Imagine a cafeteria that’s filled with fresh story ideas and the facts and figures to fill out ideas you already have. AcademyHealth is that cafeteria.

The Washington-based group is the successor to the Association for Health Services research, a longer label that explains what it actually does. AcademyHealth members research questions related to health care costs, access and quality, as well as the policy issues those questions raise.

The most recent AcademyHealth annual research meeting, held in Orlando in late June, examined Medicare from Medicare Medical Insurance (Part A) to Medical Prescription Drug Plans (Part D), plus “Medigap” (private policies that cover what Medicare doesn’t) and “dual eligibles” (those receiving both Medicare and Medicaid). For journalists, the trick to enjoying this cafeteria is to ignore the description of ingredients (“This study used univariate logistic regression…”) and just find something appetizing you want to put on your tray.

Because AcademyHealth members are social scientists, rather than particle physicists or biochemists, it’s not that hard to rephrase research terminology into the kind of story hook that grabs editors and the public. Below are a few examples of papers or posters I’ve translated into actual English:

• “Cognitive Impairment and End-of-Life Health Care Utilization,” from University of Michigan researchers. Or: “If an elderly man or woman is mentally confused, are hospitals likely to ‘pull the plug’ sooner on end-of-life care?”
• “Impact of Community Factors on Readmission Rates,” from Harvard School of Public Health researchers. Or: “Will penalizing hospitals financially when Medicare patients are discharged then readmitted inadvertently hurt the poor and minorities?”
• “Models and Tools to Monitor Medicare Complaints Resolution Performance,” from the private company IMPAQ International and the Centers for Medicare & Medicaid Services (CMS). Or: “When an elderly person files an urgent complaint about a health plan or prescription drug plan, does anyone listen and do anything?”

In case you were wondering about the results, for better or worse, cognitively impaired patients get aggressive end-of-life treatment as often as others. (The principal investigator was Lauren Nicholas, lnicholas@umich.edu.) Readmissions seem to be affected more by the availability of hospital beds and doctors in the community than by an individual hospital’s quality of care. (The principal investigator was Karen Joynt, kjoynt@partners.org.) And when a younger Medicare beneficiary or one who is black or Hispanic complains, they’re less likely to be satisfied with the response. (The principal investigator was Oswaldo Urdapilleta,  ourdapilleta@impaqint.com.)

There are some caveats about this cafeteria. No individual study is necessarily decisive, so be careful about gobbling up the first appetizing analysis you see. In addition, academics have their own version of an appetite suppressant known as “the Ingelfinger rule.” Named after a former editor of the New England Journal of Medicine, it has become an informal academic standard. It essentially says that if you want to get your research published, you can’t talk to the media about it beforehand. However, since we can’t exclude journalists from scientific meetings, we won’t penalize you if someone reports on your public remarks. Just don’t provide too much extra detail.

In my experience, if you ask a limited number of clarifying questions (and write down the answers to questions others ask, if you’re physically at a meeting), you and the researcher will both be in good shape. More to the point, while there are a handful of presentations newsworthy enough to stand on their own, that’s the exception.

The real value of health services research is to help you quickly build stories that use anecdotes to illuminate rather than mislead, even inadvertently. Good research rescues us from the inherent tendency of conventional reporting to highlight the most distraught and persuasive voice and to provide context for complaints. To illustrate, let’s go back to what even the Michigan researchers acknowledge is the “controversial topic” of end-of-life care.

Suppose that an editor’s parent or grandparent, or maybe it was the publisher’s mother, just died in the hospital after a long mental decline due to dementia or Alzheimer’s. The experience left your colleague upset, but the reason for that distress might push you into very different story angles:

“I can’t believe the doctors and hospital did all those terrible procedures in the ICU on a woman who was about to die, anyway. Couldn’t they have let her pass away in peace? No wonder Medicare costs are out of control.”

Or: “Just because my mother’s mind is gone doesn’t mean she’s not still as much a human being as the rest of us. I can’t believe the hospital and doctors were so eager to pull the plug. All anyone seems to care about these days is saving money for the government.”

Or: “There we were, the whole family sitting together in the waiting room trying to figure out whether we should do everything possible to keep mom alive or let nature takes its course. I can’t believe the doctors and hospital didn’t give us better guidance.”

In all three cases, of course, the hospital and doctors may genuinely seem to an unhappy family member to have done something wrong. You’d be hard-pressed to prove otherwise by interviewing a few doctors and hospital execs. In contrast, the Michigan study analyzed inpatient hospitalization records and a cognitive functioning score for 3,302 patients from a nationally representative Medicare sample. The data not only showed that cognitive function does not determine end-of-life care but that “a large proportion of [the] elderly” still neglect to either indicate their own preferences in a living will or designate someone else to make decisions for them.

In other words, it’s not the hospitals, doctors or government who are most responsible for the wasted money or moral dilemmas or hospital-bedside confusion. It’s us.

That’s still a good story. But who’s going to tell the publisher?

Resources

AcademyHealth holds an annual research meeting each June. If it happens to be near you, then attending some sessions, skimming through the list of presentations and posters and schmoozing at receptions and mealtime represents an all-you-can-eat opportunity for any health care beat writer.  In 2012, the meeting was in Orlando; 2013, it will be in Baltimore.

However, you don’t have to attend the meeting to access the PowerPoint slides of all the presentations from the podium and abstracts of all research presented throughout the meeting, organized by topic.  And, of course, you can contact the AcademyHealth public relations folks for help.

There’s also an annual policy conference in Washington, D.C., at the beginning of each year that’s more suitable for trade press or those who report on the Big Stories.

One way to find academic experts is to contact AcademyHealth directly. Another strategy is to use Google Scholar to find which articles on a topic are out there and which are the most cited.  (Clicking on those citations and reading even the short summaries gives you a great overview of what kinds of debate are going on.) Articles in top-notch policy journals such as Health Affairs may be particularly useful. Pub Med, from the National Library of Medicine, can be trickier to use than Google Scholar, but it does allow you to organize what you find by “most recent” and by “most cited” (though it doesn’t give the number of citations nor do the links to them work as easily). Again, this is a good quick-and-dirty check on what’s going on with a particular issue.

To check out a particular source, you might also put that author’s name into the PubMed search and see what else he or she has written.

Michael Millenson is a nationally recognized expert on patient empowerment, e-health and quality improvement. He holds an adjunct appointment as the Mervin Shalowitz, M.D. Visiting Scholar at Northwestern University’s Kellogg School of Management. He spent 13 years as the health reporter for the Chicago Tribune, where he was nominated for three Pulitzer Prizes.  

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