Patients Can Benefit From Choosing High-Volume Hospitals For Cardiovascular Procedures Even If Facilities Do Not Have High Ratings
New research published in the January issue of the Journal of the American College of Surgeons finds that while popular hospital rating systems can help identify high-quality hospitals for cardiovascular operations, patients can achieve similar outcomes by seeking care at high-volume hospitals closer to home. Hospital quality ratings have become a source of bragging rights for many hospitals, and they receive substantial attention from both the public and media. Two of the most recognized ratings are the U.S. News and World Report's "America's Best Hospitals" and HealthGrades' "America's 50 Best Hospitals." Although patients and caregivers increasingly use these quality ratings to choose hospitals, the relationship between ratings and outcomes remains unclear.
The Los Angeles Times reports on how health workers in the Mississippi Delta region of the U.S. are hoping to mimic Iran's success in reducing infant mortality by recreating the country's low-cost rural healthcare delivery system in their own backyard. "Mississippi ranks at or near the bottom of most healthcare indexes. ... The state suffers the nation's worst infant mortality rate - about 50% higher than the national average - and the lowest life expectancy, " the newspaper writes. In contrast, Iran's "17, 000 health houses, essentially rural medical outposts staffed by community health workers, " have been credited with slashing the number of infant deaths by 70 percent over the past three decades, according to the WHO.
Robert Wood Johnson Foundation: Dependent Coverage Expansions: Estimating the Impact of Current State Policies - "With an estimated 29.3 percent of Americans age 19 to 29 lacking coverage, young adults are more likely to be uninsured than any other age group, " the authors note. They examine efforts taken by 38 states to define and expand health coverage to young adult dependents. The report compares common provisions in state regulations and estimates the impact on the coverage of young adults, based on data from the Current Population Survey. "Preliminary findings based on CPS data through 2008 (reflecting coverage through 2007) found a small increase in coverage of young adults as dependents, but they also showed that this increase was offset by a decline in other sources of coverage, with no impact evident on the likelihood of being uninsured" (Cantor et al.
Canada needs standardized comparisons of the health care system, including individuals, institutions and other providers, to truly provide patient-centred care, states an editorial in CMAJ (Canadian Medical Association Journal). "A paradigm shift is needed in Canada toward a patient-centred health system, " writes Paul HÃ bert, Editor-in-Chief, CMAJ. "Change will only occur if patients have access to the necessary information to make their health care decisions." Canadians need access to standard hospital performance measurements, success rates of surgeries and major procedures as well as surveys on overall health care satisfaction. Limitations to introducing these performance measures include lack of buy-in from health decision-makers and individual practitioners.
The Associated Press/CNBC reports that New York Gov. David Paterson is "proposing new, tougher prohibitions on pharmaceutical companies, restricting them from dispensing gifts and misleading production information to doctors while promoting the use of specific drugs." Nine states have similar legislation. "The Paterson administration estimates the change will generate little money for the state through cutting the spending on prescription drugs, but argues it's important for New Yorkers to know they are being prescribed medications for the right reasons. Pharmaceutical companies argue Paterson's measures go beyond the current voluntary code by interfering with the relationships between doctors and experts.
Four new studies published in a leading journal this week link exercise with healthy aging, either through reduced risk or slower progression of several age-related conditions or through improvements in overall health in older age, and detail associations between physical activity and cognitive function, bone density and overall health. All four studies, and an accompanying editorial commentary appear in the 25 January issue of the Archives of Internal Medicine. In the accompanying editorial, Drs Jeff Williamson and Marco Pahor, of the University of Florida, point out that previous studies have linked exercise to beneficial effects on a range of conditions and diseases, including obesity, diabetes, heart disease, cancer, lung disease, arthritis, falls and fractures, that can hamper older people's ability to get on with their day to day tasks and lead indendepent lives.