Health and Medical News and Resources

General interest items edited by Janice Flahiff

[News Article] Large New Study Confirms That Childhood Vaccines Are Perfectly Safe

Large New Study Confirms That Childhood Vaccines Are Perfectly Safe | ThinkProgress.

From the 1 July 2014 Think Progress article

BY TARA CULP-RESSLER

vaccine

CREDIT: SHUTTERSTOCK

The vaccines that children receive when they’re young are quite safe, and the vast majority of them don’t lead to serious side effects, according to asweeping new review of 67 recent scientific studies on childhood vaccinations. The analysis, published on Tuesday in the journal Pediatrics, also found no link between vaccines and autism — effectively debunking a common myth that dissuades some parents from inoculating their children.

The new report is specifically intended to ease parents’ concerns about vaccines, as persistent misconceptions about vaccination have recently spurred a rise in infectious diseases. In order to reassure people who may be worried that their kids’ shots aren’t safe, the federal governmentcommissioned the RAND Corporation to review everything that scientists know about the 11 vaccines recommended for children under the age of six.

Like any medical intervention, vaccines are not without their potential risks. In some rare cases, certain shots can increase kids’ risk of fevers, seizures, and gastrointestinal problems. But the RAND researchers found that those adverse reactions are incredibly unlikely.

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July 8, 2014 Posted by | health care | , , , , , | 4 Comments

[Reblog] Is There Really a Physician Shortage?

By  DAVID AUERBACH in the 5 December 2013 posting at The Health Care Blog

Large coverage expansions under the Affordable Care Act have reignited concerns about physician shortages. The Association of American Medical Colleges (AAMC) continues to forecast large shortfalls (130,000 by 2025) and has pushed for additional Medicare funding of residency slots as a key solution.

These shortage estimates result from models that forecast future supply of, and demand for, physicians – largely based on past trends and current practice. While useful exercises, they do not necessarily imply that intervening to boost physician supply would be worth the investment. Here are a few reasons why.

1. Most physician shortage forecast modelsassume insurance coverage expansions under the ACA will generate large increases in demand for physiciansThe standard underlying assumption is that each newly insured individual will roughly double their demand for care upon becoming insured (based on the observation that the uninsured currently use about half as much care). However, the best studies of this – those using randomized trials or observed behavior following health insurance changes – tend to find increases closer to one-third rather than a doubling.

2. A recent article in Health Affairs found that the growing use of telehealth technologies, such as virtual office visits and diagnoses, could reduce demand for physicians by 25% or more.

3. New models of care, such as the patient-centered medical home and the nurse-managed health center, appear to provide equally effective primary care but with fewer physicians. If these models, fostered by the ACA, continue to grow, they could reduce predicted physician shortages by half.
4. New research has shown that physicians do an enormous amount of work that can be handled competently by medical assistants, licensed practical nurses, social workers, pharmacists and others. Proper delegation to other health care professionals and non-professionals in this way can further reduce the need for physician labor and increase the efficiency of health care services — though providers will have to pursue these changes to the see the benefits.

5. Finally, the number of active physicians per-capitavaries by more than a factor of two across states in the US (Massachusetts has more than double the physicians per capita as Idaho) and even more across smaller regions. Though health care quality and access surely suffers in some areas, there is little correlation with physician supply overall – a testament to the fact that there is a very wide range of physician supply capable of supporting successful health care.

As modeling technology continues to evolve and the effects of ACA implementation become clearer, new models should be able to account for physicians’ shifting responsibilities and new ways of practicing. It is also certainly possible that new care models will place additional demands on physicians to manage their patients’ conditions and coordinate their care. Nevertheless, on the whole, the latest research suggests that calls to redirect taxpayer dollars to subsidize physician residencies may be premature.

David Auerbach is a policy researcher at the nonprofit, nonpartisan RAND Corporation.

 

 

December 6, 2013 Posted by | health care | , , | Leave a comment

Focus on Community Resilience

Cover: Focus on Community Resilience

A 2012 study by the RAND Corporation

Resilient communities prepare for, respond to, and recover from natural and man-made disasters. RAND has implemented and evaluated community resilience-building activities worldwide and identified opportunities to integrate governments with the nonprofit and for-profit sectors in public health and emergency preparedness, infrastructure protection, and development of economic recovery programs.

June 11, 2012 Posted by | Public Health | , , , , | Leave a comment

International variation in the usage of medicines

A review of the literature

From a Rand Corporation item by Ellen Nolte, Jennifer Newbould, Annalijn Conklin

The report reviews the published and grey literature on international variation in the use of medicines in six areas (osteoporosis, atypical anti-psychotics, dementia, rheumatoid arthritis, cardiovascular disease/lipid-regulating drugs (statins), and hepatitis C).

We identify three broad groups of determinants of international variation in medicines use:

(1) Macro- or system level factors: Differences in reimbursement policies, and the role of health technology assessment, were highlighted as a likely driving force of international variation in almost all areas of medicines use reviewed. A related aspect is patient co-payment, which is likely to play an important role in the United States in particular. The extent to which cost-sharing policies impact on overall use of medicines in international comparison remains unclear.

(2) Service organisation and delivery: Differences in access to specialists are a likely driver of international variation in areas such as atypical anti-psychotics, dementia, and rheumatic arthritis, with for example access to and availability of relevant specialists identified as acting as a crucial bottleneck for accessing treatment for dementia and rheumatoid arthritis.

(3) Clinical practice: Studies highlighted the role of variation in the use and ascertainment methods for mental disorders; differences in the use of clinical or practice guidelines; differences in prescribing patterns; and reluctance among clinicians in some countries to take up newer medicines.

Each of these factors is likely to play a role in explaining international variation in medicines use, but their relative importance will vary depending on the disease area in question and the system context.

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November 2, 2010 Posted by | Biomedical Research Resources, Professional Health Care Resources | , | Leave a comment

   

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