About the public’s health
Estimating the Attributable Cost of Physician Burnout in the United States: Physician burnout has been discussed as an availability problem. This research puts a price on it: “On a national scale, the conservative base-case model estimates that approximately $4.6 billion in costs related to physician turnover and reduced clinical hours is attributable to burnout each year in the United States.”
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World's rivers 'awash with dangerous levels of antibiotics': Antibiotic resistance is one of the world’s biggest health problems. Fixes have been directed at physicians to decrease unnecessary prescriptions and at patients to lessen their demands when treatments will not help. This article highlights a potentially bigger problem--”Hundreds of sites in rivers around the world from the Thames to the Tigris are awash with dangerously high levels of antibiotics.” The worst area is Africa, where 35% of tested rivers contain unsafe levels of antibiotics. (North America is at 15%). Clearly we need to address this source in our effort to combat drug resistance.
New directions in incidence and prevalence of diagnosed diabetes in the USA: Finally some “good news.” According to the CDC: “ After an almost 20-year increase in the national prevalence and incidence of diagnosed diabetes, an 8-year period of stable prevalence and a decrease in incidence has occurred. Causes of the plateauing and decrease are unclear but the overall burden of diabetes remains high and deserves continued monitoring and intervention.” The reason the cause is particularly unclear is that obesity and overweight incidences are still rising.
Why smelling good could come with a cost to health: “Fragrances” are found in dozens of products we use every day. But they are not regulated by the FDA and their exact chemical compositions are trade secrets. Many of these fragrances have been found to contain harmful substances. Read this article before you use any of these products.
About healthcare IT
Babylon’s GP at Hand app raises questions over NHS tech tie-ups: This British app collects a patients’ symptoms and enables them to talk to an NHS physician at one of two sites. However, a recent study calls into question whether the technology is medically accurate or if it saves money for the NHS. One big problem is that NHS sites are funded to care for their local populations. But only 10% of the app’s subscribers are in the catchment areas of the two participating providers.
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Using Health IT for Care Coordination: Insights from Six Medicare Accountable Care Organizations: This report from the HHS Inspector General’s office revealed some insights into problems ACOs face in using IT for care coordination. While organizations that share a single electronic health record (EHR) show promise in enhanced coordination of care, ACOs that use multiple systems “faced challenges from physician burnout due to the workload of managing EHRs. Most of the ACOs had access to HIEs [Health Information Exchanges] with little or incomplete data, making it difficult to coordinate care when patients saw providers outside the ACOs' networks. Few of the ACOs use analytics to customize care to an individual patient's needs.”
Two Years In and WannaCry is Still Unmanageable: 40% of healthcare organizations suffered an attack by this malware in the last 6 months. One issue (as previously reported) is that many organizations use Windows 7 and older versions- 70% in healthcare compared to less than 30 % in the tech sector. The article has some suggestions on protection.
About healthcare systems
UCSF ends affiliation talks with Dignity Health following protests: Several months ago, San Francisco-based Dignity Health and Denver-based CHI (formerly Catholic Health Initiatives) merged to form a 21 state $29 billion system. The new entity is called CommonSpirit Health and in headquartered in Chicago. UCSF (part of the public University of California system) had been in affiliation talks with Dignity. However, the plan prompted protests by those concerned that an affiliation "with a healthcare system that has certain limits on women’s reproductive services, LGBTQ care, and end-of-life options.” The deal is now off.
Specialty Drug Pricing and Out-of-Pocket Spending on Orally Administered Anticancer Drugs in Medicare Part D, 2010 to 2019: After spending a certain amount on drugs, seniors are responsible for all costs up to a maximum. This responsibility has been called the doughnut hole because it is between two corridors of coverage. The cost has decreased from 100% in the gap in 2010 to 25% this year. However: “Despite efforts to close the coverage gap between 2010 and 2019, mean expected out-of-pocket spending in 2019 benefit designs increased for 12 of 13 orally administered anticancer drugs available in both years (mean 12-month out-of-pocket spending in 2010 was $8794 and in 2019 is expected to be $10 470; mean increase, $1676).” In other words, the increases in costs are outpacing the decreased financial responsibility.
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As Trump Battles Congress, U.S. Drug Spending To Eclipse $370B: The bottom line is “U.S. drug spending is projected to grow this year by 2.5% to more than $370 billion, boosting overall healthcare spending past $3.3 trillion for 2019.” By 2023, the pharma is expected to be 9.7% of total spending; but it has been in the 9.5-10% range for many years.