Tag: "health care quality"

Solution for Elder Care: Robots

Researchers at the Georgia Institute of Technology have developed Cody, a robotic nurse the university says is “gentle enough to bathe elderly patients.” There is also HERB, which is short for Home Exploring Robot Butler. Made by researchers at Carnegie Mellon, it is designed to fetch household objects like cups and can even clean a kitchen. Hector, a robot that is being developed by the University of Reading in England, can remind patients to take their medicine, keep track of their eyeglasses and assist in the event of a fall.

The technology is nearly there. But some researchers worry that we are not asking a fundamental question: Should we entrust the care of people in their 70s and older to artificial assistants rather than doing it ourselves? (NYT)

May 22, 2013 | 8 comments | by

Best Analysis of the Oregon Medicaid Experiment I Have Seen

In summary, based on statistically insignificant effects of coverage from the Oregon Experiment: (1) The effects that are closest to statistical significance are that coverage would increase the rate of smoking and damage the cardiovascular prognosis of sick people; (2) the best estimated net effect on total population cardiovascular health is extraordinarily tiny; (3) this effect would be achieved by making the sick sicker, while very slightly improving the health of already healthy people; and (4) this effect is almost certainly unattractive on a risk-adjusted basis. This is not a series of effects that makes a very attractive argument for an increase in health from the experiment.

This is Jim Manzi via Megan McArdle. Entire piece is fascinating.

May 15, 2013 | 8 comments | by

Doesn’t Sound like the Cost Curve is Bending

Hospitals hoping to attract patients and build their brands are teaming up with medical-screening companies to promote tests aimed at consumers worried about potentially deadly heart disease or strokes. What their promotions don’t say is that an influential government panel recommends against using many of the tests on people without symptoms or risk factors…

Such screenings “not only can raise [health care] costs, but also can lead to additional testing that is harmful,” [Steven] Weinberger and two co-authors wrote in the Annals of Internal Medicine journal in August, calling hospital involvement without disclosing potential downsides “unethical.” (Julie Appleby/Kaiser Health News)

May 15, 2013 | 12 comments | by

Kaiser’s Death Panel

A worrisome abdominal pain drove Jalal Afshar to seek treatment last year at healthcare giant Kaiser Permanente…Kaiser granted his request to see a specialist in Arkansas. But it ultimately declined to pay for his treatment there. By June, Afshar said, Kaiser was arranging for hospice care so that he could die at home. Afshar, 58, refused to accept that. Despite Kaiser’s stance, he went back to Arkansas for six months of stem-cell transplants, chemotherapy and other treatments that he says saved his life. Now he owes $2 million for his care and is suing the company in state court for breach of contract and unfair business practices.

Source: LA Times.

May 13, 2013 | 17 comments | by

You Probably Thought the Problem Was Too Much Alcohol

Pfizer Inc. (PFE), the drug’s producer, now has a site for you: its own Viagra.com, where you can get the blockbuster impotence fighter without wondering what shady source you’re dealing with. Using CVS Caremark Corp. (CVS) to verify prescriptions and fulfill orders, the site is Pfizer’s latest attempt to fight counterfeiting. In its announcement this week, the world’s largest drug maker cited a 2011 analysis it did of pills bought from 22 sites ranking high in search results for “buy Viagra.” About 80 percent were fake, containing only 30 percent to 50 percent of the drug’s active ingredient, sildenafil citrate. The new site is a reminder of the original value of consumer branding: as a guarantee of quality. It’s also evidence of the failure ― and the perverse effects ― of online drug regulation.

Virginia Postrel at Bloomberg.

May 10, 2013 | 12 comments | by

A Million-Dollar Patient

This is what happens when the government ignores Dr. Jeffrey Brenner:

For more than two decades, Wanda Remo has battled one illness after another. Asthma, chronic lung disease, heart disease, high blood pressure, arthritis, depression, chronic pain, strokes. Specialists treat her lungs, her heart and her joints.

Her litany of ailments brought her to emergency rooms six times last year, between numerous additional visits to a federally subsidized health clinic in South Los Angeles.

“You are one of the million-dollar patients,” her doctor, Derrick Butler, tells the 57-year-old as she leans on her walker during one appointment. (LA Times)

May 09, 2013 | 11 comments | by

Are Doctors Too Optimistic?

Doctors were up front about their patients’ estimated survival 37 percent of the time; refused to give any estimate 23 percent of the time; and told patients something else 40 percent of the time. Around 70 percent of the discrepant estimates were overly optimistic.

This optimism is far from harmless. It drives doctors to endorse treatments that most likely won’t save patients’ lives, but may cause them unnecessary suffering and inch their families toward medical bankruptcy.

Source: The New York Times.

May 09, 2013 | 12 comments | by

What Hospitals Cost; What Insurers Pay

Comparing Two Hospitals in Miami, Florida:

University of Miami

Hospital

Jackson Memorial

Hospital

 

 

 

Heart attack with four stents and major complications

Average cost  $166,174 $89,027
Average reimbursement    $27,397 $33,129

Intestine procedures with major complications

Average cost $248,105 $185,927
Average reimbursement   $44,794 $73,455

 

 

 

Permanent pacemaker implant

Average cost $127,038 $66,030
Average reimbursement   $20,836 $28,668

Source: The Washington Post.

May 08, 2013 | 17 comments | by

Sentences I Wish I Hadn’t Read

I recently attended a panel discussion of hospital CEOs and CNOs. Two of the executives were touting how their facilities had just recently “stopped all non-emergent inductions and elective cesareans prior to 36 weeks”. They were so proud of this decision to “do the right thing” but lamented how it had impacted their bottom line. Why did it impact their bottom line? Because they experienced a significant (25%) reduction in NICU days. I wanted to stand up and shout “why would you induce or deliver by cesarean any expectant mother if it is not medically necessary?”

More at The Health Care Blog.

May 06, 2013 | 11 comments | by

Has Obama Changed Course on the War on Drugs? No

This is Richard Posner:

The new (that is, the ostensibly new) strategy gives continued primacy to the “war on drugs,” which best describes the criminal-law and (abroad) paramilitary campaigns against the drug trade. No one thinks these campaigns can eradicate illegal drugs. The realistic-seeming objective is, by increasing expected punishment cost and by taking out of circulation (through imprisonment) those not deterred by the cost, the war on drugs raises the prices of illegal drugs. Yet those prices remain very low. The reason appears to be the very high elasticity of supply of drug dealers. It’s like Karl Marx’s “reserve army of the unemployed”; if there is no dearth of persons willing to be drug dealers at modest wages, the principal effect of law enforcement may be to increase labor turnover, at enormous cost in police and prosecutorial resources and above all in incarceration: half the federal prison population in the United States consists of drug offenders. Some 1.7 million persons who are in prison or jail (state or federal) or on probation or parole (or its federal equivalent, supervised release) are in those situations of confinement or restriction because of drug offenses. No doubt the mere fact that drugs are illegal deters some consumers — but how many relative to the large number of persons who have no interest in consuming mind-altering drugs, legal or illegal?

Gary Becker here.

May 06, 2013 | 11 comments | by
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