Pain is more than just a complaint -- it's a public health issue. And the time has come to do something about it. So concludes a new report from the Institute of Medicine, written at the request of the Department of Health and Human Services. The report, mandated by the healthcare overhaul law, estimates that chronic pain costs between $560 billion and $635 billion each year in medical expenses and lost productivity. But, it adds, pain is also personal, affecting each person individually. One-size-fits-all approaches won't address the problem, the report concludes. Chronic pain, from cancer to back pain, is influenced by heredity, stress, depression and other factors, and sometimes lingers after the underlying condition is treated because of changes in the nervous system. So pain can be a disease in and of itself. Yet, the report points out, few medical schools require, or even offer, courses on pain.
Death certificates in Illinois will soon reflect what patient safety advocates say has been a secret killer - - staph infections that are resistant to antibiotics. Under the new law, healthcare providers who fill out the certificates will have to include the presence of methicillin-resistant staphylococcus aureus, known as MRSA, and other infections that are resistant to multiple drugs if they contributed to or caused a death. Gov. Pat Quinn is expected to sign the bill into law. Illinois would become the second state after Washington to require the infections be included on death certificates when appropriate. MRSA is a prevalent staph bacteria that can cause skin, ear, nose and throat infections when acquired through close contact - - typically in dorms, jails, day care centers and locker rooms. More serious MRSA infections can occur in hospitalized patients with compromised immune systems following surgeries or other procedures that allow the bacteria to enter the body and cause blood infections and pneumonia.
With the prohibitive and rising cost of healthcare, there has never been a greater need for accountable care organizations, according to Mark McClellan, MD, former administrator for the Centers for Medicare and Medicaid Services. McClellan's comments came at the National Health IT and Delivery System Transformation Summit, held in conjunction with Second Annual National Accountable Care Organization Summit June 27 and 28 in Washington, DC. The challenge of achieving better care at lower costs has never been more important or more urgent, he said, and the serious challenges of getting from here to there have never been more daunting. McClellan, who is now the director of the Engelberg Center for Health Care Reform at the Brookings Institution, said in the past year the Centers for Medicare and Medicaid Services has identified many of the challenges faced by providers when starting an ACO, and there are now some successful ACOs from which to draw experience. "ACOs are about fundamental changes," he said. "The main emphasis is to get away from fee-for-service payment structures."
Radiation after a mastectomy for advanced breast cancer is part of the standard treatment guidelines. But more than a decade after the lifesaving value of radiation was confirmed, about half of all women who should get radiation therapy aren't getting it, researchers reported Monday. In the mid-1990s, several studies confirmed that mastectomy patients with advanced breast cancer have better outcomes if they undergo radiation after surgery. Initially, the medical community seemed to pay attention to the findings. From 1996 and 1998, the rates of radiation following mastectomy for women ages 66 and older increased from 36.5% to 57.7%. But in a review of data from 1998 to 2005, researchers from MD Anderson Cancer Center in Houston found no further increase. Almost half of all eligible women are not getting radiation therapy. The study appears online in the journal Cancer.
New, noninvasive blood tests are being developed for expectant mothers to find out if their babies have genetic conditions such as Down syndrome, without the risks of tests available now. Pregnant women often opt for a prenatal test called amniocentesis that requires a needle to be inserted through the walls of the abdomen and uterus to draw a sample of the fluid surrounding the fetus. The test is uncomfortable and carries a small risk of miscarriage, as does another invasive test for genetic disorders called chorionic villus sampling, or CVS, that samples tissue from the placenta. Now, scientists say new tests of fetal DNA sampled from a mother's blood can be used to screen for Down syndrome. The new blood tests could be performed as early as nine weeks into a pregnancy?earlier than amniocentesis?and may be available as soon as the end of this year. And with the price of gene sequencing and other advanced technology continuing to drop, researchers anticipate noninvasive tests can also be used to detect other inherited diseases such as cystic fibrosis or sickle-cell anemia.
Of all the indignities that befall us at the doctor's office or in a hospital, the interminable wait is probably the most universal. It costs you time, money, agony. And guess what? It costs the hospital time and money, too. You'd think a solution to this constant and unsustainable economic problem would have revealed itself long ago. But the wait may be over -- based on lessons learned from a car manufacturer.