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4% drop in U.S. birth rate is largest in 3 decades
Birth rates nationwide declined by 4% on average between 2007 and 2009, reaching 66.7 births per 1,000 women age 15 to 44, according to a federal report. This is the biggest decrease in more than 30 years. Rates dropped most sharply in the West and Southeast, and among Hispanic women and younger women, according to the report. Birth rates decreased by 9% for Hispanic women and 9% for women age 20 to 24. The study was released March 29 by the National Center for Health Statistics, a division of the Centers for Disease Control and Prevention. Although the CDC report does not link the decline to the most recent economic recession, other studies have. For example, the Pew Research Center concluded in an April 2010 analysis that there was a strong correlation between the decline in birth rates between 2007 and 2008 and the economic downturn in states. Older women bucked the national trend. Birth rates for women 40 to 44 increased 6% between 2007 and 2009 to reach 10.1 per 1,000 wom [Read more]
32% of hospitals ill-equipped for mass-casualty disasters
Nearly a third of hospitals are unprepared for the six types of mass-casualty disasters that public health officials fear most, according to a report published in March by the Centers for Disease Control and Prevention. All of the nearly 400 hospitals that responded to questions about emergency preparedness as part of the National Hospital Ambulatory Medical Care Survey had plans for at least one of the six types of disasters -- chemical, natural, epidemic, biological, nuclear-radiological and explosive-incendiary. The last two hazards were the ones for which hospitals were least likely to be prepared, with 20% lacking plans for either nuclear or explosive scenarios (www.cdc.gov/nchs/data/nhsr/nhsr037.pdf). "There are things that hospitals do well -- planning for chemical releases, natural disasters, biological incidents," said Richard W. Niska, MD, MPH, co-author of the report and medical epidemiologist at the CDC's National Center for Health Statistics. "One of my concerns is t [Read more]
Long work hours linked to cardiovascular risk
Someday, asking patients about how many hours a day they work may be a way to help predict whether they will develop heart disease. A study in the April 5 Annals of Internal Medicine found that over time, patients who worked an 11-hour day had a 67% greater chance of developing heart disease than those who worked seven to eight hours (annals.org/content/154/7/457.abstract/). "We were really surprised to learn that a simple measure, such as information on working hours, can improve a 10-year prediction of heart disease," said Mika Kivimaki, PhD, a study author and professor of social epidemiology in the Dept. of Epidemiology and Public Health at University College London. Researchers looked at self-reported working hours from 7,095 men and women ages 39 to 62 in Great Britain who did not have prevalent heart disease. They also created a Framingham Risk Score that incorporates conventional risk factors such as lipid levels, blood pressure and smoking habits. A baseline medical e [Read more]
Second round of Medicare equipment bidding plan delayed
Washington -- The agency overseeing the Medicare program has delayed the second round of a durable medical equipment bidding program that was set to expand the initiative to 91 areas in the U.S. At its Program Advisory and Oversight Committee meeting on April 5, the Centers for Medicare & Medicaid Services announced that the bidding process would be delayed by six months. According to an updated timeline, bidding will open soon after the start of 2012 and close in the spring of that year. CMS subsequently will announce the suppliers that have secured contracts for 2013. The Medicare Modernization Act of 2003 required the agency to set up the bidding program. The first round, which required a re-bidding in 2009, identified a select set of suppliers that would be allowed to provide medical equipment for beneficiaries in Charlotte, N.C.; Cincinnati; Cleveland; Dallas-Fort Worth; Kansas City, Mo.; Miami; Orlando, Fla.; Pittsburgh; and Riverside, Calif., starting Jan. 1, 2011. Round t [Read more]
Health institutions team up to improve care
A new collaboration is bridging medical education, patient care and research in an effort to improve the safety and quality of health care nationwide. Two hundred medical schools, teaching hospitals and health systems representing 12% of U.S. hospital admissions have committed to participate. The Assn. of American Medical Colleges announced March 30 the Best Practices for Better Care initiative (https://www.aamc.org/initiatives/bestpractices/). The goal is to get institutions to work together and improve care based on proven methods, said AAMC Chief Advocacy Officer Atul Grover, MD, PhD. "We've had a number of individual efforts at individual institutions," he said. "What we found was there wasn't a lot of information-sharing between institutions about what different folks were doing." The initiative will work to improve medical education about quality and patient safety, increase use of surgical checklists, reduce central-line infections, decrease hospital readmissions, an [Read more]
Practices are better at retaining nurses than hospitals, study says
Physician offices may have characteristics that make them attractive employers for registered nurses despite usually paying less than a hospital or a large health system. "There are some aspects of working in a hospital that can burn nurses out more quickly," said Sanja Licina, PhD, senior director of talent intelligence and consulting with CareerBuilder, an online job search and recruitment company. RNs work an average of 3.3 years at a physician office before changing employers, according to a CareerBuilder analysis of resumes in the company's database (www.careerbuildercommunications.com/pdf/turnoverrx-whitepaper.pdf). Licina co-wrote the study, which was released March 29. RNs spent an average of 3.1 years at general hospitals and specialty hospitals before moving on. At 1.8 years, nursing care facilities had the worst retention rate. RNs worked an average of two years at kidney dialysis centers and home health care services. The report did not analyze why physician off [Read more]
Discovery of Alzheimer's genes provides hope for future treatment
The discovery of five genes linked to Alzheimer's disease offers scientists insight into what causes the condition and advances efforts to treat and eventually prevent the disease, say the authors of two studies. The finding boosts the number of known Alzheimer's-related genes to 10. But it is not expected to have an immediate impact on how physicians diagnose and treat Alzheimer's patients, experts say. "The effect right this minute is probably limited. ... But in the long term, this is the kind of data you're going to need to tailor your therapies to a specific individual, " said Bill Thies, PhD, chief medical and scientific officer of the Alzheimer's Assn., the largest private, nonprofit funder of Alzheimer's research. When scientists identify enough Alzheimer's-related genes -- possibly 100 or more -- health professionals could conduct a genome-wide test on patients to measure their likelihood of developing the disease, Thies said. The more Alzheimer's-related genes a pati [Read more]
AMA identifies Medicare's top regulatory burdens
Washington -- Eliminating various unfunded mandates, restoring Medicare payment for consultation services and better aligning quality incentive programs would reduce the regulatory burden placed upon physician practices, doctors say. The American Medical Association outlined these complaints and more in a letter to the Centers for Medicare & Medicaid Services on April 13. On Jan. 18, President Obama requested input on how his administration could reduce the regulatory burden on various sectors of the U.S. economy. The AMA responded by conducting a survey in which more than 2,000 doctors provided feedback on federal rules that they said increase administrative costs at their practices and interfere with patient care. The AMA's nine-page letter requests relief from unfunded mandates in the Medicare program. "While these requirements generally have laudable goals, costs frequently exceed benefits and are simply unrealistic in a program which fails to recognize the cost of practic [Read more]
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