Though the pandemic and all its attendant health care crises remained the major health care story of 2022, churning all the while in the background has been the critical work of academic scholars, operating on longer timelines, who are still trying to make sense of US health care and of medicine itself, to get a better idea of what’s wrong and how to make it better.
To wrap up this year, I asked a couple dozen health policy experts what research released this year (though, as one of them reminded me, these papers are often years in the making) had surprised them, changed their thinking, or struck them as especially notable.
Here are five particularly interesting papers, at least in my view. Because many more than that warrant mention, I have tried to cram in as many references to other work as I could. One of my lessons from this exercise was that there are noteworthy new studies being produced all the time. The US health system certainly merits such extensive investigation, given the number and diversity of its flaws.
These studies cover a broad range of subjects, from the intricacies of Medicaid provider networks to prescription uptake by Medicare beneficiaries to how bystanders react when a person experiences a cardiac episode in public. But first, on the topic of the pandemic…
1) Vaccination education campaigns in nursing homes didn’t make much difference
Several experts pointed me to data sets related to Covid-19 vaccination in nursing homes, the scenes of so much illness and death in that frightening first year of the pandemic. Larry Levitt, executive vice president of the Kaiser Family Foundation, flagged one recent KFF survey that found less than half of nursing-home residents are up to date on their vaccines.
That put into sharp relief the findings of a study that Harvard Medical School’s David Grabowski cited as one of his favorites of the year. The paper, published in JAMA Internal Medicine in January 2022, evaluated an effort to use educational campaigns and other incentives to improve vaccination rates among residents and staff in nursing homes.
They did not find a meaningful effect, despite three months of programming. There was plenty of room to grow, particularly among the staff, roughly half of whom were unvaccinated during the study period. (Vaccination rates among residents were already high at the time, though the experiment still did not find a significant effect of the multi-faceted campaign.)
“The conventional wisdom was that a big part of lagging vaccination rates was a lack of information and knowledge about the benefits of vaccination,” Grabowski said. But this study found instead that “these educational efforts were unsuccessful at encouraging greater vaccination. Although information campaigns sound like great policy, they really aren’t.”
He lamented that the study had been ignored by policymakers, noting federal efforts to increase vaccination rates among this population remain focused on education. Grabowski said the policies with the strongest evidence are vaccine clinics and vaccine mandates for staff.