Media, messages, and medication: strategies to reconcile what patients hear, what they want, and what they need from medications

Background:

Over the past 30 years, patients’ options for accessing information about prescription drugs have expanded dramatically. In this narrative review, we address four questions: (1) What information sources are patients exposed to, and are they paying attention? (2) Is the information they hear credible and accurate? (3) When patients ask for a prescription, what do they really want and need? Finally, (4) How can physicians reconcile what patients hear, want, and need?

Source: BMC Medical Informatics and Decision-making [via eScholarship Repository]

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How Medicaid Expansions and Future Community Health Center Funding Will Shape Capacity to Meet the Nation’s Primary Care Needs

Without Sufficient Support, Community Health Centers Will Drop 1 Million Patients

A new report by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at the George Washington University School of Public Health and Health Services (SPHHS) examines the impact of federal and state policy decisions on community health centers (CHCs) and their ability to continue providing primary care to the nation’s poorest residents. The report, “How Medicaid Expansions and Future Community Health Center Funding Will Shape Capacity to Meet the Nation’s Primary Care Needs,” estimates that under a worst-case scenario, the nation’s health centers would be forced to contract, leaving an estimated 1 million low-income people without access to health care services by the year 2020.

Source: Geiger Gibson/RCHN Community Health Foundation Research Collaborative at the George Washington University School of Public Health and Health Services (SPHHS)

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Improving Health Care through Mobile Medical Devices and Sensors

Introduction:

Health care access, affordability, and quality are problems all around the world and large numbers of individuals do not receive the quality care that they need. Mobile technology offers ways to help with these challenges. Through mobile health applications, sensors, medical devices, and remote patient monitoring products, there are avenues through which health care delivery can be improved. These technologies can help lower costs by facilitating the delivery of care, and connecting people to their health care providers. Applications allow both patients and providers to have access to reference materials, lab tests, and medical records using mobile devices.

Source: Brookings Institution

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Determining who responds better to a computer- vs. human-delivered physical activity intervention

From the Abstract:

Little research has explored who responds better to an automated vs. human advisor for health behaviors in general, and for physical activity (PA) promotion in particular. The purpose of this study was to explore baseline factors (i.e., demographics, motivation, interpersonal style, and external resources) that moderate intervention efficacy delivered by either a human or automated advisor.

Source:

International Journal of Behavioral Nutrition and Physical Activity, 10(1), 109. doi: http://dx.doi.org/10.1186/1479-5868-10-109. Retrieved from: eScholarship Repository: http://escholarship.org/uc/item/5584f2sq

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The global burden of unsafe medical care: analytic modelling of observational studies

Abstract:

 

Objective To contextualise the degree of harm that comes from unsafe medical care compared with individual health conditions using the global burden of disease (GBD), a metric to determine how much suffering is caused by individual diseases.

Design Analytic modelling of observational studies investigating unsafe medical care in countries’ inpatient care settings, stratified by national income, to identify incidence of seven adverse events for GBD modelling. Observational studies were generated through a comprehensive search of over 16 000 articles written in English after 1976, of which over 4000 were appropriate for full text review.

Results The incidence, clinical outcomes, demographics and costs for each of the seven adverse events were collected from each publication when available. We used disability-adjusted life years (DALYs) lost as a standardised metric to measure morbidity and mortality due to specific adverse events. We estimate that there are 421 million hospitalisations in the world annually, and approximately 42.7 million adverse events. These adverse events result in 23 million DALYs lost per year. Approximately two-thirds of all adverse events, and the DALYs lost from them, occurred in low-income and middle-income countries.

Conclusions This study provides early evidence that adverse events due to medical care represent a major source of morbidity and mortality globally. Though suffering related to the lack of access to care in many countries remains, these findings suggest the importance of critically evaluating the quality and safety of the care provided once a person accesses health services. While further refinements of the estimates are needed, these data should be a call to global health policymakers to make patient safety an international priority.

 Source: British Medical Journal

BMJ Qual Saf 2013;22:809-815 doi:10.1136/bmjqs-2012-001748

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Berkeley Forum on Better Health Care at Lower

From the Executive Summary:

California private and public sector leaders came together in an unprecedented collaborative effort, with academic expertise and analytic support provided by the University of California, Berkeley’s School of Public Health, to address these challenges. Determined to avoid solutions divorced from societal, regulatory and political realities, the Forum has devised a transformational, bottoms-up approach to creating a more affordable, cost-effective healthcare system that would, at the same time, improve Californians’ health and well-being.

 Source: Berkeley Forum (U.C. Berkeley)

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Children with Special Health Care Needs in California: A Profile of Key Issues

Description:

Compared to children in other states, California’s children with special health care needs receive care that is less coordinated, less family-centered, and fails to meet many of the key quality indicators prescribed by the Federal Maternal and Child Health Bureau, according to this new analysis of the 2009/10 National Survey of Children with Special Health Care Needs.

Source:  Program for Children with Special Health Care Needs, launched by the Lucile Packard Foundation for Children's Health.

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The Affordable Care Act: The Value of Systemic Disruption

Abstract

It is important to recognize the political and policy accomplishments of the Patient Protection and Affordable Care Act (ACA), anticipate its limitations, and use the levers it provides strategically to address the problems it does not resolve. Passage of the ACA broke the political logjam that long stymied national progress toward equitable, quality, universal, affordable health care. It extends coverage for the uninsured who are disproportionately low income and people of color, curbs health insurance abuses, and initiates improvements in the quality of care. However, challenges to affordability and cost control persist. Public health advocates should mobilize for coverage for abortion care and for immigrants, encourage public-sector involvement in negotiating health care prices, and counter disinformation by opponents on the right. 

Source: Am J Public Health. Published online ahead of print February 14, 2013: e1-e4. doi:10.2105/AJPH.2012.301180 via eScholarship Repository

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Retiree Out-of-Pocket Health Care Spending: A Study of Expert Views, Consumer.

From the abstract:

This article explores this previously unexamined question of how much Americans expect to pay for their out-of-pocket health care spending in retirement.  To answer this question,we surveyed 2000 near retirees and retirees to gauge their expectations with regard to their own likely expenditures.  We then compared their responses to experts’ estimates. Our findings suggest that, surprisingly, many respondents have a reasonable sense of the magnitude of likely out-of-pocket expenditures, at least for the median, or typical, retiree.  However, we also found people struggle to understand potential variability in expenditures that might cause them to spend more than the typical retiree.  In particular, they underestimate how much personal health experience can affect individual spending.These results suggest that misperception of typical spending may not be a primary factor in retirees’ inability to finance out-of-pocket health care costs, but that misperception of the risk of spending above the median is likely an important factor.  We discuss educational,regulatory, and health policy implications of our findings.

Souce: Hoffman, Allison K.; & Jackson, Howell E.(2012). Retiree Out-of-Pocket Health Care Spending: A Study of Expert Views, Consumer. UC Los Angeles: UCLA School of Law. Retrieved from: http://escholarship.org/uc/item/3w7521mn

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