Health and Medical News and Resources

General interest items edited by Janice Flahiff

The future of death in America

From the report summary at the Max Planck Institute for Demographic Research

Abstract
Population mortality forecasts are widely used for allocating public health expenditures, setting research priorities, and evaluating the viability of public pensions, private pensions, and health care financing systems. Although we know a great deal about patterns in and causes of mortality, most forecasts are still based on simple linear extrapolations that ignore covariates and other prior information. We adapt a Bayesian hierarchical forecasting model capable of including more known health and demographic information than has previously been possible. This leads to the first age- and sex-specific forecasts of American mortality that simultaneously incorporate, in a formal statistical model, the effects of the recent rapid increase in obesity, the steady decline in tobacco consumption, and the well known patterns of smooth mortality age profiles and time trends. Formally including new information in forecasts can matter a great deal. For example, we estimate an increase in male life expectancy at birth from 76.2 years in 2010 to 79.9 years in 2030, which is 1.8 years greater than the U.S. Social Security Administration projection and 1.5 years more than U.S. Census projection. For females, we estimate more modest gains in life expectancy at birth over the next twenty years from 80.5 years to 81.9 years, which is virtually identical to the Social Security Administration projection and 2.0 years less than U.S. Census projections. We show that these patterns are also likely to greatly affect the aging American population structure. We offer an easy-to-use approach so that researchers can include other sources of information and potentially improve on our forecasts too.

Author’s affiliation
Samir Soneji
Dartmouth College, United States of America
Gary King
Harvard University, United States of America

December 8, 2011 Posted by | Public Health | , , , | Leave a comment

Better Methods Needed to Measure Hospital Quality: Experts

Better Methods Needed to Measure Hospital Quality: Experts
Using patient death rates to assess care found to be unreliable in Massachusetts study

HealthDay news image

From the December 23, 2010 Health Day news item by Robert Preidt

THURSDAY, Dec. 23 (HealthDay News) — Hospital-wide patient death rates may not be a reliable way to assess a facility’s quality of care, a new study indicates.

Researchers in Boston compared four measures of hospital patient death rates. They found that the measures yielded both higher- and lower-than-expected rates for the same Massachusetts hospitals for the same year.

The findings add to an ongoing debate about the value of using death rates as a measure of health-care quality, said lead author Dr. David M. Shahian, a Harvard Medical School professor of surgery at Massachusetts General Hospital (MGH), and colleagues.

“It’s troubling that four different methods for calculating hospital mortality rates as a measure of quality should yield such different results. Measurement theory — not to mention plain common sense — suggests that there is a problem,” Shahian said in an MGH news release….

….

The researchers told the state they could not recommend any of the four vendors’ tools.

“But the results should not be interpreted as an indictment of any particular technique,” study co-author Sharon-Lise T. Normand, Harvard Medical School professor of health care policy (biostatistics) and a professor of biostatistics at Harvard School of Public Health, said in the news release.

Instead, Normand said, the findings “call into question the concept of measurement of hospital-wide mortality, as four different methods yielded four different results. Thus, this may not be a good way to assess hospital quality.”

The study results are published in the Dec. 23 issue of the New England Journal of Medicine.

SOURCE: Massachusetts General Hospital, news release, Dec. 22, 2010

 

Related MedlinePlus Pages

Related AHRQ Web pages (US Agency for Healthcare Research and Quality)

 

 

 

 


December 27, 2010 Posted by | Medical and Health Research News, Public Health | , , , , , , | Leave a comment

Personalized diets for elderly after hospitalization decreases mortality rates

From a Dec 2 2010 Eureka news alert

BEER-SHEVA, ISRAEL, December 2, 2010 — Intense, individually tailored dietary treatment for acutely hospitalized elderly has a significant impact on mortality, according to a new study by researchers at Ben-Gurion University of the Negev.

The intervention study just published in the prestigious Journal of the American Geriatric Society showed higher death rates six months after discharge (11.6 percent) of the control group compared to the intervention group’s death rate of 3.8 percent, which received intensive nutritional treatment designed and implemented by a registered dietician.

The study recruited 259 hospitalized adults aged 65 and older who were nutritionally at risk. After six months, the rise in the mini-nutritional assessment score (an indicator of nutritional status) was significantly higher in the intervention group than in the control group.

According to BGU researcher Dr. Danit R. Shahar, “This is the first study that used an individually tailored dietary treatment for acutely hospitalized elderly people. The results indicate that intense dietary treatment reduces mortality and can help reduce the need for re-hospitalization.”

In the study, a dietician met each patient upon admission to the hospital. The dietitian then followed the patient in his home, visiting three times after discharge.

The study dieticians (case managers) were the decision-makers regarding appropriate treatment and set up treatment goals. The basic approach was to develop a dietary menu based on inexpensive food sources and recipes. Patients had monthly contact by telephone to improve cooperation and prevent dropout from the study. The dieticians performed follow up assessment three to six months after discharges for all patients.

While the overall dropout rate was 25.8 percent, a standard range for elderly studies, after six months the rise in the mini-nutritional assessment score (an indicator of nutritional status) was significantly higher in the intervention group than in the control group.

 

 

December 3, 2010 Posted by | Nutrition | , , , | Leave a comment

   

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