Archive for March, 2008

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Adolescents with Chronic Insomnia Report “Twofold to Fivefold” Increase in Personal Problems

March 18th, 2008 by Melanie Matthews

Documenting a “twofold to fivefold” increase in personal problems among adolescents with persistent sleeplessness, public health researchers at The University of Texas Health Science Center at Houston say they have completed the first prospective study demonstrating the negative impact of chronic insomnia on 11- to 17-year-olds. The study involved adolescents enrolled in health maintenance organizations who were screened for sleep problems and issues affecting physical health, psychological health and interpersonal relationships at the beginning and end of a 12-month-period. The initial screening was in 2000 and the follow-up evaluation in 2001.


  • More than one fourth of the youths surveyed had one or more symptoms of insomnia and almost half of these youngsters had chronic conditions.
  • Adolescents with chronic insomnia were much more likely to have problems with drug use, depression, school work, jobs and perceived health.

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Go Green for Health

March 17th, 2008 by Melanie Matthews

As the American Dietetics Association celebrates its 35th annual National Nutrition Month this March, this week’s Disease Management Update looks at nutrition and the impact it can have on health. Researchers have discovered a correlation between eating greens and decreasing your risk of breast cancer, and another study documents the effect dietary changes can have on lowering cholesterol levels.

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Go Green for Health

March 17th, 2008 by Melanie Matthews

As the American Dietetics Association celebrates its 35th annual National Nutrition Month this March, this week’s Disease Management Update looks at nutrition and the impact it can have on health. Researchers have discovered a correlation between eating greens and decreasing your risk of breast cancer, and another study documents the effect dietary changes can have on lowering cholesterol levels.

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More Companies, Workers Adopt Consumer-Directed Health Plans

March 13th, 2008 by Melanie Matthews

The number of companies that offer a consumer-directed health plan (CDHP), a high-deductible plan offered with a personal account that can be used to pay a portion of medical expenses not covered under the plan, is rising. The number of workers who enroll in the programs has nearly doubled over the last two years. Furthermore, health cost increases for companies with high CDHP enrollment are roughly half those facing companies offering only traditional health coverage, according to an annual survey conducted by Watson Wyatt and the National Business Group on Health.


  • Nearly half (47 percent) of the 453 large U.S. employers that participated in the survey currently offer a CDHP, an increase from 39 percent in 2007 and 33 percent in 2006. By 2009, 54 percent of companies plan to offer a CDHP.
  • As adoption rates climb, employee enrollment also continues to rise. Fifteen percent of employees at organizations that offer CDHPs are currently enrolled in such plans, up from 8 percent in 2006 and 10 percent in 2007. Only 6 percent of companies report 100 percent enrollment in a CDHP, but that number is expected to rise to 9 percent in 2009.

Posted in Consumer-Driven Healthcare, News | No Comments »

Medical Homes for Diabetes Raise Compliance, Reduce Disease-related Costs

March 10th, 2008 by Melanie Matthews

Early results from two groundbreaking pilots validate the benefits of the patient-centered medical home model for patients with diabetes:

First, a unique data exchange between the largest insurer in New Jersey and an 850-physician organization resulted in the creation of a member-specific profile for each diabetes patient accessible at the point of care. Partners in Care (PIC) Medical Director Dr. James Barr said the one-year pilot that joined the disease management efforts of Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) with those of PIC physicians dramatically improved compliance levels and clinical outcomes for patients with diabetes — from 43 percent to 91 percent for the key HbA1c blood test. The program focused on New Jersey State Health Benefits Program members with diabetes. Dr. Barr said participating practices spent approximately 15 to 30 additional minutes per month with each patient in the pilot. This could be time spent with the provider or a staff member, he explained. The payor-provider collaboration has been so successful that Horizon BCBSNJ plans to extend the model to other chronic illnesses. The patient-centered medical home model makes the personal physicial responsible for all the patient’s healthcare needs for all stages of life — and arranging this care with other qualified professionals.

A second pilot for Medicaid patients in North Carolina saved the state $231 million in healthcare costs in 2005 and 2006. Roberta Burgess, nurse case manager for Community Care Plan of Eastern North Carolina through Heritage Hospital in Tarboro, N.C., said that provider toolkits and patient diabetes action plans developed for the program were key communication vehicles in the diabetes medical home project. She also said that case managers were effective liaisons between provider and patient, suppporting patients with information and sometimes even transportation. As a result, patients were better educated about care and self-management and better prepared for their doctors’ appointments. The program was one of seven winners in Harvard University’s 2007 Innovations in American Government Awards.

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MRSA Detection and Prevention News

March 5th, 2008 by Melanie Matthews

We recently surveyed healthcare organizations on their reactions to MRSA outbreaks. We invite you to comment here on your strategies, as well as review two new advances this week in the detection and prevention of Methicillin-resistant Staphylococcus aureus (MRSA):

In The New York Times, Andrew Pollack spotlights a California company that has developed a rapid genetic test to detect MRSA:

Patients might not particularly like the new admission procedure at a growing number of hospitals: having what looks like an elongated Q-Tip stuck up their noses. But it smells great to Cepheid. Cepheid, a biotechnology company in Silicon Valley, sells a rapid genetic test to detect MRSA, an antibiotic-resistant “superbug” that has received considerable media coverage and kills more Americans than AIDS.

And healthcare workers in Canada are receiving electronic reminders to disinfect before touching patients, according to CBC News:

Researchers at the Toronto Rehabilitation Institute have developed a hand hygiene device. It consists of a sensor worn around the neck, infrared lights above the patient’s bed, and an alcohol gel dispenser attached to the waistband.

A healthcare worker wears the sensor and a beep is triggered when the person approaches a patient’s bed, reminding them to use the sanitizing gel. If the healthcare worker has already done so, the beep will not sound.

The system also records the time of entry and exit from each patient area and the number of times hands are disinfected. This data can be downloaded into a computer so individual staff members can check their overall hand hygiene and compare it anonymously against their peers.

Posted in Disease Management, Healthcare Quality Ratings, Wellness/Prevention | No Comments »

Many Patients Can Reach LDL Cholesterol Goal Through Dietary Changes Alone

March 4th, 2008 by Melanie Matthews

Patients worried about their cholesterol may want to visit a registered dietitian (RD) to get some sound advice about how to shape up eating habits, according to a new national study led by University of Michigan Health System researchers. The new results, published in the February issue of the Journal of the American Dietetic Association, are based on data from 377 patients with high cholesterol who were counseled by 52 RDs at 24 sites in 11 states.


  • In the group of 175 patients who started the study with triglycerides less than 400 milligrams per deciliter of blood (mg/dL), and who had their cholesterol measured before they changed or added medication, 44.6 percent either reduced their levels of “bad” cholesterol by at least 15 percent, or reached their cholesterol goal.
  • A significant number of patients reduced the fat in their diets to less than 30 percent of calories, as recommended for heart health. Many participants also lost weight and/or increased the number of days each week on which they exercised for 30 minutes or more.

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Americans Have Trouble Paying for Drugs or Skip Prescriptions Due to Cost

March 4th, 2008 by Melanie Matthews

A new poll, the third in a series conducted jointly by USA Today and public opinion researchers at the Kaiser Family Foundation and the Harvard School of Public Health, finds Americans greatly value prescription drugs‘ potential benefits for their families, but most believe they cost too much money and many struggle to pay for needed medicines.


  • Four in 10 Americans (and half of those regularly taking at least one medication) report experiencing at least one of three cost-related concerns in their family: 16 percent say it is a “serious” problem to pay for prescription drugs; 29 percent say they have not filled a prescription in the past two years because of the cost; and 23 percent say they have cut pills in half or skipped doses in order to make a medication last longer. People are most likely to report one of these three issues if they lack drug coverage (52 percent), if they have low incomes (54 percent) or if they take four or more drugs regularly (59 percent).
  • Nearly eight in 10 Americans say that the cost of prescription drugs is unreasonable, and seven in 10 say pharmaceutical companies are too concerned about making profits and not concerned enough about helping people. Nearly two-thirds (64 percent) of the public say that there is not enough government regulation to limit the price of drugs. Nearly six in 10 say insurers should only pay for new drugs if they are proven to be not just safe but also more effective than existing ones.

Posted in Healthcare Costs, News, Prescription Drugs | No Comments »

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