Case management influences hospital financial stability
December 1st 2007Case management is critical to help measure a hospital's success in quality care and financial stability. As noted by the Case Management Society of America, a case manager must be an advocate for both hospital and patient.
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Elevating to ICD-10: It may be a great fit for healthcare
December 1st 2007The World Health Organization's latest version of the International Classification of Diseases and Related Health Problems (ICD) will bring "the good, the bad, and the ugly" for nearly all who use this classification system. However, the biggest asset is that the latest version is much more detailed and organized than ICD-9.
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Quality and cost (SIDEBAR to Executive Profile, Dec. 2007)
December 1st 2007An important component of the legislation that has not received a lot of press to date has been the Health Care and Quality Cost Council (HCQCC) which was established by the same health reform law that created the Connector.
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Mail-order pharmacy steps up patient services
December 1st 2007What works for retail pharmacy patients should work for mail-order recipients, namely, personalized drug counseling. When consumers pick up their prescriptions at a local pharmacy, they have access to pharmacists who can advise them on how and when to take medications, warn them of potential side effects and discuss generic alternatives.
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Cost effectiveness can be part of benefit judgments
December 1st 2007For payers struggling with unmanageable cost increases in the business of delivering care, however, price cannot be overlooked. Insurers don't necessarily deny coverage of a treatment just because it's expensive, but they would be remiss if they didn't take cost into consideration, as well as safety and effectiveness.
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Making the Connection: Commonwealth Connector's Jon Kingsdale
December 1st 2007Perhaps it's no coincidence that former historian Jon Kingsdale, PhD, finds himself overseeing one of the most progressive healthcare initiatives in the country, the Massachusetts Commonwealth Health Insurance Connector Authority. The Connector facilitates the purchase of health insurance for individuals and small businesses across New England.
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Understand choice, implications of law principles
December 1st 2007Choice of law issues arising from coverage disputes of both individual and group insurance policies many times determine which party will prevail on the merits of a particular case. Also, in today's mobile economy, insurance transactions frequently cross state boundaries.
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Consumer-driven pharmacy plans must focus on compliance and safety
December 1st 2007A recent survey by the Employee Benefit Research Institute found that 70% of those enrolled in consumer-directed health plans (CDHP) say that they consider costs when deciding to see a doctor or filling a prescription as compared with fewer than 40% of those in a comprehensive plan. However, the survey also found that CDHP enrollees were twice as likely to avoid, skip or delay healthcare services.
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Study: Side effects not major reason for statin discontinuation
November 7th 2007Persistence with statins is only approximately 50% by 12 months after therapy is started, with Spanish-speaking patients at highest risk of discontinuing therapy, said Michael H. Davidson, MD, during the American Heart Association Scientific Sessions, Nov. 3-7, 2007, in Orlando.
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Two new studies presented during the American Hospital Association Scientific Sessions, Nov. 3-7, 2007, in Orlando, could speed the replacement of abciximab by eptifibatide in cardiac patients. EVA-AMI showed similar outcomes between the two drugs when used in percutaneous coronary intervention (PCI) and BRIEF-PCI showed that a two-hour infusion of eptifibatide can be as effective as the standard 18-hour course following uncomplicated PCI procedures.
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Antiplatelet reduces cardiac events in PCI
November 7th 2007Prasugrel, a new antiplatelet agent in Phase 3 clinical trials, is superior to clopidogrel in preventing major adverse cardiac events in patients undergoing percutaneous coronary intervention (pCI), but is associated with an increase in the risk of major bleeding.
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Real-time genotype-based warfarin dosing feasible, but not linked to fewer out-of-range INRs
November 7th 2007Real-time pharmacogenetic-guided dosing of warfarin does not lead to a reduction in prothrombin time international normalized ratios (INRs) out of the therapeutic range compared with standard warfarin dosing, although it did lead to smaller and less frequent warfarin dosing changes, reported Jeffrey L. Anderson, MD.
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Statin has no effect on cardiovascular outcomes in advanced systolic heart failure
November 7th 2007In older patients with advanced systolic heart failure, rosuvastatin added to standard heart failure medications failed to significantly reduce incidence of a composite of cardiovascular death, nonfatal myocardial infarction (MI), and nonfatal stroke compared with placebo, although it did reduce the incidence of all-cause and cardiovascular-related hospitalizations.
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Parkinson disease (PD) is a chronic, progressive neurodegenerative disorder affecting approximately 1% of people aged >60 years. Levodopa has long been the cornerstone of PD treatment, but many patients receiving long-term levodopa therapy experience dyskinesia and motor fluctuations. Dopamine agonists act directly on dopamine receptors and are associated with a lower incidence of dyskinesias. There are 2 subclasses of dopamine agonists: ergot-derived and nonergot-derived. The use of ergot-derived dopamine agonists has declined in recent years due to the agents' association with valvular heart disease. Nonergot-derived dopamine agonists such as ropinirole and pramipexole are used more widely in the treatment of PD. Rotigotine is a nonergot-derived dopamine agonist that was approved by FDA on May 9, 2007, for the treatment of early-stage idiopathic PD. Rotigotine is the first approved nonergot-derived dopamine agonist that is delivered continuously through a transdermal silicone-based patch that is replaced..
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Adding prostaglandin blocker to niacin ER reduces flushing without compromising effects on lipids
November 1st 2007An investigational drug that combines niacin extended-release (ER) and laropiprant, a prostaglandin D2 receptor antagonist, reduces the flushing that often leads to niacin ER discontinuation while preserving the agent's beneficial effects on lipids, according to lead author Darbie Maccubbin, PhD, Merck Research Laboratories, Rahway, New Jersey, et al. The results of this research were presented at the European Society of Cardiology Congress 2007 in Vienna, Austria, September 1 to 5, 2007. The drug is pending FDA approval.
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In a randomized, controlled, open-label trial in patients with peripheral arterial disease (PAD), it was demonstrated that antiplatelet therapy plus an oral anticoagulant was no better at preventing major cardiovascular complications than antiplatelet therapy alone. The combination therapy was also associated with a significant increase in life-threatening bleeding complications compared with monotherapy.
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