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2008 National Healthcare ScorecardOn July 17, The Commonwealth Fund, a private foundation that aims to promote a high performing healthcare system, released its report Why Not the Best? Results from the National Scorecard on U.S. Health System Performance, 2008. They summarized, "The 2008 Scorecard, which presents trends for each dimension of health system performance and for individual indicators, confirms that the U.S. health system continues to fall far short of what is attainable, especially given the resources invested. Across 37 core indicators of performance, the U.S. achieves an overall score of 65 out of a possible 100 when comparing national averages with U.S. and international performance benchmarks. Overall, performance did not improve from 2006 to 2008. Access to health care significantly declined, while health system efficiency remained low." Some other findings, which are a mix of bad news and good news: • In 2007, more than 75
million adults (42% of all adults ages 19 to 64)
were uninsured during the year or underinsured, up
from 35% in 2003. Additionally, 37% of all American
adults reported going without needed care because
of costs in 2007, versus only 5% in the benchmark
country.
• The country now ranks
last out of 19 countries on a measure of mortality
amenable to medical care, falling from 15th. Up to
101,000 fewer people would die prematurely if the
United States could achieve leading, benchmark country
rates.
• A key patient safety
measure, hospital standardized mortality ratios,
improved by 19% from 2000-2002 to 2004-2006.
• Rates of control of two
common chronic conditions, diabetes and high blood
pressure, have improved significantly.
• "The Medicare program
could potentially save at least $12 billion a year
by reducing readmissions or by reducing hospitalizations
for preventable conditions."
• The nation spends twice
per capita what other major industrialized countries
spend on healthcare, and costs continue to rise faster
than income. "We are headed toward $1 of every $5
of national income going toward health care. We should
expect a better return on this investment." Activity Levels in KidsA contribution published in the July 16 issue of The Journal of the American Medical Association reports that as kids get older, their activity level drops. Researchers looked at a group of 1,032 kids at nine, 11, 12, and 15 years. At nine, kids engaged in moderate-to-vigorous physical activity (MVPA) for about three hours each day. However, as kids grew older, things changed, with weekday MVPA decreasing by 38 minutes per year, and weekend MVPA decreasing by 41 minutes per year. By age 15, adolescents were only engaging in MVPA for 49 minutes per weekday and 35 minutes per weekend day. The rate of decrease in MVPA was the same for boys and girls, but overall, boys spent 18 more minutes per day in MVPA on weekdays and 13 more on weekends. The recommended amount of MVPA is 60 minutes per day – something girls failed to reach when aged 13.1 (weekdays) and 12.6 (weekend days), and boys failed to reach when aged 14.7 (weekdays) and 13.4 years (weekend days). The amount of time engaged in activity was determined by having the kids wear accelerometers for a week at the four different ages. Nutritional Value of Foods Marketed at KidsA study published in the July issue of Obesity Reviews assessed 367 grocery products (excluding confectionery, soft drinks, and bakery items) aimed at kids. Researchers found that 89% of the products could be classified as of poor nutritional quality, owing to high levels of sugar, fat, and/or sodium. Cancer Survival RatesA population-based study published online on July 17 in The Lancet Oncology looked at five-year cancer survival rates for breast, colon, rectum, and prostate cancers in 31 countries on five continents. The study found that the United States, Australia, Canada, France, and Japan had the highest five-year survival rates. In general, survival rates were also higher in Northern, Western, and Southern Europe, while they were lower in Algeria, Brazil, and Eastern Europe. Organ Transplants & Cancer RiskResearch published in the July 15 issue of Cancer Research has found through animal and lab experiments that the anti-rejection drug cyclosporine seems to promote the growth of cancer by activating different forms of protein kinase C, which stimulates vascular endothelial growth factor (VEGF) production, which can aid in developing blood supply to the transplanted organ, but can also lead to blood vessel growth that can feed tumors. As stated in a July 16 news release from the American Association for Cancer Research, 15% to 20% of transplant patients develop cancer within a decade of receiving new organs. With this connection discovered, the senior investigator said, "It may be that anti-VEGF agents given judiciously after transplantation can reduce future cancer occurrence. … once the organ has stabilized, it may be possible to lower the level of VEGF expression to prevent tumor growth. … We would need to figure out how to balance benefit and risk to keep cancer at bay." Women, Obesity, & Pancreatic Cancer RiskA short communication published online on July 15 in the British Journal of Cancer warns about obesity and pancreatic cancer risk. The findings, which were based on 138,503 postmenopausal women in the Women's Health Initiative in the United States, show that women with the highest waist-to-hip ratios are 70% more likely to develop pancreatic cancer compared with women with the lowest ratios. Women, Fruit Juice, & Diabetes RiskA paper published in the July issue of Diabetes Care, which looked at 71,346 women aged 38 to 63, who were enrolled in the Nurses' Health Study, has concluded that consumption of green leafy vegetables and fruit was associated with a lower risk of diabetes, while consumption of fruit juices may be associated with an increased risk. Diabetes & TB RiskResearch published online on July 15 in PLoS Medicine, which looked at data from 13 observational studies (1,786,212 participants), has concluded that diabetes is associated with increased risk of contracting TB. Regardless of study design and geographic region, those who have diabetes experienced a three-fold higher risk for TB than those without diabetes. Researchers also estimated that diabetes may already be responsible for more than 10% of TB cases in countries such as India and China. Malaria Protection & HIV RiskAn article published in the July issue of Cell Host and Microbe suggests that a genetic trait that provides people of African descent with protection against a now-uncommon form of malaria may account for 11% of HIV cases in Africa. The genetic trait, found in 60% of African Americans and 90% of Africans, makes HIV infection 40% more likely. The Bright Side of Higher Gas PricesEarly results of a study presented June at a health economist meeting in North Carolina say that if gas remains at $4 a gallon or higher for a year or more, traffic deaths could drop by more than 1,000 per month. In a July 10 news release, co-author of the study, Dr. Michael Morrisey said, "It is remarkable to think that a percent change in gas prices can equal lives saved, which is what our data show. … For every 10 percent rise in gas prices, fatalities are reduced by 2.3 percent. The effects are even more dramatic for teen drivers." Joint Replacements for the ElderlyAn investigation published in the July 14 issue of Archives of Internal Medicine, which looked at 175 patients with an average age of 75 years, found that those who had undergone hip or knee replacements for severe osteoarthritis took several weeks to recover but experienced excellent long-term outcomes. The researchers noted, "Physicians often do not discuss joint replacement surgery with elderly patients who might benefit." Fitness & Alzheimer'sAn article published in the July 15 issue of Neurology has found that increased cardiorespiratory fitness is associated with reduced brain atrophy in Alzheimer's disease patients. Those with early stage Alzheimer's who were less fit had four times more signs of brain shrinkage than those with early stage Alzheimer's who were fit. Discuss This ArticleHave something you'd like to say? Tell us what you think! Read and post comments for this article. Like this article? Read more! Browse our archive of 1,133 articles. Also, see our master index of all MedHunters articles! Find a JobChoose your career: MedHunters is the world's biggest healthcare job board. Our job directory has 17,260 jobs with 2,476 hospitals and other direct employers. We want you to find your next job on MedHunters. Need Help? Call us at 1-888-884-8242, email us at info@medhunters.com or sign up now. Have an article or story for MedHunters? Email us today at submissions@medhunters.com. |
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