Diabetes

Study: Millions of chronically ill not getting care they need

Anne Zieger — Tue, 05 Aug 2008 10:35:42 -0400

A new study confirms what most in the provider arena already knew--that far too many patients with chronic conditions like diabetes or high blood pressure aren't getting the care they need because they lack health insurance. The study, published in the Annals of Internal Medicine, estimates that roughly one of every three uninsured, working-age adults--or about 11 million people--has been diagnosed with a chronic illness. Researchers concluded that many of these patients seldom see primary care doctors, with some relying instead on emergency rooms for their care.

In their survey, researchers found that almost one-quarter of the uninsured with a chronic illness hadn't visited a health professional within the last year, and about 7 percent said they typically went to an emergency room for care. This puts them at high risk for complications, given that, for example, people with high blood pressure can face catastrophic problems like a stroke if they don't get the right drugs or monitoring.

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

Related Articles:
Study: Uninsured cancer patients die sooner
Chicago hospitals steer uninsured to affordable care
Study: Uninsured ranks could be much lower
EDs seeing more affluent patients, less uninsured

SPOTLIGHT: Doctors often miss cultural signals

Tue, 10 Jun 2008 06:59:52 -0400

Research has often highlighted that blacks routinely see worse outcomes than whites in treatment of chronic illness. Now, a new study of diabetes patients has suggested that there are significant difference in outcome among various races even among patients treated by the same doctors. The authors suggest that these differences may be due less to racism than a failure by doctors to address cultural norms. Article

VistA may be in its waning years; How hospitals are thinning down ED crowding; and much more...

Tue, 10 Jun 2008 06:59:50 -0400

> For many years, the VA's VistA open source EMR has been held up as an example for the industry to follow. Now, it's looking like VistA may be in its waning years. FierceHealthIT

> This week's meeting of the American Diabetes Association is yielding some big news, including updates on the effectiveness of a handful of blockbuster diabetes drugs. FiercePharma

> Today's Wall Street Journal blog item offers some interesting ideas on how hospitals are thinning down emergency department crowding. Article

> A Swiss company should be able to introduce an experimental malaria vaccine as early as 2014. FierceVaccines

And Finally... If you want to work here, you'd better have a favorite girl you can pop the question to--quickly! Article

ALSO NOTED: Hospitals begin auctioning unpaid debts online; US stockpiling antivirals against bird flu pandemic; and much more.

Fri, 06 Jun 2008 06:59:50 -0400

> Hoping to get another shot at collecting their money, hospitals are auctioning off patient debt via online auctions. FierceHealthFinance

> The U.S. has begun stockpiling Tamiflu and Relenza antivirals to protect against a potential bird flu pandemic. FiercePharma

> It looks like the prevalence of HIV in pregnant women is declining in South Africa. Article

> New research suggests that diabetes boosts liver cancer risks in hepatitis and cirrhosis cases. Article

And Finally... The sound of her baby granddaughter's terrified scream woke this woman from a coma. Article

ALSO NOTED: Boston hospital faces $30M investment; Vaccine could someday halt Type 1 diabetes; and much more...

Mon, 02 Jun 2008 06:59:50 -0400

> It's no fun being this deep in the hole. To get back into fighting shape, Boston's Carney Hospital will have to invest $30 million in facilities upgrades. FierceHealthFinance

> A vaccine designed to block or reverse type 1 diabetes has gone into human studies. FierceVaccines

> A group of Seattle-area hospitals have vowed to change their food to make it healthier, focusing not only on improved nutritional choices, but also community and environmentally-conscious ones. Article

> Texas Woman's University has gotten a $2.25 million gift designed to help it build its pending T. Boone Pickens Institute of Health Sciences-Dallas Center. Article

And Finally... OK, I'll admit it, it sounds intriguing. Still, what's the point of skiing if you can't see the sky? Article

Panel issues care guidelines for heart implant patients

Thu, 15 May 2008 06:59:55 -0400

In the past, much of the discussion over implantable heart devices like pacemakers and defibrillators was over which patients were suitable candidates--and how to get health plans to pay for them. Today, however, now that two million people world-wide have such devices in their chests, the question is how to care for such patients properly over the long term.

To address such issues, an international panel of heart specialists have issued guidelines for caring for such patients. The guidelines, which were announced at a meeting of the Heart Rhythm Society, address such issues as when to shut the device off in dying patients and stress the need for closer follow-up care.

The guidelines also encourage the use of wireless technology that allows physicians to monitor patients remotely, while the patient is still at home. A related five-year study presented at the meeting found that over five years, raising the volume of patients being remotely monitored from 94 to more than 5,000 didn't pose a big burden on clinic staff.

To learn more about the guidelines, and the Clinic's remote monitoring research:
- read this Associated Press article

Related Articles:
Study: Remote monitoring improves heart failure outcomes
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Vendor trials cellphone-based diabetes monitoring

ALSO NOTED: Health plans vow premium, reimbursement crackdown; Diabetes drug spending takes lead position; and much more...

Thu, 15 May 2008 06:59:50 -0400

> Hoping to calm nervous investors, health plans are promising Wall Street types that they're going to hike premiums and ratchet down payments to providers. Good luck, guys. FierceHealthFinance

> Here's some interesting news: Diabetes drugs have displaced cholesterol drugs as the leading drivers of prescription drug spending growth. FiercePharma

> In a recent blog entry, the Wall Street Journal's Jacob Goldstein contends that retail clinics are reaching a "Bust" stage, with some clinics closing and other companies scaling back. Blog

> In an effort to make their lives easier--and decisions simpler--New Hampshire's Blue plan is giving its physicians access to its electronic medical record via mobile devices. FierceHealthIT

And Finally... If a roach breeds in space, does anyone hear it? Article

Study: More than half of insureds on chronic-care meds

Wed, 14 May 2008 06:59:54 -0400

A new study suggests that for the first time, more than half of insured Americans are regularly taking prescriptions for chronic health problems. The most popular drugs include those used to lower blood pressure and cholesterol, according to Medco Health Solutions, which manages prescription benefits for about one in five Americans.

According to Medco data, 51 percent of American children and adults were taking one or more prescription drugs for a chronic condition, marginally up from 50 percent the previous four years and 47 percent in 2001. Use of medication for chronic conditions was spread across age groups. However, the biggest jump in the use of such medications was in the 20- to 44-year-old age group, due largely to more use of drugs for depression, diabetes, asthma, attention-deficit disorder and seizures.

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

Related Articles:
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Employers offering free meds for chronic diseases
SPOTLIGHT: PA commission studying care for chronic conditions

OH pharmacists lobby health plans to expand patient care role

Mon, 12 May 2008 06:59:56 -0400

Fresh from the success of a 10-year demonstration in Asheville, North Carolina, Ohio pharmacists are lobbying insurers to convince them to pay for care coordination services. The pharmacists contend that they're among the only ones in a position to know all of the drugs patients are taking, particularly those with complex, chronic conditions such as diabetes or asthma.

The pharmacists are taking their cue from the "Asheville Model," under which the city of Asheville and another local employer paid a fee to pharmacists to consult with patients. The program also gave employees an incentive to see the pharmacists, such as waived co-pays. The program has produced positive health results, including improvements in patient blood pressure and cholesterol levels, researchers have found.

To learn more about this initiative:
- read this Cleveland Plain Dealer piece

Related Articles:
Pharmacists a valuable asset in the ER
Errors encouraged by fast pharmacy pace
Study: Pharmacist oversight improves cardiac outcomes

Hospital rates for some PA HMOs patients rising

Fri, 04 Apr 2008 07:59:56 -0400

For decades, it's looked like HMOs had pretty much cracked the problem of keeping hospitalization rates at a minimum across broad populations. But for some reason, that doesn't seem to be the case in Pennsylvania, where in 2006, more adults were hospitalized for various illnesses, and more children for asthma. These stats are courtesy of the Pennsylvania Health Care Cost Containment Council, an agency that analyzes hospital finances and care quality. Among other key trends, the agency found that for the nine major for-profit HMOs studied, 105.9 of every 10,000 patients were hospitalized with diabetes, up from 94.3 during the previous year. Meanwhile, patients hospitalized for gastrointestinal infections rose from 3.9 to 4.8 of 10,000 during the same period, with children hospitalized for asthma going up from 14.7 to 18.5. Oddly enough, despite these trends, the HMOs performed at or above national averages in most preventive care categories. The agency has said that it doesn't know why the numbers went up.

To learn more about the study:
- read this Philadelphia Inquirer piece