of women use LARCs, which are hormone-releasing rods placed under the skin or intrauterine devices. From 2011 to 2015, 8% of women were using LARCs, which increased to 11.3% in the 2015 to 2017 period. The most common form of contraception is female sterilization (18.6%), followed by oral contraceptives (12.6%).

 

Opioid Use Is Up and Increasing Surgical Complications

People with prolonged opioid use have an increased risk for cardiovascular problems, but they are also more likely to develop major surgery complications. While mortality rates are similar between patients with and without opioid use disorder (OUD) who underwent heart surgery, those with OUD were more likely to have serious complications, reported Reuters. These surgical complications result in longer hospital stays and higher costs. The research in JAMA Surgery also found that people with OUD having heart surgery were almost 2 decades younger than patients having heart surgery without OUD.

 

The Difficulty of Seeking Healthcare While Undocumented

There are an estimated 11 million undocumented immigrants in the United States, and they struggle to receive basic medical care. A new article in Vice highlighted the hurdles these immigrants face when seeking care. In addition to approximately 40% being uninsured, they have been seeking less care as the immigration debate continues. The article follows one woman’s journey for a doctor’s appointment for an infection in her foot due to a growing ulcer, and the challenges she faces: traveling 3 hours to the doctor’s office, a language barrier, paying for public transportation, and more.

 
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