Research into many kinds of hospital care has found disparities in the morbidity and mortality outcomes for patients who seek treatment during the week compared with those unfortunate enough to get sick on weekends. This “weekend effect” has been demonstrated in hospital treatment of pulmonary embolism, gastrointestinal bleeding, diverticulitis and more.

Now a study of nearly 90,000 U.S. hospitalizations for atrial fibrillation has found another gap in weekend care. About 20% of the irregular heart-rhythm patients studied were hospitalized over the weekend, and 1.1% of these patients died. That is compared with 0.9% of the patients admitted during the week. After adjusting for hospital and patient characteristics and patient comorbidities, the weekend patients had a 24% higher chance of dying compared with weekday patients.

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It takes between 20 and 40 minutes for the OraQuick In-Home HIV Test to deliver results on whether a person is HIV positive, but it took seven years for the test to win Food and Drug Administration approval for over-the-counter sales to patients.

FDA officials required the product’s manufacturer, OraSure Technologies, to conduct studies to prove that patients could reliably follow written instructions to use the test, interpret the results and access follow-up care. In July, OraSure won FDA approval.

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Massachusetts has repealed a 2008 state ban on industry-provided meals for physicians and other health professionals.

The change allows medical industry companies to pay for “modest meals and refreshments” for doctors and other health professionals in connection with educational presentations that are not certified by the Accreditation Council for Continuing Medical Education. The presentations must happen “in a venue and manner conducive to informational communication,” the new law says.

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Transplants involving recipients who are not U.S. citizens or residents will get closer scrutiny under new rules adopted by the organizations that set American transplantation policy.

The move comes after high-profile controversies over wealthy foreigners who received deceased-donor transplants in the U.S. A Los Angeles Times investigation in 2008 uncovered four Japanese gangsters who got liver transplants at the University of California, Los Angeles Medical Center.

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The people behind an effort to make Massachusetts the third state to enact a law allowing physician-assisted suicide have secured enough signatures to put the issue on the ballot in November.

“We’re confident … that we’ll be successful in November,” said Stephen Crawford, communications director of the Dignity 2012 campaign, which is pushing the initiative. Among the measure’s original petitioners is Marcia Angell, MD, former editor-in-chief of The New England Journal of Medicine.

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The National Quality Forum’s board of directors in late June reaffirmed its decision to endorse a measure of all-cause readmissions. Many hospital leaders say the metric is unfair and could have adverse, unintended consequences if it is used to determine payment.

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Physicians should send patients with long histories of heavy smoking to lung cancer screenings using low-dose computed tomography every year, say guidelines issued by the American Assn. for Thoracic Surgery.

A multidisciplinary, 14-member task force established by the society recommends annual CT scans for patients 55 to 79 years old who have smoked the equivalent of a pack of cigarettes daily for 30 years — that is, the number of packs smoked every day multiplied by the number of years patients kept the habit. For example, smoking two packs a day for 15 years would be equivalent to smoking a pack a day for 30 years and make screening a good idea.

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Racial and ethnic minorities are less likely than white patients to choose palliative care in the last six months of life, says a study of Medicare beneficiaries published in The American Heart Journal.

After adjusting for the characteristics of about 220,000 Medicare heart-failure patients studied, the nonwhite patients were 20% less likely to enter hospice care. The disparities in end-of-life care did not end there. Among patients who opted for hospice, minorities were likelier to visit the emergency department and stay in the intensive care unit. Nonwhites also were about 40% likelier to disenroll — or leave — hospice, the study said.

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Every year, more patients go to emergency departments. The growing severity of the medical problems that bring them there means that it takes longer for emergency physicians to diagnose and treat them using interventions such as advanced medical imaging and intravenous fluids.

All of this has added up to increased crowding that delays care and can harm patients entering an ED’s doors.

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Physicians at an open forum voice concerns about confidentiality and the potential for abuse when remote care happens without an initial in-person consultation.

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Chicago Physicians have an obligation to recommend the less expensive option when the available medical alternatives offer a “similar likelihood” of patient benefit, according to ethics policy adopted at the AMA Annual Meeting.

Doctors ought to be “prudent stewards of the shared societal resources with which they are entrusted,” says the ethical opinion. The Council on Ethical and Judicial Affairs report overcame objections that it could wrongly limit physicians’ ability to advocate for the interests of individual patients when those conflict with the need to constrain health care costs. Medical spending consumes nearly 18% of the U.S. gross domestic product.

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The U.S. health system is underperforming in delivering care that could prevent heart attacks, stroke, cancer and the spread of HIV, says the Centers for Disease Control and Prevention.

For example, only 47% of Americans diagnosed with ischemic cardiovascular disease were prescribed aspirin or another antiplatelet, according to federal survey data from 2005 to 2008 analyzed in a CDC report published as a special supplement to the June 15 Morbidity and Mortality and Weekly Report.

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If the challenges facing individual practices moving toward the patient-centered medical home concept were not already daunting enough, a study published in June presents a new wrinkle: Patients may not like the new approach to care.

Researchers asked 393 physician practices whether they implemented medical-home elements such as team-based care, electronic health records, disease registries, clinical decision support, quality measurement, patient reminders, email access and group visits. Then they surveyed 1,304 patients who received care at those clinics about their experience during the last six months. The study, published online June 7 in the journal Health Services Research, found no association between a clinic’s use of patient-centered medical home processes and patients’ satisfaction with care.

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