Skip to main content

2011 Potpourri V

By January 28, 2011Commentary

CVS Caremark released a description of research published in the Journal of General Internal Medicine on the quality of health information on Facebook.  The researchers monitored 15 Facebook communities dedicated to diabetes, which had an average of 9,300 participants.  They found that 66% of the posts were descriptions of personal experiences with diabetes; 24% were sharing of personal information; 29% included people providing emotional support to others; 13% were responses to specific information requests and 27% were promotional in nature, usually for non-FDA approved products.  Physicians need to be aware of their patients sources of information and help them be careful in assessing what they read or hear.   (CVS Release)

A Perspective in the New England Journal of Medicine extends the topic of geographic variation to the quality of drug prescribing.  The authors briefly describe an analysis to look at two HEDIS measures across the country.  They found even more variation on these measures of quality of prescribing than on drug spending and they found only a weak positive correlation between quality of prescribing and higher drug spending.  In other words, spending more on drugs did not necessarily indicate that the prescribing was higher quality in nature.   In addition, medical spending was higher when quality of prescribing was worse.  At least based on these two HEDIS measures, it does not appear that spending more on drugs is indicative of higher quality care.  (NEJM Perspective)

An Archives of Internal Medicine study examined computed hourly wages across physician types.   Looking at 6,381 doctors, the study found that primary care physicians were paid the least per hour.  Neurologic surgeons and radiation oncologists earned the most, at over $125 per hour.   Internal medicine practitioners and pediatricians earned the least, at about $50 per hour.  Quite a gap.  And it probably is even higher, since radiologists, anesthesiologists and pathologists were excluded.  Lets say we equalized every physician at about $75 an hour.  A lot of money would be saved for the system.   (Archives Study)

Research reported in Clinical Transplantation looked at strategies for ensuring medication adherence among transplant patients.  The findings might be relevant to other areas of drug prescribing.  The study was small, involving only 15 non-adherent patients.  It tested a continuous improvement method that involved the patient and care team in identifying reasons for not taking medications and overcoming those problems.  The authors suggest that the results from this method were three times better than for other adherence improvement techniques.  No information was given on costs of the program or potential medical cost savings.   (Adherence Article)

The New England Journal of Medicine covered research on a comprehensive surgical safety system, which primarily consisted of an extensive multidisciplinary checklist.  The trial compared a group of hospitals which implemented the checklist with a group that did not and also looked at performance in the intervention group before and after the start of using the checklist.  Surgical errors declined by almost a third and in-hospital mortality by half in the intervention group, while there was no change in the control group.  Seems like a powerful tool to prevent surgical errors, which cause poor health outcomes and increases in health spending.   (NEJM Article)

Research in the British Medical Journal examined the validity of using patient survey responses to assess physicians and physician practices.  The authors examined data from over 4500 patients using 150 different doctors in England and used a mathematical model to assess utility of survey data.  They found that responses to specific questions regarding items of care or access were more reliable than general questions about overall satisfaction.  Since patient experience increasingly is a factor in pay-for-performance and physician ranking schemes, it is important to only use surveys that are highly reliable.    (BMJ Article)

Leave a comment