Health Care Access in the News:  Sunday, September 9, 2007
Consumer Health Coalition (CHC) has highlighted major news headlines and studies related to health care access from the past week. We hope you find this information INTERESTING AND useful!

HEALTH CARE QUALITY

NEW YORK CITY PUTS HOSPITAL ERROR DATA ONLINE
Friday, September 07, 2007
By Sarah Kershaw, The New York Times

"The New York City Health and Hospitals Corporation, the nation’s largest public health system, plans to begin publicly releasing data today on infection and death rates at its 11 hospitals, in response to widespread concern about deadly, preventable and costly hospital-acquired conditions and pressure to crack open the shrouded culture of many hospitals. In posting the safety and performance information on the hospital corporation’s Web site, www.nyc.gov/hhc, the public hospitals, which treat 1.3 million patients a year, are far ahead of the industry, health care experts and consumer advocates said. The Web site allows the public to see the overall death rate, the rate of deaths after heart attacks, preventable bloodstream infections and pneumonia cases, among other measures, at the 11 hospitals. The federal Centers for Disease Control and Prevention projected that 1.7 million patients nationwide would get an infection during a hospital stay this year, and that of those, 99,000, or about 270 per day, would die. The centers estimate the cost of treating such infections at more than $30 billion a year."

MORE HOSPITALS, HEALTH CLINICS USE PICTURE BOARDS TO REDUCE LANGUAGE BARRIERS
Tuesday, September 04, 2007
By Kaiser Daily Health Policy Report

"Hospitals, health clinics and rescue teams in a number of states have begun to use picture boards to communicate with patients who cannot speak English to help improve quality of care, AP/USA Today reports. The large, double-sided picture boards, manufactured by Florida-based Servision, allow patients to select icons to indicate their symptoms and the affected parts of their bodies. In addition, patients can select their native languages from a list on the picture boards to allow medical personnel to locate interpreters. The picture boards also can improve communication between medical personnel and patients who are deaf, mute, hearing impaired or unable to speak because of a medical condition. Hospital associations in nine states -- New Jersey, New York, Pennsylvania, Kentucky, Missouri, Oklahoma, Rhode Island, Utah and Washington -- have agreed to participate in the program."

FOR DOCTORS, DIAGNOSING GETS A TECHNOLOGICAL BOOST
Thursday, September 06, 2007
By Erin Donaghue, USA Today

"According to a 2003 Journal of the American Medical Association review of autopsy studies, doctors misdiagnose 8% to 24% of the time. Cognitive errors, such as latching onto a diagnosis that seems the most likely without considering other possibilities — which experts call "anchoring" — are among many root causes, according to Jerome Groopman, chairman of experimental medicine at Harvard University and author of the book How Doctors Think. The solution for some is technology. Doctors are increasingly using the Internet, even search programs as basic as Google, when they're stumped, according to "Googling for a Diagnosis," a British Medical Journal study last year. Although Isabel is used in only 18 hospitals, interest in similar decision-support systems is growing in the medical community, according to the American Medical Informatics Association. Priced at around $50,000 a year for a typical 300 bed hospital, Isabel is considered a robust tool, highly rated by the Healthcare Information and Management Systems Society. Many doctors who use Isabel argue that technology doesn't supersede individual judgment but rather acts as an aid in the decision-making process."

CUTTING DOCTORS' HOURS HAD LITTLE EFFECT
Wednesday, September 05, 2007
By The Associated Press, USA Today

"Cutting the grueling work hours of doctors-in-training had little effect on reducing patient deaths, according to two large studies. Death rates dropped in one group of patients in veterans' hospitals but not in three other groups, the researchers reported. The results come from what the authors describe as the largest and most comprehensive national look at work-hour restrictions, which were implemented four years ago in an effort to reduce medical errors by tired physicians. The new work-hour rules limit doctors-in-training to 80-hour weeks. Critics of the restrictions feared they would hurt continuity of care for patients and create a shift-work mentality among doctors. Others supported the limits, saying they might lead to fewer deaths from medical mistakes. Before the rules, medical residents often worked 100-hour weeks, with some shifts lasting 36 hours straight. Although the new limits are still roughly double what other full-time jobs require, long hours for doctors-in-training are seen as a traditional trial-by-fire approach that give them necessary, intensive experience. For the groups with no change, Volpp said one possible explanation is that more patient handoffs by residents offset the benefits of reduced fatigue. He also noted the work-hour limits may not be strictly enforced at every hospital. Ingrid Philibert, a senior vice president for the Accreditation Council for Graduate Medical Education, said the lower mortality rate in the one VA group is "a very significant finding" that proves the restrictions work. As for the groups that didn't show improvement, she noted that there are many aspects to medical care. "It would be naive to expect that changing one input would produce a vast difference in outcomes," she said."

ACCESS TO HEALTH CARE FOR PEOPLE WITH DISABILITIES

STATE IS FIRST TO REIMBURSE HOME CARE PROVIDERS FOR MONITORING
Friday, September 07, 2007
By Kris Mamula, Pittsburgh Business Times

"Home care providers can now bill the state for electronically monitoring some patients, a change in policy that is expected to spur an increasing number of agencies to adopt the technology. Effective Sept. 1, the state Department of Public Welfare began reimbursing for remotely monitoring pulse, blood pressure, weight and other vital signs, according to Jim Pezzuti, DPW's director of long-term care. Patients must be eligible for admission to a nursing home and for Medicaid, the state's health care program for the poor. Few commercial insurers cover electronic monitoring, and Pennsylvania is the first state in the nation to receive federal approval to reimburse for the service, he said."

GIRLS' SUICIDE RATES JUMP; OVERALL YOUTH RATE UP
Friday, September 07, 2007
By Anita Manning, USA Today

"A sharp increase in the rate of suicide among pre-teen girls and teens between 2003 and 2004 drove an overall increase in the reported number of young people committing suicide, federal health officials said Thursday. No cause for the increase is given, but an article in the September issue of The American Journal of Psychiatry says the increase in youth suicide, which also has been seen in the Netherlands, occurred at the same time threre was a decline in prescribing antidepressants known as SSRIs to children and teens. "Obviously, this is a concern," said Thomas Laughren of the U.S. Food and Drug Administration's division of psychiatry products. "It's true that antidepressant prescribing in pediatric patients has come down, and that coincides with this one year uptick in suicides," he said, but you cannot conclude that the drop in prescriptions caused the increase. He said the FDA will continue to monitor reports. Why there was a sharper increase seen in girls than boys is not clear, said Richard McKeon, a special adviser on suicide prevention with the Substance Abuse and Mental Health Services Administration, 'but it does underscore the importance of taking seriously when adolescent girls report suicidal thoughts, make suicidal statements or make a suicide attempt. It's very important they be taken seriously both in boys as well as in girls.'"

BIPOLAR ILLNESS SOARS AS A DIAGNOSIS FOR THE YOUNG
Tuesday, September 04, 2007
By Benedict Carey, The New York Times

"The number of American children and adolescents treated for bipolar disorder increased 40-fold from 1994 to 2003, researchers report today in the most comprehensive study of the controversial diagnosis. Many experts theorize that the jump reflects that doctors are more aggressively applying the diagnosis to children, and not that the incidence of the disorder has increased. Bipolar disorder is characterized by extreme mood swings. The increase makes bipolar disorder more common among children than clinical depression, the authors said. Psychiatrists made almost 90 percent of the diagnoses, and two-thirds of the young patients were boys, said the study, published in the September issue of The Archives of General Psychiatry. About half the patients were identified as having other mental difficulties, mostly attention deficit disorder. The children’s treatments almost always included medication."

PUBLIC HEALTH/HEALTHY COMMUNITIES

BOARD OF HEALTH ACTS ON POLICY CHANGES
Thursday, September 06, 2007
By Pittsburgh Post-Gazette

"Allegheny County Board of Health members yesterday voted to direct the board's policy committee to review its needle exchange policy in light of County Council suggestions and present any proposed revisions at its next meeting in October. Policy regarding notifying family members of hospitalizations of jail inmates is under review as well. The county's air quality rules may also be revised to agree with recent changes in state regulations governing new sources of emissions."

ALLEGHENY COUNTY TO REQUIRE MORE SHOTS FOR K-12
Thursday, September 06, 2007
By Justin Vellucci, Pittsburgh Tribune Review

"Every Allegheny County student in grades K-12 will need an additional dose of at least two vaccines before they can return to school next autumn, based on immunization guidelines the county Board of Health adopted Wednesday. The guidelines require students to get an extra dose of vaccines for mumps and chicken pox. They also require students in grades 7-12 to receive an extra tetanus/diphtheria/pertussis shot and another dose of the meningitis vaccine. The changes are due, in part, to increases in reports of mumps and pertussis, said Nancy D. McManus, a public health nurse for the county Health Department. The guidelines apply to the 127,128 students enrolled in Allegheny County public schools. They also apply to those who are home-schooled or attending private, parochial or cyber schools, McManus said."

HEALTH CARE POLICY & MARKETPLACE

RURAL AREAS UNDERSERVED BY DOCTORS
Sunday, September 02, 2007
By Robin Acton, Pittsburgh Tribune-Review

"At 67, the Fayette County physician is part of a dying breed of family practice doctors and dentists who have made the choice to work in rural, small-town America. Many of these practitioners are over 50 and beginning the last stages of their careers, according to the American Medical Association and American Dental Association. Health care professionals and industry experts predict that as advancing age, retirement and death remove them from the workforce, there will be an overwhelming shortage in areas identified as underserved because few are willing to take their places. About 20 percent of the U.S. population lives in rural areas, but only 10 percent of the nation's physicians practice there, the American Academy of Family Physicians and other professional organizations report. For dentists, the numbers are worse, according to the National Rural Health Association."

POLL SHOWS SUPPORT FOR SCHIP AMONG VOTERS
Friday, September 07, 2007
By Kaiser Daily Health Policy Report

"A recent poll by Democratic pollster Stanley Greenberg found that 60% of voters would be more likely to vote for the Democratic incumbent if he or she supports SCHIP legislation, and 40% said that they would be much more likely to do so, according to a memo received by The Hill. House Democrats will use the SCHIP issue to "put President Bush and congressional Republicans on the defensive once the political turbulence surrounding forthcoming reports on the Iraq war subsides and the Congress refocuses on domestic issues," The Hill reports. In related news, House leaders on Thursday said that they will negotiate informally the SCHIP bill if Senate Republicans continue to block a formal conference committee, CQ Today reports. House Democrats on Thursday held a rally with labor union activists intended to put pressure on Bush and the Senate to act quickly to reauthorize the program (Wayne, CQ Today, 9/6)."

MEDICAID PHYSICIAN PAYMENTS VARY WIDELY AMONG STATES
Thursday, September 06, 2007
By Kaiser Daily Health Policy Report

"Medicaid payments to primary care physicians vary widely among states, while Medicare physician payments are more similar across the country, according to a report released Wednesday by Public Citizen, the Philadelphia Inquirer reports (Burling, Philadelphia Inquirer, 9/6). States with the lowest rates were New Jersey, New York, Pennsylvania and Rhode Island, as well as Washington, D.C. (Philadelphia Inquirer, 9/6). The report found significant differences in state Medicaid reimbursement rates. For example, in New York, Medicaid reimburses physicians $20 for an hour-long visit with an established patient, while higher-paying states, on average, pay $49.20 for a 15-minute visit or $157.92 for an hour-long appointment (New York Sun, 9/6). Annette Ramirez de Arellano, a Public Citizen researcher and co-author of the report, said the lowest-paying states tended to have broader eligibility requirements and more generous benefits than states with the highest reimbursements (Philadelphia Inquirer, 9/6)."

EMPLOYER-SPONSORED HEALTH PLAN COSTS COULD INCREASE BY 6.7% IN 2008
Thursday, September 06, 2007
By Kaiser Daily Health Policy Report

"Health care benefit costs for U.S. employers may rise an average of 6.7% to $8,500 per employee in 2008, a slight increase over 2007's 6.1% increase, according to a nationwide survey of 1,557 employers conducted by Mercer Health & Benefits, the Hartford Courant reports. The preliminary survey found that 36% of employers want to raise the percentage of premiums employees pay, while 29% expect to increase deductibles, copayments or the maximum out-of-pocket payments allowed for employees. Some companies plan to take both approaches (Levick, Hartford Courant, 9/6). "Employer thinking on what constitutes a 'fair share' for employees has definitely changed over the past few years," Blaine Bos, a senior Mercer consultant in Minneapolis, said."

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