Affiliates' Research in Medical Journals, Spring 2022

Trends in Mortality Rates among Medicare Enrollees with Alzheimer’s Disease and Related Dementias before and during the Early Phase of the COVID-19 Pandemic
Gilstrap L, Zhou W, Alsan M, Nanda A, Skinner JS. JAMA Neurology, February 2022.

This retrospective cross-sectional study examined deaths among elderly Medicare beneficiaries with and without Alzheimer’s disease and related dementias (ADRD), living in the community versus nursing homes. Data were from 53,640,888 beneficiaries of fee-for-service Medicare Parts A and B aged 65 and over, between January 1, 2019 and December 31, 2020. Mortality rates from March through December 2020 were compared with those from March through December 2019. Excess mortality was calculated by comparing mortality rates in 2020 with rates in 2019 in each of 306 hospital referral regions in the US. Compared with 2019, adjusted mortality in 2020 was 12.4 percent higher among enrollees without ADRD and 25.7 percent higher among enrollees with ADRD, with even higher percentages for Asian (36.0 percent), Black (36.7 percent), and Hispanic (40.1 percent) populations with ADRD. The hospital referral regions in the lowest quintile for COVID-19 infections in 2020 had no excess mortality among enrollees without ADRD but 8.8 percent higher mortality among community-dwelling enrollees with ADRD and 14.2 percent higher mortality among enrollees with ADRD living in nursing homes. These results suggest that the COVID-19 pandemic may be associated with excess mortality among older adults with ADRD, especially for Asian, Black, and Hispanic populations and people living in nursing homes, even in areas with low COVID-19 prevalence.

False-Positive Results in Rapid Antigen Tests for SARS-CoV-2
Gans JS, Goldfarb A, Agrawal AK, Sennik S, Stein J, Rosella L. JAMA 327(5), January 2022, pp. 485–486.

To address concerns about the extent to which rapid antigen tests for SARS-CoV-2 can result in false-positive results, this study investigated the incidence of false-positive results in a large sample of rapid antigen tests used to serially screen asymptomatic workers throughout Canada. Asymptomatic employees at 537 workplaces were screened twice weekly from January 11 to October 13, 2021, on a voluntary basis. Over this period, Canada experienced two significant Delta-variant-driven waves from March to June and August to October. Approximately two-thirds of tests were trackable with a lot number. There were 903,408 rapid antigen tests conducted for workplaces, with 1,322 positive results (0.15 percent), of which 1,103 had results of PCR tests within 24 hours. False-positive rapid test results (those followed by a negative confirmatory PCR) were matched to lot number and test manufacturer. The number of false-positive results was 462 (0.05 percent of tests and 42 percent of positive test results with PCR information). However, of these, 278 false-positive results (60 percent) occurred in two workplaces 675 km apart run by different companies between September 25 and October 8, 2021. All of the false-positive test results from these two workplaces were drawn from a single batch of Abbott’s Panbio COVID-19 Ag Rapid Test Device. The cluster of false-positive results from one batch was likely the result of manufacturing issues rather than implementation, which demonstrates the importance of having a comprehensive data system to quickly identify potential issues. The overall rate of false-positive results among the total rapid antigen test screens was very low, below 1 percent, consistent with other, smaller studies.

Association between Assistance with Medicaid Enrollment and Use of Health Care after Incarceration among Adults with a History of Substance Use
Burns ME, Cook S, Brown LM, Dague L, Tyska S, Hernandez Romero K, McNamara C, Westergaard RP. JAMA Network Open 5(1), January 2022, e2142688.

The transition from prison to community is characterized by elevated morbidity and mortality, particularly owing to drug overdose. However, most formerly incarcerated adults with substance use disorders do not use any health care, including treatment for substance use disorders, during the initial months after incarceration. This retrospective cohort study evaluated the effects on health care use of a prerelease Medicaid enrollment assistance program implemented in Wisconsin in January 2015. It followed 16,307 adults aged 19 to 64 years (mean age 35.5 years) with a history of substance use who were released from state prison between April 1, 2014, and December 31, 2016, comparing the use of Medicaid-reimbursed health care within 30 days of prison release before and after program implementation using an intention-to-treat analysis. The likelihood of outpatient care use within 30 days of release increased significantly (p < .001) after implementation of enrollment assistance relative to baseline, by 7.7 percentage points for any visit, 0.7 percentage points for an opioid use disorder visit, 1.0 percentage point for any substance use disorder visit, and 0.4 percentage points for receipt of medication for opioid use disorder. There was no significant change in use of the emergency department, and the probability of an inpatient stay increased by 0.4 percentage points. These results suggest that prerelease Medicaid enrollment assistance was associated with increased use of outpatient health care after incarceration and highlights the benefits of making this assistance available within correctional settings.

Effects of the 2014 Affordable Care Act Medicaid Expansions on Health Care Access and Health Status of Poor Adults Aged 60–64 Years: Evidence from the First Six Years
Bin Abdul Baten R, Wehby GL. The Gerontologist, December 2021.

Those aged 60–64 are closer to retirement and have more chronic conditions and unmet health care needs than younger adults. This study employed a difference-in-differences design comparing health care access and health status of low-income adults aged 60–64 years in states that expanded Medicaid in 2014 under the Affordable Care Act and nonexpansion states over 6 years postexpansion. The data are from over 25,000 respondents to the 2011–19 Behavioral Risk Factor Surveillance System national telephone survey who were aged 60–64 years and had incomes below the Federal Poverty Level. In expansion states, the rate of having any health care coverage increased by 8.5 percentage points (p < .01), while the rate of forgoing a needed doctor’s visit due to cost declined by 6.6 percentage points (p < .01). Similarly, rates of having a personal doctor/provider and completing a routine checkup increased by 9.1 (p < .01) and 4.8 (p < .1) percentage points, respectively. Moreover, days not in good physical health in the past 30 declined by 1.5 days (p < .05), with suggestive evidence of a decline in days not in good mental health and improvement in self-rated health. This evidence that Medicaid expansions have improved health care access and health status of poor near-elderly adults suggests the benefits of policies that bridge coverage for this group.

Adolescent Chronic Health Conditions and School Disconnectedness
James C, Corman H, Noonan K, Reichman N, Jiménez M. Journal of Developmental and Behavioral Pediatrics 43(2), February/March 2022, pp. 87−95.

Mortality among US Veterans after Emergency Visits to Veterans Affairs and Other Hospitals: Retrospective Cohort Study
Chan DC, Danesh K, Costantini S, Card D, Taylor L, Studdert DM. BMJ 376, February 2022, e068099.

Eviction, Healthcare Utilization, and Disenrollment among New York City Medicaid Patients
Schwartz GL, Feldman JM, Wang SS, Glied SA. American Journal of Preventive Medicine 62(2), February 2022, pp. 157−164.

Trends in Medicaid Enrollment and Disenrollment during the Early Phase of the COVID-19 Pandemic in Wisconsin
Dague L, Badaracco N, DeLeire T, Sydnor J, Tilhou AS, Friedsam D. JAMA Health Forum 3(2), February 2022, e214752.

Effects of the ACA Medicaid Expansions on Access and Health by Nurse Practitioner Scope of Practice Laws
Bin Abdul Baten R, Wehby GL. Nursing Outlook, January 2022.

Gestational Age, Newborn Metabolic Markers, and Academic Achievement
Wehby GL. International Journal of Environmental Research and Public Health, January 2022.

Racial and Ethnic Disparities in Dental Services Use Declined after Medicaid Adult Dental Coverage Expansions
Wehby GL, Lyu W, Shane D. Health Affairs 41(1), January 2022, pp. 44−45.

The Impact of Household Health Insurance Coverage Gains on Children’s Achievement in Iowa: Evidence from the ACA
Wehby GL. Health Affairs 41(1), January 2022, pp. 35−43.

Pooled Testing Efficiency Increases with Test Frequency
Augenblick N, Kolstad J, Obermeyer Z, Wang A. PNAS 119(2), January 2022.

Further Decoding the Mystery of American Pain: The Importance of Work
Blanchflower DG, Bryson AJ. PLOS ONE, January 2022.

Characteristics of Hydroxychloroquine Dispensing in the United States, January to May 2020
Levin Z, Chang J, Karaca-Mandic P, Duarte-Garcia A, Jeffery MM. Journal of General Internal Medicine 37, January 2022, pp. 176−178.

Coverage Denials: Government and Private Insurer Policies for Medical Necessity in Medicare
Schwartz AL, Chen Y, Jagmin CL, Verbrugge DJ, Brennan TA, Groeneveld PW, Newhouse JP. Health Affairs 41(1), January 2022, pp. 120−128.

Impact of Spousal Death on Healthcare Costs and Use among Medicare Beneficiaries: NHATS 2011–2017
Lei L, Norton EC, Strominger J, Maust DT. Journal of General Internal Medicine, January 2022.

Increasing Medicaid’s Stagnant Asset Test for People Eligible for Medicare and Medicaid Will Help Vulnerable Seniors
Cornelio N, McInerney MP, Mellor JM, Roberts ET, Sabik LM. Health Affairs 40(12), December 2021, pp. 1943−1952.

Association of Opioid Fills with Centers for Disease Control and Prevention Opioid Guidelines and Payer Coverage Policies: Physician, Insurance and Geographic Factors
Togun AT, Karaca-Mandic P, Wurtz R, Jeffery MM, Beebe T. International Journal of Clinical Pharmacy, December 2021.

Association of Fluoroquinolone Prescribing Rates with Black Box Warnings from the US Food and Drug Administration
Sankar A, Swanson KM, Zhou J, Jena A, Ross J, Shah ND, Karaca-Mandic P. JAMA Network Open, December 2021.

How Is the Distribution of Psychological Distress Changing over Time? Who Is Driving These Changes? Analysis of the 1958 and 1970 British Birth Cohorts
Gondek D, Lacey RE, Blanchflower D, Patalay P. Social Psychiatry and Psychiatric Epidemiology, November 2021.

Assessing Utilization of a Marketwide Price Transparency Tool
Kim G, Glied S. American Journal of Managed Care 27(11), November 2021.

Growth in ACA-Compliant Marketplace Enrollment and Spending Risk Changes during the COVID-19 Pandemic
Hsu J, Chin CY, Weiss M, Cohen M, Sastry J, Katz-Christy N, Bertko J, Newhouse JP. Health Affairs 40(11), November 2021, pp. 1722−1730.

The Organ Procurement Costs of Expanding Deceased Donor Organ Acceptance Criteria: Evidence from a Cost Function Model
Cheng XS, Held PJ, Dor A, Bragg-Gresham JL, Tan JC, Scandling JD, Chertow GM, Roberts JP. American Journal of Transplantation 21(11), November 2021, pp. 3694−3703.

Financial Impacts of the Medicaid Expansion on Community Health Centers
Luo Q, Moghtaderi A, Markus A, Dor A. Health Services Research, October 2021.

Child and Adolescent Psychosocial Support Programs following Natural Disasters – A Scoping Review of Emerging Evidence
Gibbs L, Marinkovic K, Nursey J, Tong LA, Tekin E, Ulubasoglu M, Callard N, Cowlishaw S, Cobham V. Current Psychiatry Reports 23(12), October 2021, 82.

Association between Statewide COVID-19 Lottery Announcements and Vaccinations
Dave D, Friedson AI, Hansen B, Sabia JJ. JAMA Health Forum 2(10), October 2021, e213117.

Association of Three CDC Opioid Prescription Guidelines for Chronic Pain and Two Payer Pharmacy Coverage Changes on Opioid Initiation Practices
Togun AT, Karaca-Mandic P, Wurtz R, Jeffery M, Beebe T. Journal of Managed Care and Specialty Pharmacy 27(10), October 2021.

Trends in Testosterone Prescriptions for Older Men Enrolled in Commercial Insurance and Medicare Advantage
Everhart A, Harper K, Jeffery MM, Levin Z, Morden NE, Sankar A, Karaca-Mandic P. JAMA Network Open 4(9), September 2021, e2127349.

Physician Network Connections Associated with Faster De-adoption of Dronedarone for Permanent Atrial Fibrillation
Stecher C, Everhart A, Smith LB, Jena A, Ross JS, Desai NR, Shah N, Karaca-Mandic P. Circulation: Cardiovascular Quality and Outcomes 14(10), September 2021.

Family Care Availability and Implications for Informal and Formal Care Used by Adults with Dementia in the US
Choi H, Heisler M, Norton EC, Langa KM, Cho TC, Connell CM. Health Affairs 40(9), September 2021, pp. 1359–1367.

Quality and Cost in Community Health Centers
Carey K, Luo Q, Dor A. Medical Care 59(9), September 2021, pp. 824−828.

Resource Profile and User Guide of the Polygenic Index Repository
Becker J, Burik CAP, Goldman G, Wang N, Jayashankar H, Bennett M, Belsky DW, Linnér RK, Ahlskog R, Kleinman A, Hinds DA, 23andMe Research Group, Caspi A, Corcoran DL, Moffitt TE, Poulton R, Sugden K, Williams BS, Harris KM, Steptoe A, Ajnakina O, Milani L, Esko T, Iacono WG, McGue M, Magnusson PKE, Mallard TT, Harden KP, Tucker-Drob EM, Herd P, Freese J, Young A, Beauchamp JP, Koellinger PD, Oskarsson S, Johannesson M, Visscher PM, Meyer MN, Laibson D, Cesarini D, Benjamin DJ, Turley P, Okbay A. Nature Human Behaviour 5, June 2021, pp. 1744−1758.

Optimal Staffing in Community Health Centers to Improve Quality of Care
Luo Q, Dor A, Pittman P. Health Services Research 56(1), February 2021, pp. 112−122.