healthcare research

Blue plans see 18 percent drop in operating earnings for '07

Anne Zieger — Thu, 19 Jun 2008 13:38:21 -0400

A new analysis by healthcare research and consulting firm the Sherlock Co. found that last year was not a good one for the nation's Blue Cross and Blue Shield plans, which lost money despite increased revenue. The Blue plans posted an overall 18.2 percent decline in operating earnings during 2007, though revenue rose 7.4 percent. Among the 39 plans, six actually showed improved operating margins of 1 point or more, but nine had worsening operating margins of at least 3 percentage points, according to Sherlock.

These results come, in part, because the plans' revenues aren't keeping pace with medical costs. The plans' median premium-rate increase during 2007 was 5.4 percent, but median medical costs per member rose by 6.4 percent. What's more, administrative costs grew at a median rate of 7.6 percent per member. Meanwhile, insured membership among the plans fell by 1.4 percent, to 51.5 million, and operating margins dropped 1 point for 2007, to 3.3 percent.

Given these numbers, it seems likely that the Blues will be among the crowd of insurers who raise rates substantially for next year. Several health plans announcing troubling results this year have already vowed to jack up rates for 2009.

To learn more about this study:
- read this Modern Healthcare article (reg. req.)

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Study: Despite earlier deaths, obese pay higher medical bills

Tue, 10 Jun 2008 06:59:54 -0400

New research suggests that young adults in their 20s who are as little as 30 pounds overweight may pay lifetime medical bills that are $5,000 to $21,000 higher than their normal-weight. Meanwhile, extremely obese young adults (70 pounds or more overweight) will incur $15,000 to $29,000 more in lifetime medical expenses than healthy-weight peers, according to a study in the journal Obesity. These numbers take into account that heavy people have shorter life expectancies.

The data varied by ethnicity. According to the study, medical expenses are much greater in obese white women than obese black women, probably because white women tend to use more health services at every weight level. Correspondingly, white men's costs at 70 pounds overweight were slightly higher than black men's costs.

To learn more about the study:
- read this USA Today piece

Trend: 'Evidence based' hospital design increasingly popular

Mon, 09 Jun 2008 06:59:55 -0400

Ask any hospital patient what hospitals look like, and they'll probably conjure up a dull landscape of long, featureless hallways, rattling vents and a generally uninviting atmosphere. However, of late a new architectural movement has been working to change this, transforming hospitals into welcoming buildings that bring in sunlight and nature, make friends and family comfortable and put patients in charge wherever possible. This movement, known as evidence-based design, is taking root nationwide after bubbling beneath surface for a couple of decades.

The approach is called "evidence-based" because the designs respond to research on what makes patients recover more quickly--taking into account, for example, a study from the 1980s concluding that giving patients a view of an outdoor vista rather than a brick wall cut delivery times by 24 percent, as well as reducing complaints for conditions like nausea. Another influential study found that patient falls dropped 75 percent at one Indianapolis cardiac critical care unit when nursing stations were spread out and placed near patient rooms.

Studies like these, and others looking at design features like single-patient rooms, sound-dampening carpets and brighter lighting, have come together into new design standards used to create more therapeutic, comfortable and efficient environments, architects and researchers say. With the buildings themselves quieter and more tranquil, rooms designed to be more comfortable and accommodating spaces for families, and features like room lighting and blinds designed to let patients control them, the net result is a building much more conducive to clinical improvement, proponents say.

To learn more about this trend:
- read this Jacksonville Business Journal article

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Study: Clot-sucking device cuts death rates for heart attacks

Mon, 09 Jun 2008 06:59:54 -0400

A new study suggests that a vacuum-cleaner-like device that sucks block clots out of the arteries of heart attack victims before angioplasty can have a dramatic effect on survival rates. In fact, the procedure can reduce the death rate in the following year by nearly half, according to the researchers. By physically removing the clots from the arteries,the device prevents loose fragments from breaking off and causing further damage. Cardiovascular surgeons in many large medical centers, such as Santa Monica-UCLA and Orthopaedic Hospital, have already started using the device successfully.

The device, which was developed by Medtronic, allows the cardiac surgeon to thread a thin wire guide into the body through the groin, all the way to the clot, then insert a tube and suck up as much of the clot as he or she can prior to an angioplasty. A New England Journal of Medicine study found that in the first full year after the device was used, 19 of the 535 patients who got the aspiration died, compared with 36 of the 536 who had an angioplasty alone.

To learn more about the study:
- read this Los Angeles Times article

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Study: Hospitalized kids suffer too many infections

Wed, 04 Jun 2008 06:59:54 -0400

A new study released this week concludes that hospitalized children suffer a high rate of infections and other preventable complications that lead to longer stays and cost millions of dollars. The study, which appears in this month's issue of the journal Pediatrics, found that some types of complications occurred in as many as 4 percent of children treated at 38 children's hospitals in the U.S., in part because children are three times more susceptible to infections in hospitals than adults.

To conduct the study, researchers looked at medical records from thousands of children hospitalized in 2006, looking for 12 adverse events identified by the Agency for Healthcare Research and Quality. They found that of 430,000 children hospitalized in 2006, more than 6,600 suffered complications caused by their care, including nearly 3,000 cases of infections caused by care. Complications increased lengths of stay from three days for an accidental laceration to 24 days for sepsis. Added costs ranged from $35,000 to $337,000, researchers concluded.

To learn more about the study:
- read this piece in The Seattle Times

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Study: Social networks can have impact on health behavior

Wed, 28 May 2008 06:59:55 -0400

Underscoring the results of existing studies, new research has found that social networks can have a much bigger impact on health behaviors than previously suspected. The study, published in the New England Journal of Medicine, found that an individual's decision to stop smoking is strongly impacted by whether people in their social network quit--even by people they don't know personally. In fact, entire social networks of smokers appear to quit almost simultaneously, according to the researchers, medical sociologist Nicholas Christakis of Harvard Medical School and political scientist James Fowler of the University of California at San Diego.
Their study follows on previous research by the two suggesting that obesity too, can follow a pattern within social groups, appearing in one person and 'spreading' to another almost as though it were a virus.

The researchers used data derived records kept between 1971 and 2003 on about 5,124 people who participated in the landmark Framingham Heart Study. Because the subjects were connected to the suburb of Framingham, MA, many had social connections, allowing the researchers to study a network of about 12,000 people. When they analyzed the patterns of those who managed to quit smoking over the 32-year period, they found that the decision was highly influenced by whether someone close to them stopped; for example, someone was 67 percent more likely to quit if a spouse stopped, and 36 percent more likely if a friend did.

To learn more about the research:
- read this Washington Post article

Study: Admission day dictates heart failure, length of stay

Thu, 22 May 2008 06:59:55 -0400

A new study suggests that heart failure patients admitted to the hospital on Thursdays and Fridays have longer stays in the hospital than those admitted on other days of the week, while those admitted on Tuesday have the shortest stays. Generally speaking, there were far fewer discharges over the weekends, particularly on Sundays, noted Dr. Gregg Fonarow, professor of cardiovascular medicine at the University of California, Los Angeles, David Geffen School of Medicine. Interestingly, there was no relationship between the day admitted and death rates, though heart attack patients admitted on weekends were more likely to die than those admitted on weekdays.

To conduct the study, Fonarow and his colleagues looked at data from a sample of 48,612 heart failure patients admitted to 259 hospitals across the U.S. They found that hospital lengths of stay differed from 5.39 days for those admitted on Tuesdays to 5.88 days for those admitted on Fridays.

To learn more about the study:
- read this HealthDay News item

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Study: ICU docs discuss end-of-life with blacks less often

Thu, 22 May 2008 06:59:54 -0400

New research from the Center for Reducing Health Disparities (CRHD) suggests that ICU physicians discuss prognoses and end-of-life issues less frequently with black patients and their families than they do with white patients. Researchers, who interviewed more than 1,200 ICU physicians caring for 9,105 seriously ill patients at five major medical centers, concluded that doctors discussed prognoses with 58 percent of white patients and 41 percent of black patients. In addition, only 43 percent of the ICU doctors reported feeling comfortable during these conversations with black patients. (It's worth noting, however, that the interviews were conducted between 1989 and 1994, which makes the data sufficiently dated.)

Previous data has shown that ICU physicians, when predicting the likelihood that a patient will survive, were less likely to predict that their African-American patients would do so, while in reality, such patients were statistically more likely to survive. Given this concern, as well as the fact that physician discussions can influence family decisions to take steps like pulling life support, it's critical that researchers better understand factors influencing ICU physicians' communication with blacks in the ICU, said Dr. J. Daryl Thornton of the CRHD.

To learn more about the study:
- read this HealthDay News piece

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Harvard, RAND-backed provider payment model to be tested

Wed, 21 May 2008 06:59:57 -0400

An evidence-based healthcare payment model driven by researchers at RAND Corporation and the Harvard School of Public Health will be rolled out in January at four pilot test sites with funding from a $6.4 million grant.

The project, dubbed Prometheus--for payment reform for outcomes, margins, evidence, transparency, hassle-reduction, understandability and sustainability--is funded by the Robert Wood Johnson Foundation. Payments will be built around a total amount to be paid to all providers for a patient's condition. The project includes 12 evidence-based case rates, which included input from health insurers, employers, physicians and others through a not-for-profit collaboration.

The payment scheme will be kicked off in Rockford, Ill., and Minneapolis, with two other sites still to be announced. HealthPartners, a not-for-profit health plan, will run the project in Minneapolis, and employers will test the model with providers in Rockford.

To learn more about the project:
- read this article from Modern Healthcare (reg. req.)

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NIH offers free care to patients with rare illnesses

Wed, 21 May 2008 06:59:54 -0400

The NIH has launched a new pilot program designed to find patients with rare, hard-to-detect diseases and treat them--for free. The new Undiagnosed Disease Program is far from a panacea for such patients, as it can only take about 100 applicants per year, but it does offer help for some. NIH officials, for their part, hope that in treating such illnesses, they'll find clues for treating more common maladies.

The new program is aimed at patients who typically would be turned away from NIH programs because there are no studies for their condition, either because the condition is rare or because it may not have been discovered yet.

To learn more about the program:
- read this Associated Press article