5 Findings From the September 2018 Issue of AJMC®
With a focus on social determinants, the September 2018 issue of The American Journal of Managed Care® (AJMC®) yields new insights on the health effects of food insecurity, health literacy, language barriers, and more. Here are 5 findings from the research published in the issue.
Researchers, policy makers, and health systems alike have started to recognize the importance of
With a focus on social determinants, the September issue of The American Journal of Managed Care® yields new insights on the health effects of food insecurity, health literacy, language barriers, and more. Here are 5 findings from the research published in the issue.
1. Food insecurity linked to worse utilization and cost outcomes
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Although the study does not explore whether these measures improve when patients become food-secure, the authors conclude that screening for food insecurity in clinical settings and connecting needy patients with community resources may be useful in curtailing food insecurity and shifting patterns of healthcare utilization to benefit patients and health systems.
2. “High-touch” care improves outcomes and lowers costs in at-risk seniors
A model of high-intensity care that gives Medicare Advantage patients access to benefits including frequent physician visits and free transportation resulted in fewer hospital admissions and 28% lower healthcare costs compared with standard care,
Reyan Ghany, MD, and coauthors emphasize the potential role of frequent patient—physician contact in eliciting these outcomes, but the courtesy transportation offered in the Chen Medical model may have also been an important component of its success. Access to nonemergency transportation through Medicaid
3. Health literacy is associated with some preventive health screening behaviors
Authors Anil N.F. Aranha, PhD, and Pragnesh J. Patel, MD,
According to the authors, these results showed that health literacy scales may not be the most effective way to predict preventive behaviors and disease control among this population, especially because such assessments require a longer time to administer among elderly patients. Still, they suggested further investigation into the observed trends, particularly the strong association between body mass index and one of the literacy scales.
4. No evidence that language barriers result in worse lipid or blood pressure control
Despite the previous finding that language barriers between physicians and Latino patients with diabetes are associated with worse glycemic control,
As for the potential reasons that language barriers between Latino patients with limited English proficiency and non—Spanish-speaking doctors did not result in poorer lipid or blood pressure control, the authors hypothesized that these disease measures may be more easily controlled via adherence to medication, whereas glycemic control also requires lifestyle changes and patient buy-in that might be easier to achieve through a language-concordant clinical encounter.
5. After-hours paramedic care at home can reduce need for emergency visits
Lisa I. Iezzoni, MD, MSc, and coauthors
About 70% of patients who received an ACCP visit thought that it spared them an ED visit, which the authors noted is particularly important for the population served by the program, many of whom have felt stigmatized in EDs due to their sociodemographic attributes or physical and behavioral health conditions. Delivering care at home could allow patients to obtain needed care when they would have otherwise avoided an uncomfortable trip to the ED.
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