July 27th, 2010 by Medgadget in Better Health Network, News, Research
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FDA researchers have published a study in Pediatrics that analyzed patient records from child and teen ER visits in 2004 and 2005. The investigators are reporting that 70,000 kids each year go to the ER because of issues caused by medical devices.
About a quarter of the injuries were from contact lenses, while the other major contributors were needles, wheelchairs, braces, and obstetric exam tools. The study also looked at the devices most likely to cause hospitalization, and they were found to be mostly invasive devices like ostomy appliances and implanted defibrillators. Read more »
*This blog post was originally published at Medgadget*
April 7th, 2010 by KevinMD in Better Health Network, Health Policy, Opinion, Primary Care Wednesdays
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Overuse of the emergency department is commonly discussed during the healthcare conversation, especially with the lack of primary care access shunting patients with seemingly routine symptoms to the ER. But is this a myth? That’s what two emergency physicians contend in a piece from Slate.
The emergency department is functioning just fine, they say: “Just 12 percent of ER visits are not urgent. People also tend to think ER visits cost far more than primary care, but even this is disputable. In fact, the marginal cost of treating less acute patients in the ER is lower than paying off-hours primary care doctors, as ERs are already open 24/7 to handle life-threatening emergencies.” Read more »
*This blog post was originally published at KevinMD.com*
March 26th, 2010 by GruntDoc in Better Health Network, Health Policy, Opinion
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Much of the ongoing healthcare reform debate has focused on unnecessary healthcare expenses—specifically, medical bills that rack up without demonstrably improving people’s health. According to Peter Orszag, the director of the Federal Office of Management and Budget, about $700 billion, or 5 percent of the U.S. gross domestic product, is wasted on unnecessary care, such as extra costs related to medical errors, defensive medicine, and just plain fraud.
At the center of this discussion are “unnecessary” ER visits for minor conditions—colds, headaches, and feverish babies—that could be handled more cheaply in doctors’ offices. If we could only convince patients to take their stubbed toes to urgent care clinics or primary care offices instead of ERs, the thinking goes we could save a load and help fix this whole healthcare fiasco. But there are a few problems with this logic. See:
Are most emergency room visits really unnecessary? – By Zachary F. Meisel and Jesse M. Pines, Slate Magazine
It’s a short, well-written article. It makes some good points and being an EM doctor I happen to agree with most of them, specifically that a lot of money is spent in medicine on procedures of uncertain (at best) benefit. The fix is probably correct, too, though I don’t see Americans jumping on changing their sedentary, easy lifestyles (that includes me.)
*This blog post was originally published at GruntDoc*
March 25th, 2010 by KevinMD in Better Health Network, News, Opinion
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It’s well known that the use of imaging scans, like CTs, MRIs and PET scans, have been growing at an alarming rate. But a recent study provides some stark numbers. According to a recent CDC report, “MRI, CT or PET scans were done or ordered in 14 percent of ER visits in 2007.” That’s four times as often as in 1996. Although a physician called that growth “astounding,” it’s really no surprise.
Emergency departments are becoming more crowded, and with patient satisfaction scores becoming more influential in financial incentives for physicians, sometimes just ordering a test is the path of least resistance. Factor in the spector of defensive medicine which, according to a survey from the Massachusetts Medical Society, accounts for up to 28 percent of tests ordered, it’s a wonder that more scans weren’t ordered.
Imaging scans are a clear cost driver in healthcare, contributing $12 billion to Medicare’s bill. But costs won’t resonate with patients requesting the tests or the doctors ordering them. One encouraging sign is the recent trend of publicizing the harms of scans, like radiation from CTs. I’m finding that patients are becoming increasingly aware of the risk, and making a more informed decision after I explain it to them. It’s a small step forward.
*This blog post was originally published at KevinMD.com*
