Published in the January 2006 issue of Today’s Hospitalist
Hospitalizations for ID problems in seniors rises 13 percent
The number of senior citizens hospitalized for infectious diseases has risen nearly 13 percent since the early 1990s.
An article in the Nov. 28 Archives of Internal Medicine compared hospitalization rates from the years 1990-92 and 2000-02. During the more recent period, more than 21 million adults 65 and older landed in the hospital because of an infectious disease.
Researchers attributed the trend in large part to the aging of the population, particularly the rising number of patients 75 and older. The results are a particular concern because the number of Americans 65 and older is expected to nearly double between 2000 and 2035.
The study also noted that almost half of infectious disease hospitalizations and ID-related deaths among older patients between
2000 and 2002 were associated with lower respiratory tract infections.
New study gives physicians another reason to dress for success
A new study warns that dressing down may affect the level of trust between patients and physicians.
Research published in the November 2005 American Journal of Medicine interviewed 400 patients after reviewing photos of physicians dressed in different types of clothing. Respondents were asked to rank their preferred style of dress for physicians, as well as their trust and willingness to talk about sensitive medical issues.
The study found that most respondents expressed a clear preference for snappy dressers. When asked about their preferences, 76 percent said they favored professional attire with a white coat, 10 percent said they preferred business dress, and only 4.7 percent said they favored casual dress.
Researchers also noted that respondents said they would be more willing to share their social, sexual and psychological problems with a physician who is professionally dressed.
Researchers found that men and women had similar attitudes toward dress, but that respondents seemed to place a greater value on how female physicians dress.
Medicare: Pay-for-performance experiment is improving quality
Medicare has released data showing that its experiment with pay for performance has improved quality at participating U.S. hospitals.
The agency recently announced that quality increased in all five areas it has been measuring as part of its Premier Hospital Quality Incentive project: AMI, heart failure, pneumonia, CABG and hip and knee replacement. To reward hospitals that improved their scores, Medicare paid a total of $8.85 million in quality bonuses.
Two hospitals were in the top two deciles for all five clinical conditions: Hackensack University Medical Center in New Jersey and McLeod Regional Medical Center in South Carolina. Hackensack was also the recipient of the largest reward in the program, receiving $326,000 for improving its care of CABG patients.
Under the current plan, Medicare gives hospitals in the top 10 percent of performance a 2 percent bonus of their Medicare payments. Hospitals in the second 10 percent receive a 1 percent bonus.
Later this year, Medicare plans to reduce the pay of hospitals in the bottom decile by 2 percent. Hospitals in the second worst decile will have their pay reduced by 1 percent.
More than 260 hospitals volunteered to participate in the program, which is scheduled to end in September of this year.
U.S. medical schools teaching bumper crop of students
The current crop of first-year medical students, the biggest on record, is fueling hopes that an end of the shortage of physicians may be in sight.
According to data from the Association of American Medical Colleges, the current class of medical students includes more than 17,000 medical students enrolled in the nation’s 125 medical schools. That’s a 2.1 percent increase over last year’s class.
Seven U.S. medical schools saw enrollment increases of more than 10 percent, and 14 expanded their class size by at least 5 percent.
In addition, U.S. medical schools have seen signifi cant growth in the number of Hispanics (up by 6.4 percent), Mexican Americans (up by 8 percent) and Asians (up by 8.1 percent) applying for medical school.
How American medicine stacks up on errors, coordination of care
A new study that found a high rate of errors and coordination of care problems in U.S. health care offers relatively good news for hospitals.
The study, which appears on the Web site of the journal Health Affairs, surveyed patients in six countries about problems they encountered both in and out of the hospital. In a number categories, the outlook was not good for American medicine.
Nearly one-third of Americans, for example, reported experiencing a medical mistake, being given a wrong medicine or dose, receiving incorrect test results, or hearing about abnormal test results after a lengthy delay. By comparison, 30 percent of Canadians, 25 percent of New Zealanders and 23 percent of Germans said that they had experienced those kinds of errors.
The report notes that U.S. patients were more likely to report problems when they had seen four or more physicians in the previous two years. Half of that population reported at least one of the four types of errors.
When it came to problems with coordination of care after being discharged from the hospital, however, the standing of U.S. health care improved somewhat.
Only 11 percent of U.S. respondents, for example, said they had not received clear instructions about symptoms to watch for and when they should seek additional care. Nearly 20 percent of patients in Australia and Germany reported discharge coordination problems, while 26 percent of respondents in the UK reported similar problems.
Hospital-acquired infections in Pa. cost nearly $2 billion
A new report on the staggering costs of hospital-acquired infections says that in 2004, Pennsylvania hospitals billed insurers an additional $2 billion to care for the problem.
According to the Pennsylvania Health Care Cost Containment Council, the state agency that collects information from hospitals, 11,668 Pennsylvanians got an infection while in the hospital for another condition in 2004.
Hospitals in the state billed Medicare $1 billion to treat the infections, while the tab for Medicaid came to more than $371 million. Commercial insurers were billed an additional $600 million to care for the infections.
The report on infections, which is the agency’s second, says that hospital-acquired infections were associated with 1,793 deaths. The report notes that 1,510 of those deaths were unexpected.
State officials extrapolated that if the rest of the country experienced similar rates of hospital-acquired infections. Medicare alone would pay an additional $20 billion a year.
Pennsylvania is one of a handful of states that requires hospitals to report infections. The report on hospital-acquired infections gives only overview data and does not provide infection rates for individual hospitals.