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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

 

BCBS Association: The Health of America Report Understanding Health Conditions Across the U.S.

In partnership with Moody’s Analytics, the Blue Cross Blue Shield Association has published a report on understanding health conditions across the U.S. The report sets out to address these questions:

  • Why are some communities healthier than others?
  • Which factors are most important in keeping a population healthy: economics, healthy behaviors, or access to quality care?
  • How does the importance of these factors change when measuring different health conditions?

The report analyzes and scores the impact of population demographics, socio-economic factors, healthy behaviors, and access to care and other health care considerations for each of the following conditions:

  • Substance abuse
  • Depression
  • Hypertension
  • High cholesterol
  • Coronary artery disease
  • Chronic obstructive pulmonary disease (COPD)
  • Hyperactivity
  • Breast cancer
  • Lung cancer

Source: Blue Cross Blue Shield Association: Health of America Report-Understanding Health Conditions across the U.S. December, 2017. https://www.bcbs.com/sites/default/files/file-attachments/health-of-america-report/BCBS.HealthOfAmericaReport.Moodys_02.pdf.

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

Investing in social services as a core strategy for health organizations: developing the business case

Social determinants of health — economic stability, neighborhood and physical environment, education, food, transportation, community and social context — can all impact health outcomes. With the growing emphasis on population and community health, how do hospitals and health systems make the business case for investing in social services to improve the health of their patients and communities?

A new report from the KPMG Government Institute focuses on building the business case for social services investment by healthcare organizations of all types. After defining social services investment and its common barriers, the guide focuses on these six steps:

  1. Identifying what to invest in
  2. Determining what success is by selecting the care outcomes
  3. Measuring costs of care
  4. Determining the appropriate investment model
  5. Setting up the return on investment approach
  6. Sensitivity analysis and investment kick-off

The appendices include several short business case examples from different types of healthcare organizations.

Source: Investing in social services as a core strategy for healthcare organization: developing the business case – a practical guide to support health plan and provider investments in social services. March. 2018. http://www.kpmg-institutes.com/ content/dam/kpmg/governmentinstitute/pdf/2018/investing-social-services.PDF. Also available from the Commonwealth Fund at http://www.commonwealthfund.org/~/media/files/publications/other/2018/investingsocialservices_pdf.pdf

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

POPULATION HEALTH: Kaiser Permanente innovative model

Kaiser Permanente Oakland Medical Center is collaborating with the UC Berkeley School of Public Health in offering a population-health focused residency program.  The program is small – there are two degrees being offered and only two residents matched into each of the programs each year.  Two residents are in an Internal Medicine-Masters in Public Health (MPH) track and the other two are in a Pediatrics MPH track.  There have been a total of 16 program graduates so far.

Source: Lo, J.C., and others. (2017). Innovative partnerships to advance public health training in community-based academic residency programs. Advances in Medical Education and Practice. 8, 703-706. Click here for full text: https://www.dovepress.com/innovative-partnerships-to-advance-public-health-training-in-community-peer-reviewed-article-AMEP  Posted by AHA Resource Center, (312) 422-2003 rc@aha.org

POPULATION HEALTH: How many complex patients?

Data on complex patients are provided based on an analysis done by PricewaterhouseCoopers of data collected in the federal government’s 2013 Medical Expenditure Panel Survey.  The following are some national counts of patients, “visits” are not defined in the text:

  • 24.7 million people are complex chronic patients (average of 13 visits each year)
    • 4.9 million of these are complex chronic patients who are top spenders (average of 29 visits each year)
      • 2.9 million of these have asthma or chronic obstructive pulmonary disease (average of 30 visits each year)

Source: PricewaterhouseCoopers. (2016, May). Population health: Scaling up. Health Research Institute Spotlight. Click here: http://www.pwc.com/us/en/health-industries/health-research-institute/publications/pdf/pwc-hri-population-health.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

POPULATION HEALTH: 678,383 ESRD patients in US (2014)

Each year, there are about 120,000 patients newly diagnosed with end stage renal disease (ESRD) and this number has been rising steadily.  Here are the exact counts of incidence – that is, new cases treated in the U.S.:

  •   77,018 new ESRD cases in 1996
  •   94,662 new cases in 2000
  • 106,662 new cases in 2005
  • 115,920 new cases in 2010
  • 120,688 new cases in 2014

The prevalence of end stage renal disease – the total number of patients who are living with the disease at any given point in time – has more than doubled during the 1996 to 2014 time period.  Here are the exact prevalence counts:

  • 303,311 total ESRD cases in 1996
  • 390,158 total cases in 2000
  • 484,935 total cases in 2005
  • 591,776 total cases in 2010
  • 678,383 total cases in 2014

What kind of treatment do ESRD patients receive?

Looking at the entire population of patients with end stage renal disease, about two-thirds are on hemodialysis – usually received in a dialysis center.   Another seven percent are on peritoneal dialysis.  The balance (30 percent) have received a kidney transplant.  These percentages are based on 2014 data.

Geographic differences

There are substantial differences in the incidence of kidney failure in different parts of the country.  Areas with the highest rates of new end stage renal disease patients include Texas and Southern California, while New England states have the lowest rates.

Source: United States Renal Data System. (2016). Incidence, prevalence, patient characteristics, and treatment modalities. In Annual data report 2016: Epidemiology of kidney disease in the United States. (Vol. 2, Chapt. 1). Ann Arbor, Michigan: USRDS Coordinating Center. Click here for free full text https://www.usrds.org/adr.aspx  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

 

CANCER: 5-year survival rate improves in recent decades

Survival improved substantially over this time period for both whites and blacks overall (all sites) and for almost all cancer types…”

The overall five-year survival rate for cancer patients has improved in the past 40 years, according to national data in this fact-packed, scholarly article.

Looking at the more treatable cancers, here are the top five with the highest survival rates, based on recent data:

  • Prostate (99.3 percent five-year survival rate)
  • Thyroid (98.3 percent)
  • Skin (93.2 percent)
  • Breast (90.8 percent)
  • Uterine (83.4 percent)

Source: Jemal, A., and others. (2017). Annual report to the nation on the status of cancer, 1975-2014, featuring survival. Journal of the National Cancer Institute, 109(9).  Click here for free full text: https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djx030  Posted by AHA Resource Center (312) 422-2050 rc@aha.org