NEWS & TRENDS

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IS THERE A NURSE IN THE HOUSE?

The shortage of registered nurses could be deadly for patients — and there are some 126,000 vacant nursing jobs. That could expand to 400,000 by 2020, partly because only 12 percent of current RNs are under age 30. What's more, 90 percent of nursing homes report not having enough nurses to maintain basic patient care. A report by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) says that nursing staff shortages were a factor in one out of four patient deaths and injuries since 1996.

JCAHO also reported that nursing shortages cause emergency department overcrowding, elective surgery cancellations, clinical service discontinuation and a limited ability to respond to mass casualties. The Commission's proposed solutions include positively transforming the nursing workplace to foster empowerment and respect of nursing staff (as well as adopting zero-tolerance policies for abusive behaviors by health care practitioners and diversifying the nursing workforce), creating a clinical foundation for nursing educational preparation and advancement, and providing financial incentives for health care organizations to invest in high-quality nursing care. Click here for the full report. And be sure to read the latest What We Think for Managing Director, and former editor and publisher of RN magazine, Rick Service's take on the problem.

The JCAHO also just released new national safety patient goals to help reduce errors and save lives. The six goals focus on confusion in identifying patients, miscommunication among caregivers, wrong-site surgery, infusion pumps, medication mix-ups and clinical alarm systems. Starting January 1, more than 17,000 JCAHO-accredited health care organizations will be evaluated for compliance with the group's new recommendations.

Affordability, not access, is the most likely reason why employees lack health insurance, says Harvard economist David Cutler in his 2002 report, "Employee Costs and the Decline in Health Care Coverage." Amid rising premiums, he notes, the percentage of employees offered benefits remained at 80 percent between 1987 and 2000.

GENERIC DRUGS: A STANDOFF AND A JUMP START

After a whole lot of talk, Congress broke for the summer without weakening drug manufacturers' ability to stave off generic competition for their patented brands. Bolstered by a Federal Trade Commission report that at least eight generic drugs have been delayed in getting to market over the past decade, some lawmakers were seeking to amend the Hatch-Waxman Act. That 1984 law gave drug makers an extra 30 months of exclusivity when they filed a new patent on an existing drug. Critics charge the manufacturers with repeated overuse to foil competition. The Senate passed legislation limiting drug company options in delaying consumer use of generic counterparts, which leaves things in the hands of the House.

Meanwile, AdvancePCS is hoping to boost support for generic drugs with a new plan that goes a step beyond tiered co-payments. The company is encouraging the use of low-cost generics by waving the initial co-pay for new prescriptions. The pharmacy benefits manager's new program, AdvanceGenerics, will offer patients vouchers that let them fill their first Rx for a generic drug for free.

Alzheimer's caregivers miss work and lose their jobs more than the norm, according to research presented at the recent International Conference on Alzheimer's Disease and Related Disorders in Stockholm. Their caregiving consumes an average 46 hours a week, but 38 percent still work full-time. Sixteen percent missed 10 or more days of work. Over half have lost jobs, retired early or become part-timers. Employees can visit www.caregiver.org for resources.

LET THE BENEFITS BUYER BEWARE

Secretary of Labor Elaine Chao recently warned employers about an increased marketing of fraudulent health insurance plans. Scam promoters are aggressively going after small businesses, disguising themselves as federally regulated employer trusts, labor unions or religious organizations that can offer premiums due to exemptions from state insurance regulations.

Currently, the Department of Labor has recovered about $116 million through 478 civil and criminal investigations into multiple employer welfare arrangements (MEWAs) that have affected 1.75 million participants and their families.

The DOL offers a number of tips to protect employers: Always compare benefits and costs of multiple products. If one seems much cheaper for the same benefit, ask questions. Confirm that the seller is a licensed insurance agent with a proven record of reliability. Contact your Regional Office of the Pension and Welfare Benefits Administration (toll-free hotline: 1-866-275-7922) to report any issues. Visit the DOL web site for more tips.

Age is all in the mind, according to a study in August's Journal of Personality and Social Psychology. After studying a group of 660 people 50 and older for more than 20 years, researchers found that people with "positive self-perceptions" lived an average of 7 1/2 years longer than others.

SUBSTANCE ABUSE: OVER 1 MILLION SERVED

Pick a day, any day, and chances are that roughly 1 million people are being treated for drug or alcohol addiction — nine out of 10 in outpatient settings — according to the 2000 National Survey of Substance Abuse Treatment Services recently released by the Substance Abuse and Mental Health Services Administration (SAMHSA).

The study — involving over 13,000 facilities — revealed that 48 percent were in treatment for both alcohol and drug abuse, with 29 percent receiving only drug abuse treatment and 23 percent alcohol abuse treatment. Outpatient rehabilitation was the most widely available type of care, with non-intensive outpatient rehabilitation offered by 78 percent of all facilities and intensive rehabilitation offered by 46 percent. Residential rehabilitation was offered by 26 percent, followed by partial hospitalization programs at 16 percent and outpatient detoxification at 13 percent.

Over half (54 percent) of all facilities had managed care contracts in 2000, as opposed to some 42 percent back in 1996. The bulk of the system in 2000 was made up of private non-profit facilities (60 percent), followed by private for-profit (26 percent) and state/local government (11 percent).

More employees are getting oral contraceptive coverage in their health plans according to the 2002 Kaiser/HRET Survey of Employer Health Benefits. This year, 78 percent of covered workers have coverage for oral contraception, as opposed to 64 percent in 2001.

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