Andrew M. Seaman

NEW YORK (Reuters Health) - Low-income adults in the U.S. likely benefited if their states expanded Medicaid in 2014 under the Affordable Care Act, suggests a new study.

Researchers found increased rates of insurance coverage, healthcare use, and chronic disease diagnoses among low-income adults in states that expanded access to the government-funded health insurance program.

"It looks like there is better medical care for these adults," said lead author Dr. Laura Wherry, of the David Geffen School of Medicine at the University of California, Los Angeles.

A key provision of the Affordable Care Act (ACA), sometimes referred to as Obamacare, was to force states to expand their Medicaid programs by 2014. But with a Supreme Court decision allowing states to opt out of the expansion, only 26 states actually expanded their Medicaid programs.

For the new study, the researchers analyzed 2010-2014 survey data collected from low-income U.S. adults ages 19 to 64.

In the pre-expansion era, from 2010-2013, about 33% had no insurance in states that ultimately expanded Medicaid, compared to about 42% in states that opted out of expansion, according to an article online April 18 in Annals of Internal Medicine.

In 2014, those rates fell to about 18% in states that expanded Medicaid andabout 34% in states that didn't.

Overall, the uninsured rate fell by about 7 percentage points more in states that expanded Medicaid than in those that didn't.

States with expanded Medicaid coverage also had a larger increase in the proportion of people who thought their insurance coverage improved over the previous year.

Additionally, there was evidence that people in states with expanded Medicaid programs were using their coverage, because they had larger increases in interactions with general physicians and overnight hospital stays.

There were also more diagnoses of diabetes and high cholesterol in states with expanded Medicaid programs.

Gaining insurance likely leads to more screening for these conditions, and more diagnoses may lead to early treatment and important downstream health effects, Dr. Jeffrey Kullgren wrote in an editorial.

The new study shows what's happening in states that expand Medicaid and "what is foregone by states that reject the ACA's opportunity to expand Medicaid," write Kullgren, of the University of Michigan Medical School and the Veterans Affairs Ann Arbor Health System.

While the new study did not show that people felt healthier in expanded-Medicaid states, Dr. Wherry said it may be too early to see changes in that measure.

"I think long-term follow up will be very important," she said. The results help confirm the value of the ACA for people who obtain this coverage, said Dr. John McDonough, who worked on the ACA but was not involved with the new study.

He said the new findings likely won't convince reluctant states to expand their Medicaid programs, however.

"It's not about evidence at this point," said Dr. McDonough, who is a professor at the Harvard T.H. Chan School of Public Health in Boston. "It's about a political fear over Obamacare that at this point is not influenceable by meaningful evidence."

The authors reported no funding or disclosures.

NEW YORK (Reuters Health) - Low-income adults in the U.S. likely benefited if their states expanded Medicaid in 2014 under the Affordable Care Act, suggests a new study.

Researchers found increased rates of insurance coverage, healthcare use, and chronic disease diagnoses among low-income adults in states that expanded access to the government-funded health insurance program.

"It looks like there is better medical care for these adults," said lead author Dr. Laura Wherry, of the David Geffen School of Medicine at the University of California, Los Angeles.

A key provision of the Affordable Care Act (ACA), sometimes referred to as Obamacare, was to force states to expand their Medicaid programs by 2014. But with a Supreme Court decision allowing states to opt out of the expansion, only 26 states actually expanded their Medicaid programs.

For the new study, the researchers analyzed 2010-2014 survey data collected from low-income U.S. adults ages 19 to 64.

In the pre-expansion era, from 2010-2013, about 33% had no insurance in states that ultimately expanded Medicaid, compared to about 42% in states that opted out of expansion, according to an article online April 18 in Annals of Internal Medicine.

In 2014, those rates fell to about 18% in states that expanded Medicaid andabout 34% in states that didn't.

Overall, the uninsured rate fell by about 7 percentage points more in states that expanded Medicaid than in those that didn't.

States with expanded Medicaid coverage also had a larger increase in the proportion of people who thought their insurance coverage improved over the previous year.

Additionally, there was evidence that people in states with expanded Medicaid programs were using their coverage, because they had larger increases in interactions with general physicians and overnight hospital stays.

There were also more diagnoses of diabetes and high cholesterol in states with expanded Medicaid programs.

Gaining insurance likely leads to more screening for these conditions, and more diagnoses may lead to early treatment and important downstream health effects, Dr. Jeffrey Kullgren wrote in an editorial.

The new study shows what's happening in states that expand Medicaid and "what is foregone by states that reject the ACA's opportunity to expand Medicaid," write Kullgren, of the University of Michigan Medical School and the Veterans Affairs Ann Arbor Health System.

While the new study did not show that people felt healthier in expanded-Medicaid states, Dr. Wherry said it may be too early to see changes in that measure.

"I think long-term follow up will be very important," she said. The results help confirm the value of the ACA for people who obtain this coverage, said Dr. John McDonough, who worked on the ACA but was not involved with the new study.

He said the new findings likely won't convince reluctant states to expand their Medicaid programs, however.

"It's not about evidence at this point," said Dr. McDonough, who is a professor at the Harvard T.H. Chan School of Public Health in Boston. "It's about a political fear over Obamacare that at this point is not influenceable by meaningful evidence."

The authors reported no funding or disclosures.

NEW YORK (Reuters Health) - Low-income adults in the U.S. likely benefited if their states expanded Medicaid in 2014 under the Affordable Care Act, suggests a new study.

Researchers found increased rates of insurance coverage, healthcare use, and chronic disease diagnoses among low-income adults in states that expanded access to the government-funded health insurance program.

"It looks like there is better medical care for these adults," said lead author Dr. Laura Wherry, of the David Geffen School of Medicine at the University of California, Los Angeles.

A key provision of the Affordable Care Act (ACA), sometimes referred to as Obamacare, was to force states to expand their Medicaid programs by 2014. But with a Supreme Court decision allowing states to opt out of the expansion, only 26 states actually expanded their Medicaid programs.

For the new study, the researchers analyzed 2010-2014 survey data collected from low-income U.S. adults ages 19 to 64.

In the pre-expansion era, from 2010-2013, about 33% had no insurance in states that ultimately expanded Medicaid, compared to about 42% in states that opted out of expansion, according to an article online April 18 in Annals of Internal Medicine.

In 2014, those rates fell to about 18% in states that expanded Medicaid andabout 34% in states that didn't.

Overall, the uninsured rate fell by about 7 percentage points more in states that expanded Medicaid than in those that didn't.

States with expanded Medicaid coverage also had a larger increase in the proportion of people who thought their insurance coverage improved over the previous year.

Additionally, there was evidence that people in states with expanded Medicaid programs were using their coverage, because they had larger increases in interactions with general physicians and overnight hospital stays.

There were also more diagnoses of diabetes and high cholesterol in states with expanded Medicaid programs.

Gaining insurance likely leads to more screening for these conditions, and more diagnoses may lead to early treatment and important downstream health effects, Dr. Jeffrey Kullgren wrote in an editorial.

The new study shows what's happening in states that expand Medicaid and "what is foregone by states that reject the ACA's opportunity to expand Medicaid," write Kullgren, of the University of Michigan Medical School and the Veterans Affairs Ann Arbor Health System.

While the new study did not show that people felt healthier in expanded-Medicaid states, Dr. Wherry said it may be too early to see changes in that measure.

"I think long-term follow up will be very important," she said. The results help confirm the value of the ACA for people who obtain this coverage, said Dr. John McDonough, who worked on the ACA but was not involved with the new study.

He said the new findings likely won't convince reluctant states to expand their Medicaid programs, however.

"It's not about evidence at this point," said Dr. McDonough, who is a professor at the Harvard T.H. Chan School of Public Health in Boston. "It's about a political fear over Obamacare that at this point is not influenceable by meaningful evidence."

The authors reported no funding or disclosures.

(Reuters Health) - The proportion of older Americans taking at least five medications or supplements went up in a recent study.

The increase in people using multiple medications - known as polypharmacy - paralleled an increase in the number of older Americans at risk for major drug interactions, researchers found.

"That's a concern from a public health standpoint, because it's getting worse," said Dima Qato, the study's lead author from the University of Illinois at Chicago.

Qato and her colleagues previously reported that polypharmacy is common among older Americans. More than half were taking prescription and nonprescription medications between 2005 and 2006.

There have been a lot of changes in U.S. regulations and the pharmacy market since that time, however. Some of those changes include new and less expensive generic drugs and the implementation of Medicare Part D, which is the prescription component of the government-run health insurance program for the elderly or disabled.

To evaluate the change in polypharmacy over time, the researchers compared the 2005-2006 results to data collected from 2010-2011.

Participants in the study were between the ages of 62 and 85 and were living at home. The researchers interviewed 2,351 people in 2005-2006 and 2,206 in 2010-2011.

Overall, about 67 percent were taking five or more medications or supplements in 2010-2011, up from about 53 percent in 2005-2006.

Use of cholesterol-lowering statins rose from about 34 percent to about 46 percent, the researchers reported in JAMA Internal Medicine. The proportion of people taking blood-thinning medications also increased, from about 33 percent to 43 percent, and use of omega-3 fish oil pills rose from about 5 percent to about 19 percent.

Along with the increase in polypharmacy, the researchers found the risk of major drug interactions nearly doubled, going from about 8 percent to about 15 percent.

"I think we have to keep in mind that while it's important to improve access to medications, we need to make sure they're used safely," said Qato.

On one hand, the new results can be seen as positive, said Dr. Michael Steinman, a gerontologist at the University of California, San Francisco.

We're treating more people with medications that could potentially help them," he said. "But when people have four or five chronic conditions, medications quickly balloon to a large number."

It's important to ensure clear communication between everyone involved in a patient's care, including the patient, said Steinman, who wrote an editorial accompanying the new study.

"You can get rid of problems and excess medications by talking with your doctors," he said.

A separate study reported in the same issue of the journal found that nearly 42 percent of adults did not tell their doctors about the use of complementary or alternative medicine, which includes - among other things - supplements, herbs, homeopathy, special diets and acupuncture.

Many patients said they didn't tell their doctors about these alternative medicines because they weren't asked or because their doctors didn't need to know that information, write Judy Juo and Pamela Jo Johnson, of the University of Minnesota in Minneapolis.

"If a person is talking with their doctor about the medications they're using, they should be talking about all the medications they're using," said Steinman.

(Reuters Health) - The proportion of older Americans taking at least five medications or supplements went up in a recent study.

The increase in people using multiple medications - known as polypharmacy - paralleled an increase in the number of older Americans at risk for major drug interactions, researchers found.

"That's a concern from a public health standpoint, because it's getting worse," said Dima Qato, the study's lead author from the University of Illinois at Chicago.

Qato and her colleagues previously reported that polypharmacy is common among older Americans. More than half were taking prescription and nonprescription medications between 2005 and 2006.

There have been a lot of changes in U.S. regulations and the pharmacy market since that time, however. Some of those changes include new and less expensive generic drugs and the implementation of Medicare Part D, which is the prescription component of the government-run health insurance program for the elderly or disabled.

To evaluate the change in polypharmacy over time, the researchers compared the 2005-2006 results to data collected from 2010-2011.

Participants in the study were between the ages of 62 and 85 and were living at home. The researchers interviewed 2,351 people in 2005-2006 and 2,206 in 2010-2011.

Overall, about 67 percent were taking five or more medications or supplements in 2010-2011, up from about 53 percent in 2005-2006.

Use of cholesterol-lowering statins rose from about 34 percent to about 46 percent, the researchers reported in JAMA Internal Medicine. The proportion of people taking blood-thinning medications also increased, from about 33 percent to 43 percent, and use of omega-3 fish oil pills rose from about 5 percent to about 19 percent.

Along with the increase in polypharmacy, the researchers found the risk of major drug interactions nearly doubled, going from about 8 percent to about 15 percent.

"I think we have to keep in mind that while it's important to improve access to medications, we need to make sure they're used safely," said Qato.

On one hand, the new results can be seen as positive, said Dr. Michael Steinman, a gerontologist at the University of California, San Francisco.

We're treating more people with medications that could potentially help them," he said. "But when people have four or five chronic conditions, medications quickly balloon to a large number."

It's important to ensure clear communication between everyone involved in a patient's care, including the patient, said Steinman, who wrote an editorial accompanying the new study.

"You can get rid of problems and excess medications by talking with your doctors," he said.

A separate study reported in the same issue of the journal found that nearly 42 percent of adults did not tell their doctors about the use of complementary or alternative medicine, which includes - among other things - supplements, herbs, homeopathy, special diets and acupuncture.

Many patients said they didn't tell their doctors about these alternative medicines because they weren't asked or because their doctors didn't need to know that information, write Judy Juo and Pamela Jo Johnson, of the University of Minnesota in Minneapolis.

"If a person is talking with their doctor about the medications they're using, they should be talking about all the medications they're using," said Steinman.

(Reuters Health) - The proportion of older Americans taking at least five medications or supplements went up in a recent study.

The increase in people using multiple medications - known as polypharmacy - paralleled an increase in the number of older Americans at risk for major drug interactions, researchers found.

"That's a concern from a public health standpoint, because it's getting worse," said Dima Qato, the study's lead author from the University of Illinois at Chicago.

Qato and her colleagues previously reported that polypharmacy is common among older Americans. More than half were taking prescription and nonprescription medications between 2005 and 2006.

There have been a lot of changes in U.S. regulations and the pharmacy market since that time, however. Some of those changes include new and less expensive generic drugs and the implementation of Medicare Part D, which is the prescription component of the government-run health insurance program for the elderly or disabled.

To evaluate the change in polypharmacy over time, the researchers compared the 2005-2006 results to data collected from 2010-2011.

Participants in the study were between the ages of 62 and 85 and were living at home. The researchers interviewed 2,351 people in 2005-2006 and 2,206 in 2010-2011.

Overall, about 67 percent were taking five or more medications or supplements in 2010-2011, up from about 53 percent in 2005-2006.

Use of cholesterol-lowering statins rose from about 34 percent to about 46 percent, the researchers reported in JAMA Internal Medicine. The proportion of people taking blood-thinning medications also increased, from about 33 percent to 43 percent, and use of omega-3 fish oil pills rose from about 5 percent to about 19 percent.

Along with the increase in polypharmacy, the researchers found the risk of major drug interactions nearly doubled, going from about 8 percent to about 15 percent.

"I think we have to keep in mind that while it's important to improve access to medications, we need to make sure they're used safely," said Qato.

On one hand, the new results can be seen as positive, said Dr. Michael Steinman, a gerontologist at the University of California, San Francisco.

We're treating more people with medications that could potentially help them," he said. "But when people have four or five chronic conditions, medications quickly balloon to a large number."

It's important to ensure clear communication between everyone involved in a patient's care, including the patient, said Steinman, who wrote an editorial accompanying the new study.

"You can get rid of problems and excess medications by talking with your doctors," he said.

A separate study reported in the same issue of the journal found that nearly 42 percent of adults did not tell their doctors about the use of complementary or alternative medicine, which includes - among other things - supplements, herbs, homeopathy, special diets and acupuncture.

Many patients said they didn't tell their doctors about these alternative medicines because they weren't asked or because their doctors didn't need to know that information, write Judy Juo and Pamela Jo Johnson, of the University of Minnesota in Minneapolis.

"If a person is talking with their doctor about the medications they're using, they should be talking about all the medications they're using," said Steinman.

NEW YORK - Medicare Advantage plans might not be meeting the needs of patients requiring the costliest and most complex levels of care, a new study suggests.

Between 2010 and 2011, such patients were more likely to switch from Medicare Advantage plans to traditional Medicare, rather than vice versa, researchers found.

The results suggest people should carefully consider all the benefits, payments, and quality measures before enrolling in Medicare Advantage plans, said lead author Dr. Momotazur Rahman of Brown University in Providence, R.I.

Unlike traditional Medicare, which is the U.S. health insurance program for the elderly and disabled, Medicare Advantage is offered by private insurance companies. While the plans cover all services provided under traditional Medicare, Advantage plans may also include added services like eye and dental coverage. They may also charge different out-of pocket costs and offer access to different sets of providers.

At the beginning of each month, the government pays Medicare Advantage companies a lump sum to cover enrollees' expenses - with higher sums for high-risk patients.

Rahman and his colleagues write in Health Affairs that lump sums encourage companies to keep healthcare costs low. But there's been some concern that companies were maximizing profits by enrolling healthier people, whereas traditional Medicare is obligated to enroll all comers.

According to the authors of the new study, legislation in 2003 aimed to address those concerns, and research suggests it helped close the gap in deaths and healthcare use and spending between people in the two types of plans.

Other studies, however, have suggested Advantage plans were still overpaid under the new system and switching between plans was limited to those needing the most care.

The researchers analyzed data on more than 36,000 Medicare beneficiaries, about a quarter of whom were enrolled in Medicare Advantage plans, to see how many switched from one type of plan to the other over the course of the year.

Overall, there was little difference, with 4 percent of traditional Medicare beneficiaries switching, compared to 5 percent of those in Medicare Advantage plans.

But there was a difference when the researchers looked at people requiring complex care - with more switching away from Medicare Advantage plans than from traditional Medicare.

For example, 17 percent of people in nursing homes for long stays switched from Medicare Advantage to traditional Medicare between 2010 and 2011, while only 3 percent moved in the opposite direction.

Also, 8 percent of people receiving home healthcare switched from Medicare Advantage during that time, compared to 3 percent switching from traditional Medicare.

The results were more exaggerated for people enrolled in both Medicare and Medicaid. Those people are allowed to switch anytime and usually use increasingly expensive care, Dr. Rahman said.

It's not clear why people needing higher levels of care are more likely to switch out of Medicare Advantage plans, said Dr. Gretchen Jacobson, associate director with the Kaiser Family Foundation's Program on Medicare Policy in Washington, D.C.

For example, it could be due to limited provider networks, unused extra benefits, or prescription drug needs, said Dr. Jacobson, who wasn't involved with the new study.

However, she said, it's important to point out that the vast majority of people remain in their chosen programs.

"Most people are not changing when they make an initial decision about their coverage, but this is an area that's ripe for more research," she said.

A representative of America's Health Insurance Plans (AHIP) also stressed that the study only looked at one point in time, and changes for Medicare Advantage plans were adopted since that period.

"More specifically, enrollment in Medicare Advantage has continued to increase year after year as program continues to offer coordinated care that leads to better outcomes for seniors and those with chronic conditions," said AHIP's Clare Krusing.

"If the type of disenrollment that was highlighted in this study was as pervasive as the authors suggest, there would be much greater evidence that beneficiaries were leaving the program in significant numbers," she said.

NEW YORK - Medicare Advantage plans might not be meeting the needs of patients requiring the costliest and most complex levels of care, a new study suggests.

Between 2010 and 2011, such patients were more likely to switch from Medicare Advantage plans to traditional Medicare, rather than vice versa, researchers found.

The results suggest people should carefully consider all the benefits, payments, and quality measures before enrolling in Medicare Advantage plans, said lead author Dr. Momotazur Rahman of Brown University in Providence, R.I.

Unlike traditional Medicare, which is the U.S. health insurance program for the elderly and disabled, Medicare Advantage is offered by private insurance companies. While the plans cover all services provided under traditional Medicare, Advantage plans may also include added services like eye and dental coverage. They may also charge different out-of pocket costs and offer access to different sets of providers.

At the beginning of each month, the government pays Medicare Advantage companies a lump sum to cover enrollees' expenses - with higher sums for high-risk patients.

Rahman and his colleagues write in Health Affairs that lump sums encourage companies to keep healthcare costs low. But there's been some concern that companies were maximizing profits by enrolling healthier people, whereas traditional Medicare is obligated to enroll all comers.

According to the authors of the new study, legislation in 2003 aimed to address those concerns, and research suggests it helped close the gap in deaths and healthcare use and spending between people in the two types of plans.

Other studies, however, have suggested Advantage plans were still overpaid under the new system and switching between plans was limited to those needing the most care.

The researchers analyzed data on more than 36,000 Medicare beneficiaries, about a quarter of whom were enrolled in Medicare Advantage plans, to see how many switched from one type of plan to the other over the course of the year.

Overall, there was little difference, with 4 percent of traditional Medicare beneficiaries switching, compared to 5 percent of those in Medicare Advantage plans.

But there was a difference when the researchers looked at people requiring complex care - with more switching away from Medicare Advantage plans than from traditional Medicare.

For example, 17 percent of people in nursing homes for long stays switched from Medicare Advantage to traditional Medicare between 2010 and 2011, while only 3 percent moved in the opposite direction.

Also, 8 percent of people receiving home healthcare switched from Medicare Advantage during that time, compared to 3 percent switching from traditional Medicare.

The results were more exaggerated for people enrolled in both Medicare and Medicaid. Those people are allowed to switch anytime and usually use increasingly expensive care, Dr. Rahman said.

It's not clear why people needing higher levels of care are more likely to switch out of Medicare Advantage plans, said Dr. Gretchen Jacobson, associate director with the Kaiser Family Foundation's Program on Medicare Policy in Washington, D.C.

For example, it could be due to limited provider networks, unused extra benefits, or prescription drug needs, said Dr. Jacobson, who wasn't involved with the new study.

However, she said, it's important to point out that the vast majority of people remain in their chosen programs.

"Most people are not changing when they make an initial decision about their coverage, but this is an area that's ripe for more research," she said.

A representative of America's Health Insurance Plans (AHIP) also stressed that the study only looked at one point in time, and changes for Medicare Advantage plans were adopted since that period.

"More specifically, enrollment in Medicare Advantage has continued to increase year after year as program continues to offer coordinated care that leads to better outcomes for seniors and those with chronic conditions," said AHIP's Clare Krusing.

"If the type of disenrollment that was highlighted in this study was as pervasive as the authors suggest, there would be much greater evidence that beneficiaries were leaving the program in significant numbers," she said.

NEW YORK - Medicare Advantage plans might not be meeting the needs of patients requiring the costliest and most complex levels of care, a new study suggests.

Between 2010 and 2011, such patients were more likely to switch from Medicare Advantage plans to traditional Medicare, rather than vice versa, researchers found.

The results suggest people should carefully consider all the benefits, payments, and quality measures before enrolling in Medicare Advantage plans, said lead author Dr. Momotazur Rahman of Brown University in Providence, R.I.

Unlike traditional Medicare, which is the U.S. health insurance program for the elderly and disabled, Medicare Advantage is offered by private insurance companies. While the plans cover all services provided under traditional Medicare, Advantage plans may also include added services like eye and dental coverage. They may also charge different out-of pocket costs and offer access to different sets of providers.

At the beginning of each month, the government pays Medicare Advantage companies a lump sum to cover enrollees' expenses - with higher sums for high-risk patients.

Rahman and his colleagues write in Health Affairs that lump sums encourage companies to keep healthcare costs low. But there's been some concern that companies were maximizing profits by enrolling healthier people, whereas traditional Medicare is obligated to enroll all comers.

According to the authors of the new study, legislation in 2003 aimed to address those concerns, and research suggests it helped close the gap in deaths and healthcare use and spending between people in the two types of plans.

Other studies, however, have suggested Advantage plans were still overpaid under the new system and switching between plans was limited to those needing the most care.

The researchers analyzed data on more than 36,000 Medicare beneficiaries, about a quarter of whom were enrolled in Medicare Advantage plans, to see how many switched from one type of plan to the other over the course of the year.

Overall, there was little difference, with 4 percent of traditional Medicare beneficiaries switching, compared to 5 percent of those in Medicare Advantage plans.

But there was a difference when the researchers looked at people requiring complex care - with more switching away from Medicare Advantage plans than from traditional Medicare.

For example, 17 percent of people in nursing homes for long stays switched from Medicare Advantage to traditional Medicare between 2010 and 2011, while only 3 percent moved in the opposite direction.

Also, 8 percent of people receiving home healthcare switched from Medicare Advantage during that time, compared to 3 percent switching from traditional Medicare.

The results were more exaggerated for people enrolled in both Medicare and Medicaid. Those people are allowed to switch anytime and usually use increasingly expensive care, Dr. Rahman said.

It's not clear why people needing higher levels of care are more likely to switch out of Medicare Advantage plans, said Dr. Gretchen Jacobson, associate director with the Kaiser Family Foundation's Program on Medicare Policy in Washington, D.C.

For example, it could be due to limited provider networks, unused extra benefits, or prescription drug needs, said Dr. Jacobson, who wasn't involved with the new study.

However, she said, it's important to point out that the vast majority of people remain in their chosen programs.

"Most people are not changing when they make an initial decision about their coverage, but this is an area that's ripe for more research," she said.

A representative of America's Health Insurance Plans (AHIP) also stressed that the study only looked at one point in time, and changes for Medicare Advantage plans were adopted since that period.

"More specifically, enrollment in Medicare Advantage has continued to increase year after year as program continues to offer coordinated care that leads to better outcomes for seniors and those with chronic conditions," said AHIP's Clare Krusing.

"If the type of disenrollment that was highlighted in this study was as pervasive as the authors suggest, there would be much greater evidence that beneficiaries were leaving the program in significant numbers," she said.

NEW YORK - Chemotherapy-related hospitalization happens much more often in the real world than in drug trials, according to a new study.

Patients with advanced lung cancer receiving chemotherapy in real-world settings were almost eight times more likely to be hospitalized during treatment than those participating in clinical trials.

What's more, very few clinical trials even report how often participants are hospitalized during the research, the study authors found.

"Clinical trials should be routinely reporting their hospitalization rates so we know what to expect," said senior author Dr. Monika Krzyzanowska of the Princess Margaret Cancer Center in Toronto, Canada. "I think that (hospitalization is) actually much more common than we ever anticipated," Krzyzanowska said.

For the new meta-analysis, released online September 17 in JAMA Oncology, the researchers looked at data on patients receiving chemotherapy for metastatic non-small-cell lung cancer, from five reports of clinical trials with a total of 3962 people that specified how many hospitalizations occurred, and five studies involving 8624 people receiving chemotherapy in real-world settings.

Overall, 51% of the real-world patients were hospitalized during their treatments, compared to 16% of those in clinical trials.

Some of the research looked at factors related to the risk of hospitalization like the type of chemotherapy used and hospital performance measures, but results varied from study to study and Krzyzanowska said that she can't say with confidence which factors may be tied to an increased risk of being hospitalized.

But, she said, similar patterns of high hospitalizations are likely to be found among people with other cancers and on other types of treatments.

"I think this is unfortunately a common phenomenon across disease site and treatment regimen," Krzyzanowska said.

Knowing how much time patients may spend in hospitals during chemotherapy might help them and their doctors in deciding which treatment is right, Krzyzanowska said.

"I think the low-hanging fruit is that clinical trials should start reporting hospitalizations," she said of the findings.

With that kind of data, the researchers suggest, scientists can calculate the risk of hospitalization per month of chemotherapy and ultimately provide that to patients.

Krzyzanowska also said she'd like to look at what factors drive hospitalizations among cancer patients receiving chemotherapy.

"I definitely think there is a substantial portion of people whose symptoms can be managed earlier so they don't end up in the hospital," she said.

NEW YORK - Chemotherapy-related hospitalization happens much more often in the real world than in drug trials, according to a new study.

Patients with advanced lung cancer receiving chemotherapy in real-world settings were almost eight times more likely to be hospitalized during treatment than those participating in clinical trials.

What's more, very few clinical trials even report how often participants are hospitalized during the research, the study authors found.

"Clinical trials should be routinely reporting their hospitalization rates so we know what to expect," said senior author Dr. Monika Krzyzanowska of the Princess Margaret Cancer Center in Toronto, Canada. "I think that (hospitalization is) actually much more common than we ever anticipated," Krzyzanowska said.

For the new meta-analysis, released online September 17 in JAMA Oncology, the researchers looked at data on patients receiving chemotherapy for metastatic non-small-cell lung cancer, from five reports of clinical trials with a total of 3962 people that specified how many hospitalizations occurred, and five studies involving 8624 people receiving chemotherapy in real-world settings.

Overall, 51% of the real-world patients were hospitalized during their treatments, compared to 16% of those in clinical trials.

Some of the research looked at factors related to the risk of hospitalization like the type of chemotherapy used and hospital performance measures, but results varied from study to study and Krzyzanowska said that she can't say with confidence which factors may be tied to an increased risk of being hospitalized.

But, she said, similar patterns of high hospitalizations are likely to be found among people with other cancers and on other types of treatments.

"I think this is unfortunately a common phenomenon across disease site and treatment regimen," Krzyzanowska said.

Knowing how much time patients may spend in hospitals during chemotherapy might help them and their doctors in deciding which treatment is right, Krzyzanowska said.

"I think the low-hanging fruit is that clinical trials should start reporting hospitalizations," she said of the findings.

With that kind of data, the researchers suggest, scientists can calculate the risk of hospitalization per month of chemotherapy and ultimately provide that to patients.

Krzyzanowska also said she'd like to look at what factors drive hospitalizations among cancer patients receiving chemotherapy.

"I definitely think there is a substantial portion of people whose symptoms can be managed earlier so they don't end up in the hospital," she said.

NEW YORK - Chemotherapy-related hospitalization happens much more often in the real world than in drug trials, according to a new study.

Patients with advanced lung cancer receiving chemotherapy in real-world settings were almost eight times more likely to be hospitalized during treatment than those participating in clinical trials.

What's more, very few clinical trials even report how often participants are hospitalized during the research, the study authors found.

"Clinical trials should be routinely reporting their hospitalization rates so we know what to expect," said senior author Dr. Monika Krzyzanowska of the Princess Margaret Cancer Center in Toronto, Canada. "I think that (hospitalization is) actually much more common than we ever anticipated," Krzyzanowska said.

For the new meta-analysis, released online September 17 in JAMA Oncology, the researchers looked at data on patients receiving chemotherapy for metastatic non-small-cell lung cancer, from five reports of clinical trials with a total of 3962 people that specified how many hospitalizations occurred, and five studies involving 8624 people receiving chemotherapy in real-world settings.

Overall, 51% of the real-world patients were hospitalized during their treatments, compared to 16% of those in clinical trials.

Some of the research looked at factors related to the risk of hospitalization like the type of chemotherapy used and hospital performance measures, but results varied from study to study and Krzyzanowska said that she can't say with confidence which factors may be tied to an increased risk of being hospitalized.

But, she said, similar patterns of high hospitalizations are likely to be found among people with other cancers and on other types of treatments.

"I think this is unfortunately a common phenomenon across disease site and treatment regimen," Krzyzanowska said.

Knowing how much time patients may spend in hospitals during chemotherapy might help them and their doctors in deciding which treatment is right, Krzyzanowska said.

"I think the low-hanging fruit is that clinical trials should start reporting hospitalizations," she said of the findings.

With that kind of data, the researchers suggest, scientists can calculate the risk of hospitalization per month of chemotherapy and ultimately provide that to patients.

Krzyzanowska also said she'd like to look at what factors drive hospitalizations among cancer patients receiving chemotherapy.

"I definitely think there is a substantial portion of people whose symptoms can be managed earlier so they don't end up in the hospital," she said.