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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

CONSUMER CHOICE: Nearly half of patients who need elective surgery bypass their local rural hospital for care

The bypass rate for elective surgical procedures at rural CAHs is 48.3%, similar to other estimates on surgery-related bypass.  This rate indicates that rural CAHs are losing a significant portion of people with surgical needs in their community to outside hospitals, thereby affecting their ability to continue offering other services in their community.”

The number of patients who chose to travel for elective surgical procedures, bypassing a closer critical access hospital, was studied based on 2011 data for four states: Colorado, North Carolina, Vermont and Wisconsin.  Patients who were found to be more likely to bypass the small local hospital included those undergoing elective orthopedic, ophthalmology, and digestive system procedures.

Source: Weigel, P.A.M., and others. (2017, Spring). Rural bypass for elective surgeries. Journal of Rural Health, 33(2), 135-145.  Click here for access to publisher’s website: http://onlinelibrary.wiley.com/wol1/doi/10.1111/jrh.12163/full  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

EMERGENCY DEPARTMENTS: New capacity metric finds 6 ED beds per 10,000 ED visits in California hospitals

Our novel metrics capturing both supply of beds and visit demand demonstrate that recent trends of hospital supply may be insufficient to keep pace with growing ED patient demand and evolving, complex medical conditions.”

The change in supply of emergency department facilities and in demand for emergency care in California hospitals from 2005 to 2014 was studied using data from the California Office of Statewide Health Planning and Development (OSHPD).  The total number of ED visits in California increased by about one-third over this ten-year period, reaching a total of over 13 million visits in 2015, or 342 ED visits/1,000 population.  The number of emergency departments in California remained about the same – 339 facilities in 2014 – but the number of ED beds increased about 30 percent to 7663 in 2014.

The researchers developed a new metric – ED bed supply per ED visit.  Over the ten-year study period, there was a small decrease of about 4 percent in this metric.  It was roughly 6 ED beds per 10,000 ED visits in both 2005 and 2014.

Sources:

Chow, J.L., Niedzwiecki, M.J., and Hsia, R.Y. (2017, May 11). Trends in the supply of California’s emergency departments and inpatient services, 2005-2014: A retrospective analysis. BMJ Open, 7(5).  Click here for free full text: http://bmjopen.bmj.com/content/bmjopen/7/5/e014721.full.pdf

For more information on OSHPD data, click here: https://www.oshpd.ca.gov/HID/

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

POPULATION HEALTH: How many diabetics in 2030?

The team finds that in spite of medical advances and prevention efforts, diabetes presents a major health crisis in terms of prevalence, morbidity, and costs, and that this crisis will worsen significantly over the next 15 years.

An estimated 54.9 million people will have diabetes in the U.S. in the year 2030, compared to 35.6 million in 2015, according this study from the Institute for Alternative Futures.  This represents a 54 percent increase.  The prevalence of diabetes will represent a cost to the nation of over $622 billion in 2030 (calculated in 2015 dollars), up from roughly $408 billion in 2015.  Maps included in the article show some clustering projected for 2030 – states with higher proportions of diabetics are in the southeast, southwest, and Rust Belt regions.

Source: Rowley, W.R., and others. (2017, February). Diabetes 2030: Insights from yesterday, today, and future trends. Population Health, 20(1), 6-12.  Click here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5278808/pdf/pop.2015.0181.pdf.  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

BEST PRACTICES: Implementing a quality improvement bundle for care of high risk infants in the delivery room

This was a case study of 548 high-risk infants born 2010 to 2012 at Palomar Medical Center (Escondido, CA) who were then transferred to the neonatal intensive care unit at Palomar Rady Children’s Hospital (San Diego).  About half of the infants were born before implementation of an quality improvement project intended to standardize delivery room management – a preintervention group.  The merits of each of the changes in practice – such as a significant decrease in intubation – are discussed.  A delivery room checklist is included.

Source: Sauer, C.W., and others. (2016, November 16). Delivery room quality improvement project improved compliance with best practices for a community NICU. Scientific Reports, 6, 37397.  Click here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5116615/pdf/srep37397.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

POPULATION HEALTH: Trends in heart disease and cancer death rates by county shows geographic clusters in U.S.

Thirty years ago researchers first noted an ‘enigma of the Southeast’ with high mortality rates in that region, often due to stroke, and a range of possible causes including environmental exposures related to coal and metal mining, housing and population density, and access to health care.”

Death rates from different types of cardiovascular disease and 29 types of cancer were studied at the county level for the entire U.S. in these related articles out of the University of Washington’s Institute for Health Metrics and Evaluation.  Extensive variation was found in death rates between counties and some degree of clustering was found.  For example, there is a cluster of counties with high death rates from ischemic heart disease on a line between central Oklahoma and eastern Kentucky and also along the Mississippi River valley – although there were also counties with high mortality in other parts of the country.  Death rates from stroke and hypertension were found to be concentrated in the South.  Counties with higher rates of breast cancer death were found to be along the Mississippi River and in the South.  High death rates from lung and related cancers were found to be clustered in Kentucky and West Virginia.  Again, in each of these categories, there are also counties with high mortality rates in other parts of the country.

NOTE: There is also information in these articles about areas of the country where the mortality rates were found to be unusually low.

Sources:

Roth, G.A., and others. (2017, May 16). Trends and patterns of geographic variation in cardiovascular mortality among US counties, 1980-2014. JAMA, 317(19), 1976-1992. Click here: http://jamanetwork.com/journals/jama/fullarticle/2626571?resultClick=3

Mokdad, A.H., and others. (2017, January 24). Trends and patterns of disparities in cancer mortality among US counties, 1980-2014. JAMA, 317(4), 388-406.  Click here: http://jamanetwork.com/journals/jama/fullarticle/2598772  Posted by AHA Resource Center (312) 422-2050, rc@aha.org