Stanford University’s hospitals and clinics have saved $3.2 million in annual premiums since establishing a program to disclose and investigate adverse events and offer an apology and compensation to patients when the bad outcome has been deemed preventable.
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The hospital pay-for-performance program that is part of the Patient Protection and Affordable Care Act starts paying in October 2012 and could exacerbate racial and economic health disparities, suggests a study published in the October Health Affairs.
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Patients insured by HMOs are likelier to receive guideline-based wellness, preventive and chronic disease care from their physicians than patients covered by preferred-provider organizations, but the gap between the two types of health plans is shrinking.
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Internists, family physicians and pediatricians could help slash nearly $7 billion in annual health spending by avoiding the top-five commonly ordered, low-evidence interventions in each of their specialties.
Nearly 90% of the primary care “don’t” savings, or $5.8 billion, would come from prescribing generic, rather than brand-name, statins when starting lipid-lowering therapy, according to research published online Oct. 1 in Archives of Internal Medicine.
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The nation has improved its overall grade on providing hospital-based palliative care to a B, up from a C in 2008.
The higher grade is due to a 19% rise in the number of hospitals with palliative care teams since 2008, according to a report released in October. The number of 50-plus bed hospitals with palliative care teams has nearly tripled since 2000 to 63%, said the research conducted by the Center to Advance Palliative Care, a New York nonprofit that helps hospitals set up palliative care operations. Eighty-five percent of hospitals with 300 beds or more have such teams in place, the report said.
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The effort to reduce painkiller overdoses and deaths is moving beyond prosecuting so-called pill mills to direct regulation of any physician who prescribes opioids for patients with chronic noncancer pain.
The strictest regulation of opioid prescribing is in Washington state. In July, rules affecting osteopathic physicians and nonphysician prescribers took effect. The rules, which cover allopathic physicians starting in January 2012, include detailed instructions on how to evaluate and care for patients with chronic noncancer pain. Also required are written treatment plans known as “patient contracts” that call for mandatory, periodic urine screenings.
The rules mandate that primary care doctors consult with board-certified pain specialists before prescribing daily morphine-equivalent doses of 120 mg or greater — the first dosage threshold of its kind in the U.S.
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Hospitals struggled to lower readmission rates among Medicare patients between 2003 and 2009, according to a September report from the Dartmouth Institute for Health Policy & Clinical Practice. The report comes as hospitals prepare for Medicare penalties for high readmission rates that start in October 2012.
Researchers affiliated with the institute’s Dartmouth Atlas of Health Care examined the records of all 10.7 million Medicare patient hospital discharges from July 1, 2003 to June 30, 2009, and found little progress.
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The number of hospitals offering complementary and alternative medical services has tripled since 2000, driven principally by patient demand for low-risk therapies such as massage, guided imagery, meditation and the “healing touch” practice known as Reiki.
Forty-two percent of the 714 hospitals surveyed said they provide unconventional therapies, and executives listed patient demand as the top criterion in choosing which therapies to offer, according to a report released in September by the American Hospital Assn.’s Health Forum and the Samueli Institute, a think tank that supports alternative medicine. In 2000, just 14% of hospitals told AHA researchers that they provided complementary therapies.
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Informing patients about the roles that residents will play in their surgical procedure reduces their willingness to consent and could adversely affect surgical training.
Ninety-five percent of patients want to be informed about residents’ participation in a major surgical procedure. But the more patients know about the extent of that participation, the less likely they are to consent to it, according to a Sept. 19 Archives of Surgery study.
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After a drug is developed, approved and prescribed, the patient should take the medicine, but it isn’t that easy. These strategies can help.
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Proposed changes to federal regulations would override existing laws in 20 states and give patients access to laboratory test results without having first to talk with the physicians who ordered the tests.
The Dept. of Health and Human Services said its proposal, announced in September, could enable wider deployment of personal health record systems and give patients more control over their health care information. Yet some physicians say the changes could come at a cost, because life-altering test results delivered without the context of a doctor’s explanation may increase patient anxiety and degrade the physician-patient relationship.
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… everything in life, directly or indirectly, has a great degree of mystery. To paraphrase Warren Zevon, “Some days I feel like my shadow’s casting me.” Persons, places, things … time itself is a mystery. You know, like, who can explain it? It’s really difficult to define anything. What’s slow can speed up. Love can turn into hate. Peace can turn into war. Pride can turn into humility. Anger to grief.
How would you define a simple thing like a chair, for instance—something you sit on? Well, it’s more than that. You can sit on a curb, or a fence. But they are not chairs. So what makes a chair a chair? Maybe it’s got arms? A cross has arms, so has a person. Maybe the chair doesn’t have arms? Okay, so it’s a post or a flagpole. But those aren’t chairs. A chair has four legs. So does a table. So does a dog. But they’re not chairs either. So a chair is a mystical thing. It’s got a divine presence.
There’s a gloomy veil of chaos that surrounds it. And “chaos” in Greek means “air.” So we live in chaos and we breathe it. Is it any wonder why some people snap and go crazy? Mystery is ancient. It’s the essence of everything. It violates all conventions of beauty and understanding. It was there before the beginning, and it will be there beyond the end. We were created in it.
The Mississippi Sheiks recorded a song called “Stop and Listen.” To most music aficionados, it’s but a ragtime blues. But to me, it’s words of wisdom. Saint Paul said we see through the glass darkly. There’s plenty of mystery in nature and contemporary life. For some people, it’s too harsh to deal with. But I don’t see it that way.
— Bob Dylan, on painting
The Dept. of Health and Human Services in September launched an ambitious plan to prevent 1 million heart attacks and strokes in the next five years.
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