Special Populations

Though the use of publicly reported quality measures has been touted as a way to improve care, there are "substantial barriers" to using the tactic to affect consumers, providers and purchasers in the nursing home industry, according to a study in the Journal of Health Politics, Policy and Law.

The study, by David Stevenson of Harvard Medical School, compared occupancy of nursing homes before and after quality information was reported to the federal Nursing Home Compare Web site. Making public the quality of nursing home care through the Web site has had little effect on occupancy rates, the study found.

The study noted some limitations of the finding, including that the extent to which the Nursing Home Compare site is used or whether it is helpful to consumers is unknown.

While the study suggested that quality information should continue to be reported, it cautions against spending time and resources on quality improvement methods that are ineffective. The study also raised concerns about the consequences of reporting select quality measures.

Further research into how publicly reported nursing home quality information affects care is needed, the study concluded (Stevenson, Journal of Health Politics, Policy and Law, August 2006).

Findings from a study in the American Journal of Public Health indicate support for routine sexually transmitted infections screenings when an inmate enters prison, as well as screenings in a jail setting, where most detainees are held before being transferred to prison.

For the study, researchers examined urine specimens from 572 female inmates ages 18 and older and 698 male inmates ages 18 to 25 that were taken as the inmates entered one of six California prisons from Jan. 25, 1999, through March 19, 1999. The study found an overall low prevalence of gonorrhea, a finding consistent with other studies, and a high prevalence of Chlamydia.

The study also found that among the study population:

Overall prevalence of Chlamydia was 6.9% and gonorrhea was 0.2%;
Male prevalence of Chlamydia was 9.9% and female prevalence was 3.3%; and
Blacks had the highest Chlamydia prevalence followed by Hispanics.

According to the study, the high Chlamydia prevalence indicates that individuals entering California prisons have a high risk for the infection and have minimal access to screening and treatment. In addition, the researchers said their findings support age-based recommendations for STI screening for women ages 30 and younger. Researchers were unable to address age-based recommendations for men, as they did not study samples from men older than age 25 (Bernstein et al., American Journal of Public Health, October 2006). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.