November 20th, 2011 by RyanDuBosar in Research
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Adults who received care from a medical home in 11 Westernized countries were less likely to report medical errors and were happier with their care, according to a new Commonwealth Fund international survey.
The 2011 survey included more than 18,000 ill adults in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. It included people who reported they were in fair or poor health, had surgery or had been hospitalized in the past two years, or had received care for a serious or chronic illness, injury or disability in the past year. The vast majority had seen multiple physicians.
A medical home was defined as patients reporting a regular source of care that knows their medical history, is accessible and helps coordinate care received from other providers. Results were published in Health Affairs.
Sicker adults in the U.S. were the most likely to Read more »
*This blog post was originally published at ACP Internist*
October 13th, 2011 by RyanDuBosar in Research
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Hospitals that provide the lowest quality care at the highest cost care for more than twice the proportion of elderly minority and poor patients as the nation’s best performers, researchers found. And patients at the “worst” institutions are more likely than patients elsewhere to die of certain conditions, such as heart attacks and pneumonia.
These hospitals and their patients may be the ones most at risk under new Medicare payment arrangements that could cut payments to hospitals that fail to meet quality metrics, reported researchers from the Harvard School of Public Health.
The researchers examined how quality, costs and patients served correlated among 3,200 hospitals nationwide. They then identified 122 “best” hospitals, those that were in the highest quartile of quality and lowest quartile of risk-adjusted costs, and 178 “worst” hospitals, those in the lowest quartile of quality and the highest quartile of costs.
Hospital quality and performance data were Read more »
*This blog post was originally published at ACP Hospitalist*
August 12th, 2011 by RyanDuBosar in Research
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Prescriptions for antidepressants given by nonpsychiatrists to patients without a specific psychiatric disorder increased more than 12% in 12 years, leading to the drug class becoming the third most commonly prescribed, a study found.
A study in the August issue of Health Affairs reported that antidepressant prescriptions by doctors who didn’t record a specific psychiatric disorder increased from 59.5% of all prescriptions by nonpsychiatrists in 1996 to 72.7% in 2007.
Researchers reviewed data on patients age eighteen or older from the 1996-2007 Centers for Disease Control and Prevention’s National Ambulatory Medical Care Surveys, a national sample of more than 233,000 office-based visits. The proportion of antidepressants prescribed for patients without a psychiatric diagnosis increased from 2.5% of all visits to nonpsychiatrist providers to 6.4% between 1996 and 2007. For visits to primary care providers, antidepressant prescribing grew from 3.1% to 7.1%. For other nonpsychiatric providers, visits without a psychiatric diagnosis grew from 1.9% to 5.8%. In contrast, antidepressants prescribed with a psychiatric diagnosis increased from 1.7% to 2.4%.
Patients who received antidepressants without a psychiatric diagnosis by nonpsychiatrist providers were more likely to be Read more »
*This blog post was originally published at ACP Internist*
July 19th, 2011 by RyanDuBosar in Health Policy, Research
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Generic medications appear to be far more cost-effective than previously reported, concluded a team of Harvard professors. But, physicians and patients aren’t adopting them wholeheartedly.
Patents of 20 drugs with annual sales of more than $1 billion expired or will do so between 2010 and 2013, including Lipitor and Plavix, the highest- and second-highest revenue producing drugs in the U.S. While highly effective generics provide low-cost options for chronic disease management, they are not always factored into cost analyses, and are sometimes viewed with concerns about their safety and efficacy.
The Harvard team revisited a 2008 study that used brand-name medication costs in an analysis of the cost-effectiveness of strategies to prevent adverse outcomes associated with cardiovascular disease and diabetes. The study found that up to 244 million quality-adjusted life-years could be gained over 30 years with appropriate preventive care. But, the study authors wrote, that “most prevention activities are expensive when considering direct medical costs.”
The Harvard team recalculated figures from the 2008 research, Read more »
*This blog post was originally published at ACP Internist*
June 17th, 2011 by RyanDuBosar in Health Tips, Research
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Some parents remain unpersuaded that all childhood vaccines are safe or even necessary, a new survey published in Health Affairs shows.
While most parents vaccinate their children, they lack confidence in them, researchers pointed out. Parental education should include thorough explanations why infants should be fully immunized before age two.
Vaccination levels for most recommended vaccines were above 90% of national immunization goals in 2009, reported the CDC’s National Immunization Survey. But, researchers wrote, high immunization rates aren’t the same as high confidence in the vaccines.
Using data from the 2010 HealthStyles survey of 6,253 households (response rate 67%), researchers identified Read more »
*This blog post was originally published at ACP Internist*