Today's News and Commentary

About the public’s health

Meeting Individual Social Needs Falls Short Of Addressing Social Determinants Of Health: On the continuing theme of addressing social determinants of health, this article is a nice summary that defines terms and gives examples of initiatives.
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Kaiser Permanente Unveils Housing Program to Address SDOH: Picking up on the theme of the previous article, this one provides an in-depth explanation of what Kaiser is doing in Oakland to address homelessness.
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Appropriateness of outpatient antibiotic prescribing among privately insured US patients: ICD-10-CM based cross sectional study: Inappropriate prescription of antibiotics is a major problem that has led to increased pharmaceutical costs and emergence of drug-resistant bacteria. How big a problem is it? According to this study: “Among all outpatient antibiotic prescription fills by the cohort, 12.8% were appropriate, 35.5% were potentially appropriate, 23.2% were inappropriate, and 28.5% were not associated with a recent diagnosis code.” But the data was gathered using diagnosis codes. The accuracy of coding is notoriously poor; for examples: coding the wrong precise code, but listing a related diagnosis because it is quicker to retrieve; coding a more severe diagnosis to justify treatment and possible higher billing codes; or forgetting to add a diagnostic code when the patient was seen for more than one reason. Read the study and draw your own conclusions about its accuracy.
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Medscape National Physician Burnout, Depression & Suicide Report 2019: Given the shortage of physicians in many specialties and geographic areas, it is important to retain those we have. Yet the stresses of practice can be overwhelming. According to this survey, “burnout has been defined as long-term, unresolvable job stress that leads to exhaustion and feeling overwhelmed, cynical, detached from the job, and lacking a sense of personal accomplishment.” 44% of surveyed physicians reported having those feelings with another 15% reported feeling depressed. The results varied by specialty, ranging from a high of 54% for urology to a low of 28% for public health and preventive medicine.

Read the report for more details on reasons for burnout and what physicians are doing about it

About information technology

Apple is in talks with private Medicare plans about bringing its watch to at-risk seniors: The watch can now detect changes in heart rhythm (such as atrial fibrillation) and falls. It can also tally the number of steps the wearer takes. Are these benefits worth the cost ($399)? Should the watches be given to all seniors or be available only for those at high risk? When does the information capability violate privacy? What happens when insurance companies require members to wear this or similar devices as a condition of insurance (or incur a large penalty/increased premium for not doing so)?
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About pharma

The FDA has five weeks till money runs out for approving new drugs:Pharma companies may be hard hit if the budget crisis is not resolved. The FDA has stretched its resources but only has five weeks of funding left to review new drug applications (NDAs). The patent protections, however, continue to run- meaning the lost revenue by delayed approval could be substantial.

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Forget to take your medication? A new digital pill will alert you — and your doctor: Patients do not always take their medications. Reasons vary from high costs to being unable to open the bottle. This technology targets patients who do not take their medication- leaving the reasons to be determined. After they are ingested, pills containing sensors will transmit to a receiver on the abdomen. The receiver will then transmit via a mobile app to the physician.

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About insurance

Medicare Advantage industry sees slower growth for 2019: Despite “slower growth,” Medicare Advantage plans added 1.4 million more members in the past year. Now about 22.4 million beneficiaries belong to these private plans. The article has more details about growth and who the major players are.

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