Planning can help home health agencies thrive in the era of P4P
November 1st 2006Pay-for-Performance (P4P) provides home health agencies an opportunity to show their value and expertise to the healthcare industry. The primary goal of home health has always been to educate the client and family on how to proactively manage a chronic illness and avoid the reoccurrence of an acute illness. Home health nurses are the eyes and ears of the physician, often recommending modifications to the plan of care based on their knowledge of the patient's medical condition and home environment. With the advancement of healthcare technologies and pending P4P regulations, this knowledge becomes a more important basis for assessing patient and family compliance to care recommendations.
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Less CABG bleeding observed with enoxaparin compared with unfractionated heparin after PCI
October 1st 2006A 0.5-mg/kg dose of a low molecular weight heparin, enoxaparin, resulted in less non-coronary-artery bypass grafting (CABG) bleeding compared with unfractionated heparin in the first 48 hours after elective percutaneous coronary intervention (PCI), according to a prospective, open-label, multicenter, randomized trial reported in the New England Journal of Medicine.
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Intensive lipid lowering with high-dose 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) provides a significant benefit over standard-dose statin therapy in preventing nonfatal cardiovascular outcomes and also may reduce the incidence of cardiovascular death, according to results of a meta-analysis published in the Journal of the American College of Cardiology.
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Intensive lipid lowering with high-dose 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) provides a significant benefit over standard-dose statin therapy in preventing nonfatal cardiovascular outcomes and also may reduce the incidence of cardiovascular death, according to results of a meta-analysis published in the Journal of the American College of Cardiology.
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An angiotensin receptor blocker (ARB) valsartan-based regimen offered advantages over a calcium channel blocker (CCB) amlodipine-based regimen in preventing heart failure (HF) and diabetes in patients with hypertension, according to results of an analysis published in Hypertension.
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Von Eschenbach closer to approval as FDA head; CMS Administrator McClellan departing
October 1st 2006Although acting FDA Commissioner Andrew von Eschenbach, MD, has been on the job since September 2005, it was only last month that he received approval from the Senate's Health, Education, Labor and Pension (HELP) committee for his nomination as FDA commissioner to be considered by the full Senate. However, the step was an incremental one at best for Dr von Eschenbach and the agency, which has been without an officially appointed commissioner for all but 18 months over the past 5? years.
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Isotretinoin may trigger IBD in subgroup of patients
October 1st 2006A review of adverse event data associated with the synthetic vitamin A retinoid isotretinoin between 1997 and 2002 suggests that the acne treatment is a "probable" cause of inflammatory bowel disease (IBD) and may precipitate its presentation within a certain subset of patients who are either predisposed to the disease or have subclinical symptoms.
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An ointment containing calcipotriol (50mcg/g) plus betamethasone diproprionate (0.5mg/g) demonstrated significant efficacy against psoriasis within 4 weeks compared with 12 weeks of biological therapy, regardless of disease severity, as measured by the Psoriasis Area and Severity Index (PASI), according to a meta-analysis recently reported in the International Journal of Dermatology.
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Atorvastatin reduced the overall incidence of strokes and cardiovascular events in patients without known coronary disease who had recently experienced a stroke or a transient ischemic attack (TIA), according to a randomized, placebo-controlled, double-blind study of 4,731 patients. Results from the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) study, however, also demonstrated an increase in the incidence of hemorrhagic strokes among those receiving atorvastatin compared with placebo.
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Effect of a medication assistance program on clinical outcomes in patients with diabetes
October 1st 2006Approximately 17 million people in the United States have type 2 diabetes, and the prevalence continues to rise.1 More than 45% of patients with end-stage renal disease have type 2 diabetes as an etiology, and a patient with type 2 diabetes has the same risk of developing an acute coronary syndrome (unstable angina, myocardial infarction [MI]) over the next 10 years as someone who has had an acute coronary syndrome in the past.2 In addition to these complications, type 2 diabetes also increases the risk of blindness, neuropathy, and amputation.3
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Drug-eluting stents: Emerging efficacy and safety data and clinical considerations
October 1st 2006Drug-eluting stents (DES) represent an innovative application of pharmaceutical technology that has piqued the interest of hospital and managed care decision-makers. Since their introduction to the US market in 2004, the sirolimus- and paclitaxel-eluting stents have featured drugs employing different mechanisms of action to reduce the risk of restenosis following percutaneous coronary intervention (PCI) in an attempt to improve cardiovascular outcomes.
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Vildagliptin: A dipeptidyl peptidase-IV inhibitor for the treatment of type 2 diabetes
October 1st 2006Despite the variety of medications available to treat type 2 diabetes, the disease is inadequately controlled in many patients. In order to improve glycemic control, manufacturers are pursuing compounds that affect the incretin hormones that stimulate insulin release in response to increased glucose levels. Although stimulation of the incretin receptors by the glucagon-like peptide-1 (GLP-1) enhances the body's ability to produce insulin in response to elevated blood glucose concentrations, the clinical usefulness of GLP-1 is limited by its rapid degradation by dipeptidyl peptidase-IV (DPP-IV). Drug companies have developed compounds intended to act as inhibitors of DPP-IV. Vildagliptin (Galvus, Novartis) is the second DPP-IV inhibitor under investigation by FDA to offer this new mechanism to achieve glycemic control. An NDA for vildagliptin was submitted to FDA in March 2006, 1 month after the submission of the first DPP-IV inhibitor, sitagliptin.
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National Reports-New Orleans officials recently announced that they believe the city has reached half of its previous population prior to Hurricane Katrina. Some of the city's hospitals have not reopened, and many doctors and allied health professionals have not returned to the city.
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National Reports-New Orleans officials recently announced that they believe the city has reached half of its previous population prior to Hurricane Katrina. Some of the city's hospitals have not reopened, and many doctors and allied health professionals have not returned to the city.
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There is a growing records management crisis in the world of healthcare. Hospitals are awash with paperwork, as legal, payer and regulatory requirements steadily generate an increasing number of documents per patient visit. Unfortunately, most healthcare information technology (HIT) systems are wholly inadequate to meet these growing documentation requirements.
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The immeasurable value of EMRs for improved patient care
October 1st 2006Among large physician practices and acute care facilities, physicians and healthcare executives widely recognize the value of electronic medical records (EMRs). However, physicians at small or individual practices are just beginning to use the technology, noting high implementation costs as a deterrent.
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Healthcare as a business model defies many typical economic principles, making forecasting somewhat difficult. The federal government is expecting 2006 to end with a slight reduction in healthcare cost growth over last year, and for 2007 to end with a lower growth rate than the previous two years. With an aging population, advances in medical technology and increased utilization, growth is expected to hover at about 7.2% per year.
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Keeping watch: Senator Charles Grassley champions choices provided by competitive plans
October 1st 2006According to Senator Charles (Chuck) Grassley, the Medicare Modernization Act of 2003 (MMA) has worked out better than expected, but he still keeps a close watch to ensure healthcare dollars are well spent. As chairman of the Senate Finance Committee, Grassley has tremendous clout in Washington. His committee is responsible for tax policy, Social Security, Medicare and Medicaid, which made him a central player in developing and enacting MMA.
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