Addiction, Author Interviews, Health Care Systems / 25.05.2024
Thirty-fold state level prescribing disparities of naloxone to both Medicaid and Medicare patients
MedicalResearch.com Interview with:
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Srivastava Kodavatiganti, MBS[/caption]
Srivastava Kodavatiganti, MBS
Department of Medical Education
Geisinger Commonwealth School of Medicine
Scranton, PA
MedicalResearch.com: What is the background for this study?
Response: Prescription and illicit opioid misuse and overdoses have continued to escalate in the U.S. with annual overdoses exceeding 110,000[1]. There was a substantial rise from 2013 to 2022 in the number of opioid-related overdoses due to synthetic opioids [2]. Even nonfatal opioid-involved overdoses increased 4% quarterly between January 2018 and March 2022 as observed by encounters by emergency medical services [3]. Although the eastern U.S. has been particularly impacted by fatal overdoses, annual increases have increased as of last year in the western states including in Nevada (+27.9%), Washington (+36.9%), Oregon (+38.6%), and Alaska (+45.9%). In contrast, other states have seen more modest changes (New Mexico = +1.3%) including decreases (South Dakota = -2.4%, Nebraska = -19.5%) [1]. These findings underscore the importance for understanding patterns in usage of prevention and treatment strategies.
Naloxone is an opioid antagonist which can reverse the effects of an opioid overdose. This crucial lifesaving tool is administered as an injection or as a nasal spray. This study characterized the patterns of naloxone prescriptions in Medicaid patients from 2018 – 2021 and Medicare patients for 2019. State level differences were also quantified as the fold difference in prescribing between the highest and lowest states when correcting for the number of enrollees in each state.
Srivastava Kodavatiganti, MBS[/caption]
Srivastava Kodavatiganti, MBS
Department of Medical Education
Geisinger Commonwealth School of Medicine
Scranton, PA
MedicalResearch.com: What is the background for this study?
Response: Prescription and illicit opioid misuse and overdoses have continued to escalate in the U.S. with annual overdoses exceeding 110,000[1]. There was a substantial rise from 2013 to 2022 in the number of opioid-related overdoses due to synthetic opioids [2]. Even nonfatal opioid-involved overdoses increased 4% quarterly between January 2018 and March 2022 as observed by encounters by emergency medical services [3]. Although the eastern U.S. has been particularly impacted by fatal overdoses, annual increases have increased as of last year in the western states including in Nevada (+27.9%), Washington (+36.9%), Oregon (+38.6%), and Alaska (+45.9%). In contrast, other states have seen more modest changes (New Mexico = +1.3%) including decreases (South Dakota = -2.4%, Nebraska = -19.5%) [1]. These findings underscore the importance for understanding patterns in usage of prevention and treatment strategies.
Naloxone is an opioid antagonist which can reverse the effects of an opioid overdose. This crucial lifesaving tool is administered as an injection or as a nasal spray. This study characterized the patterns of naloxone prescriptions in Medicaid patients from 2018 – 2021 and Medicare patients for 2019. State level differences were also quantified as the fold difference in prescribing between the highest and lowest states when correcting for the number of enrollees in each state.
As technology continues to evolve within the healthcare sector, creating new opportunities for enhancing patient care, it's crucial that empathy doesn't get lost in the shuffle. Innovative tools and systems should be seen as avenues to deepen our understanding and connection with patients, rather than as barriers to the human touch. Embracing technology with empathetic intention can lead to an even greater level of personalized care.
One specific area where empathy can play a transformative role is in addressing
Dr. Khullar[/caption]
Dhruv Khullar, M.D., M.P.P.
Director of Policy Dissemination
Physicians Foundation Center for Physician Practice and Leadership
Assistant Professor of Health Policy and Economics
Weill Cornell Medicine, NYC
MedicalResearch.com: What is the background for this study?
Response: From prior research, we know that there are racial/ethnic differences in the acute impact of COVID-19, including higher rates of hospitalization and death among Black and Hispanic individuals compared to white individuals. Less is known about whether there are differences in the rates or types of long COVID by race and ethnicity.
Dr. Caraballo-Cordovez[/caption]
César Caraballo-Cordovez, MD
Joanna Jiang, PhD
Agency for Healthcare Research and Quality
Rockville, Maryland
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Over the last decade we have seen two trends occurring to rural hospitals – closures and mergers. A hospital in financial distress could likely face closure. But if the hospital affiliates with a multihospital system, it may have access to resources from the system that help shelter the hospital from closure.
That is exactly what we found in this study. System affiliation was associated with a lower risk of closure for financially distressed hospitals. However, among hospitals that were financially stable, system affiliation was associated with a higher risk of closure. This is somewhat puzzling and needs further study to better understand the reason for closure.
Dr. McPeek Hinz[/caption]
Eugenia McPeek Hinz MD MS FAMIA
Associate CMIO - DHTS
Duke University Health System
MedicalResearch.com: What is the background for this study?
Response: Clinician burnout rates have hovered around 50% for much of the past decade. Burnout is a significant concern in healthcare for its effects on care givers and associated downstream adverse implications on patient care for quality and safety. The ubiquitous presence of Electronic Health Records (EHR) along with the increased clerical components and after hours use has been a significant concern for contributing to provider burnout.
Mr. Olin[/caption]
Steve Olin
Chief Product Officer
Rally Health, Inc., part of the Optum business of UnitedHealth Grou
MedicalResearch.com: Can you please elaborate on Rally Health’s mission?
Mr. Olin: Our founding mission 10 years ago and still to this day is to put health in the hands of the individual. As a digital health company, we live this mission through our focus in three key areas:
1) Providing digital-first access to care by giving individuals easy-to-use digital tools and support to navigate their health care and take full advantage of their health benefits;
2) Engaging people in their daily health by creating experiences that people enjoy and that inspire them to perform healthy actions, and by giving them access to resources that help them achieve their health goals;
3) Saving people time and money by providing digital tools that help them understand health care costs and guide them to lower-cost, high-quality care options.