Health-Related Social Needs Following Onset of the COVID-19 Pandemic in Oregon.

Purpose: Efforts during the COVID-19 pandemic to address the health-related social needs (HRSN) of Medicare and Medicaid beneficiaries, such as food and housing, were insufficient. We examined HRSN data from the Accountable Health Communities study collected in Oregon to understand changes in these needs at the onset and during the first 2 years of the pandemic.

Methods: We conducted an interrupted time series analysis with data from 21,522 Medicare and Medicaid beneficiaries screened for overall HRSN between May 13, 2019 and December 24, 2021.

Blood stored in EDTA tubes provides accurate peanut basophil activation test results for 48 hours.

Background: The peanut basophil activation test (BAT) has demonstrated excellent diagnostic accuracy with heparinized blood, but its clinical utility is limited by the short stability of samples stored in this anticoagulant.

Objective: Using EDTA anticoagulated blood, these investigations determined if Peanut BAT sample stability can be extended to 2 days, the minimum stability requirement for diagnostic tests currently offered through American reference laboratories.

Methods: Peanut non-allergic control (NAC), peanut IgE sensitized (PS), and peanut allergic (PA) children aged 6 months through 17 years were recruited from members of Kaiser Permanente Southern California.

Patients' Willingness to Accept Social Needs Navigation After In-Person versus Remote Screening.

Background: Social needs screening and referral interventions are increasingly common in health care settings. Although remote screening offers a potentially more practical alternative to traditional in-person screening, there is concern that screening patients remotely could adversely affect patient engagement, including interest in accepting social needs navigation.

Methods: We conducted a cross-sectional study using a multivariable logistic regression analysis and data from the Accountable Health Communities (AHC) model in Oregon.

"It Made Me Feel like Things Are Starting to Change in Society:" A Qualitative Study to Foster Positive Patient Experiences during Phone-Based Social Needs Interventions.

Many healthcare organizations are screening patients for health-related social needs (HRSN) to improve healthcare quality and outcomes. Due to both the COVID-19 pandemic and limited time during clinical visits, much of this screening is now happening by phone. To promote healing and avoid harm, it is vital to understand patient experiences and recommendations regarding these activities.

The Organizational Risks Of Cross-Sector Partnerships: A Comparison Of Health And Human Services Perspectives.

What factors do health and human services leaders assess when considering collaborative opportunities, and what do they worry about? How organizational decision makers perceive risk can influence the success or failure of cross-sector partnerships designed to address social determinants of health. This article captures insights from leaders at twenty-two health and human services organizations in Oregon who were involved in the Centers for Medicare and Medicaid Services' Accountable Health Communities initiative in 2019 and familiar with efforts by their local health systems to identify people with unmet social needs and refer them to community programs. We explore perspectives on the risks and benefits associated with this cross-sector work.

Effect of omalizumab on outcomes in patients with aspirin-exacerbated respiratory disease.

The current treatment for patients with aspirin-exacerbated respiratory disease (AERD) who have uncontrolled asthma or chronic rhinosinusitis is aspirin desensitization. For patients who are unable to undergo or do not benefit from aspirin desensitization, treatment with biologics is an option, although efficacy data for AERD is scarce. We reported a series of patients with AERD who were started on omalizumab and measured the outcomes to assess improvement.

Angioedema deaths in the United States, 1979-2010.

Background: Hospital admission data indicate that the angioedema incidence has increased during the past several decades. Little is known about mortality trends.

Objectives: To count the number of deaths associated with angioedema in the United States, investigate correlations with age, sex, race, and other contributory causes, and analyze trends from 1979 to 2010.

Categorization of allergic disorders in the new World Health Organization International Classification of Diseases.

Background: Although efforts to improve the classification of hypersensitivity/allergic diseases have been made, they have not been considered a top-level category in the International Classification of Diseases (ICD)-10 and still are not in the ICD-11 beta phase linearization. ICD-10 is the most used classification system by the allergy community worldwide but it is not considered as appropriate for clinical practice. The Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) on the other hand contains a tightly integrated classification of hypersensitivity/allergic disorders based on the EAACI/WAO nomenclature and the World Health Organization (WHO) may plan to align ICD-11 with SNOMED CT so that they share a common ontological basis.

Use of commercial anti-penicillin IgE fluorometric enzyme immunoassays to diagnose penicillin allergy.

Background: The intermittent unavailability of penicilloyl-polylysine since September 2000 has focused interest on commercial anti-penicillin IgE fluorometric enzyme immunoassay (FEIA) tests to evaluate penicillin allergy. There has been no published comparison of commercial anti-penicillin IgE FEIAs and penicillin skin testing performed in the United States.

Objective: To determine whether the current commercial anti-penicillin IgE FEIAs can replace or augment penicillin skin testing and oral challenges when evaluating individuals with a history of penicillin allergy for future therapeutic penicillin tolerance.

The association of family continuity with infant health service use.

Purpose: Continuity of care is a fundamental component of family medicine that has been shown to improve health care quality. Family continuity, when different family members are seen by the same clinician or practice, has not been well studied.

Methods: We performed a retrospective cohort study of Medicaid enrollees in Oregon using administrative data.

Penicilloyl-polylysine stability and clinical use over time.

Background: The major penicillin skin test reagent, penicilloyl-polylysine, has not been commercially available since October 2004. The minimal concentration of penicilloyl-polylysine necessary for safe penicillin skin testing has not been determined.

Methods: Penicillin skin testing was performed on 596 individuals between October 2004 and October 2006 using out-of-date commercially produced penicilloyl-polylysine as part of a complete panel of reagents.

Detection of IgE antibodies to bacitracin using a commercially available streptavidin-linked solid phase in a patient with anaphylaxis to triple antibiotic ointment.

Background: Bacitracin is a commonly used topical antibiotic that has on occasion been reported to cause anaphylaxis. Evidence of the role of bacitracin specific IgE in such reactions has been demonstrated by skin testing. Because of the potential for provoking a systemic reaction by skin testing, it would be advantageous to develop an in vitro test for bacitracin specific IgE.

Utility of an intervention to detect depression in primary care.

Objective: To determine whether a 3-part intervention consisting of raising physicians` awareness of depression, mass depression screening using a 2-item version of the Prime MD Questionnaire, and communicating the results of the screening to the physician, will improve detection and treatment of depression in a primary care setting.

Methods: The study took place in Hilsboro, Oregon between July 1, 2001 and September 30, 2001. We distributed educational materials to the primary care physicians 2 months before screening patients.

Health policy roundtable--view from the state legislature: translating research into policy.

This roundtable examines the role of health services research from the perspective of the state legislature. Four research and policy experts-each of whom is a current or former legislator-explore how research can be translated effectively into state health policy, and how researchers and legislators can communicate clearly with one another and engage in productive collaborations.

Effects of a prior-authorization policy for celecoxib on medical service and prescription drug use in a managed care Medicaid population.

Background: Prior authorization (PA) is a poorly studied but commonly employed policy used by health care payers to manage the rising costs of pharmacy benefits.

Objective: The aim of this study was to evaluate the intended and unintended effects of a PA policy for celecoxib on pharmacy and medical-service utilization in a Medicaid managed-care organization.

Methods: This was a retrospective, interrupted time-series analysis of 22 monthly health-related utilization rates from January 1, 1999, to October 31, 2000.

Kaiser Permanente's Convergent Medical Terminology.

This paper describes Kaiser Permanente's (KP) enterprise-wide medical terminology solution, referred to as our Convergent Medical Terminology (CMT). Initially developed to serve the needs of a regional electronic health record, CMT has evolved into a core KP asset, serving as the common terminology across all applications. CMT serves as the definitive source of concept definitions for the organization, provides a consistent structure and access method to all codes used by the organization, and is KP's language of interoperability, with cross-mappings to regional ancillary systems and administrative billing codes.

Optimal skin prick wheal size for diagnosis of cat allergy.

Background: The skin prick test is the diagnostic procedure of choice for determination of immediate hypersensitivity. A wheal diameter of 3 mm or larger is generally accepted as the cutoff for a positive test result, although the validity of this assumption has not been rigorously demonstrated.

Objective: To determine the skin prick wheal size that best identifies clinical allergy to cat.

A practice-based study of patients with acute and chronic low back pain attending primary care and chiropractic physicians: two-week to 48-month follow-up.

Objective: This study reports pain and disability outcomes up to 4 years for chiropractic and medical patients with low back pain (LBP) and assesses the influence of doctor type and pain duration on clinical outcomes.

Design: Prospective, longitudinal, nonrandomized, practice-based, observational study.

Setting: Fifty-one chiropractic and 14 general practice community clinics.

Chiropractic and medical care costs of low back care: results from a practice-based observational study.

Objective: To compare the 1-year costs for patients treated for acute and chronic ambulatory low back pain by medical physicians and chiropractors.

Study Design: Prospective, practice-based observational study undertaken in 13 general medical practices and 51 chiropractic community-based clinics.

Patients And Methods: Of 2872 study patients, 2263 had complete 1-year records of services.