Things are Looking Better

According to a recent study, hospitals are doing better in treating certain diseases and conditions. The study found that the recent focus on quality improvements have been effective in changing hospital practices to ensure that standards of care are being met in a more uniform fashion. Thus, the good news is that focusing on the issues of error and quality is starting to have a great effect! Read more here:
http://www.google.com/hostednews/ap/article/ALeqM5haPS-JKQrNLfoy9yfDsX75YlpFLgD9ID7MO80

The Cost of Dementia

A study released today has identified that the worldwide cost of caring for individuals with dementia is over $600 billion!!! The report further predicts that the number of individuals suffering from Alzheimer's disease and other forms of dementia will likely triple by 2050. Interestingly, richer nations were noted to have about 46% of all dementia cases, but these same richer nations account for 89% of money spent on dementia. Read more about the report at this link: http://www.reuters.com/article/idUSTRE68K0HL20100921

Insulin for Alzheimer's Disease??

A recent randomized, small trial of non-diabetic Alzheimer's patients (n=109) found that patients treated with twice daily doses of nasally inhaled insulin had mild improvements in their cognitive functioning. Plans are underway to conduct a large scale, multi-site randomized trial to replicate these results and assist in determining the appropriate dosing of the insulin.

While this was a small scale study, it certainly does present some interesting considerations. We currently have very few treatments available to Alzheimer's patients and none of our accepted treatments have demonstrated the ability to improve cognitive function. I will look forward to seeing additional studies along this line of inquiry!

Googling for Health Care Information -- Feeling Lucky?

A research UK based study of Interent searches related to common childhood health questions yielded mixed results. In general, 39% of the 500 sites visited provided accurate information, 11% provided incorrect info and 49% provided information that did not truly address the question/issue.

So what does this mean? Where do you go when you want to learn more about a health-related problem? Is your standard to "google it?" How do you decide what is the best source? According to this study, government sites were uniformly most accurate -- however, government sites are not without bias. At the start of the Bush administration, several years ago, there was actually a push to remove all STI prevention information other than abstinence, from the CDC site. So, while government sites do provide factually accurate information, it may not be "the whole picture." New sites were accurate in only about 55% of the cases -- this is particularly concerning since I imagine a majority of people do get their health information from news sites! Next time you are searching, try sites like the Mayo Clinic or other well-established health care organizations.

Deciding Where to Get Treatment?

Are there ways to determine if a particular hospital is the right one to treat your problem? According to a recent US New & World Report article (Iink below), there are some factors to be considered. Factor such as patient volumes, surgeon/surgery volumes, nurse staffing and more are discussed. The question remains, can you reasonably investigate all these factors before going to the hospital AND can you then choose to be admitted to the hospital you select? After you read the article below, try some out some of the evaluation sites listed -- did you find them helpful? Would your findings change where you would want to go to the hospital?

http://health.usnews.com/health-news/best-hospitals/articles/2010/07/14/when-a-hospital-is-bad-for-you.html

Health Care Service Use Going Down?

In an interesting new trend, fewer Americans (including those with health insurance) are utilizing health care services. Insurance companies noted for the first time, they have seen a decrease in the number of services used. Experts suggest that increasing co-pays, less elective procedures during the recession and other issues may be to blame. Will this trend continue? Or if health care reform continues to move forward, will we see a sudden increase in service use as more individuals gain access to health care? In the interim, will more health care professionals find themselves out of work due to decreasing volumes? Only to be highly sought when volumes increase again? does the increase in co-payments make us more reasonable and responsible consumers of health care or do they place an unnecessary burden on us? Read more here:

http://online.wsj.com/article/SB10001424052748703940904575395603432726626.html?mod=dist_smartbrief

Chocolate is Good for You?

In honor of Valentine's Day (a little late:), see the link below for more information about the potential health benefits of chocolate. One recent study showed that moderate (a key word) consumption of chocolate may decrease stroke risk. More studies are needed to fully understand this concept.

http://www.msnbc.msn.com/id/35354279/ns/health-heart_health/ns/health-heart_health/

Stroke Carries a High Mortality Risk

As we noted in class, strokes are largely preventable -- mainly through blood pressure management, behavior modification, etc. According to a recent study (link included below), 25% of people who suffer a stroke will die within the next year! This level of mortality is quite significant -- but I wonder how many people would guess that it was that high? In another recent study, researchers found that many Americans rate their own health as higher than their peers. In fact, about 30% of the 2000 people surveyed gave themselves an "A" in health. Conversely, 92% of physicians gave the same subjects a grade of "C" or lower for health. Perhaps we are not as self-aware as we imagine ourselves to be!

http://www.msnbc.msn.com/id/35410389/ns/health-heart_health/

Big Brother May Be Watching

About a year ago, I first heard of an upcoming technology that could monitor whether or not health care workers washed their hands upon entering and exiting patient rooms. Now that technology is in place at at least one hopsital in Alabama. Staff at the hospital wear a badge that is enabled to wirelessly monitor handwashing habits of staff. Staff members can be reminded to wash hands via text or email -- and even the hospital CEO is notified of the results.

It is well known that handwashing, upon entering and exiting a patient room is one key to decreasing hospital acquired -- also known as nosocomial -- infections. Is this type of monitoring the right way to acheive imporoved compliance? Studies have shown that only 40% of healthcare workers follow proper hand hygiene techniques, despite repeated education, reminders, etc.

http://www.npr.org/templates/story/story.php?storyId=123139695&ps=cprs

Does the Public Want Health Care Reform?

According to a recent CNN poll, most Americans are not in favor of the current health care reform legislation and many do not want any reform. http://www.cnn.com/2010/POLITICS/01/26/poll.health.care/

However, one must question if those that claim to not want health care reform are well - informed in making that choice or are they simply afraid of what the change might be? Further, did those polled already have health insurance? Or were they among those without basic coverage -- that certainly would influence how critical one views the issue of health care reform.

I believe that without some type of reform, we will be unable to maintain our current system. It is unlikely that Medicare can be sustained in the coming decades without reform -- as the Baby Boomers enter the Medicare system in droves, costs will continue to rise -- potentially to levels to high to finance.

Are Nurse Patient Ratios The Answer?

As you can see in the linked article, the number of patient a nurse cares for at a given time is an important factor in patient safety, quality and overall patient outcomes. Numerous studies have demonstrated that nursing levels, in particular the number of registered nurses, are critical indicators in preventing various complications, decreasing length of stay and decreasing mortality. However, there is no good answer as to what is the right number of patients for each nurse. So much depends on the acuity, or overall illness/intensity of care, of a given patient. Thus, simply applying set ratios, such as 1 nurse for every 5 patients is inadequate to fully address the myraid of issues.

In PA, the PA State Nurses Association has introduced safe staffing legislation that calls for each organization to establish staffing patterns that are appropriate to the particular facility -- and staff nurses must be involved in the decision making. Rather than looking to mandated ratios, the PSNA bill calls for acuity, staffing experience, skill mix and more to be considered.

As the article at the attached link describes, sometime set ratios are also a limiter -- for example the ratio of one nurse to every four patients in Emergency Rooms. While a good rule to follow, there are certainly times when a nurse could accomodate an additional patient, thus decreasing ER waiting. However, in order for a more flexible system to work, all parties must be reasonable and have a voice!

http://www.healthleadersmedia.com/page-1/NRS-245408/Does-Mandating-NursePatient-Ratios-Improve-Care

Top Ten Healthcare Issues for 2010

According to a recent report, efforts to decrease healthcare costs, enact healthcare reform, improvements in information technology, great focus on community health, not just individual health, better public health preparation are among the top 10 healthcare issues for 2010. Also in the top 10 are continued increases in physcians joining existing hospital organzations rather than having private community based practices, as well as continued focus on decreased insurance fraud and abuse. Read more at the following link:

http://www.healthcareitnews.com/news/healthcare-it-among-pwcs-list-top-10-healthcare-issues-2010