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H. influenzae disease rising among adults, especially the elderly
Due to the success of the childhood Haemophilus influenzae type b vaccine, the disease that once was the leading cause of bacterial meningitis in youths under age 5 is almost nonexistent in children today. Invasive H. influenzae disease, however, is on the rise among adults, a study shows. The study, published online Aug. 10 in the Centers for Disease Control and Prevention's Emerging Infectious Diseases, highlights the importance of developing an adult H. influenzae vaccine. Particular attention should be paid to preventing the condition among the elderly, who had the highest incidence of disease, said lead study author Matthew P. Rubach, MD. Adults 65 and older had a 12-fold greater risk of invasive disease than did patients 18 to 34, the study shows ( Clinical syndromes of such invasive disease include meningitis, bacteremia or sepsis, and pneumonia, according to the CDC. "No one thinks much about Haemophilus influenzae in a [Read more]
Greater awareness of practice guidelines helps reduce unrecommended tests
A physician-driven approach cut in half the number of unwarranted tests that doctors ordered for newly diagnosed prostate cancer patients, research shows. Increased awareness of practice guidelines and being presented with comparative data on tests they and their colleagues ordered resulted in more physicians following recommendations on what tests to order, according to a study in the September issue of The Journal of Urology. It also improved the quality of care by reducing variations in practice patterns. Fewer unnecessary tests -- in this case bone scans and computerized tomography scans -- mean fewer patients are exposed to radiation and the inherent risks. They also avoid needless costs to the health care system, said lead author David C. Miller, MD, MPH. "This approach was physician-led. ... It's a new solution to an old problem," said Dr. Miller, a urologist and an assistant professor at the University of Michigan Medical School in Ann Arbor. "This was about enhancing [Read more]
HHS finalizes administrative standards for electronic claims submissions
Washington -- The Obama administration has set electronic standards for health plans exchanging insurance coverage information with physician practices and for the status of claims submitted for payment. The Dept. of Health and Human Services published the new criteria on June 30 to standardize electronic health care transactions, administration officials said. Health plans, clearinghouses for claims and health professionals who transmit health information in electronic formats must adopt the new rules by 2013. "The use of these operating rules is going to make the existing standards work better," said Denise Buenning, director of the administrative simplification group at the Centers for Medicare & Medicaid Services. "By making them work better, we're forecasting that the use of standards will expand and information will be streamlined so that the process will be faster, better and less expensive." The new administrative simplification standards were outlined in the national [Read more]
Chronic pain costs U.S. $635 billion a year
More than 116 million Americans struggle with chronic pain each year, and associated medical charges and lost productivity cost the nation as much as $635 billion annually. These are the findings of "Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education and Research," a July report by an Institute of Medicine panel that calls for an aggressive national strategy to combat the problem. "That's a conservative estimate of the overall economic impact because it excludes children, members of the military and individuals in nursing homes or chronic care facilities," said Philip A. Pizzo, MD, chair of the IOM panel. "We are looking at a broad demography of pain." The report, mandated under the Patient Protection and Affordable Care Act, includes 16 recommendations for action. The panel said that by the end of 2012, the Dept. of Health and Human Services, the Centers for Medicare & Medicaid Services and other federal agencies should: Create a popula [Read more]
Pertussis vaccine recommended for pregnant women
In an effort to better protect infants against pertussis, a federal vaccine advisory committee recommends that physicians administer the Tdap immunization to pregnant women after 20 weeks' gestation. Vaccinating during pregnancy will enable pertussis antibodies to pass from the mother to her unborn child, according to the Advisory Committee on Immunization Practices. This transplacental transmission will help protect newborns against the bacterial illness until they can receive the first dose of the diphtheria, tetanus and pertussis vaccine at 2 months old, the ACIP said at a June 22 meeting in Atlanta. The 15-member committee advises the Centers for Disease Control and Prevention on vaccine issues. The CDC recommends that the remaining four doses of DTaP be administered between 4 months and 6 years. Data show that pertussis disproportionately affects infants, particularly those who are too young to be vaccinated. Of the 194 pertussis deaths in the U.S. between 2000 and 2009, [Read more]
Grants to bolster local quality improvement efforts
Sixteen communities across the country received a $1.3 million boost to continue testing innovative ways to improve health care quality and efficiency. The grants from the Robert Wood Johnson Foundation will help the local health care collaboratives develop and test payment models as part of the foundation's Aligning Forces for Quality initiative. The program, which began in 2006, brings together physicians, hospitals, payers and consumer groups in participating communities to collaborate on improving health care delivery in their area. The communities are comprised of a city, such as Boston and Cleveland; a region, such as western Michigan and Puget Sound, Wash.; or an entire state, such as Minnesota and Oregon. A main goal of the grant money, now totaling $300 million, is to provide examples of quality improvement for communities across the country, particularly as they look to adapt to health system reform, said Robert Graham, MD. He is director of the AF4Q national program [Read more]
GOP bill would create health care tribunals
Washington -- New House legislation aims to curb the overuse of health care by establishing clinical best practices for physicians and creating health care tribunals to hear medical liability cases. "The practice of defensive medicine adds billions of dollars of unnecessary costs to our health care system and diverts doctors' focus away from delivering quality care," Rep. Tom Price, MD, (R, Ga.) said in a statement after introducing the legislation on June 24. The bill would use a three-pronged approach to end overutilization of tests and other unnecessary care while respecting the rights of patients and doctors to determine the best course of treatment, he said. The legislation would: Protect doctors and other health professionals from liability if they practice medicine consistent with best practices developed by physician specialty and quality organizations, and then approved by the Health and Human Services secretary. Provide grants to states to create administrat [Read more]
Research confirms rise in number of new physicians
Research shows that an influx of fledgling physicians to hospitals nationwide each July contributes to a rise in patient deaths and inefficiencies in care. But the extent of those increases and the reasons behind them remain unclear, says an Annals of Internal Medicine study. Many researchers have studied the so-called July effect, in which patient outcomes decline as a result of hospitals undergoing major work-force changes as new residents come in and older ones complete their training. "Teaching hospitals experience a massive exodus of highly experienced physician trainees who are also familiar with the working environment of the hospital," said John Q. Young, MD, lead study author and associate program director of the University of California, San Francisco, School of Medicine's psychiatry residency program. "Those that remain assume new, more responsible roles in treating patients. And many newly minted physicians arrive to begin their training." He likened it to a footba [Read more]
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