Tag Archives: Medical

Health: Medical Experts Explain “Coronavirus” & Its Transmission (BMJ)

The emergent corona virus (SARS-CoV-2) outbreak in China is fast changing, just this week reported cases of the disease covid-19 jumped as new data became available. In this video Wendy Burns, and Peter Openshaw from Imperial College London explain what we know about the basic structure of the virus, it’s mode of transmission, the symptoms and pathogenesis of the diease, what we currently know about treatment, and how the virus may adapt in the future.

To read more about corona virus, all The BMJ’s resources are being made freely available at https://www.bmj.com/coronavirus

Healthcare: “2018 Health Care Cost Report” Shows Spending Grew 18% Per-Person From 2014 – 2018

HCCI Releases 2018 Health Care Cost and Utilization Report 

Per-Person Health Care Spending Grew 18% from 2014 to 2018, Driven Mostly by Prices

Health Care Cost Institute 2018 Health Care Cost and Utilization Report Cumulative Change in Spending per Person by Service Category

 

The report examines four groups of health care services and dozens of sub-categories. Of the four major categories, outpatient visits and procedures saw the highest 2018 spending increase (5.5%). Other notable trends include:

  • Inpatient services. 
    • Per-person spending on inpatient admissions rose 11.4% between 2014 and 2018
    • Within each sub-category of inpatient admissions, average prices grew steadily between 2014 and 2018 while utilization trends varied. However, the 2.0% price increase in 2018 was lower than the near 4% annual increases from 2014 to 2017.
  • Outpatient services.
    • ​Increases in prices and use led to a 16% increase in spending from 2014 to 2018.
    • ver that period, ER visit spending increased 32% and spending on observation stays went up 29%.
  • Professional services.
    • ​Spending increased 16% and growth accelerated over the 5-year period, driven by office visits and administered drugs.
    • Psychiatry also saw strikingly high spending growth of 43% from 2014 to 2018, which was driven mostly by increased use.
  • Prescription Drugs.
    • Generic drugs accounted for 88% of all prescriptions. .
    • Out-of-pocket payments for prescriptions for generic drugs was less than one-fifth of out-of-pocket payments on brand drugs.

Read full report

Study: 20% Of Surgery Patients Get “Surprise” Out-Of-Network Bills Averaging Over $2000

From a JAMA Network online study (February 11, 2020):

JAMA Network NewsIn this analysis of commercially insured patients who had undergone elective surgery with an in-network surgeon at an in-network facility, approximately 1 in 5 received an out-of-network bill, with a mean potential balance bill of $2011.

In this retrospective analysis of 347 356 surgical episodes among commercially insured patients who had undergone elective surgery with in-network primary surgeons and facilities, 20% of episodes involved out-of-network charges.

The patterns of out-of-network bills varied with the clinical scenario. Simpler ambulatory procedures that tend to involve 1 surgeon (arthroscopic meniscal repair, breast lumpectomy) had fewer out-of-network bills (13%-15% of cases), whereas inpatient procedures (hysterectomy, knee replacement, colectomy, CABG surgery) had more frequent out-of-network bills (24%-33% of cases). These more complex procedures were also associated with larger potential balance bills, in the range of $2000 to $4000.

Read full study

Top Medical Podcasts: Lung-Cancer Screenings, Placebo Effects (NEJM)

Lung-Cancer Mortality with Volume CT Screening NEJM February 2020Featuring articles on lung-cancer screening in the NELSON trial, ribociclib and fulvestrant in metastatic breast cancer, vitamin D in pregnancy and asthma, treatment thresholds for neonatal hypoglycemia, and CAR-NK cells in anti-CD19 lymphoid tumors; a review article on placebo and nocebo effects; a Clinical Problem-Solving describing a rapid change in pressure; and Perspective articles on altruism in Extremis, on abuses of FDA regulatory procedures, and on joining forces against delirium.

The New England Journal of Medicine logo

High, Non-Transparent Prices And Aggressive Collection Tactics Erode Trust In Healthcare (JAMA)

From a JAMA Network online article (February 4, 2020):

Billing Quality is Medical Quality JAMA Network ViewpointHigh medical prices and billing practices may reduce public trust in the medical profession and can result in the avoidance of care. In a survey of 1000 patients, 64% reported that they delayed or neglected seeking medical care in the past year because of concern about high medical bills. The field of quality science in health care has developed measures of medical complications; however, there are no standardized metrics of billing quality.

JAMA NetworkA recent study found that only 53 of 101 hospitals were able to provide a price for standard coronary artery bypass graft surgery. Notably, among the hospitals that provided a price, the price ranged from approximately $44 000 and $448 000 and was not associated with quality of care as measured by risk-adjusted outcomes and the Society of Thoracic Surgeons composite quality score.

Possible metrics of assessing billing quality JAMA

In the same way that there is wide variation in pricing, aggressive collection tactics also can be highly variable by institution. In a recent analysis, 36% (48/135) of hospitals in Virginia garnished wages of patients with unpaid medical bills, and 5 hospitals accounted for 4690 garnishment cases in 2017, representing 51% of all cases.7 In total, 20 054 lawsuits were filed in Virginia against patients for unpaid debt. For many hospitals that sue patients, legal action follows multiple attempts to contact patients through letters and calls, and some hospitals may offer to set up payment plans or even negotiate charges.

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Medical Care: “Restoring Hearing Loss – The Patient Experience” (Penn ENT)

At Penn Medicine ENT, we offer patients the most advanced developments in hearing technology. Our multidisciplinary approach to medicine ensures that each patient path is tailored to the patient’s specific needs.

  • When they come to our center, patients typically begin by having a diagnostic assessment.
  • Often, those patients are also seeing an ear, nose and throat physician after they have their hearing evaluation.
  • Together, the team can then make the appropriate recommendation of what should come next.

In terms of hearing devices, we offer access to almost every hearing aid manufacturer available, as well as advanced implantable technology. This includes the auditory brain stem implant, which Penn Medicine is the first in the region to offer.

Hearing is currently the only sense that we can completely restore. We’re proud to be able to offer our patients everything available to help restore their communication with family and friends.