Health and Medical News and Resources

General interest items edited by Janice Flahiff

[Report] Sex, contraception, or abortion? Class gaps in unintended childbearing | Brookings Institution

Sex, contraception, or abortion? Class gaps in unintended childbearing | Brookings Institution.

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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.”

March 7, 2015 Posted by | Public Health | , , , , , , | Leave a comment

Why the despicable deserve the best care possible

The comment about this piece I left on Facebook.

Wonderful piece. Yes it is up to God. Whom I believe is pure love, pure mercy. All we can do is do our best to be instruments of his peace. And that includes doctors of compassion as Dr. Greg Smith.

 

From the 2 October article at KevinMD.com by Greg Smith, MD

I received a very intriguing question the other day.

“What happens when someone despicable, someone who has committed some horrible act or made some terrible decision, comes in for evaluation or treatment and you have to see them?”

I have been asked to see child molesters of the worst kind, men (usually) who have done things so vile to children that it would make your stomach turn to hear about them. Having raised three daughters of my own and now having two grandchildren and another on the way, these things brought forth such a visceral reaction from me that it was all I could do sometime to continue the interview and not just scream, “Enough!”

I have sat three feet away, close enough for the toe of our shoes to touch, from a murderer in little interview rooms in a county jail. The feeling is almost surreal when a murderer tells you about his family, spending holidays with his wife, his love for his Chevy truck, and the day he got his first job. You listen and you piece the story together and you do your job, but somewhere in the deep recesses of your brain that little protective, self-preserving blinking red light warns you. This man shot another person at point blank range with a twelve gauge shotgun. He could kill you too.

I have interviewed husbands who beat their wives so badly that they sent them to the hospital, jaws broken, ribs cracked, bleeding, faces blue and puffy and swollen. I have heard them blame their wives for the beatings, explaining to me in plaintive, sincere, pleading tones about how she asked for it, she provoked it, she wanted it, she needed it. Again, stomach-turning stuff, my friends.

The question made me think about these people I’ve interviewed over the years in hospitals and emergency rooms and county jails and clinics and courthouses. What is the common denominator here?

Read the entire article here

October 8, 2013 Posted by | health care | , , , | Leave a comment

Substantial Health Disparities Among Young US Adults

Substantial Health Disparities Among Young US Adults

From the Fri Dec 2, 2011 issue of Medical News Today 

Health disparities among young American adults born after 1980 have grown substantially, according to a new study led by Hui Zheng, assistant professor of sociology at Ohio State University, that is published in the December issue of the American Sociological Review. Zheng and colleagues also found that the gaps tend to widen as people reach middle age, and then narrow again as they reach old age. They suggest this is because most young people are generally healthy, and at this stage, disparities stay low.
Zheng and colleagues also found that the gaps tend to widen as people reach middle age, and then narrow again as they reach old age.

They suggest this is because most young people are generally healthy, and at this stage, disparities stay low. But as they age, some develop health problems and diseases, so disparities grow. But these fall off again in old age as sicker people die and healthy ones remain. In old age there may also be an effect from older people sharing similar health risk factors due to frailty, and there may also be an equalizing effect from health care usage and protection through Medicare coverage for the elderly…

December 3, 2011 Posted by | health care | | Leave a comment

Cultural Competence or Cultural Competency ?

This is a great blog entry, with bibliography, about how not understanding ethnic/cultural backgrounds can lead to misdiagnosis.

               Cultural Competence or Cultural Sensitivity? May 12, 2011

Some Related Resources

May 14, 2011 Posted by | Public Health | , | Leave a comment

Reports on Health Care Disparities at the State Level Available

Reports on Health Care Disparities at the State Level Available

Cover of National Healthcare Disparities Report, 2010

From the AHRQ (Agency for Healthcare Research and Quality) press release

AHRQ has released two reports from its Healthcare Cost and Utilization Project that provide information on approaches to using race/ethnicity data for reducing disparities in the quality of health and health care.  The data is from the 2010 National Health Quality Report and National Healthcare Disparities Report.

The following reports focusing provide information on approaches to using race/ethnicity data for reducing disparities in the quality of health and health care.

 

Also…

2010 National Healthcare Quality & Disparities Reports

For the eighth year in a row, the Agency for Healthcare Research and Quality (AHRQ) has produced

the National Healthcare Quality Report (NHQR) [Full Report (PDF File, 4.4 MB) PDF Help] and

the National Healthcare Disparities Report (NHDR [Full Report (PDF File, 4.3 MB) PDF Help{).

These reports measure trends in effectiveness of care, patient safety, timeliness of care, patient centeredness, and efficiency of care. New this year are chapters on care coordination, health system infrastructure. The reports present, in chart form, the latest available findings on quality of and access to health care.

 

April 1, 2011 Posted by | Public Health | , , , | 1 Comment

Health Care Quality Still Improving Slowly, but Disparities and Gaps in Access to Care Persist

Health Care Quality Still Improving Slowly, but Disparities and Gaps in Access to Care Persist

From the Agency for Healthcare Research and Quality (AHRQ) Press Release

ress Release Date: February 28, 2011

Improvements in health care quality continue to progress at a slow rate—about 2.3 percent a year; however, disparities based on race and ethnicity, socioeconomic status and other factors persist at unacceptably high levels, according to the 2010 National Healthcare Quality Report and National Healthcare Disparities Report issued today by the Department of Health & Human Services’ (HHS) Agency for Healthcare Research and Quality (AHRQ).The reports, which are mandated by Congress, show trends by measuring health care quality for the Nation using a group of credible core measures. The data are based on more than 200 health care measures categorized in several areas of quality: effectiveness, patient safety, timeliness, patient-centeredness, care coordination, efficiency, health system infrastructure, and access.

“All Americans should have access to high-quality, appropriate and safe health care that helps them achieve the best possible health, and these reports show that we are making very slow progress toward that goal,” said AHRQ Director Carolyn M. Clancy, M.D. “We need to ramp up our overall efforts to improve quality and focus specific attention on areas that need the greatest improvement.”

Gains in health care quality were seen in a number of areas, with the highest rates of improvement in measures related to treatment of acute illnesses or injuries. For example, the proportion of heart attack patients who underwent procedures to unblock heart arteries within 90 minutes improved from 42 percent in 2005 to 81 percent in 2008.

Other very modest gains were seen in rates of screening for preventive services and child and adult immunization; however, measures of lifestyle modifications such as preventing or reducing obesity, smoking cessation and substance abuse saw no improvement.

The reports indicate that few disparities in quality of care are getting smaller, and almost no disparities in access to care are getting smaller. Overall, blacks, American Indians and Alaska Natives received worse care than whites for about 40 percent of core measures. Asians received worse care than whites for about 20 percent of core measures. And Hispanics received worse care than whites for about 60 percent of core measures. Poor people received worse care than high-income people for about 80 percent of core measures.

Of the 22 measures of access to health care services tracked in the reports, about 60 percent did not show improvement, and 40 percent worsened. On average, Americans report barriers to care one-fifth of the time, ranging from 3 percent of people saying they were unable to get or had to delay getting prescription medications to 60 percent of people saying their usual provider did not have office hours on weekends or nights. Among disparities in core access measures, only one—the gap between Asians and whites in the percentage of adults who reported having a specific source of ongoing care—showed a reduction.

Each year since 2003, AHRQ has reported on the progress and opportunities for improving health care quality and reducing health care disparities. The National Healthcare Quality Report focuses on national trends in the quality of health care provided to the American people, while the National Healthcare Disparities Report focuses on prevailing disparities in health care delivery as it relates to racial and socioeconomic factors in priority populations.

The quality and disparities reports are available online at http://www.ahrq.gov/qual/qrdr10.htm, by calling 1-800-358-9295 or by sending an E-mail to ahrqpubs@ahrq.hhs.gov.

For more information, please contact AHRQ Public Affairs: (301) 427-1892 or (301) 427-1855.

Use Twitter to get AHRQ news updates: http://www.twitter.com/ahrqnews/ Exit Disclaimer

 

 

 

March 6, 2011 Posted by | Uncategorized | , , , , , | Leave a comment

Enabling Personalized Medicine through Health Information Technology: Advancing the Integration of Information

Enabling Personalized Medicine through Health Information Technology: Advancing the Integration of Information

Enabling Personalized Medicine through Health IT

From the Brookings Institute Executive Summary

With federal officials pursuing the goal of a personal human genome map under $1,000 in five years (White House, 2010), it is possible to envision a future where treatments are tailored to individuals’ genetic structures, prescriptions are analyzed in advance for likely effectiveness, and researchers study clinical data in real-time to learn what works. Implementation of these regimens creates a situation where treatments are better targeted, health systems save money by identifying therapies not likely to be effective for particular people, and researchers have a better understanding of comparative effectiveness (President’s Council of Advisors on Science and Technology, 2010).

Yet despite these benefits, consumer and system-wide gains remain limited by an outmoded policy regime.  Federal regulations were developed years before recent advances in gene sequencing, electronic health records, and information technology.  With scientific innovation running far ahead of public policy, physicians, researchers, and patients are not receiving the full advantage of latest developments.  Current policies should leverage new advances in genomics and personalized medicine in order to individualize diagnosis and treatment.  Similarly, policies creating incentives for the adoption of health information technology should ensure that the invested infrastructure is one that supports new-care paradigms as opposed to automating yesterday’s health care practices.

To determine what needs to be done, a number of key leaders from government, academia, non-profit organizations, and business were interviewed about ways to promote a better use of health information technology to enable personalized medicine.  The interviews focused on policy and operational issues surrounding interoperability, standards, data sharing protocols, privacy, predictive modeling, and rapid learning feedback models.

This paper outlines the challenges of enabling personalized medicine, as well as the policy and operational changes that would facilitate connectivity, integration, reimbursement reform, and analysis of information.   Our health system requires a seamless and rapid flow of digital information, including genomic, clinical outcome, and claims data.  Research derived from clinical care must feed back into assessment in order to advance care quality for consumers.  There currently are discrete data on diagnosis, treatment, medical claims, and health outcomes that exist in parts of the system, but it is hard to determine what works and how treatments differ across subgroups.  Changes in reimbursement practices would better align incentives with effective health care practices……

A related commentary…

A commentary featured in the January 19 issue of The Journal of the American Medical Association (JAMA) from AHRQ Health IT grant recipient, Alex Krist, M.D. calls for the design of a patient-centered health information system that goes beyond the Personal Health Record.  Krist explains that in order for technology to be used, a system should be designed to help patients access health information, interpret data from multiple sources and serve as a tool to facilitate action.  Select to access the abstract.
(For suggestions on how to get this article for free or at low cost, click here)

Related articles

Despite increasing Internet availability, the ‘digital divide’ (disparities in access to technology) appears to exist among primary care patients adopting an online personal health record, according to a report in the March 28 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. “The personal health record (PHR) is an Internet-based set of tools that allows people to access and coordinate their lifelong health information,” the authors write as background information in the article..

February 1, 2011 Posted by | Consumer Health, Public Health | , , , , , , , | Leave a comment

   

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