Thousands of American retirees in Mexico have quietly signed up for the healthcare plan run by the Mexican Social Security Institute. The healthcare plan has no limits, no deductibles, free medicines, tests, X-rays, eyeglasses, and dental work—all for a flat fee of $250 or less a year.
MinuteClinics and other walk-in clinics found in retail stores offer a similar quality of service to physicians' offices and urgent-care centers, for prices as much as a third less, a study has found. The average cost of care at a retail clinic was $110, compared with $166 at doctors' offices, $156 at urgent-care centers and $570 at emergency rooms, according to research published in the Annals of Internal Medicine.
Results from an industry-funded study of cardiac resynchronization therapy defibrillators, medical implants that slow heart deterioration, found benefits more pronounced than in a preliminary analysis in June. But some cardiologists remain skeptical that the findings justify broad use of the $30,000 devices for patients with mild heart failure.
In hospitals, staffers can call on rapid-response teams if a patient takes a turn for the worse. But increasingly, families have the right to summon the rapid-response teams directly or at least to demand immediate medical attention from a senior physician if they feel a patient is in trouble and their concerns are not being met.
Some hospital staff fear families who are allowed to bypass the chain of command in hospitals will push the panic button and call response teams for every minor gripe. But a study indicates that is not likely to happen.
A Washington nonprofit organization, Consumers' Checkbook, has created a new model for online doctor reviews that is designed to address their shortcomings. Instead of being based on blurbs that are self-selected and anonymous, this model uses surveys. Most of the survey questions focus on doctor-patient communication, and other questions address access to care.
Representatives of Parkway Holdings Ltd., Singapore's largest private-hospital operator, said the number of people seeking treatment at its hospitals may climb in 2009, overcoming two quarters of patient declines as the global economy recovers. Parkway is aiming to attract more people from Russia, Ukraine, Kazakhstan, and Saudi Arabia for procedures such as cancer treatment and organ transplants.
Like residents of the United Kingdom and their defense of their National Health Service, Canadians are coming to the defense of their healthcare system. Those who oppose President Obama's reform efforts contend that Canadians endure long waits for critical procedures, medical rationing, scant resources, and heavy-handed government interference.
In 2008, Linda Severson, RN, was called into her superintendent's office after the facility had experienced a near miss pertaining to look-alike/sound-alike drugs. He asked her if there was anything she could do to prevent this kind of problem from happening again.
In response, Severson, who works at Cherokee Mental Health Institute (CMHI), in Cherokee, IA, took matters into her own hands and changed the CMHI computer system settings for all look-alike/sound-alike drugs so that they show up differently than the rest by default. This change brings additional attention to look-alike/sound-alike drugs to the person entering the record.
Since implementing the new process, CMHI has seen and is now tracking a noticeable reduction in errors associated with look-alike/sound-alike drugs.
Electronic medical records
The facility's original medical record system was used as an order entry form. For example, if the practitioner filling out the form worked in pharmacy, he or she would identify pharmacy in the order type. Then the order code would be brought up, which in pharmacy's case, would be the particular type of drug.
When it came time for the pharmacy practitioner to choose the type of drug, this was where CMHI experienced problems.
One particular case was distinguishing between the drug hydroxyzine, an antihistamine used to treat insomnia, and hydralazine, an anti-hypertensive drug used to treat high blood pressure.
"When you chose the drug, you would only have to put a portion of the drug name in," says Severson. "When you typed in [the letters] 'HYDR,' you would get every drug with those four letters in it."
Picking the right list and defaults
Severson went to The Joint Commission's Web site for a list of all the look-alike/sound-alike drugs. She then took this list to CMHI physicians and asked them to come up with a common list she could default into the computer system.
With the help of the practitioners, Severson developed a list of 42 look-alike/sound-alike drugs to be programmed and defaulted into the CMHI computer system.
"It would have been ideal if the system had a little bell that would ding or something," says Severson on making look-alike/sound-alike drugs distinguishable from the rest. Instead, Severson alternated capitalization on each of the 42 pre-determined drugs.
CMHI (and its computer system) is part of the state of Iowa Department of Human Services healthcare facilities, and because Severson is on the order entry team for that system, she has been able to share her new default process with the other institutions in the association.
"Only one other institution [in our statewide association] is Joint Commission surveyed," so it is unclear how many other, non-Joint Commission surveyed facilities in the system use the look-alike/sound-alike system, says Severson.
The important accomplishment, says Severson, is that staff are able to work comfortably with the system—and staff feedback has been very positive.
"The practitioners are very supportive, seeing that it is a Joint Commission safety goal," says Severson. "They thought it was a very good idea to have a separate way to identify the drugs than just in a book."
John Creighton Campbell, a professor emeritus of political science at the University of Michigan and a visiting researcher at the Tokyo University Institute of Gerontology, discusses Japanese healthcare in this interview with the New York Times. As part of the interview, Campell compares Japanese healthcare with that of the United States and offers some lessons the U.S. can take from the Japanese.
In what appears to be another signal that the recession may have bottomed out, a new report shows that online job listings are on the increase in many employment sectors, with healthcare practitioners and technicians leading the way.
The Conference Board's Help Wanted Online Data Series report, which tracks more than 1,000 online job boards across the United States, found that advertised vacancies for healthcare practitioners and technical occupations grew by 52,700 listings in August, for a total of 574,400. In August 2008, there were 584,600 such job vacancy listings.
"Advertised vacancies in this occupational category have been declining, and the August increase is the first significant monthly rise we have seen in over a year," says Gad Levanon, a senior economist at The Conference Board and a co-author of the report. "In recent months, we've seen an upward trend beginning to emerge and this is usually a leading indicator of employment. Usually, a few months after we see increases in job ads, we see an increase in employment itself."
Bureau of Labor Statistics show that the healthcare sector is one of the few areas in the economy that has seen monthly job growth throughout the recession, although that growth has slowed considerably in 2009.
In July, for every unemployed person looking for work in a healthcare practitioner or technical occupation, there were 2.5 advertised vacancies and the average wage in these occupations is $32.64/hour.
Because healthcare is a broad field, the report noted that the relative tightness of the labor market varies substantially from the higher-paying practitioner and technical jobs to the lower-paying support occupations. Individual occupations showing increases included physical and occupational therapists, physical and occupational therapists' assistants, speech language pathologists, home healthcare aides, and registered and practical nurses.
However, in some healthcare support occupations, such as dental assistants and pharmacy aides, where the average wage is $12.66, there were more than two unemployed people for every advertised vacancy, the report stated.
For all industries, online job demand grew by 169,000 advertised vacancies in August, or 5%. Since April, online job demand is up by 300,000, with many of the largest states showing stable trends following two years of losses that began in May 2007. With the August data, there are now three states—New York, Maryland, and Virginia—where the job demand trends have turned positive. The August increase included strong gains in California (26,700), Texas (21,900), Florida (15,700), and New York (11,100).
The Conference Board's recently released Consumer Confidence Index also rose in August, largely reflecting consumers' feelings that jobs were becoming easier to find. "While all of this is good news, the gap between the number of unemployed and the number of advertised vacancies still remains at about 11 million, with more than four unemployed people for every online advertised job vacancy," Levanon says.
