Idea #305 for December 20th, 2009: Saving Money In The Long-Run or Paying For Medicaid Patients to Quit Smoking

A change in Medicaid led to a significant drop in smoking among Medicaid patients in Massachusetts, and federal legislators have taken notice. The state began paying for counseling and drugs for smoking cessation two years ago. Since then, the smoking rate among Medicaid patients has fallen by 25%. At the same time, the smoking rate among uninsured patients in that state remained unchanged. Two senators have introduced an amendment to the healthcare bill that would require Medicaid to cover similar anti-smoking treatments. Based on the success in Massachusetts, it’s a sensible step to take in the fight against smoking nation-wide.

Read more about this here.

Idea #304 for December 19th, 2009: The $60 Billion Sinkhole or Stopping Medicare Fraud

With the federal government trying desperately to do something about rising healthcare costs, we sometimes forget about an especially devious way that healthcare dollars are sometimes sucked down the drain. A story in the news today reminds us of this costly ploy: Medicare fraud. Twenty-six people were arrested by federal agents in three states for allegedly committing $61 million worth of Medicare fraud. A Florida doctor and 14 associates were arrested for fraudulently referring 1,300 patients for unnecessary treatments. We shouldn’t lose sight of the fact that Medicare fraud costs us $60 billion a year, and efforts to reform healthcare should address this problem.

Read more about this story here.

Idea #303 for December 18th, 2009: A Large Chunk Of Change or The Costs Associated With MRSA

Infections resulting from surgery are a major concern in healthcare, and it’s been addressed here several times already. The economic aspect of these infections has been difficult to pin down, though. A new study sought to estimate the per-patient cost of the infections, and the amount is staggering.

The study, which was conducted by researchers at Duke, followed hundreds of patients in the 9o days following surgery. Patients who contracted MRSA infections accrued additional costs of around $60,000 for the three additional weeks of hospitalization they required, on average, to clear the infection. In that same 90 day period, the MRSA infected patients were seven times likelier to die than other patients, the study says. At just the seven hospitals that the study investigated, the MRSA infections accounted for more than $19 million in additional costs. These stats remind us once again that preventing MRSA-related infections in hospitals can save us not only unnecessary deaths, but also significant amounts of money.

Read more about the study here.

Idea #302 for December 17th, 2009: A Clearer Message or Using Video To Better Communicate End-of-Life Care Options

Patients with terminal illnesses face many difficult choices when it comes to coordinating end-of-life care. Usually those options are spelled out on paper, but the majority of patients do not complete all the necessary documentation. Researchers have found that using video rather than documentation to convey the message resulted in better understanding on the part of the patients.

Terminal cancer patients in the study were shown either a video that illustrated the options for end-of-life care, or were given the traditional documentation for that purpose. Patients who viewed the video were much more likely to choose less aggressive care, and also scored better on assessments that gauged their understanding of the different options. This seems like a pretty simple fix for a problem that plagues patients with terminal illness, and hospitals should pay close attention to further studies on the matter.

Read more about this study here.

Idea #301 for December 16th, 2009: Bad Break or Easy Way To Prevent Playground Injuries

Playground accidents account for about 200,000 injuries a year in school children. Those numbers suggest maybe we should start ripping down jungle gyms and other potentially hazardous equipment. But there’s another solution that could cut down on injuries without spoiling all the fun for kids. Simply replacing the playground surfaces — which is often wood fiber based — with sand can have a big effect.

The surfaces made from wood fibers don’t have as much “give” as ones made from sand, so kids are an estimated five-times as likely to break a limb when falling on those surfaces compared to sand. So replacing wood fiber surfaces with sand in playgrounds could significantly reduce broken limbs while still allowing children access to the physical activity many of them need.

Read more about this study here.

Idea #300 for December 15th, 2009: Teach Your Children Well or Teaching School Children To Recognize Stroke Symptoms In Adults

Being able to spot the first signs of an impending stroke is key to ensuring rapid treatment and optimal prognosis. But placing the onus entirely on the stroke victim to recognize his own symptoms may be the wrong approach. That’s why a group in Texas began a program to teach children to recognize and respond to potential stroke symptoms observed in others.

A group of several hundred middle-schoolers was selected to receive four lessons per year on stroke awareness throughout grades 6 to 8. Their stroke knowledge was test prior to and during the program. After the first year, the group scored significantly better on their test than the control group. While it remains to be seen whether the study group will put their knowledge to use and save lives down the line, the program holds promise. With only a handful of lessons per year, these kids may be adept at recognizing oncoming strokes in older populations.

Read more about this here.

Idea #299 for December 14th, 2009: Glowing In The Dark or The Alarming Variability in CT Scan Radiation

The potentially harmful levels of radiation exposure associated with undergoing CT scans have been well-documented. What’s surprising, though, is how widely the amount of radiation emitted by CT scans varies. The amount of radiation can vary by a factor of ten for a given scan, new research suggests.

The study involved 1,000 patients who received scans at four hospitals, and there was significant variability in radiation exposure from patient-to-patient receiving the same scans. While some variation is expected, the amount of variation in these cases was considered unacceptable. Researchers estimate that 1 in 270 women who receive a coronary CT angiography at age 40 will develop cancer as a result of the scan, and that number is 1 in 600 for men.

Patients should expect some slight risk of potential cancer as a result of CT scans, and that is normally outweighed by the diagnostic benefit of the scan itself. However, high levels of variation in levels of radiation are unacceptable when they provide no additional diagnostic benefits. Hospitals must monitor and address the problem, as they are unnecessarily exposing patients to unknown levels of radiation for no reason.

Read more about this issue in the Wall St Journal.

Idea #298 for December 13th, 2009: Shaping Young Minds or Many Children Forgo Treatment For Mental Health Conditions

A report from the National Institute of Mental Health claims that only 55% of children with mental health problems actually seek treatment. That number represents an increase over the previous year, but it is still surprisingly low. The researchers determined that 13% of the children aged 8-15 they surveyed suffered from depression, ADHD, anxiety, or a conduct disorder, but only about half sought treatment.

The incidence of these adolescent mental health conditions varied across different socio-economic groups, the study found. Most of the disorders were more prevalent in poorer populations. Anxiety conditions, though, occurred more frequently in populations of higher socio-economic status. African American and Mexican American children were the least likely to seek treatment for their mental health issues. If we want to continue to make progress in treating adolescent mental health, we’re going to have to remove any stigma attached to these disorders as well as make treatment more widely available.

Read more about this issue here.

Idea #297 for December 12th, 2009: Closing The Gap or Ensuring Stroke Patients Receive Life-Saving Drugs

Victims of ischemic stroke, in which blood flow to the brain is blocked by a clot, can reduce the likelihood of future strokes with medication. However, about 20% of them do not take those medications, which may be costing some of them their lives. Drugs like blood thinners, including the over-the-counter drug aspirin, can help prevent recurrence of stroke.

The groups most likely to take the medications are men, older patients, and non-Hispanic patients. Currently, it is not known why these demographics are more likely to take proper medication, but socio-economic factors may be at play. If further research reveals that to be the case, we’ll need to focus efforts on ensuring that all groups receive adequate medications for this. When a life-saving drug can be something as simple and ubiquitous as aspirin, there’s no excuse for 20% of patients missing out.

Read more about this here.

Idea #296 for December 11th, 2009: Food Fight or Improving Food Safety In School Lunches

Considering that many American children rely on school lunches on a daily basis, we should expect that this government-subsidized program delivers a quality product. That’s why it’s disheartening and surprising to hear that meat used by school lunch programs is not even up to the standards of fast-food restaurants, in some cases. Jack in the Box, for instance, sets the acceptable level of bacteria in their beef ten times lower than the USDA does for school lunch meat. And the type of chicken used in school lunches is deemed sub-standard by KFC and Campbell’s Soup. In fact, this type of chicken is normally reserved for pet food.

If not properly cooked, the meat in school lunches could contain enough bacteria to cause food poisoning. Tougher standards don’t have to come at a high cost. The safety changes that Jack in the Box implemented only added a fraction of a penny to the cost of a pound of beef. That’s trivial compared to the cost of treating children sickened by E. coli or salmonella from tainted meat. At the very least, school lunch programs should strive for the level of quality demanded by the fast food industry.

http://www.usatoday.com/news/education/2009-12-08-school-lunch-standards_N.htm