iLoveBenefits: Industry News Blog

Better understanding of BP measures in frail elderly people

Study warns of risks when frail older patients take multiple BP meds Frail elderly nursing home residents with low systolic blood pressure taking two or more antihypertensive medications were at a twofold higher risk of dying within two years compared with peers, according to a study in JAMA Internal Medicine. Researchers also found a higher portion of those deaths were from cardiovascular causes — 14.5% of patients on multiple antihypertension medications, compared with 9.4% of others taking fewer than two blood pressure-lowering drugs. Medscape (free registration) (2/19)

Are the bugs beginning to win the drug war?

Consumers Union released a report that finds the “overwhelming majority (85%) of surveyed doctors reported that one or more of their patients had been diagnosed with a presumed or confirmed case of a multi-drug resistant bacterial infection in the past twelve months.  Of those 35% had a patient either die or suffer significant complications as a result of the illness.  Recognizing the severity and frequency of these illnesses in their patients, the vast majority of doctors (97%) expressed concern about the growing problem of multi-drug resistant infections and were taking a series of measures in their own practices to minimize the problem of antibiotic resistance.”

Screening everyone for diabetes over age 45… is that really necessary

Generally, people will get a glucose screen sometime in their lives, however, is this an appropriate strategy…telling EVERYONE after age 45 to get tested? Is this economically viable? Should there be other risk factors included in the analysis of whether to get a screening, just as they are those under 45?

USPSTF recommends wider diabetes screening in draft statement Draft recommendations from the U.S. Preventive Services Task Force call for diabetes and blood glucose screening for people 45 and older and younger adults with risk factors. The guidelines, updated from 2008, are similar to those made by other medical groups and include recommendations for diet and exercise interventions for at-risk patients. Medscape (free registration) (10/6)

For now it is the prices

Study: Health care utilization down, but costs are up
Americans with employer-sponsored insurance had fewer hospital stays and visited outpatient clinics less frequently from 2009 to 2010, but prices for inpatient and outpatient care rose by about 10% or more, according to a Health Care Cost Institute analysis of more than 3 billion claims for medical care. The average price of generic drugs fell over the same period, but prices for brand-name drugs rose, the analysis found. The Washington Post (5/21),  Read report at: www.healthcostinstitute.org

But the study also showed that the biggest driver of the increase was facility prices, not utilization or severity of conditions.   

  • Average facility payments for inpatient surgeries increased by 6.4% (from $25,469 to $27,100)
  • Average facility payments for outpatient surgeries increased by 8.9% (from $3,163 to $3,443)
  • Average facility payments for emergency room visits increased by 11.0% (from $1,195 to $1,327)

 

Overall, inpatient admissions decreased by 3.3%, prices increased by 5.1%, and the intensity/severity of inpatient cases increased by 0.7%.  After adjusting for the small increase in intensity/severity, inpatient admission prices increased by 4.6%, i.e., increases in prices more than offset the lower utilization

 

Three in Five Americans Misuse Their Prescription Drugs, Finds National Study of Prescription Medication Lab Testing

An interesting report. The report does not correlate results to the type of health insurance an individual carries. Whether these are copay plans, high deductible plans or a government sponsored plan.

Results of a report from Quest Diagnostics indicate that the majority of Americans tested misused their prescription drugs, including potentially addictive pain medications. The results show that more than three in five patients, or 63%, tested through Quest Diagnostics were inconsistent with clinician orders.

The study found high rates of inconsistency with clinician orders among all specific drug classes tested, including opioid pain medications, such as oxycodone (including OxyContin(R)) (44%), central nervous system depressants like alprazolam (including Xanax(R)) (50%), and the stimulant amphetamine (such as Adderrall(R)) (48%). High rates of misuse were found in women and men across all ages, income levels and government and commercial health plan coverage.

Source: Quest Diagnostics
http://ir.questdiagnostics.com/phoenix.zhtml?c=82068&p=irol-newsArticle&ID=1688624&highlight=

April 30, 2012 | Categories: drugs,healthcare,Overuse,Patient | Tags: , , , | Comments (0)

As the economy recovers and consumers pay more which direction will utilization patterns take?

Lower Utilization of Healthcare and Medicines

A recent report from the IMS Institute for Healthcare Informatics found that there were important variations across the country and by patient age in the use of healthcare services.

Overall per capita use of medicines declined slightly in 2011, as physician office visits and non-emergency room hospital admissions dropped, and older Americans reduced their retail drug use. The number of office visits declined 4.7 percent while emergency room admissions – which are relatively small in number – rose 7.4 percent. Retail prescription usage declined on average 1.1 percent in 2011 and fell by more than 3 percent in ten states, reflecting variations in demographics, epidemiology, clinical practice and payer dynamics. Seniors age 65 and over reduced their use of prescription drugs by 3.1 percent last year, most notably in the antihypertensive class. Individuals age 19 to 25 increased their use of medicines by 2.0 percent, notably for ADHD treatments and antidepressants. This was the only age group that increased drug utilization in 2011.

Source: IMS Institute for Healthcare Informatics
www.theimsinstitute.org

If you want information about the care of many common conditions follow this link

Links to AHRQ publications for consumers on effective health care programs

Choose wisely: Visit Choosingwisely.org

 

Choosing Wisely® aims to promote conversations between physicians and patients by helping patients choose care that is:

  • Supported by evidence
  • Not duplicative of other tests or procedures already received
  • Free from harm
  • Truly necessary

In response to this challenge, national organizations representing medical specialists have been asked to “choose wisely” by identifying five tests or procedures commonly used in their field, whose necessity should be questioned and discussed. The resulting lists of “Five Things Physicians and Patients Should Question” will spark discussion about the need—or lack thereof—for many frequently ordered tests or treatments. Learn More.

This concept was originally piloted by the National Physicians Alliance, which, through an ABIM Foundation Putting the Charter into Practice grant created a set of three lists of specific steps physicians in internal medicine, family medicine and pediatrics could take in their practices to promote the more effective use of health care resources. These lists were first published in Archives of Internal Medicine.

Visit at: www.choosingwisely.org

 

Cervical cancer screening recommendations changes…and not a peep.

Did you see this? Were there headlines? Think back to when breast cancer screening guidelines were suggested for change. Why do you suppose you haven’t heard of this proposed change?

Researchers suggest longer wait between gynecological exams
A U.S. study that followed 331,818 women found that the five-year risk of cervical cancer in those who had normal Pap smear and negative results for human papillomaviruses was “very low,” suggesting that women over 30 could get gynecological tests every three years instead of annually. Researchers also said that HPV tests alone “identified more women at high risk for cervical cancer than Pap tests” and would be “enough to give a high level of security for extending the testing interval to every three years.” Google/Agence France-Presse (5/18)

Study: Overtesting in Late-Stage Cancer Patients

If you knew you had one year to live, would you have medical tests you didn’t need?

Turns out a surprising number of patients with late-stage cancer get useless screening tests for new cancers that couldn’t possibly kill them.

A new study of Medicare patients with cancers so advanced they had limited life expectancies and little hope of cure reveals “a culture of screening on autopilot,” said lead author Dr. Camelia Sima of Memorial Sloan-Kettering Cancer Center in New York.

Read more here: http://www.ahiphiwire.org/Clinical/News/Default.aspx?doc_id=677640&utm_source=10/13/2010&utm_medium=email&utm_campaign=HiWire_Newsletter&uid=TRACK_USER

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