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PREVENTION: Appointment time of physician office visits found to be associated with getting cancer screening tests

Patients with office visit times later in the clinic day were found to be less likely to receive orders for breast or colorectal screening tests in this study of 33 primary care practice sites.  Additionally, patients with appointments later in the day were found to be less likely to actually have the screening done within the following 12 months.  The authors suggest that as it gets later in the day, physicians may fall behind schedule which may contribute to shorter discussions with patients, among other factors.

Source:  Hsiang, E.Y., Mehta, S.J., Small, D.S., Rareshide, C.A.L., Snider, C.K., Day, S.C., and Patel, M.S. (2019). Association of primary care clinic appointment time with clinician ordering and patient completion of breast and colorectal cancer screening. JAMA Network Open, 2(5).  Click here for full text:  https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2733171  Posted by AHA Resource Center (312) 422-2050 rc@aha.org

 

How many physician office visits in U.S. each year?

In 2016, a total of 883,700,000 visits were made to office-based physicians in the U.S., according to newly released federal government estimates.  This represents 278 visits per 100 persons in the U.S.  Not surprisingly, children under one year old and the elderly had higher physician office visit rates than patients of other ages.  The payer mix for physician office visits was found to be:

  • 54 percent private insurance
  • 26 percent Medicare
  • 15 percent Medicaid
  •   3 percent no insurance

Source: Characteristics of office-based physician visits, 2016. (2019, January). NCHS data brief. 331. Click here for full text free: https://www.cdc.gov/nchs/data/databriefs/db331-h.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Drug Discount: Characteristics of Hospitals Participating and Not Participating in the 340B Program

The U.S. Government Accountability Office (GAO) released a report on the results of the study that analyzes the characteristics of hospitals that participate or do not participate in the 340B drug discount program. The GAO conducted this study due to the sixty percent increase from 2011 to 2016 in program participation, as well as the impact of Medicaid expansion on 340B participation.

The study was focused on three of the six hospital types, as they accounted for ninety five percent of U.S. hospitals participating in the 340B program. These three hospital types include:

  • Critical Access Hospitals (CAH)
  • Sole Community Hospitals (SCH)
  • General Acute Care Hospitals (Also Known As 340B DSH)

The full report can be found on the U.S. Government Accountability Office website, https://www.gao.gov/products/GAO-18-521R.

Posted by the AHA Resource Center, (312) 422-2050, rc@aha.org.

Average Cost of a Hospital Stay, Emergency Room Visit, Physician or Dental Office Visit, or Home Care Service

In 2014, the mean cost for a hospital stay was $13,450, with an average out-of-pocket expense of $351. That’s according to Medical Expenditures Panel Survey [MEPS] Household Component data available from the Agency for Healthcare Research and Quality.

An emergency room visit averaged $1,048 in 2014, with $95 of that in out-of-pocket expenses.

A hospital outpatient visit expense averaged $927 with a $54 out-of-pocket cost, while an office-based physician visit totaled $222 with $29 out-of-pocket. The mean out-of pocket expense for a dental visit was $132 of the total visit cost of $295.

Finally, home health care expenses averaged $1,454 per month for those who had the expense during the year.

MEPS data on household medical expenditures is also available for earlier years.

Source: Expenditures per event by health care service type. Medical Expenditures Panel Survey, Household Component summary tables, Agency for Healthcare Research and Quality, accessed Feb. 15, 2017 at https://meps.ahrq.gov/mepsweb/data_stats/quick_tables_results.jsp?component=1&subcomponent=0&year=-1&tableSeries=9&searchText=&SearchMethod=1&Action=Search

Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

New CDC Data on Emergency Department Use

The National Center for Health Statistics has just released updated numbers on emergency department use in the U.S. and the five most populous states Here are some key findings:

  • The national ED visit rate in 2012 was 42 visits per 100 persons.
  • The national percentage of ED visits resulting in an admission to the same hospital was 11%.
  • Nationwide, 63% of all ED visits were made by adults aged 18-64; children accounted for 21% of visits and the elderly 65 and over for 16%.
  • Private insurance was the expected primary source of payment for 29% of ED visits, and Medicaid or CHIP accounted for 25%.

Data is also available for California, Florida, Illinois, New York, and Texas.

Source: Hing E and Rui P. Emergency department use in the country’s five most populous states and the total United States, 2012. NCHS [National Center for Health Statistics] Data Brief, no. 252, June 2016.  https://www.cdc.gov/nchs/data/databriefs/db252.pdf

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

INCIDENCE: One lung cancer detected per every 65 screenings at OhioHealth program

The OhioHealth Lung Cancer Screening Program, implemented in mid-2013 and based on a low-dose chest CT scan, is described in this article.  A key part of this program is the team of oncology lung nurse navigators who accompany and guide the patient through the process.

I particularly wanted to note the incidence rate that they have encountered to date:

  • “Currently, the OhioHealth Lung Cancer Screening Program has diagnosed, on average, one lung cancer for every 65 screenings.  The statistic is a substantially higher ratio than the National Lung Screening Trial ratio of one in 320 screenings.”

Of the 16 patients found to have lung cancer in the OhioHealth program, 14 were at an early stage.

Sources:

[About the OhioHealth program]: Jansak, B. (2015, Nov.-Dec.). Expanding a comprehensive lung cancer screening program. Radiology Management, 37(6), 42-46.  Publisher’s website here: http://www.ahraonline.org/radiologymanagement

[Here is the earlier article about the National Lung Screening Trial]: The National Lung Screening Trial Research Team. (2011, Aug. 4). Reduced lung-cancer mortality with low-dose computed tomographic screening. The New England Journal of Medicine, 365(5), 395-409.  Click here for full text: http://www.nejm.org/doi/full/10.1056/NEJMoa1102873#t=articleResults  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

HOUSE CALLS: Smart phone apps and home visits

Entrepreneurs are developing businesses that will bring physicians or nurse practitioners to the home or workplace or other location where the patient is, based on smartphone apps.  Here are some of the new companies:

In the case of Mend, the charge for this service is discounted to $50 for the first visit and $199 for any subsequent visit (with college student and staff discounts available).  The nearest competitors would be retail clinics located in chain pharmacies and big box stores.

Sources: Goodman, M. (2015, Oct.). Urgent care goes Uber. D Magazine. Retrieved from http://www.dmagazine.com/publications/d-ceo/2015/october/urgent-healthcare-smartphone-services 

Jolly, J. (2015, May 5). An Uber for doctor housecalls. The New York Times. Retrieved from http://well.blogs.nytimes.com/2015/05/05/an-uber-for-doctor-housecalls/?_r=0  Posted by AHA Resource Center (312) 422-2050, rc@aha.org