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House calls increase satisfaction and cut hospital admissions among elderly

A house call program may not always reduce health care costs in treating older adults with numerous chronic conditions, but there may be other benefits, according to the August American Journal of Managed Care. “The problem is not the model but most likely the way we selected the people,” said Susan Enguidanos, MPH, PhD, one of the authors and an assistant professor at the University of Southern California in Los Angeles. “We need to better select the population based on illness and need.” House calls are one of many possibilities being considered to reduce medical costs within health system reform. The paper looked at 156 elderly patients randomized to a house call program run by HealthCare Partners. These patients were compared with 142 who were not in the program. Enguidanos is a consultant with HealthCare Partners, based in Torrance, Calif., and operates medical groups and physician networks in California, Florida and Nevada. The majority of the other authors are e ...

U.S. performs poorly on preventable death rates

Americans younger than age 65 have higher chances of dying from preventable conditions than those in other industrialized nations, according to a new study. The study, sponsored by the Commonwealth Fund and published online by Health Affairs, concluded that the U.S. ranked behind the United Kingdom, France and Germany on avoidable mortality rates, and that it also was progressing at the slowest pace to improve these statistics. “Despite spending about twice as much per person each year on health care as France, Germany or the U.K. — $8,400 in 2010 — the U.S. is increasingly falling behind these countries in terms of progress in lowering the potentially preventable death rate,” Commonwealth Fund President Karen Davis said in a statement. In conducting their research, Martin McKee, professor of European public health at the London School of Hygiene & Tropical Medicine, and Ellen Nolte, director of the health and health care at RAND Europe, looked at “amenable mortality ...

Patients often seek general medical care from specialists

When adults have a fever, nasal congestion or a common condition such as asthma, many seek medical care from a specialist rather than a primary care physician. The percentage of patients visiting specialists for such care, however, has remained fairly steady over a decade. In 2007, 43% of patients with such symptoms or illnesses visited a specialist, nearly unchanged from the 42% who did so in 1999, according to a research letter published online Aug. 20 in Archives of Internal Medicine. Specialists included internal medicine sub-specialists, neurologists and obstetrician-gynecologists. The number of patients seeking primary care from specialists “is remarkably higher than we expected,” said lead study author Minal S. Kale, MD. “It points to an ongoing issue with how our primary care is delivered.” Possibly contributing to the findings is the belief by some patients that specialists are better able to treat specific conditions than general physicians, said Dr. Kale, a ...