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The perils of picking the wrong hospital


The New York Times summarized the findings of an important and alarming new comprehensive study:

“Researchers have found that patients at the worst American hospitals were three times more likely to die and 13 times more likely to have medical complications than if they visited one of the best hospitals.”

The study,  in the academic journal PLOS One, shows “there is considerable variation in outcomes that really matter to patients, from hospital to hospital, as well as region to region,” Dr. Thomas H. Lee, M.D., a longtime healthcare executive not involved in the research, told The Times.

The Times reported that “The study’s authors looked at 22 million hospital admissions, including information from both the federal Medicare program and private insurance companies, and analyzed them using two dozen measures of medical outcomes. Adjusting the results for how sick the patients were and other factors, like age and income, the researchers discovered widespread differences among hospitals. Even a hospital that had excellent outcomes for heart care might have poor outcomes in treating diabetes.”

To read the study, please hit this link.

To read The New York Time’s article on it, please this link.

Study cites weak care transition for young diabetics


MedPage Today reports on a troubling lack of coordination “between providers treating young adults with type 1 diabetes transitioning from pediatric to adult care, along with inadequate access to mental-heath providers for referral of young-adult patients.”
“Just one-third of nonpediatric endocrinologists surveyed reported having access to their transitioning patients’ pediatric records, even though three out of four felt that reviewing these records was important.”

Katharine Garvey, M.D., MPH, and colleagues from Boston Children’s Hospital wrote in the journal Diabetes Care that “Fewer than 15% of responding endocrinologists reported having a phone conversation or email exchange with their young adult patient’s pediatric diabetes provider or receiving a formal transition medical summary.”






For ‘deintensification’ of old folks’ healthcare

Researchers in Michigan have found that accumulating evidence suggests that older adults with diabetes, hypertension and some other conditions associated with aging  should receive less aggressive treatments than they have usually been getting.

“In our healthcare system, we are all more scared of failing to do something than of doing too much,”  Jeremy Sussman, M.D., a primary-care physician and research scientist at University of Michigan and the Veterans Affairs Ann Arbor Healthcare System, told The New York Times.

The New York Times reported that a large national study by Dr. Sussman and his colleagues, published last month in JAMA Internal Medicine, revealed how rarely “deintensification” of treatment occurs among patients over age 70. The habit in medicine continues to be to over treat more than under treat.

Diabetes treatment needs ‘disruptive innovation’


The universal symbol for diabetes.

This piece from the Commonwealth Fund identifies the financial, institutional and regulatory-policy barriers that have hindered the diffusion of diabetes-care innovations  and other successful healthcare innovations through accountable-care reforms.

The authors conclude that “disruptive innovation” in diabetes care is essential in the fight against this costly global disease.

CDC targets elderly in diabetes program


Video and text: The Centers for Disease Control and Prevention is targeting older people in a drive to prevent and control diabetes.

The agency notes:

“These past few years we have been setting up the National Diabetes Prevention Program (DPP). It has caused us to work with a variety of groups and a variety of populations. The original DPP research study demonstrated that the intervention is even more effective in patients older than 60 years of age. It is 58 percent effective for the general population and 71 percent effective for those older than 60 years of age. This is certainly a population that will benefit from this intervention. To that end, the Centers for Medicare & Medicaid Services has given out some grants to help study this.”

Given how bad diabetes is in itself and how associated  it is with other life-threatening and expensive ailments, most people will applaud this initiative.



Geriatrician argues for lower Medicare age


Americans are living longer, so why not lower the eligibility age for Medicare?

That prescription might sound  paradoxical: Rising longevity often is used as an argument for delaying Medicare eligibility past age 65. However, one of America’s top  geriatricians  thinks that Medicare should start covering preventive healthcare when we turn 50.

Dr. Linda Fried, dean of the Mailman School of Public Health at Columbia University, says that Medicare should start covering preventive healthcare for everyone when they turn 50, Reuters reports.

She argues that could help people not just live longer, but enjoy more healthy years, while saving Medicare money on treatment of  seniors’ chronic illnesses.

Her argument is founded on the idea that age 50 to 65 is the period of greatest risk of disability because of  cancer, heart disease and stroke, obesity and diabetes.









A chronic-care success in Pennsylvania


The  Pennsylvania Chronic Care Initiative, which enrolled more than 150 primary-care practices in its multiple regional collaboratives, has provided data management for all practices and interventional services for low-performing ones.

Participating practices achieved excellent results, including:

  • “Decreasing the percentage of patients with diabetes (DM) in participating practices who have an A1C measure of greater than 9% from 33% to 20% (target: <5 %).
  • “Increasing the percentage of patients with DM in participating practices whose BP is documented in the past year < than 130/80 mm Hg from 40% to 49% (target: >70%).
  • “Increasing the percentage of patients with DM in participating practices with LDL < 100 mg/dl from 38% to 50% (target: >70%).
  • “Increasing the percentage of patients with DM in participating practices who have a self-management goal documented within the past 12 months from 33% to 62% (target: >90%).”

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