Research Roundup: Depression disparities; Parents' views of vaccines

Shefali S. Kulkarni compiled this selection of recently released health policy studies and briefs.

Archives Of Pediatrics And Adolescent Medicine: Hospital-Based Programs For Children With Special Health Care Needs: Implications Of Health Care Reform -- This study looks at 33 hospital-based comprehensive care programs for children with special needs to evaluate their effectiveness. The authors find that evidence that these hospital programs improve care for special needs children "is generally positive" but point out that there are limited studies looking at a broad based population of such children. They write that hospital programs may have  a role in "efforts to improve quality and to reduce costs using global payments and shared savings," but more study needs to confirm that (Cohen et. al, June 2011).

Health Affairs: Confidence About Vaccines In The United States: Understanding Parents' Perceptions -- This study, using national survey data, seeks to gauge parent's confidence in vaccine safety in the U.S., especially given misinformation and some concerns parents about side effects. The authors found "that most parents—even those whose children receive all of the recommended vaccines—have questions, concerns, or misperceptions about them." They identify strategies for continuing to keep vaccination levels high (Kennedy et. al, 6/9).

The Archives Of General Psychiatry: Collaborative Depression Care Management And Disparities In Depression Treatment And Outcomes -- This study looks a the racial and educational disparities of depression care management among older primary care patients. The use of mental health services are lower in minority and low-income communities: "patients are more likely to delay initial treatment of mental disorders and are less likely to seek treatment from mental health specialists or to receive minimally adequate care for depression and other mental disorders." The authors reexamined an earlier controlled study that found depression care management programs were effective in treating elderly patients to see what the effects were in minority and low income patients. The new study found the although the intervention benefitted whites more than minorities, it "had a larger and more lasting effect in less-educated patients" (Bao et. al., June 2011).

The Kaiser Family Foundation/Health Policy Alternatives: The Nuts And Bolts Of Medicare Premium Support Proposals -- Following the House GOP plan to convert Medicare into a premium support system, this brief examines the history of the premium support concept and how it would affect the federal health care program for seniors and the disabled. The brief reviews "how the government's contributions would be set and adjusted over time; whether and how those payments would vary based on beneficiaries' age, income, health status and geographic location, and the extent to which enrollees' costs could vary accordingly; the role of the current traditional Medicare program, if any; and the core requirements for plans, such as whether they would be required to provide a defined set of benefits or whether they would be permitted to vary premiums based on age" (Fuchs and Potetz, 6/8).

The Commonwealth Fund: Delivery System Reform Tracking: A Framework For Understanding Change -- This brief looks at how the Affordable Care Act will change the current health care delivery system -- with the establishment of medical homes and accountable care organizations and other new care options -- and what kind of tools are needed to monitor the changes. The brief outlines "a framework for a delivery system reform tracking tool ... This information could be used by policymakers to evaluate overall progress, identify high performers, and develop policies to help these high performers continue to improve and share their best practices with others" (Tollen, Enthoven, Crosson et. al, 6/2).

American Sociological Review: Nonmarital Childbearing, Union Health, and Women's Health At Midlife -- Authors analyzed data from the National Longitudinal Survey of Youth to assess the health of midlife women who had been unmarried when they gave birth. "In general, the results showed that unwed mothers reported poorer health at age 40 than did other mothers. But there were several notable differences between racial and ethnic groups. ... Results showed that for most women, the negative consequences of having a first birth out of wedlock won't be eased by a later marriage or cohabiting union. The one exception, at least in some cases, was marrying the biological father," a press release about the study points out (Williams et. al., 6/2).