A paper published in this weeks issue of PLoS Medicine provides a substantial new resource for the developers of guidelines of the reporting of health research. The authors of the paper have been key in the development of many of the most important health research guidelines published over the past few years, including the CONSORT guidelines for clinical trials and the PRISMA guidelines for systematic reviews. The accurate reporting of a study is key to the understanding of the importance of the study. Before the development of CONSORT, for example, there was no consensus on what must be reported in order for a reader to accurately assess the validity of a trial.
Value-based insurance design (VBID) in which consumer payments are waived for highly effective treatments, but are raised for less effective ones, could increase the benefits of healthcare in the US without increasing expenditures, according to research published in PLoS Medicine. The costs saved by VBID could be used to subsidize coverage for the currently uninsured, providing a substantial improvement in health outcomes. Strategies that influence the quantity of health care consumed are essential to controlling healthcare costs. Such strategies can target health care providers (for example, requiring primary care physicians to provide referrals or to go through cumbersome administrative procedures before their patients insurance will cover specialist care) or can target consumers by charging co-payments and out-of-pocket deductibles (cost sharing).
The public is being urged to join the BMA's ' Look After our NHS' campaign against the role of commercial companies providing NHS care in England. Successive government policies have created a market in healthcare and allowed commercially run firms to compete against existing NHS trusts and GP practices to provide NHS care. The BMA is concerned that this is having an adverse impact on many parts of the NHS in England. The BMA's 'Look After our NHS' campaign website has been revamped, so that members of the public can show their support for an NHS which is publicly funded and publicly provided. And this week the BMA is sending 'Look After our NHS' campaign packs to each of its members in England - over 100, 000 doctors and medical students.
Minority patients in New York City appear less likely than white patients to have surgeries performed by surgeons or at facilities that have handled large numbers of similar procedures in the past, according to a report in the February issue of Archives of Surgery, one of the JAMA/Archives journals. Racial and ethnic differences in medical care and health outcomes have been widely documented, according to background information in the article. "One specific concern is whether minorities disproportionately receive treatment from lower-quality providers, " the authors write. "While measuring quality accurately is difficult, research has shown mortality [death] to be inversely related to hospital and surgeon volume for many surgical procedures.
The more specialized a hospital is in orthopedic surgical care, the better the outcomes appear to be for patients undergoing hip and knee replacement surgery, University of Iowa researchers report in a new study of Medicare patients. Among more specialized hospitals, there were fewer serious post-surgical complications such as blood clots, infections and heart problems, as well as fewer deaths. The findings, which were published online Feb. 11 by the British Medical Journal, were based on data for nearly 1.3 million patients who received hip or knee replacement surgeries between 2001 and 2005 at 3, 818 hospitals in the United States. "The findings suggest that more specialized hospitals have better outcomes even after we account for the type of patients each hospital cares for and the number of hip and knee replacement surgeries that each hospital performs, " said the study's lead author Tyson Hagen, M.
The (New Orleans) Times-Picayune: Louisiana "Gov. Bobby Jindal will present his 2010-11 budget request Friday, which is expected to call for cuts to health care, education and other areas of state government as his administration outlines plans for plugging a $1 billion shortfall. ... The general-fund growth is not nearly enough to offset a loss of about $650 million in federal health-care financing, the rising cost of state pensions, automatic pay raises for state workers and inflation in health-care programs." "Many of the health-care cuts proposed today may not be enacted, as there is a decent likelihood that Congress will approve a temporary fix for the biggest problem facing Louisiana's budget: a $400 million Medicaid cut due to a lower federal match rate and the expiration of the federal economic stimulus law" (Moller, 2/11).