Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for October 2018. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Sub-Concussive Hits May Not Be Tied to Neurocognitive Changes

WEDNESDAY, Oct. 31, 2018 (HealthDay News) — Sub-concussive head impacts suffered over the course of a single season of youth tackle football may not be associated with neurocognitive functional outcomes, according to a study published Oct. 12 in the Journal of Head Trauma Rehabilitation.

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AMA Announces Initiative to Reinvent Physician Training

TUESDAY, Oct. 30, 2018 (HealthDay News) — The American Medical Association (AMA) today announced a new $15 million competitive grant initiative, the “Reimagining Residency” initiative, aimed at improving residency training.

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Many Hospitals Noncompliant With Record Request Regulations

MONDAY, Oct. 29, 2018 (HealthDay News) — Among top-ranked U.S. hospitals, data reveal discrepancies in information provided to patients regarding medical records release processes as well as noncompliance with state and federal regulations, according to a study published online Oct. 5 in JAMA Network Open.

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Trump Administration Announces Plan to Cut Drug Prices

FRIDAY, Oct. 26, 2018 (HealthDay News) — In an effort to cut high drug costs, the prices paid by Medicare for certain prescription drugs would be based on those in other advanced industrial nations, according to a proposal announced Oct. 25 by the Trump administration.

HHS Study
New York Times Article

Novel Troponin Assay, hs-cTnI Comparable in Ruling Out AMI

FRIDAY, Oct. 26, 2018 (HealthDay News) — A single point-of-care troponin concentration measured on arrival to the emergency department (ED) with 15-minute turnaround time can accurately rule out acute myocardial infarction (AMI), according to a study published online Oct. 17 in JAMA Cardiology.

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Millions of ER Visits for Asthma Due to Air Pollution

FRIDAY, Oct. 26, 2018 (HealthDay News) — Air pollution accounts for millions of emergency room visits for asthma each year, according to a study published Oct. 24 in Environmental Health Perspectives.

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No Drop Seen in CT Use for Pediatric Head Trauma

FRIDAY, Oct. 26, 2018 (HealthDay News) — Computed tomography (CT) neuroimaging did not decrease from 2007 to 2015 among pediatric patients evaluated in the emergency department for head injury, according to a study published in the October issue of Pediatrics.

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Editorial (subscription or payment may be required)

Oxygen Saturation Should Not Top 96 Percent in Acutely Ill

THURSDAY, Oct. 25, 2018 (HealthDay News) — For acutely ill patients, an oxygen saturation of no more than 96 percent should be maintained, according to a clinical practice guideline published online Oct. 24 in the BMJ.

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Editorial

HEART Pathway Can Safely Identify Low-Risk ER Patients

THURSDAY, Oct. 25, 2018 (HealthDay News) — Implementation of the HEART Pathway is associated with decreased hospitalizations, increased identification of myocardial infarction (MI) at the index visit, and a very low death and MI rate among low-risk emergency department patients with chest pain, according to a study published online Sept. 28 in Circulation: Cardiovascular Quality and Outcomes.

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Pace of Change Has Accelerated in Alternative Payment Models

THURSDAY, Oct. 25, 2018 (HealthDay News) — The impact of alternative payment models (APMs) on physician practices has been described in a study published by the RAND Corp. and the American Medical Association.

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Nearly Half of Children Seen in ED for Bronchiolitis Get Radiography

THURSDAY, Oct. 25, 2018 (HealthDay News) — Despite guideline recommendations to the contrary, nearly half of children seen in the emergency department for bronchiolitis receive radiography, according to a research letter published online Oct. 16 in the Journal of the American Medical Association.

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7 Children Dead From Adenovirus Outbreak in New Jersey

WEDNESDAY, Oct. 24, 2018 (HealthDay News) — New Jersey health officials on Wednesday confirmed the deaths of seven children after infection with an adenovirus.

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Article from The Record (Bergen County)

FDA Approves First New Influenza Drug in 20 Years

WEDNESDAY, Oct. 24, 2018 (HealthDay News) — For the first time in nearly two decades, the U.S. Food and Drug Administration has approved a new type of antiviral influenza drug.

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Almost One in 10 Treated in Hospital for Non-Fatal Injury

WEDNESDAY, Oct. 24, 2018 (HealthDay News) — In 2013, 9.8 per 100 people were treated in the hospital for a non-fatal injury, with costs estimated at $1.853 trillion, according to a study published online Oct. 8 in Injury Epidemiology.

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High-Dose Flu Vaccine May Cut Hospitalization in Dialysis Patients

WEDNESDAY, Oct. 23, 2018 (HealthDay News) — Receipt of the high-dose influenza vaccine in 2016 to 2017 was associated with lower rates of hospitalization among dialysis patients, according to a study published online Oct. 23 in the Clinical Journal of the American Society of Nephrology.

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Editorial (subscription or payment may be required)

Deep Neural Network Improves Detection of Wrist Fractures

WEDNESDAY, Oct. 24, 2018 (HealthDay News) — Deep learning methods allow senior medical specialists to deliver their expertise to emergency medicine clinicians via use of a deep neural network, which is associated with considerable improvement in sensitivity and specificity of detecting fractures in wrist radiographs, according to a study published online Oct. 22 in the Proceedings of the National Academy of Sciences.

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Most Supplements Contain Prohibited Stimulants

WEDNESDAY, Oct. 24, 2018 (HealthDay News) — Many supplements contain one or more stimulants that have been the subject of U.S. Food and Drug Administration-issued public notices, according to a research letter published online Oct. 22 in JAMA Internal Medicine.

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Health Enterprise Zone Initiative Cut Hospitalizations, Costs

WEDNESDAY, Oct. 24, 2018 (HealthDay News) — Maryland’s Health Enterprise Zone Initiative reduced hospitalizations and led to net cost savings, according to a study published in the October issue of Health Affairs.

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White House Unveils New Insurance Option for Small Firms

TUESDAY, Oct. 23, 2018 (HealthDay News) — A plan to allow small businesses to use tax-free accounts to provide health coverage for employees was announced today by the Trump administration.

AP News Article
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Policy Denying Coverage for Nonemergent ED Visits Imprecise

TUESDAY, Oct. 23, 2018 (HealthDay News) — A policy retrospectively denying insurance coverage if an emergency department discharge diagnosis is determined to be nonemergent is not associated with accurate identification of unnecessary emergency department visits, according to a study published online Oct. 19 in JAMA Network Open.

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Editorial

Diagnostic Strategy Can Rule Out PE in Pregnant Women

MONDAY, Oct. 22, 2018 (HealthDay News) — A diagnostic strategy based on pretest clinical probability assessment, high-sensitivity D-dimer testing, bilateral lower-limb compression ultrasonography (CUS), and computed tomography pulmonary angiography (CTPA) can safely rule out pulmonary embolism (PE) in pregnant women, according to a study published online Oct. 23 in the Annals of Internal Medicine.

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Editorial (subscription or payment may be required)

High Uptake, Acceptability of Rapid Fentanyl Test Strips

MONDAY, Oct. 22, 2018 (HealthDay News) — Young adults who report injecting drugs or using heroin, cocaine, or illicitly obtained prescription pills report high uptake and acceptability of fentanyl test strips to detect illicitly manufactured fentanyl, according to a study published online Oct. 18 in the International Journal of Drug Policy.

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CDC: First U.S. Case of Rat-Borne Andes Virus Diagnosed

FRIDAY, Oct. 19, 2018 (HealthDay News) — The first confirmed U.S. case of a virus carried by South American rodents occurred earlier this year, the U.S. Centers for Disease Control and Prevention says.

CNN Article
CDC Case Report

Sharp Drop in U.S. Life Expectancy Rankings by 2040

THURSDAY, Oct. 18, 2018 (HealthDay News) — The United States will have the largest drop in life expectancy rankings of all high-income countries by 2040, a new study says.

CNN Article
Abstract/Full Text
Editorial

Procurement Requirements Drive Interoperability in Health Care IT

THURSDAY, Oct. 18, 2018 (HealthDay News) — Interoperability of health care information technology (IT) must be improved to facilitate creation of a fully integrated health care system that can improve health and health care at lower cost, according to a report published by the National Academy of Medicine.

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Simple Clinical Assessment in ED Best for Predicting Mortality

THURSDAY, Oct. 18, 2018 (HealthDay News) — A simple clinical assessment seems to be superior to the formalized Danish Emergency Process Triage (DEPT) system for predicting mortality in patients presenting to the emergency department, according to a study published online Oct. 16 in the Emergency Medicine Journal.

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Editorial

CDC Warns of Salmonella Illnesses Linked to Raw Chicken

WEDNESDAY, Oct. 17, 2018 (HealthDay News) — The number of people sickened in a Salmonella outbreak linked to raw chicken products now stands at 92 people in 29 states, U.S. health officials said today.

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CDC Warns of Polio-Like Virus Striking More U.S. Children

TUESDAY, Oct. 16, 2018 (HealthDay News) — A rare but devastating polio-like virus appears to have made itself at home in the United States, partially paralyzing hundreds of children.

HealthDay Article
More Information: CDC

Change in Shelter Eligibility Policy Tied to More ED Visits

TUESDAY, Oct. 16, 2018 (HealthDay News) — A policy change to Massachusetts’ shelter eligibility was tied to increased pediatric emergency department visits for homelessness and substantial health care costs, according to a study published online Oct. 15 in Pediatrics.

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Editorial

High Risk for Readmission for Takotsubo Syndrome

TUESDAY, Oct. 16, 2018 (HealthDay News) — Patients with Takotsubo syndrome (TTS), which is characterized by transient left ventricular dysfunction with symptoms and electrocardiogram changes mimicking acute myocardial infarction (AMI), have lower mortality during the index admission than AMI patients but are frequently readmitted within 30 days, according to a study published online Sept. 28 in the European Heart Journal – Quality of Care & Clinical Outcomes.

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Without Medicaid Expansion, Poor Patients Forgo Medical Care

MONDAY, Oct. 15, 2018 (HealthDay News) — Doing without medical care is much more common among low-income residents of states that have not expanded Medicaid than among low-income people in other states, according to a Government Accountability Office report.

AP News Article

Active Pharmaceuticals ID’d in >700 Dietary Supplements

MONDAY, Oct. 15, 2018 (HealthDay News) — Dietary supplements often include active pharmaceuticals, even after warnings from the U.S. Food and Drug Administration, according to a study published online Oct. 12 in JAMA Network Open.

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Editorial

FDA Approves New DNA-Based Test to Verify Blood Compatibility

FRIDAY, Oct. 12, 2018 (HealthDay News) — The U.S. Food and Drug Administration has approved the ID CORE XT DNA-based test to help doctors verify blood compatibility before a transfusion.

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Eye Trauma Secondary to Falls in Older Adults Increasing

FRIDAY, Oct. 12, 2018 (HealthDay News) — Eye trauma as a secondary admission diagnosis is increasing, largely because of an increased incidence of falls in older individuals, according to a study published online Oct. 4 in JAMA Ophthalmology.

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Nine Cases of Polio-Like Illness Suspected in Children in Illinois

THURSDAY, Oct. 11, 2018 (HealthDay News) — Nine recent cases of a rare, polio-like disorder in children are being investigated in Illinois, health officials said yesterday.

CNN Article
More Information: CDC

Aetna-CVS Merger Approved

WEDNESDAY, Oct. 10, 2018 (HealthDay News) — A $69 billion merger between health insurer Aetna and pharmacy manager CVS Health has been approved, according to the U.S. Justice Department.

The New York Times Article

Polio-Like Condition in Children on Rise Again in the United States

TUESDAY, Oct. 9, 2018 (HealthDay News) — A rare, polio-like condition in children is on the rise again in the United States, with 38 confirmed cases in 16 states so far this year, the U.S. Centers for Disease Control and Prevention says.

NBC News Article
More Information: CDC

Flea-Borne Typhus Outbreak in Los Angeles County

TUESDAY, Oct. 9, 2018 (HealthDay News) — An outbreak of flea-borne typhus in Los Angeles County has so far resulted in 57 cases, including 20 in Pasadena and nine in downtown Los Angeles, public health officials say.

CNN Article
More Information: CDC

Minority Residents Experience Burdens Linked to Race/Ethnicity

TUESDAY, Oct. 9 2018 (HealthDay News) — Minority residents describe burdens associated with race/ethnicity, including microaggressions and bias on a daily basis, according to a study published online Sept. 28 in JAMA Network Open.

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Editorial

Congress Passes Bill to Fight Opioid Crisis

FRIDAY, Oct. 5, 2018 (HealthDay News) — A bipartisan bill to fight the opioid addiction crisis in the United States has been passed by Congress. President Donald Trump said he would sign the bill into law.

AP News Article

AZ Company Recalls Raw Beef Products Linked to Salmonella

FRIDAY, Oct. 5, 2018 (HealthDay News) — An Arizona company has recalled more than 6.5 million pounds (2.9 million kilograms) of beef linked to a Salmonella outbreak that has sickened 57 people in 16 states. Fourteen people have been hospitalized. No deaths have been reported, according to the U.S. Centers for Disease Control and Prevention.

AP News Article
CDC Food Safety Alert

Industry-Funded Trials Often Involve Employees in Studies

FRIDAY, Oct. 5, 2018 (HealthDay News) — Industry employees are often involved in the design, conduct, and reporting of industry-funded trials in high-impact journals, according to a study published online Oct. 3 in The BMJ.

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One-Third of Older Adults Die After Emergency Intubation

FRIDAY, Oct. 5, 2018 (HealthDay News) — Of older adults who undergo intubation in the emergency department, 33 percent die during the index hospitalization, according to a study published recently in the Journal of the American Geriatrics Society.

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No Increase in In-Hospital, Post-Discharge Death With HRRP

FRIDAY, Oct. 5, 2018 (HealthDay News) — Announcement and implementation of the Hospital Readmissions Reduction Program (HRRP) was not associated with increases in in-hospital or post-discharge mortality after acute myocardial infarction (AMI), heart failure, or pneumonia, according to a study published online Sept. 28 in JAMA Network Open.

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Editorial

Morbidity, Mortality Up for Youth With CHD Presenting to ED

FRIDAY, Oct. 5, 2018 (HealthDay News) — Children with congenital heart disease (CHD) presenting to the emergency department have increased rates of inpatient admission and mortality and higher emergency department charges than those without CHD, according to a study published in the Oct. 9 issue of the Journal of the American College of Cardiology.

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Three-Quarters of Health Care Workers Got Flu Shot Last Year

THURSDAY, Oct. 4, 2018 (HealthDay News) — Just over three-quarters of health care personnel received a flu vaccine last season, according to research published in the Sept. 28 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Price Hikes Noted in Small Subset of Generic Drugs

THURSDAY, Oct. 4, 2018 (HealthDay News) — A small but growing subset of generic drugs experienced sudden large price increases from 2007 to 2013, according to a study published in the October issue of Health Affairs.

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Tips Provided for Budgeting in Medical Residency

THURSDAY, Oct. 4, 2018 (HealthDay News) — Medical residents should start budgeting and save for the future, according to an article published in the American Medical Association AMA Wire.

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47 Percent of Emergency Doctors Have Been Assaulted at Work

THURSDAY, Oct. 4, 2018 (HealthDay News) — Nearly half of emergency medicine physicians report having been physically assaulted at work, according to a report from the American College of Emergency Physicians (ACEP).

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Red Tide May Be Cause of Florida Beachgoers’ Breathing Problems

WEDNESDAY, Oct. 3, 2018 (HealthDay News) — Red tide may be the reason why some beachgoers on Florida’s Atlantic coast have suffered breathing problems, according to Palm Beach County officials.

CBS/AP News Article

CDC: Salmonella Outbreak Linked to Gravel Ridge Farms Eggs

WEDNESDAY, Oct. 3, 2018 (HealthDay News) — The multistate Salmonella outbreak linked to Gravel Ridge Farms cage-free large eggs has grown, and consumers, restaurants, and retailers should not eat, serve, or sell the eggs, the U.S. Centers for Disease Control and Prevention says.

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Medicare Patient Readmit Rates Higher in Proprietary Hospitals

WEDNESDAY, Oct. 3, 2018 (HealthDay News) — Among Medicare patients with six major diseases, readmission rates are higher for those receiving care in proprietary hospitals compared with government or nonprofit hospitals, according to a study published online Sept. 18 in PLOS ONE.

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Fall Risk Screening Strategy Cuts Fall-Related Hospitalizations

WEDNESDAY, Oct. 3, 2018 (HealthDay News) — Implementation of a multifactorial fall risk intervention, which includes screening for fall risk assessment for modifiable risk factors, and prescribing evidence-based interventions to reduce fall risk can reduce the likelihood of fall-related hospitalization, according to a study published online Sept. 20 in The Gerontologist.

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Opioid-Related Hospital Use Up in Elderly Adults

WEDNESDAY, Oct. 3, 2018 (HealthDay News) — Rates of opioid-related prescriptions and health care utilization are rising among seniors, according to two September statistical briefs released by the Agency for Healthcare Research and Quality (AHRQ). The reports relied on data from the Healthcare Cost and Utilization Project and the Medical Expenditure Panel Survey.

Abstract/Full Text – Weiss
Abstract/Full Text – Moriya and Miller

Uninsured Rate at 8.8 Percent in First Quarter of 2018

WEDNESDAY, Oct. 3, 2018 (HealthDay News) — In the first quarter of 2018, the uninsured rate was 8.8 percent, not significantly different from a year earlier, according to a report released Aug. 29 by the National Center for Health Statistics (NCHS).

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Preventable Cardiovascular Events Are Big Economic Burden

TUESDAY, Oct. 2, 2018 (HealthDay News) — Preventable cardiovascular events place a considerable health and economic burden on the United States, according to research published in the Sept. 7 issue of the U.S. Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report.

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For Employer-Based Plans, Spending Across Services Steady

TUESDAY, Oct. 2, 2018 (HealthDay News) — Despite large health policy changes, the distribution of spending across service areas has remained fairly consistent over the past 10 years for those enrolled in employer-sponsored insurance, according to a study published in the October issue of Health Affairs.

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Blacks Less Likely to Receive Guideline-Based NSTEMI Therapy

TUESDAY, Oct. 2, 2018 (HealthDay News) — Black patients have a lower likelihood of receiving guideline-based therapies for non-ST-segment-elevation myocardial infarction (NSTEMI), according to a study published online Sept. 20 in the Journal of the American Heart Association.

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Telemedicine RTI Visits Shorter When Antibiotic Prescribed

TUESDAY, Oct. 2, 2018 (HealthDay News) — In a direct-to-consumer (DTC) telemedicine setting, respiratory tract infection (RTI) encounters in which antibiotics are prescribed are shorter than other encounters, according to a research letter published online Oct. 2 in the Annals of Internal Medicine.

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Interviews Can Help Ensure Physician Candidates Fit Culture

TUESDAY, Oct. 2, 2018 (HealthDay News) — In preparing to interview to hire a new physician, practices must understand their own cultures, according to an article published in Medical Economics.

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Number of Health-Related Data Breaches Increasing

TUESDAY, Oct. 2, 2018 (HealthDay News) — The number of health data breaches has steadily increased since 2010, according to a research letter published in the Sept. 25 issue of the Journal of the American Medical Association.

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Editorial (subscription or payment may be required)

Insufficient Sleep Tied to Unsafe Behaviors in High School Students

MONDAY, Oct. 1, 2018 (HealthDay News) — For high school students, sleeping less than eight hours on an average school night is associated with increased odds of selected unsafe behaviors, according to a research letter published online Oct. 1 in JAMA Pediatrics.

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Hospital Privacy Curtains Become Increasingly Contaminated

MONDAY, Oct. 1, 2018 (HealthDay News) — Curtains surrounding patient beds become progressively contaminated with bacteria, according to a study published in the September issue of the American Journal of Infection Control.

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More Non-Elderly Americans Uninsured in 2017 Versus 2016

MONDAY, Oct. 1, 2018 (HealthDay News) — From 2016 to 2017, there was an increase in the number of uninsured non-elderly Americans, according to a report published by the Robert Wood Johnson Foundation.

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