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INSTITUTE OF MEDICINE OF CHICAGO

  • 31 May 2023 11:31 AM | Deborah Hodges (Administrator)

    Question  How many children receive intensive care in the US annually? [JAMA Network]

    Findings  In this cohort study of all hospital discharges of children in 21 states, there was an increase in the proportion of admissions involving intensive care from 2001 to 2019. Meaning  The findings indicate increasing medical complexity and illness severity and longer hospital stays among critically ill children in the US.

    Design, Setting, and Participants  This population-based retrospective cohort study used data from the Healthcare Cost and Utilization Project’s state inpatient databases from a total of 21 US states in 2001, 2004, 2010, 2016, and 2019. Hospitalized children aged 0 to 17 years, excluding newborns (during birth hospitalization), were included. Patients admitted to rehabilitation institutions or psychiatric hospitals were also excluded. Data were analyzed from July 2021 to December 2022.

    Original Investigation - Caring for the Critically Ill Patient

    More>

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  • 30 May 2023 1:49 PM | Deborah Hodges (Administrator)

    Illinois’ health associations generally support a roughly $50.6 billion spending plan approved by the General Assembly over the weekend. [Health News Illinois] 

    A sticking point for lawmakers last week was how much to increase wages for those who work with individuals with developmental disabilities. The initial budget draft included a $2 per hour increase, but the final approved package raises that to $2.50 an hour.

    The Illinois Association of Rehabilitation Facilities was opposed to the initial proposal and thanked lawmakers for the additional funds.

    “The extra dollars will help our members address a crisis in staffing that is reducing services available to those with disabilities in Illinois,” they said in a statement. “We have to stay ahead of the growing state minimum wage to recruit and retain workers, and this increase will help do that.”

    Illinois Health and Hospital Association CEO A.J. Wilhelmi said the package has a welcome focus on healthcare services and “advances much-needed, long-term financial assistance for hospitals.”

    “This state investment secures critical, ongoing relief in response to the financial challenges and workforce pressures Illinois hospitals are navigating in the wake of the COVID-19 pandemic,” he said, referring to a provision that includes 10 percent increases to hospital Medicaid base rates. "This legislative action will help preserve access to care for all Illinois residents — particularly our most vulnerable populations — and protect the long-term viability of Illinois hospitals.”

    The Illinois Primary Health Care Association highlighted an additional $50 million their members are expected to receive to support Medicaid rates, as well as budget provisions that add $3 million for scholarship and student loan repayment programs for healthcare workers from underrepresented backgrounds and expand billable behavioral health provider types.

    “During a difficult budget climate, we greatly appreciate the Legislature’s vote of confidence and willingness to continue investing in the community health centers — a model that has proven to keep people healthy, thereby improving patient health outcomes and lowering Medicaid costs,” they said in a statement.

    The House approved the package early Saturday morning along party lines. Gov. JB Pritzker said he intends to sign it into law.

    “I look forward to signing this budget making childcare and education more accessible, healthcare more affordable and our state’s business and economic position even stronger,” he said.

    Other provisions in the plan include $550 million to fund a program that provides Medicaid-like coverage to certain undocumented individuals. The proposal does not expand eligibility for the program, a step advocates had sought this spring.

    The Medicaid omnibus approved Friday gives the Department of Healthcare and Family Services emergency rulemaking to implement provisions intended to reign in the costs of the program, which is estimated to hit $1.1 billion in the coming year.

    The budget would also:

     

    ·    Provide an additional $38 million for 23 safety-net hospitals that serve low-income communities.

    ·    Provide $18 million to establish a reproductive health navigation hotline, training and consultation programs.

    ·    Create a council to advise HFS on how to support veteran suicide prevention.

    ·    Grant the Office of Firearm Violence Prevention the ability to award violence prevention organizations grants for violence prevention services related to behavioral health, including clinical interventions, crisis interventions and group counseling supports.

    ·    Establish the Opioid Remediation Services Capital Investment Grant Program.

     

    Rep. Jehan Gordon-Booth, a Democrat from Peoria and lead House budget negotiator, said the package is a “fiscally and socially responsible plan” that will, in part, help more individuals access healthcare services.

     

    “I am appreciative of the months of negotiation and hard work from both sides of the aisle to develop this responsible and compassionate plan, and look forward to the strong, positive impact it will have on uplifting families across our state,” she said.

     

    Rep. Norine Hammond, the Republican’s chief budgeteer from Macomb, said the budget “does not reflect our shared priorities.”

     

    “Despite their statements to the contrary, the budget passed by the majority Democrats is not balanced,” she said. “It relies on a series of fiscal fabrications and schemes, such as only funding half-a-year’s-worth of Medicaid costs and shifting $700 million from local government funds into the State’s General Revenue Fund.”


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  • 26 May 2023 7:44 AM | Deborah Hodges (Administrator)

    Question  What symptoms are differentially present in SARS-CoV-2–infected individuals 6 months or more after infection compared with uninfected individuals, and what symptom-based criteria can be used to identify postacute sequelae of SARS-CoV-2 infection (PASC) cases? [JAMA etwork]

    Findings  In this analysis of data from 9764 participants in the RECOVER adult cohort, a prospective longitudinal cohort study, 37 symptoms across multiple pathophysiological domains were identified as present more often in SARS-CoV-2–infected participants at 6 months or more after infection compared with uninfected participants. A preliminary rule for identifying PASC was derived based on a composite symptom score.

    Meaning  A framework for identifying PASC cases based on symptoms is a first step to defining PASC as a new condition. These findings require iterative refinement that further incorporates clinical features to arrive at actionable definitions of PASC.

    More> 

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  • 25 May 2023 4:54 PM | Deborah Hodges (Administrator)

    After a three-year period of continuous Medicaid/CHIP enrollment under the COVID-19 public health emergency, states could begin terminating coverage for ineligible residents in April. With redeterminations underway, health policy experts say too many people in some states are losing health coverage for the wrong reasons. [Becker's Payer Issues]

    "Too many people are falling through the cracks in the system," Alison Yager, executive director of the Florida Health Justice Project, told Vox on May 19. "This should be of grave concern to all those charged with protecting the health of our residents."

    ...HHS has estimated that 15 million people total will lose Medicaid coverage during redeterminations.

    More> 

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  • 24 May 2023 8:58 AM | Deborah Hodges (Administrator)

    U.S. Sen. Dick Durbin, D-Ill., on Monday laid out a roadmap he says will prioritize recruitment and incentives for healthcare workers in rural areas, as well as expand educational programming at colleges and universities. [Health News Illinois]

    The plan identifies three priorities for stakeholders to focus on over the next four years to address shortages of health professionals in rural areas.

    That includes exploring new training partnerships between community colleges and medical facilities, the promotion of dual-credit options for high school students and increasing the number of medical residency programs operating in rural areas.

    Durbin said during a stop in Lincoln that the roadmap “will help us address the root causes of these shortages by reaching into middle and high schools to attract young people into health careers, expanding the capacity of our education programs, and creating incentives for rural recruitment.”

    Many of the initiatives will be funded through the federal Health Resources and Services Administration, with Durbin saying his office will convene regular meetings with hospitals, health centers, medical schools, nursing schools, community colleges and other stakeholders to disseminate federal funding opportunities and coordinate projects.

    Eleven Illinois associations have signed on as partners in the work, including the Illinois Association of College of Nurses, the Illinois Health and Hospital Association and the Illinois State Medical Society.

    As part of the announcement, Durbin said the Illinois State University will receive $2 million to expand its nursing school, and Southern Illinois University’s School of Medicine will receive $1 million to establish a Rural Health Institute.

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  • 23 May 2023 5:37 PM | Deborah Hodges (Administrator)

    I appreciated the recent Viewpoint by  Virudachalam et al1 highlighting the critical need to expand produce prescription programs to children as a means to advance food equity. As the principal investigator of Food for Health, a randomized clinical trial of a produce prescription program for children at New York City Health + Hospitals, the nation’s largest public health care system, I wholeheartedly agree with the authors’ sentiments. However, I regret that they overlooked the rapidly growing modality of home delivery of fruits and vegetables, which eliminates multiple barriers to inequitable fruit and vegetable access and stands to play an important role in advancing food and health equity. [JAMA Pediatrics}

    Providing vouchers or on-site pickup for prescribed produce is often a substantial barrier to fruit and vegetable access among both rural and urban populations, who often face inequitable access to healthy foods. Studies of produce prescription programs have found that, in addition to limited proximity to prescription redemption locations, barriers to redeeming produce prescriptions include limited mobility, limited or unreliable transportation, and lack of childcare.2 In recent years, produce prescription programs have begun to deliver fruits and vegetables to participants’ homes, but these have been pilot studies or serve adults.3,4

    To our knowledge, Food for Health is the first large study of a produce prescription program for children that delivers locally grown produce directly to participants’ homes.5 Our team chose home delivery to eliminate barriers to fruit and vegetable access, which we know are many among the population we serve, and to thereby advance food and health equity. Although this is more costly than vouchers or on-site pickup, we feel strongly that the benefit of overcoming barriers to fruit and vegetable access is worth the cost.

    More>

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  • 22 May 2023 3:10 PM | Deborah Hodges (Administrator)

    Senate approves insurance coverage for mental health checkups, other proposals

    The Illinois Senate approved several healthcare proposals late last week, including one requiring insurance coverage for annual mental health checkups and wellness visits. [Health News Illinois]

    The plan, sponsored by Sen. Laura Fine, D-Glenview, also encourages the Illinois Department of Public Health to work on an educational campaign for mental health and wellness. 

    The health insurance coverage provision would take effect in 2025.

    “Normalizing annual mental health checkups will give people who may not have considered seeking support the strength to do so,” Fine said in a statement after the plan passed the chamber unanimously.

    The Senate also approved a bill from Sen. Sara Feigenholtz, D-Chicago, that prohibits other states from using automatic license plate reader data gathered in Illinois to prosecute people seeking reproductive healthcare in the state or to detain people based on their immigration status.

    “Illinois is one of the most health-accessible and welcoming states in the nation, so we need to make sure that residents and visitors alike are protected and their personal medical decisions are kept private,” Feigenholtz said.

    It also approved a measure by Sen. Kimberly Lightford, D-Maywood, that requires the Illinois State Board of Education to create an index to measure community childhood trauma exposure among children between the ages of 3 and 18.

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  • 19 May 2023 9:57 AM | Deborah Hodges (Administrator)

    A House committee signed off Thursday on a proposal to lower the state’s cap on the out-of-pockets costs for insulin to $35. [Health News Illinois]

    The House’s Prescription Drug Affordability & Accessibility Committee unanimously approved a bill by Rep. Jenn Ladisch Douglass, D-Elmhurst, that would update a 2020 law that caps out-of-pocket costs for insulin at $100 for a 30-day supply for patients who have commercial insurance plans regulated by the state.

    Unlike the previously approved plan, the bill now tasks the Department of Central Management Services with providing participants with an identification card to show they qualify for the program. The agency would create the guidelines for who will be eligible for the program.

    That latter provision gave pause to Rep. Dan Caulkins, R-Decatur, who questioned why lawmakers would not set the guidelines for the program, as well as how individuals will know if they are eligible.

    Ladisch Douglass said she expects providers, insurers and Medicaid managed care organizations to inform individuals if they are eligible for the program.

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  • 18 May 2023 12:04 PM | Deborah Hodges (Administrator)
    Key Points

    Question  What is the risk of postneonatal infant mortality among infants with neonatal opioid withdrawal syndrome (NOWS) diagnosis or born to individuals with opioid use disorder (OUD)? [JAMA Peds]

    Findings  In this cohort study of 390 075 infants, after adjusting for maternal and infant characteristics, the risk of postneonatal infant mortality was significantly higher for those born to individuals with OUD or diagnosed with NOWS as compared with unexposed infants.

    Meaning  In this study, maternal OUD and NOWS diagnosis were associated with an increased risk of postneonatal infant mortality.

    Download PDF of article here>

    Read on-line article here> 

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  • 17 May 2023 7:29 AM | Deborah Hodges (Administrator)

    Ground-breaking study provides national and state-level estimates of the economic burden of health disparities by race and ethnicity and educational levels. 

    New research shows that the economic burden of health disparities in the United States remains unacceptably high. The study, funded by the National Institute on Minority Health and Health Disparities (NIMHD), part of the National Institutes of Health,  revealed that in 2018, racial and ethnic health disparities cost the U.S. economy $451 billion, a 41% increase from the previous estimate of $320 billion in 2014. The study also finds that the total burden of education-related health disparities for persons with less than a college degree in 2018 reached $978 billion, about two times greater than the annual growth rate of the U.S. economy in 2018. [NIH

    The findings from this study by researchers from NIMHD; Tulane University School of Public Health and Tropical Medicine, New Orleans; Johns Hopkins Bloomberg School of Public Health, Baltimore; Uniformed Services University, Bethesda, Maryland; TALV Corp, Owings Mills, Maryland; and the National Urban League were published in JAMA

    This study is the first to estimate the total economic burden of health disparities for five racial and ethnic minority groups nationally and for all 50 states and the District of Columbia using a health equity approach. The health equity approach set aspirational health goals that all populations can strive for derived from the Healthy People 2030 goals. It establishes a single standard that can be applied to the nation and each state, and for all racial, ethnic, and education groups. It is also the first study to estimate the economic burden of health disparities by educational levels as a marker of socioeconomic status. 

    More> 

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