The Effect Of The Affordable Care Act On Cancer Detection Among The Near-Elderly.

During the period 2014-16 the Affordable Care Act (ACA) dramatically reduced rates of uninsurance and underinsurance in the United States. In this study we estimated the effects of these coverage increases on cancer detection among the near-elderly population (ages 60-64). Using 2010-16 Surveillance, Epidemiology, and End Results (SEER) Program data, we estimated that the ACA increased cancer detection among this population.

When Guidelines Conflict: A Case Study of Mammography Screening Initiation in the 1990s.

Background: Cancer screening guidelines communicate important information to patients and physicians regarding the costs and benefits of screening. Currently, guideline recommendations from major organizations conflict regarding the age of mammography screening initiation. To understand current and future U.

TRICARE Applied Behavior Analysis (ABA) Benefit: Comparison with Medicaid and Commercial Benefits.

This study compared the Applied Behavior Analysis (ABA) benefit provided by TRICARE as an early intervention for autism spectrum disorder with similar benefits in Medicaid and commercial health insurance plans. The sponsor, the Office of the Under Secretary of Defense for Personnel and Readiness, was particularly interested in how a proposed TRICARE reimbursement rate decrease from $125 per hour to $68 per hour for ABA services performed by a Board Certified Behavior Analyst compared with reimbursement rates (defined as third-party payment to the service provider) in Medicaid and commercial health insurance plans. Information on ABA coverage in state Medicaid programs was collected from Medicaid state waiver databases; subsequently, Medicaid provider reimbursement data were collected from state Medicaid fee schedules.

The Effect of the 2009 Influenza Pandemic on Absence from Work.

In July 2009, the World Health Organization declared the first flu pandemic in nearly 40 years. Although the health effects of the pandemic have been studied, there is little research examining the labor productivity consequences. Using unique sick leave data from the Chilean private health insurance system, we estimate the effect of the pandemic on missed days of work.

How Effective is Population-Based Cancer Screening? Regression Discontinuity Estimates from the US Guideline Screening Initiation Ages.

We estimate the marginal benefits of population-based cancer screening by comparing cancer test and detection rates on either side of US guideline-recommended initiation ages (age 40 for breast cancer and age 50 for colorectal cancer during the study period). Using a regression discontinuity design and self-reported test data from national health surveys, we find test rates for breast and colorectal cancer increase at the guideline age thresholds by 109% and 78%, respectively. Data from cancer registries in twelve US states indicate that cancer detection rates increase at the same thresholds by 50% and 49%, respectively.

How Deployments Affect the Capacity and Utilization of Army Treatment Facilities.

The Army was concerned about how the Army Force Generation (ARFORGEN) cycle, established to provide a predictable process by which Army units deploy, reset, and train to become ready and available to deploy again, affected the lives of Army soldiers and their families. In particular, the Vice Chief of Staff of the Army asked RAND Arroyo Center to determine whether ARFORGEN resulted in ebbs and flows in the ability of Army military treatment facilities (MTFs) to provide medical care and respond to changes in family needs as soldiers and care providers deploy and return home. This concern is especially well-founded because military health research has shown that family members of service members utilize health care differently during deployment than when the soldier is at home.

The validity of dependence as a health outcome measure in Alzheimer's disease.

Background: Relating to Alzheimer's disease (AD), dependence has been defined as the increased need for assistance due to deterioration in cognition, physical functioning, and behavior. Our objective was to evaluate the association between dependence and measures of functional impairment.

Methods: Data were compiled by the National Alzheimer's Coordinating Center.

Measuring Alzheimer disease progression with transition probabilities: estimates from NACC-UDS.

Objectives: Estimate the probabilities, for Alzheimer's disease (AD) patients, of transitioning between stages of disease severity (mild, moderate, severe, dead) and care settings (community, institutional).

Methods: Data were compiled by the National Alzheimer Coordinating Center. The main analyses were limited to 3,852 patients who were 50 years old, diagnosed with possible/probable AD and had at least two center visits.

Are United States and Canadian cancer screening rates consistent with guideline information regarding the age of screening initiation?

Objective: To understand whether US and Canadian breast, colorectal and prostate cancer screening test utilization is consistent with US and Canadian cancer screening guideline information with respect to the age of screening initiation.

Design: Cross-sectional, regression discontinuity.

Setting: Canada and the US.

Using cost-effectiveness analysis to support research and development portfolio prioritization for product innovations in measles vaccination.

Background: Several potential measles vaccine innovations are in development to address the shortcomings of the current vaccine. Funders need to prioritize their scarce research and development resources. This article demonstrates the usefulness of cost-effectiveness analysis to support these decisions.

Workplace efforts to promote influenza vaccination among healthcare personnel and their association with uptake during the 2009 pandemic influenza A (H1N1).

Background: Survey data suggest that, in a typical year, less than half U.S. healthcare personnel (HCP) are vaccinated for influenza.

Adherence to cancer screening guidelines across Canadian provinces: an observational study.

Background: Cancer screening guidelines reflect the costs and benefits of population-based screening based on evidence from clinical trials. While most of the existing literature on compliance with cancer screening guidelines only measures raw screening rates in the target age groups, we used a novel approach to estimate degree of guideline compliance across Canadian provinces for breast, colorectal and prostate cancer screening. Measuring compliance as the change in age-specific screening rates at the guideline-recommended initiation age (50), we generally found screening patterns across Canadian provinces that were not consistent with guideline compliance.

Are U.S. cancer screening test patterns consistent with guideline recommendations with respect to the age of screening initiation?

Background: U.S. cancer screening guidelines communicate important information regarding the ages for which screening tests are appropriate.

The causal effect of health insurance on utilization and outcomes in adults: a systematic review of US studies.

Background: No current consensus exists on the causal effect of gaining or losing health insurance on health care utilization and health outcomes.

Objective: To systemically search and review available evidence of estimated causal effects of health insurance on health care utilization and/or health outcomes among nonelderly adults in the United States.

Research Design: A systematic search of 3 electronic databases (PubMed, JSTOR, EconLit) was performed.