MedPage Today

May 31, 2010May 31, 20102

by Charles Bankhead Proton pump inhibitors (PPIs) significantly increased the risk of both fracture and recurrent infection with Clostridium difficile, investigators in separate studies reported. PPI use increased the odds of spine, forearm/wrist, and total fractures by 25% to 50%…

by Charles Bankhead

Proton pump inhibitors (PPIs) significantly increased the risk of both fracture and recurrent infection with Clostridium difficile, investigators in separate studies reported.

PPI use increased the odds of spine, forearm/wrist, and total fractures by 25% to 50% over three years, but had no effect on the risk of hip fracture. Overall, the acid-fighters had a modest effect on bone mineral density (BMD), Seattle researchers reported in the May 10 …

Health policy

Paperwork results in wasted work for doctors, insurers and patients

May 30, 2010May 30, 20109

by Marianne Mattera "I Hate " Not long ago I sent an e-mail with those headline words as the subject line -- I have withheld the name of the insurer to protect . . . , well, myself. A combination…

by Marianne Mattera

“I Hate [Insert Health Insurer Here]”

Not long ago I sent an e-mail with those headline words as the subject line — I have withheld the name of the insurer to protect . . . , well, myself.

A combination of circumstances has led to massive hassles costing me what is easily 100 hours of checking, rechecking, e-mailing, and phone calling over the last 3 months. …

Virtual colonoscopy access may not reduce lower endoscopy rates

May 29, 2010May 29, 20102

by John Gever Easy access to CT colonoscopy may not reduce the number of conventional colonoscopies performed. After the University of Wisconsin's (UW) health system persuaded local insurers to cover the imaging-based screens in 2004, there was little sign that…

by John Gever

Easy access to CT colonoscopy may not reduce the number of conventional colonoscopies performed.

After the University of Wisconsin’s (UW) health system persuaded local insurers to cover the imaging-based screens in 2004, there was little sign that patients preferred them to standard endoscopic exams, according to Patrick Pfau, MD, the university’s director of clinical gastroenterology.

Mean quarterly counts of optical colonoscopies performed at UW rose from 1,104 in 2003 to …

Most primary care visits don’t need to be seen in the office

May 28, 2010May 28, 201015

by Emily P. Walker If a Martian visited Earth and wandered into a primary care physician's office, he'd marvel at how inefficiently the average doctor spends his or her time. The Martian might wonder why the primary care doctors sees…

by Emily P. Walker

If a Martian visited Earth and wandered into a primary care physician’s office, he’d marvel at how inefficiently the average doctor spends his or her time.

The Martian might wonder why the primary care doctors sees 20 or 30 patients a day when many of the consultations could be done over the phone, which would make things easier for both doctor and patients.

At least, that’s what Larry Casalino, …

Health technology

EMR use may not save money but can save lives

May 27, 2010May 27, 20108

by Joyce Frieden Two new studies of electronic medical records (EMRs) have come to different conclusions: one found that they don't save money or staffing time, but the other suggested that at least one part of EMR -- electronic prescribing…

by Joyce Frieden

Two new studies of electronic medical records (EMRs) have come to different conclusions: one found that they don’t save money or staffing time, but the other suggested that at least one part of EMR — electronic prescribing — does save lives.

In the electronic prescribing study, at a single California hospital, the mean monthly adjusted mortality rate decreased by 20% …

Drugs and prescribing

Few receive the shingles vaccine because of cost to doctors

May 26, 2010May 26, 20108

by Michael Smith It's a classic good-news, bad-news story. The vaccine against shingles, already shown to be effective, is both safe and well-tolerated, researchers found after following more than 38,000 participants in the randomized trial that led to the 2006…

by Michael Smith

It’s a classic good-news, bad-news story.

The vaccine against shingles, already shown to be effective, is both safe and well-tolerated, researchers found after following more than 38,000 participants in the randomized trial that led to the 2006 approval of the vaccine.

On the other hand, few people are getting the vaccine, and for a variety of reasons — including its cost — researchers noted in a separate study. Both analyses …

Health policy

Standardizing claims can save billions of dollars

May 25, 2010May 25, 20106

by Joyce Frieden A standardized claim form and a single set of submission and payment rules for all health plans could save the U.S. healthcare system $7 billion annually, a study has found. "Although not all costs of excessive administrative…

by Joyce Frieden

A standardized claim form and a single set of submission and payment rules for all health plans could save the U.S. healthcare system $7 billion annually, a study has found.

“Although not all costs of excessive administrative complexity have been captured in our study, both real costs in billing operations and opportunity costs in physicians’ practices are significant,” Bonnie B. Blanchfield, ScD, of Massachusetts General Hospital in Boston, and …

Definition of health includes social well-being

May 24, 2010May 24, 2010

by Emily P. Walker I was covering an FDA tobacco meeting a while back when I heard a Howard Koh, MD, assistant secretary of health at the Department of Health and Human Services (HHS) start his speech with the World…

by Emily P. Walker

I was covering an FDA tobacco meeting a while back when I heard a Howard Koh, MD, assistant secretary of health at the Department of Health and Human Services (HHS) start his speech with the World Health Organization’s definition of health.

“Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or …

Medical imaging is increasing in cancer patients

May 22, 2010May 22, 20102

by Kristina Fiore Medical imaging for cancer patients and resulting costs have increased over the last decade, particularly in positron emission tomography (PET), researchers have found. Annually, use of the diagnostic screen rose significantly between 1999 and 2006 -- ranging…

by Kristina Fiore

Medical imaging for cancer patients and resulting costs have increased over the last decade, particularly in positron emission tomography (PET), researchers have found.

Annually, use of the diagnostic screen rose significantly between 1999 and 2006 — ranging from 36% in lung cancer to 54% in breast cancer, Kevin A. Schulman, MD, of Duke University, and colleagues reported in the April 29 Journal of the American Medical Association.

Imaging costs also …

Female genital cutting complications

Female genital cutting complications

May 19, 2010May 19, 20107

by Todd Neale Clinicians should actively persuade families not to participate in the ritual cutting of female genitalia, the American Academy of Pediatrics urged. However, the organization suggested that legislatures and doctors might ultimately consider legalizing ritual "nicks" to satisfy…

by Todd Neale

Clinicians should actively persuade families not to participate in the ritual cutting of female genitalia, the American Academy of Pediatrics urged.

However, the organization suggested that legislatures and doctors might ultimately consider legalizing ritual “nicks” to satisfy cultural or religious demands without more serious and problematic cutting.

The centuries-old practice, which is illegal in the U.S. and several other developed countries, carries with it a host of physical and psychological …

Read more…

Patient voices

Children with DNR orders and the liability risk for schools

May 18, 2010May 18, 2010

by Crystal Phend When children with complex chronic diseases have do-not-attempt-resuscitation orders in place, schools should honor them, the American Academy of Pediatrics urged. More children with diseases that may involve sudden and potentially fatal attacks are attending school due…

by Crystal Phend

When children with complex chronic diseases have do-not-attempt-resuscitation orders in place, schools should honor them, the American Academy of Pediatrics urged.

More children with diseases that may involve sudden and potentially fatal attacks are attending school due to legal and societal trends over the past decade, according to a statement in the May issue of Pediatrics.

While these requests are honored in hospitals and nursing homes, schools may find it …

Body mass index (BMI) may not measure obesity accurately

May 17, 2010May 17, 20109

by Kristina Fiore The scale of the obesity epidemic may be much worse than currently believed, because the usual measure, body mass index (BMI), is a very insensitive measure of excess body fat, researchers said. In a single-center study, 66%…

by Kristina Fiore

The scale of the obesity epidemic may be much worse than currently believed, because the usual measure, body mass index (BMI), is a very insensitive measure of excess body fat, researchers said.

In a single-center study, 66% of patients classified as obese on the basis of DEXA scanning had BMI values in the nonobese range, according to Eric Braverman, MD, of New York Presbyterian Hospital/Weill Cornell Medical Center.

Among more …

Pediatricians have a role in reporting domestic violence

May 16, 2010May 16, 20104

by Crystal Phend One of the most effective ways to prevent child abuse may be for pediatricians to identify domestic violence against a child's caregiver, according to a report from the American Academy of Pediatrics. Intimate partner violence in the…

by Crystal Phend

One of the most effective ways to prevent child abuse may be for pediatricians to identify domestic violence against a child’s caregiver, according to a report from the American Academy of Pediatrics.

Intimate partner violence in the home has a profound effect on kids, Jonathan D. Thackeray, MD, of Columbus Children’s Hospital in Columbus, Ohio, and colleagues wrote in the May issue of Pediatrics.

They pointed to elevated risk of …

Endocrinologists may improve surgical care in diabetic patients

May 15, 2010May 15, 20104

by Kristina Fiore Shorter hospital stays and lower costs were the result when surgical patients with diabetes and dysglycemia received endocrinology consults, researchers said. Adding endocrinologists to surgical care teams for patients with abnormal blood glucose readings cut total length…

by Kristina Fiore

Shorter hospital stays and lower costs were the result when surgical patients with diabetes and dysglycemia received endocrinology consults, researchers said.

Adding endocrinologists to surgical care teams for patients with abnormal blood glucose readings cut total length of stay among patients in a single center by 1,342 days and saved the hospital $1.15 million, according to Arthur Chernoff, MD, of Albert Einstein Medical Center in Philadelphia.

Chernoff presented his findings …

Drugs and prescribing

Fight against salt needs consumer help

Fight against salt needs consumer help

May 14, 2010May 14, 201013

by Cole Petrochko As a person who has handled salt in cooking, is prone to headaches from sodium, and has written an article on legislating salt content in prepared and packaged foods, let me tell you about salt, because I…

by Cole Petrochko

As a person who has handled salt in cooking, is prone to headaches from sodium, and has written an article on legislating salt content in prepared and packaged foods, let me tell you about salt, because I know a thing or two.

Well, it would be hard to not know much about salt after the recent string of attention paid to the “white shaken one” — eat too …

Read more…

C-section rates as a marker for obstetric care quality

May 12, 2010May 12, 20107

by Michael Smith When cesarean section rates are lower than expected, adverse maternal or neonatal outcomes are higher, researchers said. But the converse isn't true -- higher-than-expected C-section rates aren't associated with a protective effect, according to Sindhu Srinivas, MD,…

by Michael Smith

When cesarean section rates are lower than expected, adverse maternal or neonatal outcomes are higher, researchers said.

But the converse isn’t true — higher-than-expected C-section rates aren’t associated with a protective effect, according to Sindhu Srinivas, MD, of the University of Pennsylvania, and colleagues.

The finding comes from an attempt to see if the risk-adjusted C-section rate can be used as a marker for the quality of obstetric care, Srinivas …

Health policy

Health insurance will be reformed by a little known department

May 11, 2010May 11, 20103

by Joyce Frieden In one of those “important but little noticed” announcements that government officials are prone to put out, the Department of Health and Human Services recently let the world know – via the Federal Register -- that it…

by Joyce Frieden

In one of those “important but little noticed” announcements that government officials are prone to put out, the Department of Health and Human Services recently let the world know – via the Federal Register — that it has created an Office of Consumer Information and Insurance Oversight to assist with implementation of the newly passed health insurance reform law.

This new office has four divisions. Here are a …

Children with fever may not receive antibiotics in the ER

May 10, 2010May 10, 2010

by John Gever Up to one-third of children with febrile bacterial infections failed to receive antibiotics in a large emergency department, while 20% of youngsters without such infections received antibiotics unnecessarily, Australian researchers said. A computer algorithm based on standard…

by John Gever

Up to one-third of children with febrile bacterial infections failed to receive antibiotics in a large emergency department, while 20% of youngsters without such infections received antibiotics unnecessarily, Australian researchers said.

A computer algorithm based on standard test results could do a better job of assigning feverish children to the correct treatment sooner, Jonathan C. Craig, MBChB, PhD, of the University of Sydney, and colleagues reported online in BMJ.

Although …

Online dermatology visits for acne can be effective