Inflation at 3%
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In June, the Consumer Price Index for All Urban Consumers increased 0.2 percent, seasonally adjusted, and rose 3.0 percent over the last 12 months. The Bureau of Labor Statistics (website here, report here) reported that “The medical care index was unchanged in June, after increasing 0.1 percent the previous month. The index for physicians’ services rose 0.7 percent over the month, while the index for hospital services increased 0.4 percent. The prescription drugs index was unchanged in June.”
Death By Heat
Nature Medicine reports (here) on a study of 45 million deaths in 35 European countries “Over 70,000 excess deaths occurred in Europe during the summer of 2003. The resulting societal awareness led to the design and implementation of adaptation strategies to protect at-risk populations. We aimed to quantify heat-related mortality burden during the summer of 2022, the hottest season on record in Europe.” The result: “We estimated 61,672 heat-related deaths in Europe between 30 May and 4 September 2022.”
DOCTORS, NURSES AND OTHER HEALTH CARE PROFESSIONALS
PAs Order More Imaging Studies Than MDs
Radiology Business reports (here) that “Physician assistants order imaging, and particularly CT, at rates higher than primary care doctors, according to a large-scale analysis published in the Journal of the American College of Radiology” using the National Ambulatory Medical Care Survey, 2013-2018. JACR report here.
“Researchers recently set out to determine whether patients in racial or ethnic minority groups face disparities in the ordering of imaging exams at the primary care setting. They found similar or higher rates of examinations when compared to white patients, based on a sample representing 2.8 billion patient visits. However, the study’s authors did unearth higher rates of imaging orders among PAs, a finding they may warrant further attention from radiology leadership.”
“Providers ordered diagnostic imaging in about 12.5% of visits, with X-rays requested most frequently (4.3%) and MRI least often (0.8%). Meanwhile, physician assistants ordered imaging at higher rates than medical doctors, including a 6.5% clip of requesting CT scans compared to 0.7% for MDs and DOs.”
Maternal Mortality in Hospitals Declines, Severe Maternal Morbidity Increases
A study (here) of 11.6 million delivery-related hospitalizations published in JAMA Network Open found that “Delivery-related mortality in US hospitals decreased for all racial and ethnic groups, age groups, and modes of delivery during 2008 to 2021, likely demonstrating the impact of national strategies focused on improving maternal quality of care provided during delivery-related hospitalizations. SMM [Severe Maternal Morbidity] prevalence increased for all patients, with higher rates for racial and ethnic minority patients of any age.”
More, “In-hospital maternal delivery-related mortality per 100 000 discharges declined from 10.6 to 4.6, while the prevalence of SMM per 10 000 discharges increased from 146.8 to 179.8 during 2008 to 2021. Differences were found across racial and ethnic groups, age, mode of delivery, and comorbidities for mortality and SMM.”
The Political Education of U.S. Physicians
A Commentary in JAMA Network Open (here) promotes union awareness and membership for physicians. “There are now approximately 70,000 physician union members in the US, representing 7% of physicians—a nearly 30% increase relative to a decade ago. Much of this interest in labor movements is likely due to house staff exploitation via high medical education costs, under compensation, excessive work hours, and an infantilizing hierarchical culture characterized by intensive personality policing under the veneer of racist, misogynistic, and classist professionalism norms and their self-defensive moralisms.”
PE Pitch as Middle-Men in “Value Based” Health Services
PitchBook reports (here) that “Value-based care (VBC) enablers are companies that help independent medical groups and health systems transition from fee-for-service toward value-based contracting via wraparound services and affiliation with the enabler’s network,” and profiles six such “enablers.”
Senior Drug Use Higher
The New York Times reports (here) that “As baby boomers have turned 65, the age at which they typically qualify for Medicare, substance use disorders among the older population have climbed steeply. ‘Cohorts have habits around drug and alcohol use that they carry through life,’ said Keith Humphreys, a psychologist and addiction researcher at the Stanford University School of Medicine. Aging boomers ‘still use drugs far more than their parents did, and the field wasn’t ready for that.’”
Also, “Evidence of a growing problem has been stacking up. A study of opioid use disorder in people over 65 enrolled in traditional Medicare, for instance, showed a threefold increase in just five years — to 15.7 cases per 1,000 in 2018 from 4.6 cases per 1,000 in 2013.”
HOSPITALS, ASCs, SKILLED NURSING AND OTHER HEALTH CARE FACILITIES
How Much Is Left In the Provider Relief Fund Till? $0
InsideHealthPolicy reports (here) that “Lawyers are recommending providers due provider relief funds through reconsideration consider taking HHS to court since the Biden administration halted all provider relief applications and reconsiderations after the debt ceiling bill rescinded some remaining COVID-19 relief funds.”
More, “But the debt ceiling deal changed the fate of remaining pandemic relief funds, including the COVID-19 uninsured program. The Fiscal Responsibility Act of 2023 rescinded billions in unobligated relief in the Public Health and Social Services Emergency Fund, which largely funds the Provider Relief Fund and COVID-19 Uninsured Program. Congress did not specify how this pandemic relief will be repurposed, except that it will be reserved for future use.”
Commonwealth Fund Scorecard for State Health System Performance
The Fund (report here, study appendices here) issued its annual state scorecard, finding “Massachusetts achieved the best overall score, consistently placing among the top states on the seven dimensions of health system performance we evaluate. Hawaii, New Hampshire, Rhode Island, and Vermont round out the top five. The lowest-ranked states overall are Arkansas, Texas, Oklahoma, West Virginia, and Mississippi.”
Staff Retention, Recruitment
Health Affairs publishes a study (here) on measuring methods to retain staff in hospitals. A green card hold up is identified (here) in The Wall Street Journal as an impediment to health care staff recruitment.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
July 14, 18, 19, 20, 25, 26, 27, 28
August, No editions
September 12, 13, 14, 18, 19, 20, 21, 26, 27, 28, 29
Notes to Fred Hyde, MD, JD, MBA, news@dcmedicalnews.org
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