Archive for July, 2008

Workplace Wellness Programs

July 14th, 2008 by Melanie Matthews

According to a study by Gordian Health Solutions, employees with greater health problems are more likely to sign up for wellness programs than their healthier counterparts — a somewhat counterintuitive finding.

“Employers’ conventional wisdom is often that healthier employees are more likely to self-select into employee health and wellness programs, but our research suggests otherwise,” said Dr. Adam Long, vice president of research and informatics for Gordian. “Our findings suggest that Gordian members who can receive the greatest benefit from health coaching programs are, in fact, more likely to do just that.”

The study showed that Gordian’s health coaching program enrollees had:

  • a 5 percent higher rate of acute conditions
  • an 11 percent higher rate of behavioral health problems
  • a 12 percent higher rate of chronic health conditions

Employees who completed a Personal Health Assessment also had higher prospective levels of risk than employees who did not.

Keeping a Food Diary Doubles Weight Loss

July 8th, 2008 by Melanie Matthews

Keeping a food diary can double a person’s weight loss according to a study from Kaiser Permanente’s Center for Health Research. Funded by the National Heart, Lung and Blood Institute at the National Institutes of Health, the study is one of the few studies to recruit a large percentage of African Americans as study participants (44 percent). African Americans have a higher risk of conditions that are aggravated by being overweight, including diabetes and heart disease. In addition to keeping food diaries, participants were asked to follow a heart-healthy DASH (a Dietary Approaches to Stop Hypertension) diet rich in fruits and vegetables and low-fat or non-fat dairy, attend weekly group sessions and exercise at moderate intensity levels for at least 30 minutes a day.

  • The majority of African American participants lost at least nine pounds of weight, which is higher than in previous studies.
  • After six months of the DASH diet, the average weight loss among the nearly 1,700 participants was approximately 13 pounds. More than two-thirds of the participants (69 percent) lost at least nine pounds, enough to reduce their health risks and qualify for the second phase of the study, which lasted 30 months and tested strategies for maintaining the weight loss.

Prevention Activities Could Increase Lifespan of U.S. Adults

July 7th, 2008 by Melanie Matthews

Aggressive use of nationally recommended clinical prevention activities could increase life expectancy for U.S. adults by reducing cardiovascular disease (CVD), according to a joint report of three major national healthcare organizations: the American Heart Association, the American Diabetes Association and the American Cancer Society. Using a sophisticated mathematical model called Archimedes, senior scientists from the organizations evaluated the impact of 11 widely recognized, tailored clinical preventive services for reducing CVD, such as smoking cessation, preventive aspirin therapy, cholesterol-lowering medications and weight reduction.

  • Using these CVD clinical preventive measures to their fullest potential could add about 220 million life-years over the next 30 years, or an average of 1.3 years of life expectancy for each adult in the U.S.
  • If every individual achieved 100 percent adherence with all the clinical prevention activities for which they are candidates, then heart attacks would decrease about 63 percent and strokes about 31 percent in the next three decades.

Wait Times and “Boarding” of Psychiatric Patients in Emergency Rooms

July 7th, 2008 by Melanie Matthews

The world was horrified last week after watching a surveillance video of the death of a female psychiatric patient in a New York hospital’s ER waiting room. I am not going to embed the video here. If you go to YouTube.com and search on “Kings County Hospital,” you can choose from at least 48 variations of the video.

What’s important to note is that treatment depicted in this hour-long viral video raises a host of disturbing concerns about quality of care, safety, security and confidentiality at Brooklyn’s Kings County Hospital, which last week pledged to check on waiting patients every 15 minutes and attempt to shorten the hospital’s median waiting time to around 10 hours, among other promised reforms.

The latter goal is more than twice the average waiting time of four hours and five minutes reported in Press Ganey’s 2008 ED Pulse Report. In a survey of 1,524,726 patients treated at 1,656 EDs nationwide between January 1 and December 31, 2007, New York EDs ranked 43rd in average wait times, with an average wait time of 282 minutes. (First was South Dakota at 165 minutes; last was Utah at 385 minutes.)

Long waits in the ED are not uncommon for people with psychiatric illnesses due to the practice of “boarding” — holding admitted patients in the ED instead of moving them to an inpatient bed. According to a survey of ED directors by the American College of Emergency Physicians, psychiatric patients (including children) admitted to the hospital from the ED can wait 24 hours or longer for an inpatient bed, principally because of a lack of psychiatric beds. Almost 80 percent of the 328 ED directors who responded to the survey said their hospital boards psychiatric patients in the ED. Thirty percent said their hospitals board psychiatric patients between eight and 24 hours, and more than one-quarter said that their hospitals board children with psychiatric illnesses for that long.

Eighty-five percent of these doctors said that wait times for all emergency patients would improve if there were better psychiatric services available. More than 80 percent agreed that regional dedicated emergency psychiatric facilities nationwide would work better than the current system for dealing with psychiatric emergency patients.

U.S. Healthcare System Ranked Most Unpopular of 10 Developed Countries

July 2nd, 2008 by Melanie Matthews

Several recent surveys by Harris Interactive®, including the latest Financial Times/Harris Poll, asked an identical question of cross-sections of adults in 10 developed countries about their own healthcare systems. This research finds that the United States has the most unpopular system.

  • Fully 33 percent of Americans believe that the American system “has so much wrong with it that we need to completely rebuild it,” and a further 50 percent think that “fundamental changes are needed to make it work better.”
  • In the other nine countries those who believe they need to completely rebuild their systems vary from only 9 percent in The Netherlands and 12 percent in Spain to 15 percent in France, 17 percent in New Zealand, 18 percent in Australia and 20 percent in Italy; all well below the 33 percent in this country.

Tell Us How Fuel Costs Affect Healthcare

July 1st, 2008 by Melanie Matthews

Like everyone else, healthcare is feeling the pinch from rising fuel prices.

A new study released last week by the National Association for Home Care & Hospice’s (NAHC) Foundation for Hospice and Homecare found that nurses, therapists and home care aides who serve chronically ill elderly and disabled patients drive nearly 5 billion miles each year and that escalating gasoline prices are threatening their ability to reach patients, particularly in rural areas.

In some parts of the country, organizations like Meals on Wheels whose volunteer drivers are balking at gas prices, have had to reduce services or cancel them entirely.

According to the Auto Pulse survey conducted by the Consumer Reports National Research Center, 24 percent of respondents have cut back on essentials like food or healthcare in order to cover prices at the pump.

How is your healthcare organization coping with rising energy costs? Take our monthly e-survey on Energy Costs and Healthcare by July 31 and receive a free e-summary of the results. We’re also offering a $50 gas card for the best and most cost-efficient strategy for coping with high energy costs.