Harvard Medical School

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

Harvard Med offers tuition discount

Thu, 08 May 2008 06:59:57 -0400

Harvard Medical School, the ultimate elite educational institution, will begin offering a discount on its tuition to some students, a step that observers say may ripple out into other institutions. Starting with the 2008-09 academic year, students whose families earn $120,000 or less a year will get up to $12,500 off the school's annual $65,000 cost for tuition and living expenses. The school's dean, Jeffrey Flier, MD, says that officials want to student lower debt loads so graduates can pick specialties without regard to their income potential.

It's worth noting that Harvard isn't alone. Other med schools are providing extensive aid to students, worried about the same issues Harvard has identified. For example, Stanford University offers enough scholarships that average medical grads have $78,000 in debt despite $70,000 per year in expenses. Still, Harvard's move has significant symbolic value, given the institution's particularly high prestige level. Harvard's decision comes at a time when median medical school debt is $140,000, with graduates paying 9 to 12 percent of their income toward the loans.

To learn more about Harvard's new program:
- read this AMNews article

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PA bill would forgive med school loans
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ALSO NOTED: FL plans to solve ED specialist crisis hit snag; Marriott rolls out personal health records for employees; and much

Mon, 04 Feb 2008 06:59:50 -0500

> Efforts to bring more specialists to Florida's EDs seem to be at an impasse, with hospitals reluctant to form a specialist-sharing network. Article

> Marriott has rolled out a Web-based personal health record to 50,000 employees. FierceHealthIT

> Presidential hopeful Sen. Hillary Clinton has raised eyebrows by suggesting that she might support financially penalizing those who can afford it, but don't buy health insurance. Article

> Harvard Medical School is transferring its non-profit consulting arm to Partners HealthCare, but Partners will eventually have to drop the Harvard name. Article

And Finally... When they placed electrodes in his brain, this patient suddenly found himself propelled back 30 years. Article

Study: ED waits are climbing

Tue, 15 Jan 2008 06:59:57 -0500

With emergency departments under increasing strain, patients are waiting significantly longer for care than they did in the past, according to a new study by Harvard Medical School researchers. According to the study, which appears today in the journal Health Affairs, half of ED patients waited 30 minutes or more before being examined by a doctor in 2004, up 36 percent from 22 minutes in 1997.

More worrisome was the fact that waits were high for seriously-ill patients. For example, more than half of heart attack patients waited 20 minutes or more to be examined in 2004, up from eight minutes in 1997. Generally speaking, patients whose conditions should have been attended to within 15 minutes were waiting at least 14 minutes to see a doctor, up from 10 minutes in 1997.

Researchers drew their conclusions from data provided by the National Hospital Ambulatory Medical Care Survey, collected between 1997 and 2000 and from 2003 and 2004.

To get more information from the study:
- read this Washington Post piece

Related Articles:
Overcrowding in the ED. Letters
Mentally ill wait days in Georgia EDs. Report
MD reports one-third of ED visits aren't emergencies. Report
Steps hospitals can take to reduce ER overcrowding. Report

Drug freebies not getting to the poor

Thu, 03 Jan 2008 06:59:58 -0500

A new study by Harvard-affiliated researchers has drawn a conclusion which, if widely accepted, could shift the dialog on the use of pharma-provided drug samples. The study has concluded that while the poor do receive free drug samples, almost all go to well-off patients who have insurance. This puts a stake in the argument that physicians need to accept samples to ease the burden carried by the poor and uninsured. The study, which was conducted by physicians with Harvard Medical School and the Cambridge Health Alliance, concluded that 82 percent of patients getting free samples during 2003 were insured throughout the year. Only 18 percent of those receiving free samples were uninsured for part of all of the year. Ethnicity also seems to play a role in who gets samples--a head-turning 81 percent of free-drug recipients were white. The study is set to be published in the February 2008 issue of the American Journal of Public Health.

To find out more about the study:
- read this Modern Healthcare piece
- see the Boston Globe report

Related Articles:
Time to take on the drug samples problem. Editorial
More providers limit use of free drug samples. Article
Henry Ford bans pharma perks, vendor drop-ins. Report
Stanford bans sales rep gifts to doctors. Article
UC Davis mulls pharma freebies ban. Article
FierceHealthcare readers debate ethics of freebies. Letters

Medicaid managed care not equal to commercial plans

Wed, 10 Oct 2007 06:59:55 -0400

Ideally, Medicaid beneficiaries who enroll in a managed care plan would get the same care as anyone in a commercial plan. Unfortunately, however, that's not how it actually works today, according to a new study. The research, which appears in the Journal of the American Medical Association, found that standard commercial health plans performed substantially better on nearly all of 11 quality indicators. For example, 77.2 percent of commercial health plan beneficiaries got appropriate postpartum care, while only 52.7 percent of Medicaid managed care patients did.

This study suggests that despite great hopes to the contrary, managed care probably isn't the ticket for improving care for the Medicaid population, researchers said. At minimum, resources may need to be configured a different way to address these patients' needs, according to Dr. Bruce Landon, associate professor of health care policy and medicine at Harvard Medical School, who served as lead author of the study.

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

Related Articles:
Illinois MDs upset over a proposal to force state's Medicaid patients into HMOs. Report
CT keeps disclosure pressure on Medicaid HMOs. Report

Study: When uninsured get Medicare, it's costly

Wed, 11 Jul 2007 20:01:34 -0400

A new study suggests that when chronically-ill uninsured adults age into Medicare eligibility, they're sicker than adults who had commercial insurance when they entered Medicare. The study, published in The New England Journal of Medicine, found formerly uninsured adults were hospitalized more often and had greater medical expenses through at least age 72.

The study, conducted by Dr. John Z. Ayanian of Harvard Medical School, looked at 9,760 adults who were 51- to 61-years-old in 1992. It found when uninsured people became eligible for Medicare, they had 13 percent higher levels of doctor visits, 20 percent more hospitalizations and 61 percent greater medical expenditures. The effects were strongest in people with cardiovascular disease and diabetes.

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

Related Article:
Medicare funds at-home doctor visits for chronically ill. Report

SPOTLIGHT: New England Journal editor talks reform

Wed, 04 Jul 2007 20:01:32 -0400

New England Journal editor talks reform
New England Journal of Medicine editor and Harvard Medical School professor Dr. Arnold Relman has staked out his position on health reform. In a recent interview, Relman discusses why he believes non-profits and for-profits aren't so different, why he thinks most doctors should be on salary. And, he sees a single-payer system as the best way to overhaul healthcare delivery. Interview

SPOTLIGHT: Portrait of a hospital CEO

Mon, 02 Jul 2007 20:01:32 -0400

It's been a pretty dramatic tenure for Paul Levy, CEO of Boston's Beth Israel Deaconess Medical Center. Levy, former executive dean for administration at Harvard Medical School, is widely credited with BIDMC's turnaround from hemorrhaging money and staff to making a profit. Now Levy is hoping to make an even more challenging shift--to change the customer service culture throughout his sprawling facility. Article

ALSO NOTED: PA health plan merger to proceed; Baylor plans African AIDS program; and much more...

Wed, 30 May 2007 20:01:30 -0400

> Another health plan deal will roll ahead. The Federal Trade Commission and Department of Justice antitrust division have approved the merger of two large Pennsylvania health plans, Independence Blue Cross and Highmark. Article

> Baylor College of Medicine and Texas Children's Hospital are partnering with an AIDS group to create a pediatric HIV care and treatment center in Kenya. The center is funded by Bristol-Myers Squibb. Article

> HealthSouth has partnered with a New Jersey-based therapy firm to market its robot-assistance rehab machine. Article

> InRoomMD, a Charlotte, NC-based company offering convenient healthcare for travelers, has acquired a Phoenix competitor. Article

> A Harvard Medical School researcher has joined with two New York hedge funds to create a new million-dollar annual award for the best new thinking in cancer research. Report

> Some of the country's top biomedical researchers have been beating a path to Congress in an attempt to fend off deep cuts in research funds. Report

And Finally... See? We have more in common with those hip Europeans than you thought. Article