As the opioid epidemic deepens, Yale researchers say starting treatment with medication is the most cost-effective way to treat patients in hospital emergency departments. People with opioid addiction often seek treatment in EDs for overdoses and other ailments. Those who receive buprenorphine, a medication that reduces drug cravings, in the ED incur lower health care costs over the following month than those who get a referral to treatment services or receive a brief intervention with a facilitated referral, according to a new analysis of a randomized clinical trial. The analysis, published today in the journal “Addiction,” compared the estimated health care costs for patients over the 30 days following their ED visit. Those costs included ED care, addiction treatment, inpatient and outpatient costs and medications.
When the lights power on in the operating room at Bridgeport Hospital, more than a half of the acute care team of surgeons peering from behind the masks are women. That’s unusual, given that only 28 percent of all surgeons in Connecticut are female, according to the latest figures from the American Medical Association (AMA). Flexible work schedules and hiring more surgeons to ease the on-call burden has helped to lure more women to the trauma surgical team, said Bridgeport Hospital’s chief medical officer, Dr. Michael Ivy, a trauma surgeon. Hospitals statewide have launched initiatives to help boost the ranks of women surgeons. There’s been progress, but gaps persist.
On the surface, it looks as if Connecticut children fare pretty well. According to the annual Kids Count report from The Annie E. Casey Foundation, the state ranks fourth in education, third in health, and sixth in overall well-being for children. The foundation pointed to nearly universal health insurance—97 percent—for Connecticut’s children as a major contributor to the state’s high ranking. Of all the states, Connecticut also had the lowest rate of deaths among children ages 1 to 19: 15 deaths per 100,000 children. But that’s not the entire story, not by half.
The rate of infants dying suddenly and unexpectedly has dropped in recent years, but data show that racial disparities persist. Babies born to American Indian and Alaska Natives and African American families suffer much higher rates of sudden unexpected infant deaths (SUID) than other races and ethnicities, data from the Centers for Disease Control and Prevention (CDC) show. Between 2011 and 2014, 194.1 American Indian and Alaska Native infants and 170.2 African American infants per 100,000 live births died from SUID nationwide. Those rates are significantly higher compared with 83.8 for whites, 51.1 for Hispanics and 32.1 for Asian or Pacific Islander babies per 100,000 live births, during the same time period. SUID encompasses sudden infant death syndrome, commonly known as SIDS, as well accidental suffocation and strangulation in bed, and other unspecified causes of death in children up to a year old.
A task force created by state lawmakers will examine whether the Department of Children and Families (DCF) should be prohibited from requiring that parents give up custody of their children in order to access mental health and other services, under legislation signed by the governor. The newly formed panel, which is charged with reporting its recommendations by Feb. 1, 2018, will study whether state statutes should be amended to prohibit DCF from requiring or requesting that a parent or guardian of a youth admitted to DCF on a voluntary basis terminate his or parental rights or transfer custody in order to obtain services. The task force also will study ways of increasing families’ access to voluntary services without making parents relinquish custody of their children. The legislation creating the task force was prompted by recent stories by C-HIT that detailed a practice known as ‘trading custody for care,’ in which parents who cannot meet their children’s severe behavioral health needs in a home setting are subject to “uncared for” petitions that turn their children over to DCF custody.
Many consumers who obtain insurance through Connecticut’s health care exchange don’t understand the plans they buy—and can struggle to access care as a result, according to a new report. Insurance plans typically use complicated language that is difficult to understand, according to the Health Disparities Institute, UConn Health. As a result, some patients have trouble accessing care, experience delays in care, encounter administrative hassles and face other hurdles, the study found. The institute conducted a statewide poll last year among 516 adults who enrolled in qualified health plans through Access Health CT (AHCT), the state health insurance exchange created under the Affordable Care Act. Many struggled to understand basic insurance terms like “premium,” “deductible” and “co-pay.”
More needs to be done to educate all health insurance consumers, regardless of where they buy their policies, said Lisa Freeman, executive director of the nonprofit Connecticut Center for Patient Safety.
A genetic test that helps doctors determine how best to treat breast cancer—and whether chemotherapy is likely to help—is significantly more likely to be administered to white women than blacks or Hispanics, a Yale study has found. The test, called Oncotype Dx (ODx), uses gene expression to gauge how early-stage breast cancer is affecting patients’ gene activity. It uses the information to determine how likely cancer recurrence would be, and physicians and their patients can use that knowledge to decide how to proceed with treatment. Yale researchers retrospectively analyzed a group of more than 8,000 Connecticut women who were diagnosed with hormone receptor positive breast cancer between 2011 and 2013, and found “significant racial and ethnic disparities in use of this new gene test,” said study leader Dr. Cary Gross, a member of Yale Cancer Center and professor of medicine and epidemiology at Yale School of Medicine. “It reinforces that, at the same time we are investing in developing new treatments and new testing strategies and we’re promoting them with great excitement, we really need to double-down our efforts to eliminate disparity,” Gross said.
Federally Qualified Community Health Centers (FQHCs) in Connecticut have expanded services, upped their staffing and renovated their facilities mostly due to increased revenue streams from the Affordable Care Act (ACA). Connecticut and the 30 other states that opted for the ACA Medicaid expansion program have benefitted from billions of dollars in additional core grant funding, with Connecticut receiving $150.7 million from 2011 to 2016, according to a January report by the Congressional Research Service. Health centers in Connecticut used some of that funding to hire professionals to enroll thousands of residents in health insurance—residents who were previously uninsured and used the centers for their health care. Now the centers are serving about 70,000 more insured patients, mostly covered by Husky Health plans. The cost of treating uninsured patients has declined by about $10 million since 2012, according to Deb Polun, director of government affairs and media relations at the Community Health Center Association of Connecticut.
Edith Baker of Plainville faced a devastating reality that patients with advanced cancer inevitably confront. She had stopped responding to conventional treatment. Radiation and chemotherapy could no longer contain her stage 4 bladder cancer. But there was a ray of hope. Baker’s oncologist at Saint Francis Hospital and Medical Center referred her to a clinical trial at UConn Health involving two immunotherapy drugs: the FDA-approved Keytruda (pembrolizumab) from Merck & Co., credited with successfully treating former President Jimmy Carter’s melanoma; and Epacadostat (IDO1 inhibitor), an experimental drug from Incyte Corp.
Nearly 1,400 new cases of lead-poisoned children under age 6 were reported in Connecticut in 2015, a slight drop from the year before, but more children showed higher levels of poisoning. A child whose blood test shows 5 micrograms of lead per deciliter or higher is considered poisoned. The 2015 numbers show 98 new cases of children with lead levels of 20 micrograms or higher, four times the threshold number and a 32 percent jump from 2014. “We cannot, with any certainty, explain why this is the case,” said Krista M. Veneziano, coordinator of the Connecticut Department of Public Health’s (DPH’s) Lead, Radon, and Healthy Homes Program, about the disproportionately larger numbers of higher toxicity. Exposure to lead can damage cognitive ability, including a measurable and irreversible loss in IQ points.