From the 25 January 2014 post at The Health Care Blog
By William H. Frist, MD
Here’s a point most of us can agree on. Tackling ballooning health care costs requires more than insurance reform because the charge and cost structure for health services in the U.S. is inconsistent and irrational. The same quality CT scan that costs $500 at one outpatient facility costs $2,000 at a nearby teaching hospital.
Obamacare’s typical high-deductible insurance plans encourage many cost-conscious consumers to shop around for low-ticket items below their deductible — and that is good. However, the bulk of health care spending is attributable to patients who rapidly blow through their deductible, after which they have no incentive to shop for value. Those 5 percent of people — who spend a whopping 50 percent of the nation’s health care dollars — have little incentive to consider price. With the cost of multiple medications, frequent doctors visits, use of specialists and one or more hospitalizations a year, these 5 percent will exceed even the highest deductible in the first few months of each year.
So what might be the single most powerful tool to slow the seemingly intractable yet unsustainable increases in health spending affecting practically every family in America? “Referenced-based” pricing for health services encourages patients — most significantly, those with the highest costs — to act as smart consumers by seeking the most cost-effective care, even after they have exceeded their deductible.
Here’s how it works. Insurance companies or employers set a limit they are willing to pay for a specified service of excellent quality — say, $1,000 for a CT scan — and communicate that reference price clearly to consumers. If patients choose a location where the charge is below the maximum set reimbursement rate, they pay nothing. If they choose a provider where the charge is higher, they pay the difference.
As patient-consumers shop around for the best price and quality services, competition in the market pushes prices down and value up.
Below is a map of illicit drug use by state, with the highest rates found in the West, Northeast, and Colorado. Vermont is the druggiest state, with 15.29% saying they have used illicit drugs in the past month compared to only 4.29% in Utah.
Marijuana use follows a similar pattern. Vermont takes the lead again with 13.12% using in the past month.
- More Americans are using marijuana (usatoday.com)
New Resource from the NLM: Subject Guides (Health Statistics, Library Statistics, Conference Proceedings)
This new resource is available at:
http://www.nlm.nih.gov/services/Subject_Guides/subjectguidesonselectedtopics/index.htmNew Resource from the NLM: Subject Guides
The NLM Reference and Web Services Section, Public Services Division, compiled a select set of subject guides. These guides can serve as research starting points for health professionals, researchers, librarians, students, and others. Each guide lists a variety of resources, many of which are Internet accessible and free. These subject guides consist of many resources but should not be considered completely comprehensive.
Released guides cover Health Statistics, Library Statistics, and Conference Proceedings. Two additional guides will be available in late fall covering Drug Information and Genetics/Genomics.
The topics for these Subject Guides are drawn from the most frequently asked questions the Reference and Web Services staff encounters in e-mails and onsite. The staff plans to update the guides, reviewing them as needed to maintain their links and content. We hope you find the Subject Guides useful, and we welcome your comments or suggestions.
- Health Statistics (Listed here, just some of the information at the site)
- Scope -
- The Health Statistics and Numerical Data subject guide includes some of the major sources of health and general statistics in the United States and a brief list of international resources.
- Selected Resources sections consist of a small number of resources chosen from the great number available. Resources include print and online publications, databases, datasets, online tools, and Websites. The majority are from U.S. Government agencies.
- Websites and Portals
- General selected resources
- Specific health conditions and concerns
- Special populations
- Scope -
- New Resources from the NLM: Subject Guides (thlibrary.wordpress.com)
- Subject Guides on Selected Topics | National Library of Medicine (drweb.typepad.com)
- How to access journal articles [Repost with additional link] (jflahiff.wordpress.com)
The wellness emphasis in the Affordable Care Act is built around the Centers for Disease Control and Prevention’s (CDC) 2009 call to action about chronic disease: The Power to Prevent, the Call to Control. On the summary page we learn some shocking statistics:
“Chronic diseases cause 7 in 10 deaths each year in the United States.”
“About 133 million Americans—nearly 1 in 2 adults—live with at least one chronic illness.”
“More than 75% of health care costs are due to chronic conditions.”
Shocking, that is, in how misleading or even false they are. Take the statement that “chronic diseases cause 7 in 10 deaths,” for example. We have to die of something. Would it be better to die of accidents? Suicides and homicides? Mercury poisoning? Infectious diseases? As compared to the alternatives, it is much easier to make the argument that the first statistic is a good thing rather than a bad thing.
The second statistic is a head-scratcher. Only 223 million Americans were old enough to drink in 2009, meaning that 60% of adults, not “nearly 1 in 2 adults,” live with at least one chronic illness — if their language is to be taken literally. Our suspicion is that their “133-million Americans” figure includes children, and the CDC meant to say “133-millon Americans, including nearly 1 in 2 adults, live with at least one chronic illness.” Sloppy wording is not uncommon at the CDC, as elsewhere they say almost 1 in 5 youth has a BMI > the 95th percentile, which of course is mathematically impossible.
More importantly, the second statistic begs the question, how are they defining “chronic disease” so broadly that half of us have at least one? Are they counting back pain? Tooth decay? Dandruff? Ring around the collar?
- [Repost] Putting Chronic Disease on the Map: Building GIS Capacity in State and Local Health Departments (jflahiff.wordpress.com)
- Sick! Epidemic of Chronic Diseases (infographicsking.wordpress.com)
- BMI May Not Be The Best Measure of Body Weight (medindia.net)
- The Facts about Chronic Disease in America [Infographic] (loupdargent.info)
From the Web site
The WomanStats Project is the most comprehensive compilation of information on the status of women in the world. The Project facilitates understanding the linkage between the situation of women and the security of nation-states. We comb the extant literature and conduct expert interviews to find qualitative and quantitative information on over 310 indicators of women’s status in 174 countries. Our Databaseexpands daily, and access to it is free of charge.
The Project began in 2001, and today includes six principal investigators at five universities, as well as a team of up to twenty graduate and undergraduate data extractors. Please learn more by clicking First Time Users and watching our Video Tutorials. Or visit our Blog, where we discuss what we are finding, view our Maps, or read our Researchreports.
First Time Users
Welcome to the WomanStats Database, the world’s most comprehensive compilation of information on the status of women.
The best way to acquaint yourself with the database and how to use it is to watch our Video Tutorials for beginners. The first video tutorial explains how to create a free account. The second teaches how to use the codebook and retrieve data from the View screen. The third covers reports, downloads, and maps. The fourth introduces you to other aspects of our web presence, such as our blog and social media.
New Database Reveals Thousands of Hospital Violation Reports New Database Reveals Thousands of Hospital Violation Reports
Hospitals make mistakes, sometimes deadly mistakes. A patient may get the wrong medication or even undergo surgery intended for another person. When errors like these are reported, state and federal officials inspect the hospital in question and file a detailed report.
Now, for the first time, this vital information on the quality and safety of the nation’s hospitals has been made available to the public online.
A new website, www.hospitalinspections.org, includes detailed reports of hospital violations dating back to January 2011, searchable by city, state, name of the hospital and key word. Previously, these reports were filed with the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid (CMS), and released only through a Freedom of Information Act request, an arduous, time-consuming process. Even then, the reports were provided in paper format only, making them cumbersome to analyze.
Release of this critical electronic information by CMS is the result of years of advocacy by the Association of Health Care Journalists, with funding from the Ethics and Excellence in Journalism Foundation. The new database makes full inspection reports for acute care hospitals and rural critical access hospitals instantly available to journalists and consumers interested in the quality of their local hospitals.
The database also reveals national trends in hospital errors. For example, key word searches yield the incidence of certain violations across all hospitals. A search on the word “abuse,” for example, yields 862 violations at 204 hospitals since 2011. …
- Series on N.C. hospitals wins national award (charlotteobserver.com)
- Medical execs dispute hospital study (krqe.com)
- Govt. To Publish Data On What Drug & Device Makers Pay To Individual Doctors & Hospitals (consumerist.com)
- Time Magazine Study Reveals Hospitals Hiking up Medical Bills (counselheal.com)
[Abstract] Introduction: As the U.S. population undergoes continuous shifts the population’s health profile changes dynamically resulting in more or less expression of certain psychiatric disorders and utilization of health-care resources. In this paper, we analyze national data on the psychiatric morbidity of American patients and their summated cost in different age groups. Methods: The latest data (2009) on the number of hospital discharges and national bill (hospital charges) linked with psychiatric disorders were extracted from the Nationwide Inpatient Sample (NIS). Results: National data shows that mood disorders are the largest diagnostic category in terms of percentage of psychiatri-crelated discharges in the 1 – 17 years age group. The proportion decreases gradually as age progresses while delirium, dementia, amnestic and other cognitive disorders increase exponentially after 65 years of age. Schizophrenia and other psychotic disorders as well as alcohol and substance-related disorders peak in the working age groups (18 – 64 years). From an economic point of view, mood disorders in the 18 – 44 age group has the highest national bill ($5.477 billion) followed by schizophrenic and other psychotic disorders in the same age group ($4.337 billion) and mood disorders in the 45 – 64 age group ($4.310 billion). On the third place come schizophrenic and other psychotic disorders in the 45 – 64 age group ($3.931 billion). Conclusion: This paper illustrates the high cost of psychiatric care in the U.S., especially the large fraction of healthcare money spent on working-age patients suffering from mood disorders. This underlines psychiatric cost-efficiency as a vital topic in the current healthcare debate.
- Major Depressive Episode among Full-Time College Students and Other Young Adults, Aged 18 to 22 (US Substance Abuse and Mental Health Administration, May 2012)
From the Healthcare Informatics blog item
Readmission rates, for instance, do not take into account the complexity of correcting problems involving the spine, which often call for two or more staged surgeries spaced out over several weeks, says Mummaneni. Publicly reported readmission rates do not always take into account scheduled follow-up surgeries and unplanned hospital readmissions, causing the calculated rates to be over-estimated. Additionally, he said, this problem may present surgeons with a tough choice between scheduling multiple surgeries, which may be better for the patients, and scheduling single surgeries, which would improve readmission rate calculations.
- Readmission rate could be not as relevant as it seems in measuring hospital’s performance (philippehavinh.wordpress.com)
- Hospital readmission rates misleading (eurekalert.org)
- Spinal Surgeries Much More Successful Than Reflected In Public Reported Statistics (medicalnewstoday.com)
- New tool allows hospital performance comparisons (cbc.ca)
- Reducing Hospital Readmissions (fedmark.wordpress.com)
- New Metrics for Health Care Reform (3mhealthinformation.wordpress.com)
- Simple, but wrong, approach on readmissions (thehealthcareblog.com)
- Is the hospital readmission rate a measure of quality? (kevinmd.com)
- New Study Shows EHR Can Help Reduce Hospital Readmissions (jaysimmons.org)
- Most Triad hospitals again face Medicare penalties for readmission rates (bizjournals.com)
Hospitals, health insurers and patients often rely on patient death rates in hospitals to compare hospital quality. Now a new study by researchers at Yale School of Medicine questions the accuracy of that widely used approach and supports measuring patient deaths over a period of 30 days from admission even after they have left the hospital….
…The study compared two widely used approaches to assessing hospital quality. One approach uses mortality rates of patients who die during their initial hospitalization, and the other uses rates of patients who die within 30 days, whether or not they have been discharged.
Drye and colleagues focused on mortality rates for patients with heart attack, heart failure, and pneumonia. For these conditions, one-third to one-half of deaths within 30 days occur after the patient leaves the hospital, but this proportion often varies by hospital.
“We were concerned that only counting deaths during the initial hospitalization can be misleading,” said Drye. “Because some hospitals keep their patients for less time than others due to patient transfers to other facilities or because they send patients home more quickly.”
Drye and her colleagues found that quality at many U.S. hospitals looked quite different using the two different accounting methods.
The team also found that measures looking only at deaths in the hospital favor hospitals that keep their patients for a shorter length of time.
“To assess current and future patient management strategies,” said Drye. “We should assess all patients for a standard time period, such as 30 days.”…
Citation: Annals of Internal Medicine 156:19-26. (January 3, 2012)
- Judging Hospital Quality Via Death Rate May Be Misleading (medicalnewstoday.com)
- Death rate measure used to judge hospital quality may be misleading (eurekalert.org)
- Death rate measure used to judge hospital quality may be misleading (medicalxpress.com)
- Measuring In-Hospital Mortality Favors Hospitals with Short Stays (forbes.com)
Health United States is an annual report on trends in health statistics.
Health, United States presents national trends in health statistics on suchtopics [PDF - 10.5 MB] as birth and death rates, infant mortality, life expectancy, morbidity and health status, risk factors, use of ambulatory and inpatient care, health personnel and facilities, financing of health care, health insurance and managed care, and other health topics.
Need help getting started on how to get information in this report? Click here.
FAQs about this report may be found here.
From the Web Page
Health, United States is an annual report on trends in health statistics.
Originally posted on Chronic Pain Management:
We all hear of The Center For Disease Control when something is going wrong but there is more for us to take advantage of with them. Visit their site and take a look at the information there.
Health, United States, is an annual report on trends in health statistics.
CDC.gov is CDC’s, (Center for Disease Control) primary online communication channel for health information.
Yearly, there are close to 500 million views to the site. With an average of 41 million views per month.
Take advantage of The Center For Disease Control this health information.
CDC.gov supplies users with credible, reliable health information.
Includes graph on calories consumed by 20 highest and 20 lowest countries (compared to RDA).
Another graph portrays 20 highest consuming countries and 20 lowest consuming countries (by average percentage of income spent on food)
- Graph Words: A Free Visual Thesaurus of the English Language (infosthetics.com)
CDF’s new report The State of America’s Children 2011 finds children have fallen further behind in many of the leading indicators over the past year as the country slowly climbs out of the recession. This is a comprehensive compilation and analysis of the most recent and reliable national and state-by-state data on population, poverty, family structure, family income, health, nutrition, early childhood development, education, child welfare, juvenile justice, and gun violence. The report provides key child data showing alarming numbers of children at risk: children are the poorest age group with 15.5 million children—one in every five children in America—living in poverty, and more than 60 percent of fourth, eighth and 12th grade public school students are reading or doing math below grade level.
View this year’s interactive report or download the document.
- Race and Child Welfare (fosterwee.wordpress.com)
- Op-Ed Columnist: The Decade of Lost Children (nytimes.com)
- Dire State of of America’s Children – by Stephen Lendman (jhaines6.wordpress.com)
- Report: Recession Catastrophic for Children (theroot.com)
- Many child deaths ‘preventable’ (cutie79.wordpress.com)
First Results from the 2010 Census
Initial report from the 2010 Census identifying population change in rural and metro areas. Includes statistics on the increased diversity and ethnicity in the U.S.
Geography of Need: Identifying Human Service Needs in Rural America
Uses American Community Survey five year average county-level data to compare the type and degree of human service needs in metropolitan versus non-metropolitan counties.
State of the States
State profiles of these Federal Food Programs: Demographics, Poverty and Food Insecurity; Federal Nutrition Programs; and State Economic Security Policies.
[Rural Assistance Center Human Services Update]
- 2010 Census Data on PolicyMap (policymap.com)
- More ACS All the Time (policymap.com)
- Why Are Demographics Important When Choosing a Place to Start a Business? (thinkup.waldenu.edu)
Do some statistically laden advertisements and Web sites seem misleading? Is there a disconnect between the displayed data in some ads with your gut feelings? But you just cannot put your finger on why you feel distrustful?
Just plain sloppily represented infographics could be creating some of the confusion. Infographic combines an interesting graphical element with hard data. They are commonly seen in the media, including USA Today.
Here are some excerpts from An Epidemic of Bad Infograhics: Depression
In an effort to keep trying to get people’s attention in an increasingly attention-deficit world, we get a lot of inquiries for links to websites promoting education programs and other affiliate websites. The latest effort is focused around “infographics,” those graphics made popular by the USA Todaynewspaper that combines an interesting graphical element with hard data. A well done infographic ostensibly makes data more engaging. A fantastic infographic puts data into proper perspective and gives it valuable context.
What these marketing firms send me, however, are not fantastic or even well-done. So in the interests of demonstrating that any infographic can be worse than no infographic, I’m going to critique one of the latest ones to have come across my desk. It’s about depression, one of the most common and serious mental disorders….
What about your level of depression? Well, according to the infographic — but not the research or mental health professionals — you can have different “depression levels” ranging from “Normal” (what’s a “Normal” depression?) to “Situational” or even “Major.”
Of course, the Diagnostic and Statistical Manual of Mental Disorders (the DSM-IV) doesn’t divide major depression in this manner. Instead, it specifies that major depression can be Mild, Moderate, Severe without Psychotic Features, Severe with Psychotic Features, In Partial Remission, In Full Remission, or Chronic.
I assume “Situational” refers to a completely different mental disorder — Adjustment Disorder with Depressed Mood. The person designing this graphic was obviously not too familiar with the actual information he was asked to illustrate……
Related Health Information Evaluation Resources
- Evaluating Health Information on the Internet summarizes tips and pointers
- Consumer’s Guide to Taking Charge of Health Information has 10 tips, including how to interpret risk statements, a “reliability chart”, and where to get more information. Bonus feature: snappy cartoons!
- Evaluating Health Information on the Internet by the US National Cancer Institute summarizes 10 key points. Links to related federal agencies
- Evaluating Health Information: MedlinePlus provides trusted links to overviews, specific conditions (as cancer and complementary medicine), organizations, and more
- Quackwatch is physician published guide to health fraud including 23 hot topics (as immunization,autism, homeopathy, chiropractic). While the site is a bit controversial, it does have useful information and links.
- National Council Against Health Fraud is a private nonprofit, voluntary health agency that focuses upon health misinformation, fraud, and quackery as public health problems
- patientInform is a collaborative effort of health care related professionals who interpret research articles, in the form of summaries or news items.
- What to look for when reading medical research outlines the different types of scientific studies and which ones are the best
- Participating organizations provides links to news items from over 25 publishers and organizations. “The publishers allow readers following links from patientINFORM material on the health organizations’ sites to access the full text of these articles without a subscription, and they provide patients and caregivers with free or reduced-fee access to other articles in participating journals.”
Related Statistics Resources
- Guide to Biostatistics (MedPage Today) is a bit technical, but a good introduction to biostatistical terms used in medical research
- Misleading Statistical Information in Ads: A Drug Ad Analyzed and Related Evaluation Resources (jflahiff.wordpress.com)
- Misleading information on health social sites (and tips on how to evaluate health/medical information) (jflahiff.wordpress.com)
- Women And Prescription Drugs: One In Four Takes Mental Health Meds (worldwright.wordpress.com)
- 1 in 5 of U.S. adults on behavioral meds (worldwright.wordpress.com)
- Ethical Implications of the Use of Data and Statistics (lynnmunoz.wordpress.com)
- Information Designers (fusionfinds.wordpress.com)
- 1 in 5 Adults on Behavioral Meds (abcnews.go.com)
- How our society breeds anxiety, depression and dysfunction (salon.com)