Tag: "health care quality"

Hits and Misses

divorcesDoes 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.

Headlines I Wish I Hadn’t Seen

Te1tu7pmwfxbajkvyuruhhe NSA collects 200 million text messages a day.

Electronic medical records: They don’t save money and they don’t improve quality, but they do allow hospitals to bill more. HT: Jason Shafrin.

Judge rewrites ObamaCare law to allow people to get tax subsidies in the federally run exchanges. See Background posted by Michael Cannon.

Latino (Free Enterprise) Medicine

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.

Clinicas-bodegas-1County 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)

High-Tech Innovations in Medicine

  • Virtual Care: Doctors in remote ‘command centers’ are increasingly keeping tabs on vital signs of patients in intensive-care units.
  • Medical Detectives: Got a hard-to-diagnosis ailment? Patients can now post their symptoms online and offer a reward for a diagnosis from a host of doctors.
  • Doctor on Demand: You can have a virtual consultation with a physician for nonemergency medical issues.
  • Personal Care: Bedside tablets let hospital patients text the nurse. Patients can check their own charts and lab results.
  • Transparency: New insurance tools let patients compare the price of care between hospitals and calculate out-of-pocket costs.

More on the WSJ.

Hits and Misses

Patieartificial-heartnt receives world’s first artificial heart.

McDonald’s tells employees to avoid fast food.

Can you get lifetime protection against the flu?

ObamaCare Christmas carol.

Moderate alcohol consumption boosts immunity.

Worm is a breakthrough for artificial life: Each cell is being simulated one-by-one, along with neuron links between them.

Headlines I Wish I Hadn’t Seen

521063-fish-oilModern day snake oil: Fish oil benefits oversold.

Massachusetts exchange having the same technical glitches as other states.

More than eight in ten U.S. cancer specialists have struggled to find the drugs they need to best treat their patients.

Britain’s NHS: Mothers were abandoned by their midwives during labour; serious hospital mistakes happen as often as five times a week.

More on the NHS: Over the last six months, there have been 37 cases of patients who received surgery on the wrong part of their body.