As Hyperactivity Diagnoses Rise, Concerns Grow About Overmedication Of Children


Topics: Public Health, Quality, Health Disparities

Apr 01, 2013

New CDC data shows that nearly one in five boys have a medical diagnosis of attention deficit hyperactivity disorder. Other public health issues highlighted by news outlets include stroke risks in younger people, prescription-drug deaths and OSHA policies.

The New York Times: More Diagnoses Of Hyperactivity In New C.D.C. Data
Nearly one in five high school age boys in the United States and 11 percent of school-age children over all have received a medical diagnosis of attention deficit hyperactivity disorder, according to new data from the federal Centers for Disease Control and Prevention. These rates reflect a marked rise over the last decade and could fuel growing concern among many doctors that the A.D.H.D. diagnosis and its medication are overused in American children (Schwarz and Cohen, 3/31).

NPR: As Stroke Risk Rises Among Younger Adults, So Does Early Death
Most people (including a lot of doctors) think of a stroke as something that happens to old people. But the rate is increasing among those in their 50s, 40s and even younger (Knox, 4/1).

Los Angeles Times: Prescription Drug-Related Deaths Continue To Rise In U.S.
Despite efforts by law enforcement and public health officials to curb prescription drug abuse, drug-related deaths in the United States have continued to rise, the latest data show. Figures from the U.S. Centers for Disease Control and Prevention reveal that drug fatalities increased 3% in 2010, the most recent year for which complete data are available. Preliminary data for 2011 indicate the trend has continued (Glover and Girion, 3/29).

The New York Times: As OSHA Emphasizes Safety, Long-Term Health Risks Fester
OSHA, the watchdog agency that many Americans love to hate and industry often faults as overzealous, has largely ignored long-term threats. Partly out of pragmatism, the agency created by President Richard M. Nixon to give greater attention to health issues has largely done the opposite. OSHA devotes most of its budget and attention to responding to here-and-now dangers rather than preventing the silent, slow killers that, in the end, take far more lives. Over the past four decades, the agency has written new standards with exposure limits for 16 of the most deadly workplace hazards, including lead, asbestos and arsenic. But for the tens of thousands of other dangerous substances American workers handle each day, employers are largely left to decide what exposure level is safe (Urbina, 3/30).

English: Percent of Youth 4-17 ever diagnosed ...

English: Percent of Youth 4-17 ever diagnosed with Attention-Deficit/Hyperactivity Disorder: National Survey of Children’s Health, 2003 (Photo credit: Wikipedia)

Advertisements

States Boost Laws, Regulations Governing Abortion


English: Histogram of abortions by gestational...

English: Histogram of abortions by gestational age for the United States in 2004. Horizontal axis is weeks and vertical axis is thousands of abortions. Data is taken from the Centers for Disease Control and Prevention.http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5609a1.htm#tab6 Updated version of Image:US abortion by gestational age 2002 histogram.svg, but data is almost identical. (Photo credit: Wikipedia)

Time series of induced abortions in Norway

Time series of induced abortions in Norway (Photo credit: Wikipedia)

Topics: Delivery of Care, Women’s Health, Politics, States

Apr 01, 2013

States have passed a record number of abortion bills since 2011, including curbs on clinics and chemically induced abortions, and in North Dakota, a ban on abortions as early as six weeks. On the other side, New York and Washington are weighing measures to ensure abortion rights.

The Wall Street Journal: States Harden Views Over Laws Governing Abortion
States are becoming increasingly polarized over abortion, as some legislatures pass ever-tighter restrictions on the procedure while others consider stronger legal protections for it, advocates on both sides say. … At the same time, Washington state is weighing a measure that would require all insurers doing business in new health insurance exchanges created by the Affordable Care Act to reimburse women for abortions. And New York Democratic Gov. Andrew Cuomo is seeking to update his state’s laws to clarify that women can obtain an abortion late in pregnancy if they have a medical reason (Radnofsky, 3/31).

The Associated Press: Abortion Clinics Need License, Check For Coercion
Michigan abortion clinics will need a state license and must check to make sure women are not being bullied or pressured into getting an abortion under a new law that took effect Sunday. Other regulations make clearer the proper disposal of fetal remains, after anti-abortion advocates expressed concern some were not disposed of with dignity (Eggert, 3/31).

In Montana, lawmakers are seeking to cut funding to some organizations that provide women’s health care.

The Associated Press: Women’s Health Funding Faces Cuts: House Budget Excludes $4.5M For Title X Funds
When Jennifer Strickley first learned she had ovarian cancer, it was Planned Parenthood that detected the disease. She had been going to a clinic in Billings (Montana) for about a decade, as the discounts on Pap tests, contraception and regular checkups provided an essential break for the single mom working without health insurance as a waitress to support her two kids … Strickley is one of 26,000 Montanans who rely upon clinics that receive federal family planning and preventive health funds in the form of Title X. … But the Montana House unanimously passed a state budget that excludes these funds — some $4.5 million — accounting for 30 percent of the budgets for 20 community clinics and five Planned Parenthood Clinics in the state (4/1).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

U.S. Behind France, Germany, U.K. In Stopping Preventable Deaths


US Navy 031223-D-9880W-120 Dr. William Winkenw...

US Navy 031223-D-9880W-120 Dr. William Winkenwerder, Jr., assistant secretary of defense for health affairs, holds a press conference at the Pentagon (Photo credit: Wikipedia)

Former Assistant Secretary of Defense (Health ...

Former Assistant Secretary of Defense (Health Affairs) (Photo credit: Wikipedia)

Dr. Nils Daulaire, U.S. Representative to the ...

Dr. Nils Daulaire, U.S. Representative to the WHO Executive Board and Director of the Office of Global Health Affairs (Photo credit: Wikipedia)

Topics: Delivery of Care, Health Costs, Insurance, Quality, Public Health

Aug 30, 2012

The study, published in Health Affairs, pointed the finger at the lack of health insurance — as well as conditions such as hypertension and medical errors — in the U.S. as part of the problem.

The Hill: Study: U.S. Tops France, Germany, UK In ‘Potentially Preventable’ Deaths
Americans younger than 65 are more likely to die from a lack of timely health care than their peers in France, Germany or the United Kingdom, according to a new study. Research published in Health Affairs looked at the rate of “potentially preventable” deaths — deaths before age 75 that could be avoided with timely and effective health care — and found that the United States lags behind its U.K. and European peers. The United States was also less effective than France, Germany and the United Kingdom in remedying the problem between 1999 and 2007, study authors wrote (Viebeck, 8/29).

WBUR: Report: U.S. Lags When It Comes To Preventable Deaths
More bad news for the U.S. health care system. According to a new report by the Commonwealth Fund, America is worst among three other industrialized nations when it comes to preventing avoidable deaths through timely, effective medical care. The problem, once again, is the lack of health insurance, the report suggests. (Things were worse for folks under 65; presumably those over that age qualify for Medicare.) (Zimmerman, 8/29).

Politico Pro: Study: U.S. Could Prevent More Deaths
America’s health care system doesn’t do as good a job of preventing avoidable deaths as health systems in other countries, a new study shows. A report posted online by Health Affairs on Wednesday compared the rates of “amenable mortality” — deaths that could have been prevented by better health care — in France, Germany, the United Kingdom (all countries that have universal health care) and the United States between 1999 and 2007. The research pointed to circulatory conditions like hypertension, as well as mortality rates due to surgical conditions and medical errors, as part of the problem with U.S. amenable deaths (Smith, 8/29).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Hospital News: Low Readmissions Rates At 2 NYC Hospitals; Parkland Still Facing Crisis


New York City Health and Hospitals Corporation

New York City Health and Hospitals Corporation (Photo credit: Wikipedia)

Topics: Delivery of Care, Health Costs, Hospitals, Quality, States

Aug 29, 2012

Several stories from around the country look at issues facing local health care facilities.

Modern Healthcare/Crain’s New York Business: NYC Hospitals Buck Readmissions Trend
Two New York City Health and Hospitals Corp. facilities are among the New York hospitals with the lowest rates of preventable readmissions. Hospitals face reductions in their Medicare rates starting in October, and 18 New York City hospitals will have the maximum penalty allowed under the federal health care reform law—1% of their base Medicare reimbursement (8/28).

The Dallas Morning News: At Halfway Mark In Parkland Hospital’s Overhaul, Crises Remain
Parkland Memorial Hospital has just passed the halfway  mark in its 18-month, do-or-die probation. And signs of the continuing patient safety crisis abound. Patient demand is rising at a particularly difficult time, officials say. … The report credits Parkland with completing about 80 percent of required tasks. But finishing a project is not the same as creating “a sustainable practice,” it cautions (Egerton and Moffeit, 8/28).

The Associated Press: Health Systems Align To Expand Mid-Michigan Care
The University of Michigan Health System and another system are planning to work together to expand access to care. The affiliation with MidMichigan Health is expected to align clinical services and doctors of both systems (8/28).

Pittsburgh Post-Gazette: Magee-Womens Hospital Will Review Security Protocol
The Pennsylvania Department of Health said Monday it expects Magee-Womens Hospital of UPMC to review the events surrounding the kidnapping Thursday of a newborn from its maternity ward and determine whether security should be changed in light of the incident. The health department said in a statement that it will “monitor the facility to ensure implementation of a corrective action plan if one is necessary” and noted that its role is to “ensure the facility has all the proper plans and protocols in place to ensure this type of event does not occur again” (8/28).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Public Fear Of Medical Data Theft Slows Acceptance Of Electronic Health Records


Topics: Health IT, Marketplace

Aug 27, 2012

A Harris Interactive survey has found that 63 percent of Americans fear their health data will be stolen — slowing public acceptance of electronic health records.

Medscape: Fear Of Data Theft Blunts Public Acceptance Of EHRs
Worries about the security of personal information continue to blunt public acceptance of electronic health record (EHR) systems now used by more than half of the nation’s office-based physicians, according to a survey conducted by Harris Interactive for Xerox. Sixty-three percent of Americans fear that a computer hacker will steal their personal data, down just 1 percentage point from 2010. Not much else in public opinion has changed over the last 2 years. Roughly half of Americans still say that they are concerned that their digitized health data could be lost, damaged, or corrupted. And one half continue to worry that a power outage or computer crash could prevent a physician from accessing their chart (Lowes, 8/24).

In the meantime, however, Walgreens launches a new electronic health records system across its stores —

The Atlanta Journal-Constitution: Georgia Company Partnering With Walgreens On Electronic Health Records
Pharmacy giant Walgreens is rolling out nationwide an electronic health records system built upon a platform developed by Carrollton-based Greenway Medical Technologies. The system is already operating in more than 200 Walgreens stores and will expand chainwide to nearly 8,000 locations by the end of next summer. Walgreens established a relationship with Greenway in 2010, deploying the metro Atlanta company’s electronic records system to its worksite health centers, which offer primary and acute care (Williams, 8/24).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

English: Electronic Health Records flow chart.jpg

English: Electronic Health Records flow chart.jpg (Photo credit: Wikipedia)

American Academy Of Pediatrics Says Circumcision Benefits Outweigh Risks


Topics: Delivery of Care, Public Health

Aug 27, 2012

Shifting its stance, the pediatricians’ group now says the benefits of circumcising boys to protect against disease outweighs the risk, but that the decision should be up to parents.

The New York Times: Benefits Of Circumcision Are Said To Outweigh Risks
The American Academy of Pediatrics has shifted its stance on infant male circumcision, announcing on Monday that new research, including studies in Africa suggesting that the procedure may protect heterosexual men against H.I.V., indicated that the health benefits outweighed the risks (Rabin, 8/27).

Los Angeles Times: PediatriciansGroup Shifts In Favor Of Circumcision
The American Academy of Pediatrics has shifted its official position on the contentious issue of infant circumcision, stating Monday that the medical benefits of the procedure for baby boys outweigh the small risks (Brown, 8/26).

The Associated Press/Washington Post: Circumcision Benefits Outweigh Risks And Insurers Should Pay; Pediatricians Revise Stance
The nation’s most influential pediatricians group says the health benefits of circumcision in newborn boys outweigh any risks and insurance companies should pay for it. In its latest policy statement on circumcision, a procedure that has been declining nationwide, the American Academy of Pediatrics moves closer to an endorsement but says the decision should be up to parents (8/27).

WBUR: Influential AAP Says Health Benefits Of Circumcision Trumps Risk
The American Academy of Pediatrics new policy statement today asserting that the health benefits of male circumcision outweigh the risks will inevitably set off a firestorm of reaction. Even while the pediatrics group continued to reiterate in their paper that circumcision is a personal family decision best left up to “parents in consultation with their child’s doctor” folks who oppose the procedure and equate it with genital mutilation will certainly not be pleased (Zimmerman, 8/27).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

American Academy of Pediatrics

American Academy of Pediatrics (Photo credit: Wikipedia)

Research Roundup: Who Do Patients Seek For Primary Care?


English: Medicare and Medicaid as % GDP Explan...

English: Medicare and Medicaid as % GDP Explanation: Eventually, Medicare and Medicaid spending absorbs all federal tax revenue, which has averaged around 19% of GDP for the past 30 years. Category:Health economics (Photo credit: Wikipedia)

Topics: Aging, Delivery of Care, Health Costs, Health Disparities, Public Health, Quality, Medicaid

Aug 24, 2012

Each week KHN reporter Ankita Rao compiles a selection of recently released health policy studies and briefs.

Archives of Internal Medicine: Visits For Primary Care Services To Primary Care And Specialty Physicians, 1999 and 2007 — In order to find out what kind of doctor patients were visiting for primary care service, researchers analyzed the frequency in which patients visited generalists and specialists in 1999 and 2007 by using a nationally representative sample of outpatient visits. They wrote in a research letter in the journal that “we found that fewer than two-thirds took place with primary care physicians in 1999, a proportion which remained essentially unchanged as of 2007. These findings inform our understanding of the current role primary care physicians are playing within the US health care system and raise concerns about the potential inefficiencies between primary care physician supply” (Kale, Federman and Ross, 8/20).

Archives of General Psychiatry: National Trends In The Office-Based Treatment Of Children, Adolescents, And Adults With Antipsychotics — Researchers compared trends in the antipsychotic treatment of children, adolescents and adults between 1993 and 2009 as the numbers of people using antipsychotic drugs has increased. They found the increase “has been especially concentrated among children and adolescents, particularly among youths diagnosed with mood disorders and those treated by nonpsychiatrist physicians. A substantial majority of child antipsychotic visits are for young people diagnosed with disruptive behavior disorders. In light of known safety concerns and uncertainty over long-term risks and benefits, these trends may signal a need to reevaluate clinical practice patterns and strengthen efforts to educate physicians, especially primary care physicians, concerning the known safety and efficacy of antipsychotic medications.” The safety concerns of the medication include possible weight gain and diabetes (Olfson, et al, August/2012).

Related KHN Coverage: Off-Label Use Of Risky Antipsychotic Drugs Raises Concerns (Boodman, 3/12).

The New England Journal Of Medicine: Racial and Ethnic Health Disparities Among Fifth-Graders In Three Cities — Although health-related racial and ethnic disparities have been studied in teenagers, researchers for this study looked at more than 5,000 fifth graders in Birmingham, Ala., Houston and Los Angeles County. In their interviews they “examined differences among black, Latino, and white children on 16 measures, including witnessing of violence, peer victimization, perpetration of aggression, seat-belt use, bike-helmet use, substance use, discrimination, terrorism worries, vigorous exercise, obesity, and self-rated health status and psychological and physical quality of life. … We found that harmful health behaviors, experiences, and outcomes were more common among black children and Latino children than among white children.” although they note that when adjusting for for socioeconomic status and the child’s school those differences are substantially reduced. They write, “Interventions that address potentially detrimental consequences of low socioeconomic status and adverse school environments may help reduce racial and ethnic differences in child health” and add, “The fact that disparities are prevalent among preadolescents and, in many cases, mirror disparities found in older age groups suggests that intervention efforts may need to begin early” (Schuster, et al, 8/23).

Kaiser Family Foundation: Overview Of Health Coverage For Individuals With Limited English Proficiency — There are about 21.1 million nonelderly individuals with Limited English Proficiency in the U.S. The group, which is mostly comprised of Spanish speakers, is significantly more likely to be uninsured than English speakers and face multiple barriers to getting health care. “The ACA coverage expansions will provide new coverage options for many individuals with LEP. However, to increase coverage and care for individuals with LEP, it will be important to provide adequate language assistance and address other barriers they face to enrolling in coverage and accessing needed care,” the authors write (8/17).

Here is a selection of excerpts from news coverage of other recent research:

Governing: GAO: States Spending More On Medicaid Supplemental Payments
States reported a combined $32 billion in supplemental payments to Medicaid providers in 2010, a substantial increase from 2006, according to a report released Monday by the Government Accountabilty Office (GAO), but incomplete reporting by states means the exact amount isn’t known. Medicaid supplemental payments … are divided into two categories. Disproportionate share hospital (DSH) payments are intended to offset uncompensated care costs for hospitals that serve more low-income and Medicaid patients, and non-DSH payments go to other health-care providers based on criteria set by state officials, but aren’t required by federal law. Non-DSH payments increased by $8 billion from 2006 to 2010, GAO found, to a total of $14.4 billion. Most of those payments went to inpatient hospital services. The office noted that non-DSH payments as a share of a state’s Medicaid spending varied significantly, from less than 1 percent to 17 percent (Scott, 8/21).

Medscape: Drug-Dispensing Physicians Charge More Than Pharmacies
Physicians who dispense pain medications and other commonly used drugs to workers’ compensation (WC) patients charge up to 3 times more than pharmacies in some states, according to a recent study from the not-for-profit Workers Compensation Research Institute (WCRI). That kind of mark-up could explain why physician dispensing for WC patients has grown at a rapid clip in recent years, and why some states now limit how much clinicians can charge. However, a desire for profit may not be the only reason why physicians charge more than pharmacies. Another factor may be wholesale prices that physicians pay to obtain the drugs that they sell. (Lowes, 8/21).

MedPage Today: When Elmo Likes Apples, Kids Want Them Too
Apples became substantially more popular at lunch time among grade school children when the fruits carried pictures of the Sesame Street puppet Elmo, researchers said. When the apples sported an Elmo sticker, the number of children, ages 8 to 11, taking apples with their lunches increased by about 65% compared with stickerless apples, reported Brian Wansink, PhD, of Cornell University in Ithaca, N.Y., and colleagues (Gever, 8/20).

MedPage Today: PSA Gets Partial Credit for Survival Benefit
Overall survival in metastatic prostate cancer improved significantly after the introduction of prostate-specific antigen (PSA) screening, particularly among black men, a retrospective comparison of three larger clinical trials showed. The mortality hazard decreased by 22% among men treated after PSA screening became widespread, versus those treated in trials conducted during the pre-PSA era. Median overall survival increased by about 50% in the later trial, and the traditional survival disparity between black and nonblack men disappeared (Bankhead, 8/23).

This is part of Kaiser Health News’ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.