The Center for Health Economics & Policy pilot program has awarded funding for four projects in the 2017-2018 cycle.
Demonstrating the economic value of spine nerve Injury reconstruction
Primary Investigator: Christopher Dy, assistant professor, Orthopedic Surgery Department, School of Medicine
Spine nerve injuries (i.e. brachial plexus injuries) have a profound effect on patients due to the devastating and sudden loss of shoulder, arm, and hand function. Surgical treatment is effective at restoring function and returning patients to the workforce, but awareness of its effectiveness is lacking among referring physicians. This study will demonstrate the societal value of surgical treatment using a cohort of privately- and Medicaid-insured patients with these injuries to determine the direct charges associated with surgical care. The study team will also perform a systematic literature review focused on probable outcomes and health utilities.
Medicaid eligibility variation: implications for gestational diabetes follow up
Primary Investigator: Cynthia Herrick, assistant professor, Internal Medicine Department, School of Medicine
Gestational diabetes (GDM) affects about nine percent of pregnancies in the US and is more common among racial and ethnic minorities and women of lower socioeconomic status. It increases type 2 diabetes risk by seven fold. Data on rates and predictors of recurrent GDM and progression to type 2 diabetes are limited, particularly in racially, ethnically, and geographically diverse populations of lower socioeconomic status, and there is no data on the effect of variation in Medicaid policy on these rates. This study utilizes hospital discharge data to characterize rates and predictors of recurrent GDM and progression to type 2 diabetes. It also examines the effect of insurance coverage loss between pregnancies on these rates by comparing states with differential Medicaid income eligibility criteria in non-pregnant parents.
Development and utilization of the vascular surgery cost and outcomes database
Primary Investigator: Senthil Jayarajan, assistant professor, Department of Surgery, School of MedicineVascular surgery uses innovative technologies to treat life-threatening disorders. These technologies often require high-cost devices and procedures that providers utilize without an in-depth understanding of their cost-effectiveness for patients, payers, or hospitals. Comorbidities in aging populations increase the likelihood of costly perioperative complications during vascular surgery. As reimbursement for treatment is becoming more contingent on patient outcomes, an accurate determination of the costs of treatment, outcomes, and unintended complications is critical. This project will create a centralized database that includes data on patient safety and quality improvement. The study team will conduct a cost-effectiveness analysis assessing determinants of costs related to vascular surgery, patient outcomes, and payer trends in order to help improve cost-effective care delivery. Impacts of the ACA dependent care provision on young adults with cancer Primary Investigator: Kimberly Johnson, associate professor, Brown School
In the United States, cancer is diagnosed in approximately 70-thousand 15 to 39 year-olds each year, with malignancy being the most common cause of disease-associated death for this age group. Factors contributing to cancer survival in this age group span from the individual to policy level and include access to health care services. Using data from the National Cancer Database, a nationwide cancer outcomes database that currently collects information on approximately 70% of all new invasive cancer diagnoses in the United States each year, this study examines the impact of the Affordable Care Act (ACA) dependent care provision (which allows children to stay on their parent’s private health insurance plan until age 26 years) on insurance uptake and cancer stage at diagnosis in young adults diagnosed with cancer. The study also examines whether there are disparities in the impact of the ACA dependent care provision on insurance uptake and cancer stage at diagnosis by sociodemographic, economic, and geographic characteristics.