Tag: "health care quality"
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)
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.
Compared 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)
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.
A year old story that’s worth revisiting:
The so-called bodega clinicas that line the streets of Los Angeles’ immigrant neighborhoods blend into a dense forest of commerce. Wedged between money order kiosks and pawn shops, these storefront doctors’ offices treat ailments for cash: a doctor’s visit is $20 to $40, a podiatry exam is $120 and at one bustling clinica, a colonoscopy is advertised on an erasable white board for $700.
County health officials describe the clinicas as a parallel health care system, servicing a vast number of uninsured Latino residents, yet the officials say they have little understanding of who owns and operates them, how they are regulated and the quality of the medical care they provide…
Visits to more than two dozen clinicas in South Los Angeles and the San Fernando Valley found Latino women in brightly colored nurses scrubs handing out cards and coupons that promise everything from pregnancy tests to tubal ligations. Others advertise evening and weekend hours, and, some 24-hour a day operations trumpet that they are “nunca cerramos” — never closed. That all-hours access — and up-front pricing — is critical, Latino health experts say, to a population that often works low-wage, around-the-clock jobs.
Also important, officials say, is that new immigrants from Mexico and Central America are more accustomed to a corner clinica, which is common in their home countries, than to the sprawling medical complexes or large community health centers found in the United States. And they can get the kind of medical treatments — including injections of hypertension drugs, vitamin solutions delivered intravenously and liberally dispensed antibiotics — that are frowned upon in traditional American medicine. (KHN/NYT)