[Reblog] When hospitals buy physician practices, patients hit with fees
From the 5 March 2015 post at Covering Health (Association of Health Care Journalists)
WSB-Atlanta recently explored what happens when hospitals buy physician practices, which has been happening all over the Atlanta area.
Prices for patients go up.
The same physicians – in the same offices, with the same treatments – start charging more.
“Everything is exactly the same,” said cancer patient Mike Rosenberg.
Except the bill.
Sometimes it’s an “outpatient facility fee.” And sometimes it’s a “treatment room fee.”
And it’s a lot of money – sometimes thousands of dollars, not covered by insurance.
And even patients who are savvy enough to know about these fees before they get the bill have a lot of trouble finding out about them, as Erica Byfield made clear in her strong 3-minute report.
…It’s not unique to Atlanta. She quotes a University of California, Berkeley, studythat found that patients generally pay 10 percent more at hospital-owned practices.
…
The ACA does include incentives for “vertical integration,” or having doctors and physicians part of one organization. But it’s not supposed to raise costs. It’s supposed to bring them down by improving efficiency, creating economies and encouraging care coordination. (Some of the fee problems actually stem from Medicare billing practices, not specifically the ACA.)
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Good news! Efforts To Improve Patient Safety Result in 1.3 Million Fewer Patient Harms [AHRQ report]
From the publication summary at the US Agency for Healthcare Research and Quality (AHRQ)
Interim Update on 2013 Annual Hospital-Acquired Condition Rate and Estimates of Cost Savings and Deaths Averted From 2010 to 2013
This document provides preliminary estimates for 2013 on hospital-acquired conditions (HACs), indicating a 17 percent decline, from 145 to 121 HACs per 1,000 discharges, from 2010 to 2013. A cumulative total of 1.3 million fewer HACs were experienced by hospital patients in 2011, 2012, and 2013 relative to the number of HACs that would have occurred if rates had remained steady at the 2010 level. Approximately 50,000 fewer patients died in the hospital as a result of the reduction in HACs, and approximately $12 billion in health care costs were saved from 2010 to 2013.
Exhibit 6. Estimated Deaths Averted, by Hospital-Acquired Condition (HAC), 2011-2013
Preliminary 2013 estimates show that the decline in HACs resulted in a preliminary estimate of cost savings of approximately $8 billion in 2013. Estimated cumulative savings for 2011, 2012, and 2013 are approximately $12 billion (Exhibit 7). As was the case for the deaths averted estimates, the majority of cost savings are estimated to result from declines in pressure ulcers and ADEs (Exhibit 8).
- Interim Update on 2013 Annual Hospital-Acquired Condition Rate and Estimates of Cost Savings and Deaths Averted From 2010 to 2013 (
PDF version – 546.53 KB )
- Methods To Estimate the Baseline 2010 PFP National Hospital-Acquired Condition Rate (
- Updated Information on the Annual Hospital-Acquired Condition Rate: 2011 and 2012 (
Two related Mulford Library resoruces
- Locating Health Statistics (UT Library Guide)
- Nursing Portal (Mulford Library)
As always, do not hesitate to consult a Mulford reference librarian with your research and information needs. Let us same you time and alleviate frustration!
3-D printing offers innovative method to deliver medication
From the 3 March 2015 Society of Interventional Radiology press release
3-D printing could become a powerful tool in customizing interventional radiology treatments to individual patient needs, with clinicians having the ability to construct devices to a specific size and shape. That’s according to a study being presented at the Society of Interventional Radiology’s Annual Scientific Meeting. Researchers and engineers collaborated to print catheters, stents and filaments that were bioactive, giving these devices the ability to deliver antibiotics and chemotherapeutic medications to a targeted area in cell cultures.
“3-D printing allows for tailor-made materials for personalized medicine,” said Horacio R. D’Agostino, M.D., FSIR, lead researcher and an interventional radiologist at Louisiana State University Health Sciences Center (LSUH) in Shreveport. “It gives us the ability to construct devices that meet patients’ needs, from their unique anatomy to specific medicine requirements. And as tools in interventional radiology, these devices are part of treatment options that are less invasive than traditional surgery,” he added.
Using 3-D printing technology and resorbable bioplastics, D’Agostino and his team of biomedical engineers and nanosystem engineers at LSUH and Louisiana Tech University developed bioactive filaments, chemotherapy beads, and catheters and stents containing antibiotics or chemotherapeutic agents. The team then tested these devices in cell cultures to see if they could inhibit growth of bacteria and cancer cells.
When testing antibiotic-containing catheters that could slowly release the drug, D’Agostino’s team found that the devices inhibited bacterial growth. Researchers also saw that filaments carrying chemotherapeutic agents were able to inhibit the growth of cancer cells.
….
[Research Magazine Article] Looking for alternatives to antibiotics
From the March 2015 article by the University of Oslo
Bacteria that talk to one another and organize themselves into biofilms are more resistant to antibiotics. Researchers are now working to develop drugs that prevent bacteria from communicating.
Tracing bacteria: The researchers are testing the new group of drugs in transparent worms called C. elegans, in which they can trace the bacteria while infection develops. They do this by feeding the worms with fluorescent bacteria.
The aim is to find alternatives to antibiotics and reduce the number of antibiotic-resistant bacteria.
– Understanding how bacteria communicate could provide a new means of controlling them and preventing and treating infectious diseases, says Professor Anne Aamdal Scheie at the Department of Oral Biology at the University of Oslo.
Together with Professor Fernanda Cristina Petersen, Aamdal Scheie is shedding light on one of the most important health challenges facing the world today, namely antibiotic resistance. The researchers believe that understanding bacterial communication has a key role to play in the fight against resistant bacteria.
…
Research groups at the Faculty of Dentistry therefore want to understand how bacteria talk to one another – precisely to prevent them from communicating and becoming hazardous.
…
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[Press release] What makes some women able to resist or recover psychologically from assault-related trauma?
Regions of the brain affected by PTSD and stress. (Photo credit: Wikipedia)
From the 2 March 2015 press release
In a study of 159 women who had been exposed to at least one assault-related potentially traumatic event, 30% developed major depressive disorder, which may be attributed to self-blame common to survivors of assault. Fewer women (21%) developed chronic posttraumatic stress disorder.
Mastery–the degree to which an individual perceives control and influence over life circumstances–and social support were most prevalent in women who did not develop a trauma-related psychiatric disorder after assault exposure, while mastery and posttraumatic growth were related to psychiatric recovery. These factors were less established in women with a current psychiatric disorder.
The Brain and Behavior findings have significance for the health and wellbeing of women, and for identifying individuals who are most in need of resilience-promoting interventions. “Women exposed to assault may present with post-trauma depression in lieu of posttraumatic stress disorder. Resilience factors like mastery and social support may attenuate the deleterious effects of an assault,” said lead author Heather L. Rusch. “The next step is to determine the extent that these factors may be fostered through clinical intervention.”
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Poll finds US public sees ill health as resulting from a broad range of causes
Good study. However I would like to see how this compares with what researchers believe are causes/correlations of ill health and how best to address the causes/correlations.
From the 2 March 2015 Harvard School of Public Health press release
Many believe their health has been impacted by negative childhood experiences
A new NPR/Robert Wood Johnson Foundation/Harvard T.H. Chan School of Public Health poll finds that more than six in ten people living in the U.S. (62%) are concerned about their future health. Nearly four in ten (39%) said that they had one or more negative childhood experiences that they believe had a harmful impact on their adult health.
Causes of ill health
“When the public thinks about the causes of ill health, it’s not just about germs. They also see access to medical care, personal behavior, stress, andpollution as affecting health,” said Robert J. Blendon, Richard L. Menschel Professor of Health Policy and Political Analysis at Harvard T.H. Chan School of Public Health.
When given a list of 14 factors that might cause ill health, the top five causes cited by the public as extremely important are lack of access to high-quality medical care (42%), personal behavior (40%), viruses or bacteria (40%), high stress (37%), and exposure to air, water, or chemical pollution (35%).
Those rankings diverge, however, among ethnic groups.
…
Actions to improve health
Given the wide range of reasons given for why ill health occurs, it is not surprising that people in the U.S. have a very broad view of the actions that could be taken to improve people’s health. The top five things (from a list of 16) that the public believes would improve people’s health a great deal are: improving access to affordable healthy food (57%), reducing illegal drug use (54%), reducing air, water, or chemical pollution (52%), increasing access to high-quality health care (52%), and improving the economy and the availability of jobs (49%).
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[News item] Adults only really catch flu about twice a decade
Don’t think the article is advocating skip the annual flu shots!
Adults only really catch flu about twice a decade, suggests study
From the release
Adults over the age of 30 only catch flu about twice a decade, a new study suggests.
Flu-like illness can be caused by many pathogens, making it difficult to assess how often people are infected by influenza.
Researchers analysed blood samples from volunteers in Southern China, looking at antibody levels against nine different influenza strains that circulated from 1968 to 2009.
They found that while children get flu on average every other year, flu infections become less frequent as people progress through childhood and early adulthood. From the age of 30 onwards, flu infections tend to occur at a steady rate of about two per decade.
Dr Adam Kucharski, who worked on the study at Imperial College London before moving to the London School of Hygiene & Tropical Medicine, said: “There’s a lot of debate in the field as to how often people get flu, as opposed to flu-like illness caused by something else. These symptoms could sometimes be caused by common cold viruses, such as rhinovirus or coronavirus. Also, some people might not realise they had flu, but the infection will show up when a blood sample is subsequently tested. This is the first time anyone has reconstructed a group’s history of infection from modern-day blood samples.”
Dr Steven Riley, senior author of the study, from the Medical Research Council Centre for Outbreak Analysis and Modelling at Imperial, said: “For adults, we found that influenza infection is actually much less common than some people think. In childhood and adolescence, it’s much more common, possibly because we mix more with other people. The exact frequency of infection will vary depending on background levels of flu and vaccination.”
In addition to estimating the frequency of flu infection, the researchers, from the UK, the US and China, developed a mathematical model of how our immunity to flu changes over a lifetime as we encounter different strains of the virus.
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[Press release] New nanodevice defeats drug resistance
New nanodevice defeats drug resistance
From the 3 March 2015 MIT press release
Tiny particles embedded in gel can turn off drug-resistance genes, then release cancer drugs.
Chemotherapy often shrinks tumors at first, but as cancer cells become resistant to drug treatment, tumors can grow back. A new nanodevice developed by MIT researchers can help overcome that by first blocking the gene that confers drug resistance, then launching a new chemotherapy attack against the disarmed tumors.
The device, which consists of gold nanoparticles embedded in a hydrogel that can be injected or implanted at a tumor site, could also be used more broadly to disrupt any gene involved in cancer.
“You can target any genetic marker and deliver a drug, including those that don’t necessarily involve drug-resistance pathways. It’s a universal platform for dual therapy,” says Natalie Artzi, a research scientist at MIT’s Institute for Medical Engineering and Science (IMES), an assistant professor at Harvard Medical School, and senior author of a paper describing the device in the Proceedings of the National Academy of Sciences the week of March 2.
,,,
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[Audio program] The New Medicine: Hacking our Biology
The New Medicine: Hacking Our Biology is part of the series “Engineers of the New Millennium” from IEEE Spectrum magazine and the Directorate for Engineering of the National Science Foundation. These stories explore technological advances in medical inventions to enhance and extend life.
Transcripts are included.
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[Press release]Zombie outbreak? Statistical mechanics reveal the ideal hideout | EurekAlert! Science News
Zombie outbreak? Statistical mechanics reveal the ideal hideout | EurekAlert! Science News.
To be presented at the 2015 APS March Meeting in San Antonio, Texas, March 5
From the press release
A team of Cornell University researchers focusing on a fictional zombie outbreak as an approach to disease modeling suggests heading for the hills, in the Rockies, to save your brains from the undead.
Reading World War Z, an oral history of the first zombie war, and a graduate statistical mechanics class inspired a group of Cornell University researchers to explore how an “actual” zombie outbreak might play out in the U.S.
During the 2015 American Physical Society March Meeting, on Thursday, March 5 in San Antonio, Texas, the group will describe their work modeling the statistical mechanics of zombies–those thankfully fictional “undead” creatures with an appetite for human flesh. (See the abstract: http://meeting.aps.org/Meeting/MAR15/Session/S48.8)
Why model the mechanics of zombies? “Modeling zombies takes you through a lot of the techniques used to model real diseases, albeit in a fun context,” says Alex Alemi, a graduate student at Cornell University.
…
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[Report] Sex, contraception, or abortion? Class gaps in unintended childbearing | Brookings Institution
Sex, contraception, or abortion? Class gaps in unintended childbearing | Brookings Institution.
From the report
A poor woman is about five times as likely as an affluent woman to have an unintended birth, which further deepens the divides in income, family stability, and child outcomes. But what is behind the gap? That is the question we address in our new paper, Sex, Contraception, or Abortion? Explaining Class Gaps in Unintended Childbearing, and in this data interactive.”
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How can I order Evidence Reports/Technology Assessments (ERTAs) or Comparative Effectiveness Reviews?
What are Evidence Based Reports?
EPC Evidence-Based Reports (home page and links to reports)
The Agency for Healthcare Research and Quality (AHRQ), through its EPCs, sponsors the development of various reports to assist public- and private-sector organizations in their efforts to improve the quality of health care in the United States. These reports provide comprehensive, science-based information on common, costly medical conditions and new health care technologies and strategies. The EPCs review all relevant scientific literature on a wide spectrum of clinical and health services topics. EPCs also produce technical reports on methodological topics and other types of evidence synthesis-related reports.
Where do Technology Assessments come from?
The Technology Assessment (TA) Program at the Agency for Healthcare Research and Quality (AHRQ) provides technology assessments for the Centers for Medicare & Medicaid Services (CMS). These technology assessments are used by CMS to inform its national coverage decisions for the Medicare program as well as provide information to Medicare carriers.
Fact sheets and reports can be found through The Technology Assessment (TA) Program
How can I order Evidence Reports/Technology Assessments (ERTAs) or Comparative Effectiveness Reviews? [From http://www.ncbi.nlm.nih.gov/books/NBK45610/ (accessed 3 March 2015)]
The Evidence Reports/Technology Assessments (ERTAs) and Comparative Effectiveness Reviews (CERs) are provided to Bookshelf by the Agency for Healthcare Research and Quality (AHRQ). AHRQ has a publications clearinghouse, which can be accessed through this link: http://ahrqpubs.ahrq.gov/OA_HTML/ibeCZzpHome.jsp
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United Nations News Centre – Over 5 billion people worldwide lacking access to essential medicines, says UN report
From the 3 March 2015 report
A patient in a hospital in Cambodia is given some pain killers. Photo: World Bank/Masaru Goto
3 March 2015 – Three quarters of the world population has no access to proper pain relief treatment, according to a report by the United Nations body charged with overseeing Governments’ compliance with international drug control treaties, which was released in London today.
Around 5.5 billion people still have limited or no access to medicines containing narcotic drugs such as codeine or morphine the Vienna-based International Narcotics Control Board (INCB) says in its Annual Report for 2014, which went on to point out that around 92 per cent of all morphine used worldwide is consumed by only 17 per cent of the world population, primarily living in the United States, Canada, Western Europe, Australia and New Zealand.
The report, which calls on Governments to address the discrepancy in order to comply with International Drug Control Conventions, notes that natural disasters and armed conflicts around the world can further limit access to essential medicines and the Board stressed that in cases of emergency medical care, simplified control measures can be applied.
For example in the Philippines following the destruction by Typhoon Haiyan in 2013, the Board pointed out to all countries as well as to providers of humanitarian assistance the simplified procedures for the export, transportation and delivery of medicines containing substances under international control.
In its Report, the INCB notes that drug control measures do not exist in a vacuum and that, in their implementation of the drug control conventions, States must also comply with obligations under other treaties, including international humanitarian law and their international human rights obligations, such as allowing civilians to have access to medical care and essential medicines during armed conflicts.
Additionally, the INCB noted that States were charged with deciding specific sanctions for drug-related offences, but should avoid application of the death penalty for such cases.
To achieve a balanced and integrated approach to the drug problem, Governments also should ensure that demand reduction is one of the first priorities of their drug control policies, while they should put greater emphasis on and provide support and appropriate resources to prevention, treatment and rehabilitation, the Report says.
Among the rest of the Report’s findings were an increase in the number of new psychoactive substances (NPS) by 11 per cent and a 66 per cent increase in global consumption of methylphenidate, a stimulant primarily used in the treatment of Attention Deficit Hyperactivity Disorder (ADHD).
The Report also pointed out that the legalization of production, distribution, sale and consumption of cannabis and its derivatives for recreational purposes in Uruguay, together with the moves by States in the United States to legalise sale and distribution of cannabis for non-medical purposes, ran counter to article 4 of the 1961 Single Convention on narcotic drugs, which requires States to limit the use of narcotic drugs to medical and scientific purposes.
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About
This blog presents a sampling of health and medical news and resources for all. Selected articles and resources will hopefully be of general interest but will also encourage further reading through posted references and other links. Currently I am focusing on public health, basic and applied research and very broadly on disease and healthy lifestyle topics.
Several times a month I will post items on international and global health issues. My Peace Corps Liberia experience (1980-81) has formed me as a global citizen in many ways and has challenged me to think of health and other topics in a more holistic manner.
Do you have an informational question in the health/medical area?
Email me at jmflahiff@yahoo.com
I will reply within 48 hours.
This blog is a companion site to my Health and Medical News and Resources Web site with…
- Great places to start (locating health information)
- Links to help from others (as health care providers and support groups)
- Interactive tools (as health calculators and apps)
- Select related news sites and blogs
My professional work experience and education includes over 15 years experience as a medical librarian and a Master’s in Library Science. In my most recent position I enjoyed contributing to our library’s blog, performing in depth literature searches, and collaborating with faculty, staff, students, and the general public.
While I will never be be able to keep up with the universe of current health/medical news, I subscribe to the following to glean entries for this blog.
- Science Daily – Your source for the latest research news
- MedlinePlus email updates from the US National Institutes of Health
- Partners in Information Access for the Public Health Workforce – a collaboration of U.S. government agencies, public health organizations and health sciences libraries
- US Agency for Healthcare Research and Quality (AHRQ) news now with updates on the agency’s efforts to “improve the quality, safety, efficiency, and effectiveness of health care for all Americans”
- Research Buzz, “news about search engines, digital archives, online museums, databases, and other Internet information collections since 1998”
- Scout Report, a “weekly publication offering a selection of new and newly discovered Internet resources of interest to researchers and educators”
- KevinMD.com -“Social Media’s leading physician voice”
- EurekAlert-Medicine and Health
Health and Medical News and Resources 