Dartmouth Atlas researchers largely created and fueled the perception that the significant variation in use of medical procedures and spending across geographic regions reflects likely unnecessary care. Their latest research focuses on joint replacement.
More health care nuggets for the weekend, including personalized medicine, health reform, health insurance premiums, telemedicine, and community health centers.
Research reported in JAMA suggests that while lengths of stay and in-hospital deaths for heart failure patients covered by Medicare have fallen, readmissions and out-of-hospital deaths are up. While the authors suggest some cause and effect, that is not likely the case.
One alleged benefit of health reform would be less use of the emergency room by uninsured persons who had no other way to access care. A recent report from the CDC suggests that notion may have been a myth.
Here we go again. The CBO now estimates that the health bill has a number of discretionary spending items in it which will likely add over $100 billion to the costs of the act. (CBO Letter) It is really interesting how a few weeks after the law is enacted, the government suddenly finds several new pieces of analysis suggesting it will have a higher cost. Right now there is no question, according to the Administration and Congress’ own analysis, that this law will add to the deficit very significantly.
Further adding to the point about misleading representatives and the public on the costs and effects of the reform law, HHS issued rules regarding coverage of dependents which acknowledged that just this one minor aspect of the law would raise premiums by as much as one percent. You may recall that we were promised by the President himself that the new law would reduce premiums significantly. Apparently that just wasn’t true. (HHS Rules)
Scientists continue to develop more and better methods to use communications, miniaturization and other technologies to improve health care. In the latest example Finnish researchers are working on implantable monitoring devices, such as EKG strips. The devices are so small that the user would basically be unaware of their presence. In the very foreseeable future, it will be possible to easily monitor a wide variety of biometric measures continually and cheaply. What will be done with all that data is the real problem. (Science Daily Article)
Finally, in an ironic note, researchers believe that spouses who care for their significant other with dementia are themselves more likely to develop the condition. (Science Daily Article) It is hard to know how to react to this. Dementia is truly a frightening disease and a tremendous emotional and physical burden of family and friends of the patient. It is unclear whether the stress of care-giving is responsible or that some unknown attraction of people with common susceptibilities is to blame. It creates a bit of a dilemma for physicians in terms of recommending how much time a spouse should devote to the care of a partner with this condition.
The patient-centered medical home is yet another highly touted solutions to health system problems. Several pilot programs of the concept have been underway. Health Affairs reports on the Group Health experience.
Health Affairs’ theme for the current issue is primary care. An article looks at research on the extent to which primary care improves quality and lowers costs. Ambiguity reigns.
A study in JAMA explores hospital readmissions for Medicare beneficiaries, finding that there is significant variation in discharge planning and follow-up, and that early attention to care after discharge leads to lower readmissions.
The latest in our weekend selection of health news and research developments, including any willing provider laws, emergency room visits, the link between insurance and health outcomes, hospital rankings and rising insurance premiums.
The Commonwealth Fund, the Health Research & Educational Trust and the American Hospital Association issued an analysis of what contributes to a high performance hospital system in terms of patient safety and outcomes. Culture is paramount.
Price Waterhouse Cooper has published a number of interesting reports on aspects of health care. They are one of the first large service companies to forecast changes to the health system that might result for the recently passed health law.
A JAMA article reports on a study of whether obese persons receive worse medical care, due to stigmatization of their condition or for other reasons. Despite negative perceptions, it appears that in fact their care is as good as that of non-obese persons.
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
© 2024 Healthy Skeptic.
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