American journal of preventive medicine
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This study aims to evaluate the trends in the impact of Medicaid expansion on the use of selected recommended clinical preventive services and examine the differences in use by income level over time. ⋯ These findings provide evidence that Medicaid expansion may be associated with sustainably increased use of the selected recommended clinical preventive services among the lower-income population and that Medicaid expansion to reduce financial barriers may be an effective strategy to improve population health.
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Within gender-diverse populations, gender-affirming changes in gender on record may improve mental or behavioral health. This study uses claims data to investigate whether sex assigned at birth modifies the association between change in gender on record and mental or behavioral health. ⋯ Oregon Medicaid gender-diverse beneficiaries who changed their gender on record had a meaningfully lower probability of mental and behavioral health conditions. Those assigned female at birth reporting female gender had the highest burdens.
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Video telehealth can offer people convenient, real-time access to clinicians without arranging transportation or time off work. Among people with diabetes, this study examines the association between video telehealth access and changes in HbA1c. ⋯ Gaining access to video telehealth was associated with reductions in HbA1c among people with diabetes. Video telehealth offers people with chronic conditions a new, convenient way to access health care, is not associated with worsening HbA1c, and may support better disease management, particularly among patients with higher baseline HbA1c.
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Increases in opioid prescribing contributed to the opioid epidemic in the U.S. Subsequent efforts to promote safer use of opioids for treating pain included augmenting prescription drug monitoring programs and prescribing guidelines. The purpose of this study is to characterize the distribution of opioids dispensed in the U.S. by specialty. ⋯ During a period in which prescribing interventions were expanded, opioid prescribing declined overall, although not uniformly by specialty.
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Alcohol and cannabis are commonly involved in motor vehicle crashes and fatalities. This study examines whether simultaneous use of alcohol/cannabis is associated with higher odds of reporting driving under the influence of alcohol and cannabis in the U.S. ⋯ Overall, 2 in 5 drivers who used alcohol and cannabis reported driving under the influence of alcohol and/or cannabis. People reporting simultaneous alcohol/cannabis use were more likely to report cannabis-related driving under the influence. Prevention strategies should target individuals reporting simultaneous alcohol/cannabis use to reduce the occurrence of driving under the influence.