Research Roundup: Medicaid Reduces Payday Loans; Diabetes Management; Chronic ER Use

Health Affairs:
Early Medicaid Expansion Associated With Reduced Payday Borrowing In California

We examined the impact of California’s early Medicaid expansion under the Affordable Care Act on the use of payday loans, a form of high-interest borrowing used by low- and middle-income Americans. …The early Medicaid expansion was associated with an 11 percent reduction in the number of loans taken out each month. It also reduced the number of unique borrowers each month and the amount of payday loan debt. (Allen, Swanson, Wang et. al., 10/1)

JAMA:
Insulin Pump Vs Insulin Injection And Type 1 Diabetes Complications

Are the rates of severe hypoglycemia and diabetic ketoacidosis lower with insulin pump therapy than with insulin injection therapy in young patients with type 1 diabetes? …Insulin pump therapy was associated with reduced risks of short-term diabetes complications and with better glycemic control compared with injection therapy. (Karges, Schwandt, Heidtmann et. al., 10/10)

Health Affairs:
Persistent Frequent Emergency Department Use: Core Group Exhibits Extreme Levels Of Use For More Than A Decade

Many frequent emergency department (ED) users do not sustain high use over time, which makes it difficult to create targeted interventions to address their health needs. …A small but nontrivial population (16.5 percent, 5.7 percent, and 1.9 percent) exhibited persistent frequent use for three, six, and eleven consecutive years, respectively. The strongest predictor of persistent frequent ED use was the intensity of ED use in the baseline study year. (Kanzaria, Niedzwiecki, Montoy et. al., 10/1)

JAMA Internal Medicine:
Patients’ Experiences With Institutional Responses To Medical Injury 

Do patients’ and families’ experiences with communication-and-resolution programs suggest aspects of institutional responses to injury that could better promote reconciliation after medical injuries? This interview study of 40 patients, family members, and hospital staff found that patients have a strong need to be heard after medical injury that is often unmet. …Opportunities are available to provide institutional responses to medical injuries that are more patient centered. (Moore, Bismark, Mello, et. al., 10/9)