Subject: Studies in the News 04-60 (September 13, 2004)


CALIFORNIA RESEARCH BUREAU
CALIFORNIA STATE LIBRARY
Studies in the News
Health Care Supplement


Contents This Week

Introductory Material

HEALTH
   Adolescents with depression
   Survey on AIDS prevention
   Early child development
   Drug treatment, managed care and the courts
   Prescription drug price trends
   Adolescents alcohol and drugs
   Health care costs
   Adopting innovative health programs
   Decline in employer-sponsored insurance
   Charter amendment for health plans
   Women and cardiovascular disease
   Preventing medication errors in hospitals
   Non-economic awards in medical malpractice trials
   Mandated payments by states for Medicare
   Reduction in medical matching rate
   Changes in medicaid physicians fees
   Medicaid wavers
   Pharmacy assistance programs and medicare
   Medicare prescription drug discount cards
   Mental health services in school
   Mental health care services for children
   Children's mental health and insurance
   Obesity and school policy
   Lack of health coverage
   The cost of caring for uninsured
   Percentage of uninsured Americans
   Post menopausal estrogen intake and risk of dementia
Introduction to Studies in the News

Studies in the News is a very current compilation of items significant to the Legislature and Governor's Office. It is created weekly by the State Library's Research Bureau to supplement the public policy debate in California’s Capitol. To help share the latest information with state policymakers, these reading lists are now being made accessible through the State Library’s website. This week's list of current articles in various public policy areas is presented below.

Service to State Employees:

  • When available, the URL for the full text of each item is provided.

  • California State Employees may contact the State Information & Reference Center (916-654-0206; cslsirc@library.ca.gov) with the SITN issue number and the item number [S#].

  • All other interested individuals should contact their local library - the items may be available there, or may be borrowed by your local library on your behalf.

The following studies are currently on hand:

HEALTH

ADOLESCENCE

"Fluoxetine, Cognitive-behavioral Therapy, and Their Combination for Adolescents with Depression." By John S. March and others. IN: JAMA: Journal of American Medical Association, vol. 292, no. 7 (August 18, 2004) pp. 807-820.

["The best treatment for depressed adolescents is a combination of Prozac and talk therapy, although the antidepressant does carry a risk that some patients might harm themselves or others, concludes a long-awaited study." Washington Post (August 18, 2004.) 1.]

[Request #S3948]

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AIDS

Kaiser Family Foundation Survey of Americans on HIV/AIDS: Global HIV/AIDS. By Kaiser Family Foundation. (The Foundation, Menlo Park, California) 2004. 23 p.

Full Text at: www.kff.org/hivaids/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=36560

["Half the public (53%) agrees ... that the U.S. is a global leader and has a responsibility to spend more money to fight HIV/AIDS in developing counties. However, when forced to choose, six in ten (62%) ... agree that the U.S. should address problems at home first rather then spending more money to fight HIV/AIDS in developing countries."]

[Request #S3949]

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CHILDREN

Early Child Development in Social Context: A Chartbook. By Brett Brown and others. (Child Trends, Washington DC, and Center for Child Health Research, Elk Grove Village, Illinois) September 2004. 118 p.

Full Text at: www.cmwf.org/usr_doc/Child_Devel_chartbook.pdf

["This chartbook examines how young children in the U.S. fare on more than 30 key developmental indicators: behavioral self-control; reading proficiency and use of expressive language; overall health; family functioning; parental health; receipt of care; child care; demographic, community, and neighborhood factors. The researchers find many American children, especially those from low-income or minority families, are not achieving their full potential because of problems that go unrecognized or untreated." Commonwealth Fund email alert (September 8, 2004).]

[Request #S3954]

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DRUG EDUCATION

Drug Treatment, Managed Care and the Courts: From Conflict to Collaboration. By Robert V. Wolf, Center for Court Innovation. (The Center, New York, New York) 2004. 28 p.

Full Text at: courtinnovation.org/pdf/managed_care.pdf

["The strategies suggested in this paper emphasize the importance of strengthening communication between drug court and managed care organizations and also urge advocates of drug courts to play an active role in shaping their state's health care policies."]

[Request #S3955]

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DRUG PRICES

Trends in Manufacturer Prices of Brand Name Presecription Drugs Used by Older Americans. By David J. Gross,AARP Public Policy Institute, and others. (The Institute, Washington, DC) 2004. 14 p.

Full Text at: research.aarp.org/health/ib69_drugprices.pdf

["The study found that prices drugmakers charged to wholesalers for the 197 brand-name medications used most frequently by older Americans rose 3.4 percent during the three-month period ending March 31, much higher that the 1.2 percent annual inflation rate registered during the same period." San Francisco Chronicle (July 14, 2004) 1.]

[Request #S3956]

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DRUG USE

"Adolescents, Alcohol and Drugs: The Sooner You Teach Them, the Better." By Christina Kent, Health Care and Prevention Projects Programs, National Conference of State Legislatures. IN: State Health Notes, vol. 25, no. 423 (June 28, 2004) pp. 1-2.

["Although adolescent use of illicit drugs and alcohol is declining, many kids are still using. And studies show that the younger people are when they start using substances, the greater the chance that they'll become addicted. States are adopting prevention programs, many of which are school-based."]

[Request #S3957]

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HEALTH CARE FINANCE

Health Care Costs 101: Snapshot. By the California HealthCare Foundation. (The Foundation, Oakland, California) 2004. 26 p.

Full Text at: www.chcf.org/documents/insurance/HealthCostsSnapshot04.pdf

["The Foundation has prepared a visual analysis of costs and financing trends over the past decade along with some predictions of future costs, including details on: Per capita health costs nationwide; Historic payment sources (federal vs. state); Trends on annual health care growth rates; and Prescription drug cost trends."]

[Request #S3958]

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HEALTH CARE REFORM

Translating Research into Practice: Speeding the Adoption of Innovative Health Care Programs. By Elizabeth H. Bradley, Yale University School of Medicine, and others. Issue Brief. (Commonwealth Fund, New York, New York) 2004. 12 p.

Full Text at: www.cmwf.org/programs/elders/bradley_translating_research_724.pdf

["For this study, the authors conducted case studies of four varied clinical programs to learn key factors influencing the diffusion and adoption of evidence-based innovations in health care."]

[Request #S3959]

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HEALTH INSURANCE

Work, Offers, and Take-Up: Decomposing the Source of Recent Declines in Employer-Sponsored Insurance. By Linda J. Blumberg and John Holahan, Urban Institute. (The Institute, Washington, DC) May 2004. 22 p.

Full Text at: www.urban.org/UploadedPDF/1000645_healthpolicyonline_no9.pdf

["According to the results, declines in employer coverage were particularly sharp for the low-income population.... The study estimated that over half the decline resulted from lower take-up rates, with most of the remainder attributable to changes in work and to lower offers by employers. The study also found work shifted from large employers to small ones, where the likelihood of Employer Sponsored Insurance coverage was lower." Assessing the New Federalism (May 20, 2004) 1.]

[Request #S3960]

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Proposal to Amend the Charter of the City and County of San Francisco to Authorize the Health Service Board to Offer Health Plans to City Residents: First Draft. By the Board of Supervisors of City and County of San Francisco. (The Board, San Francisco, California) May 2004. 3 p.

["Subject to the requirements of state law and the budgetary and fiscal provisions of the Charter, the Health Service Board may make provision for health or dental benefits for residents of the City and County of San Francisco as provided in section A8.421 of Appendix A of the Charter."]

[Request #S3961]

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HEART DISEASE

"A Major Health Concern: Women and Cardiovascular Disease." By Anna B. Scanlon, Health Care and Prevention Projects Program, National Conference of State Legislatures. IN: State Health Notes, vol. 25, no. 423 (June 28, 2004) pp. 3, 6.

["Cardiovascular disease is the leading cause of death and disability among women, but few women know this.... It kills about 500,000 women each year -- that's one death every minute, and 50,000 more women who die each year from this disease than men.... States are mounting prevention efforts."]

[Request #S3962]

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HOSPITALS

"Overcoming Barriers to Adopting and Implementing Computerized Physician Order Entry Systems in U.S. Hospitals." By Eric G. Poon and others. IN: Health Affairs, vol. 23, no. 4 (July/August 2004) pp. 184-190.

["Computerized physician order entry systems can help prevent medication errors — the most common cause of preventable injuries in hospitals — but few hospitals use them. According to this study, physician and organizational resistance, high costs, and product and vendor immaturity appear to be the major obstacles to implementing this technology."]

[Request #S3963]

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MALPRACTICE

Capping Medical Non-Economic Awards in Medical Malpractice Trials: California Jury Verdicts Under Medical Injury Compensation Reform Act. By Nicholas M. Pace and others, Rand Institute for Civil Justice. (The Institute, Santa Monica, California) 2004. 113 p.

Full Text at: www.rand.org/publications/MG/MG234/MG234.pdf

["This monograph presents the results of an empirical study of the effects of Medical Injury Compensation Reform Act on plaintiffs’ recoveries and on the liabilities of defendants in medical malpractice cases.... This monograph should be of particular interest to policymakers considering changes to the existing rules controlling medical malpractice litigation and compensation and to a wider audience outside the policymaking community."]

[Request #S3964]

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MEDICAID

Issues Surrounding the Medicare Drug "Clawback." By Federal Funds Information for States. Update 04-26. (FFIS, Washington, DC) July 7, 2004. 5 p.

["The clawback payments represent a major change in fiscal federalism. For the first time since the enactment of the Medicaid programs in 1965, a Medicaid benefit will be financed in significant part by mandated payments from state own-source revenues."]

[Request #S3965]

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Possible Reduction in Targeted Case Management Matching Rate. By Federal Funds Information for States. FFIS Issue Brief. 04-23. (FFIS, Washington, DC) June 23, 2004. 3 p.

["The House and Senate are considering a variety of bills that would increase federal entitlement spending and, as a result, are looking for offsets to reduce the cost of those bills. One such proposal being discussed is a reduction in the federal Medicaid matching rate for targeted case management services from state federal medical assistance percentages to the standard 50% rate for Medicaid administration."]

[Request #S3966]

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"Trends: Changes in Medicaid Physicians Fees, 1998-2003: Implications for Physician Participation." By Stephen Zuckerman and others. IN: Health Affairs (June 23, 2004) pp. 374-384.

["After slow growth during much of the 1990's, Medicaid physician fees increased, on average, 27.4 percent between 1998 and 2003. Primary care fees grew the most. States with the lowest relative fees in 1998 increased their fees the most but almost no states changed their position relative to other states or Medicare."]

[Request #S3967]

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Medicaid Waivers: HHS Approvals of Pharmacy Plus Demonstrations Continue to Raise Cost and Oversight Concerns: Report to the Committee on Finance, U.S. Senate. By the U.S. General Accounting Office. GAO-04-80. (The Office, Washington, DC) June 2004. 81 p.

Full Text at: www.gao.gov/new.items/d04480.pdf

["The General Accounting Office (GAO) was asked to provide information on a new Medicaid section 1115 demonstration initiative called Pharmacy Plus.... GAO reviewed the (1) approval status of state proposals, (2) extent to which HHS ensured that demonstrations are budget neutral, (3) basis for savings assumptions, and (4) federal and state steps to evaluate and monitor the demonstrations."]

[Request #S3968]

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MEDICARE

Grants for Transition from Pharmacy Assistance Programs to Medicare Part D. By Federal Funds Information for States. FFIS Issue Brief. 04-29. (FFIS, Washington, DC) July 16, 2004. 2 p.

["The Medicare Prescription Drug, Improvement and Modernization Act of 2003 appropriates $125 million for federal fiscal years 2005 and 2006 to assist those states with current state pharmaceutical assistance programs (SPAPs) in the transition to the new Part D Medicare coverage. Funds will only be available to states with current SPAP programs initiated on or before October 1, 2003."]

[Request #S3969]

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Private Discounts, Public Subsidies: How the Medicare Prescription Drug Discount Card Really Works. By Joseph Antos and Ximena Pinell, American Enterprise Institute for Public Policy Research. (The Institute, Washington, DC) 2004. 48 p.

Full Text at: www.aei.org/docLib/20040616_book779text.pdf

["A recent study by Joseph Antos of the conservative American Enterprise Institute found enormous savings for the roughly 8 million low-income seniors lacking drug coverage, whose drug costs could be slashed as much as 75 percent." San Francisco Chronicle (July 6, 2004) A1.]

[Request #S3970]

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MENTAL HEALTH

"School-based Mental Health Services." By the Committee on School Health. American Academy of Pediatrics Policy Statement. IN: Pediatrics, vol. 113, no. 6 (June 2004) pp. 1839-1845.

Full Text at: aappolicy.aappublications.org/cgi/reprint/pediatrics;113/6/1839.pdf

["More than 20% of children and adolescents have mental health problems. School-based programs offer the promise of improving access to diagnosis of and treatment for the mental health problems of children and adolescents. Pediatric health care professionals, educators, and mental health specialists should work in collaboration to develop and implement effective school-based mental health services."]

[Request #S3971]

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Mental Health Services for Children with Special Health Care Needs in Commercial Managed Care, 1999-2001. By Jennifer Humensky, Mathematica Policy Research, and others. (Mathematica, Washington, DC) 2004. 58 p.

Full Text at: www.mathematica-mpr.com/publications/PDFs/menhlthchil.pdf

["Mental health care is an important component of comprehensive health insurance for children with special health care needs (CSHCN), who often have emotional and behavioral disorders as either a primary diagnosis or secondary to co-occurring physical conditions, sensory disabilities, or chronic illnesses. These children's parents pay for a substantial portion of the costs of services that their children use frequently, such as mental health care and prescription drugs."]

[Request #S3972]

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Access to Children's Mental Services under Medicaid and SCHIP. By Embry Howell, Urban Institute. New Federalism: National Survey of America's Families. Series B. No. B-60 (The Institute, Washington DC) August 2004. 8 p.

Full Text at: www.urban.org/UploadedPDF/311053_B-60.pdf

["Because of Medicaid’s and SCHIP’s relatively comprehensive coverage of mental health benefits, the two programs can clearly reduce disparities in use of mental health services between higher- and lower-income children. Uninsured children have dramatically lower use of mental health services than children with insurance. On the other hand, use rates for poor children with mental health problems in 2002 did not differ significantly from rates for nonpoor children with such problems."]

[Request #S3973]

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OBESITY

Responding to Childhood Obesity Through School Policy: [Talkback Live Transcript.] By Education Week on the Web. (Education Week, Bethesda, Maryland) July 29, 2004. 15 p.

Full Text at: www.edweek.org/ew/tb/tblive/transcript_07-29-2004.htm

["As the nation's children grow heavier, policymakers, health officials, and interest groups are pressuring schools to provide students with healthier meals and snacks and more time for physical activity during the school day. Fewer than 35 percent of students today attend daily physical activity classes, and most schools don't require physical education, the CDC reports. At the same time, the federal agency says, half of all districts have a contract that gives a company the rights to sell soft drinks in schools. Some states have already moved to limit the sale of candy and soda in schools, but asking schools to give up the lucrative vending deals offered by companies such as Coca Cola is no small matter." Education Week (July 29, 2004). 1.]

[Request #S3974]

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UNINSURED

America's Achilles Heel: Job-Based Health Coverage and the Uninsured. By the Century Foundation (The Foundation, New York, New York ) 2004. 14 p.

Full Text at: www.tcf.org/Publications/healthcare/haase_achilles.pdf

["The employer-based system is the principal reason why such a large portion of the population lacks health insurance. As of 2002, 43.6 million Americans under the age of sixty-five -- more than 15 percent of the population -— had no medical coverage. Since the mid-1970s, the number of uninsured has increased at an average rate of almost 1 million per year.” Moving Ideas (June 23, 2004) 1.]

[Request #S3975]

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UNINSURED POPULATION

Estimating the Cost of Caring for California's Uninsured. By Gerald F. Kominski and Dylan H. Roby. Policy Brief. Center for University of California, Los Angeles Center for Health Policy Research. (The Center, Los Angeles, California) May 2004. 1p.

Full Text at: www.healthpolicy.ucla.edu/pubs/files/CostofCaring_pb_052004.pdf

["Providing health care coverage for 6.3 million uninsured Californians would cost about $7.4 billion, a mere fraction compared with the industry's total expenditures, according to a new study....With Californians under 65 spending approximately $61.8 billion annually on health care, that number could be stabilized if more of the uninsured had coverage." Los Angeles Daily News (May 12, 2004) 1.]

[Request #S3976]

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One in Three: Non elderly American Without Health Insurance 2002-2003. By Families USA. (Families, Washington, DC) June 2004. 44 p.

Full Text at: www.familiesusa.org/site/DocServer/82million_uninsured_report.pdf?docID=3641

["This report examines how many people under the age of 65 were without health insurance for all or part of 2002 and 2003. The findings are based exclusively on data projections drawn from the most recent CPS as well as the Census Bureau's Survey of Income and Program Participation."]

[Request #S3977]

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WOMEN

"Conjugated Equine Estrogens and Global Cognitive Function in Postmenopausal Women." By Mark A. Espeland and others. IN: JAMA: Journal of the American Medical Association, vol. 291, no. 24 (June 23/30) pp. 2959-2968.

["Older post menopausal women who take estrogen significantly increase their risk of developing dementia, whether they take the hormone alone or combined with progestin, according to a study." Sacramento Bee (June 23, 2004) A26.]

[Request #S3978]

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There are no studies in the current issue