Tag: "health care quality"

What Happens After Surgeons Take a Break?

We find that a surgeon’s additional day away from the operating room raised patients’ inpatient mortality risk by up to 0.067 percentage points (2.4% relative effect) but reduced total hospitalization costs by up to 0.59 percentage points…Our findings are consistent with the hypothesis that after returning from temporal breaks surgeons may be less likely to recognize and address life-threatening complications, in turn reducing resource use. (NBER Working Paper)

Is ObamaCare Discriminating Against the Disabled?

This is Gov. Bobby Jindal:

The federal government provides funds to states matching their Medicaid contributions. But ObamaCare includes a twist: The law provides a richer federal match for states’ coverage of childless adults than Medicaid programs receive for covering individuals with disabilities. I’ll say that again: ObamaCare prioritizes Medicaid coverage of childless adults over care for persons with disabilities. That’s a case of skewed priorities if I ever heard of one.

…[M]y proposed budget for this year directs $26 million in new funding to home and community-based services for elderly individuals and persons with disabilities. We’re focused on improving the quality of care, and giving individuals with disabilities more choices. We’ve already increased the number of individuals receiving home and community-based care by 5,000, and this year’s funding increase will ultimately reduce our waiting list for services by over 4,000.

But while we’re focused on improving the quality of care provided and reducing waiting lists for persons with disabilities, Liberals would rather our state use those resources to participate in ObamaCare’s Medicaid expansion. Liberal groups like MoveOn.org won’t say one word about caring for individuals with disabilities, or how ObamaCare prioritizes coverage of childless adults ahead of the most vulnerable — they just want to intimidate states into accepting ObamaCare’s massive new spending programs.

Hits and Misses

Surgery center of Oklahoma eliminates the $100 aspirin.

Curious factoid: About 20 percent of hospice patients are discharged alive.

Is there anything wrong with distinguishing between the “deserving” and the “undeserving” poor?

Nation’s third largest for-profit hospital chain expects only 15% of uninsured patients to get ObamaCare coverage.

Oliver Wyman actuaries estimate Medicare Advantage payment cut of $65-$145 per member per month in 2014 & 2015.

Creative destruction: Closed New Jersey hospitals reopen as for-profit medical complexes.

Hits and Misses

How the iPhone will radically change the practice of medicine. (Fascinating video)

Finding: Being really rich makes you very happy.

Health Wonk review is up.

Only 1.6% of climate scientists believe that humans are the main cause of global warming.

Digital Medicine

Today, all the physiological data monitored in a hospital intensive-care unit — including ECG, blood pressure, pulse, oxygenation, sugar level, breathing rate and body temperature — can be recorded and analyzed continuously in real time on a smartphone. A small piece of hardware, either the size of a cellphone, or one integrated with a cellphone, held against your body, functions as an ultrasound device. It can deliver information instantly to you or anyone you designate, and the information rivals that collected in a physician’s office or hospital setting. It can do so when you are experiencing specific symptoms — no appointment necessary — and at virtually no additional cost.

Thanks to more than 20 Silicon Valley startups and advances in microfluidic technology, smartphones will soon be able to function as a mobile, real-time resource for rapidly obtaining all the studies done currently in a medical laboratory, including chemistries, blood values and microbiological studies. A device worn on the wrist, called Visi, has been approved by the FDA for hospital use that can measure your heart’s electrical activity, respiratory rate, blood oxygen and blood pressure (without a cuff), and transmit the data wirelessly. Many other such devices are coming out that could be used by patients in their own homes. (WSJ)

Hits and Misses

Does a rise in the number of divorces signal an improving economy?

One in four patients consult online ratings when picking a primary care doctor.

Can robotic pills replace injections?

The White House defends the Stimulus program; Scott Sumner calls it “voodoo economics.”

A poll’s silver lining for PHRMA: People don’t like drug companies, but they like insurance companies even less.

Jonathan Alter explains why the Obama administration bungled the roll out of ObamaCare.

How Good is Medicaid?

Although half the newly insured under the Affordable Care Act will be enrolled in Medicaid and although substance use disorder (SUD) is more common among the poor,

[f]orty percent of counties in the U.S. [the goldenrod counties in the figure below] do not have an SUD treatment facility that provides outpatient care and accepts Medicaid. Counties in rural areas are much more likely to lack access to outpatient SUD facilities that accept Medicaid, particularly those in Southern and Midwestern states. Our findings also indicate that gaps in the SUD treatment infrastructure are further compounded for areas with a higher proportion of racial and ethnic minorities.

Doctors by Phone

blog-images-hand-phone-homeCompared to patients who visited a physician’s office for a similar condition, adult Teladoc users were younger and less likely to have used health care before the introduction of Teladoc. Patients who used Teladoc were less likely to have a follow-up visit to any setting, compared to those patients who visited a physician’s office or emergency department. Teladoc appears to be expanding access to patients who are not connected to other providers. (Health Affairs)

Headlines I Wish I Hadn’t Seen

Does medicamedical-malpractice_lawfuell malpractice law improve health care quality? Apparently not.

Are we going to start seeing Pro-ObamaCare messages in the movies?

Ten percent of Medicare spending is waste or fraud.

Another reason for inequality: Princes aren’t marrying Cinderellas.

Surprise: ObamaCare redistributes income.

Does More Health Insurance Lead to More Medical Innovation?

Following Medicare and Medicaid’s passage, I find that U.S.-based medical-equipment patenting rose by 40 to 50 percent relative to both other U.S. patenting and foreign medical-equipment patenting. Within the United States, increases in medical-equipment patenting were most dramatic in states where the Great Society insurance expansions were largest and in which there were large baseline numbers of physicians per resident. Consistent with historical case studies, Medical innovation’s determinants extend beyond the potential revenues associated with global market size; a physician driven process of innovation-while-doing appears to play a central role. An extrapolation of the evidence suggests that the last half century’s U.S. insurance expansions have driven 25 percent of recent global medical-equipment innovation. In a standard decomposition of health spending growth, this insurance-induced innovation accounts for 15 percent of the long run rise in U.S. health spending in hospitals, physicians’ offices, and other clinical settings.

Jeffrey Clemens, NBER Working Paper.