The week in review, November 25 - December 1, 2012
medwireNews: This week's stories include: insurance status and brain surgery outcomes; the bargain of state Medicaid expansion; alarming HIV infections in youth; cautionary views of mammogram guidelines; and fulfilling electronic health record obligations.
Coverage equals better outcomes
The Centers for Disease Control and Prevention (CDC) report that insurance coverage is strongly related to better health outcomes.
According to the CDC, this trend stems from the considerable and persistent health gap that currently exists in the USA between those who have health insurance and those who do not - a division that does not follow demographic or socioeconomic trends.
A recent study looking at the hospital mortality rates of patients who undergo brain surgery corroborates with this partition; patients without insurance are at a higher risk than those who are covered.
Insurance-related disparities have been seen in critical illness, stroke, and physical trauma situations as well.
Not a bad deal after all
The June 2012 Supreme Court decision to uphold the Affordable Care Act (ACA) leaves states to decide whether to adopt Medicaid expansion, which will have a large impact on health coverage for the low-income population.
A Kaiser Family Foundation analysis of Medicaid costs at the federal and state level shows that expansion will vary by state, based on their current coverage level and the number of uninsured in the population.
Altogether, the cost of Medicaid expansion will be modest compared with the federal funds that will be injected into the program - with some states even saving a modest amount of money.
CDC: focus on youth and HIV
According to the CDC, approximately 50,000 people are infected with HIV each year in the USA. One in four of these infections occur in 13 to 24 year olds.
The CDC points out that most of the HIV risk among young, at-risk individuals hinges on when they become sexually active or start injecting drugs. It is at this point that communicating how HIV is transmitted and prevented as well as the common risk factors becomes crucial.
The CDC says that while 1000 youths are getting infected with HIV per month, and 60% do not know they are infected, this equates to a call for action.
The nuances of mammograms
In 2009, the US Preventative Task Force (USPSTF) revised mammogram guidelines.
The changes, which generally apply to women with an average risk for breast cancer, stated that screening should be biannual, beginning at the age of 50 years. The amendments also stated that doctors should avoid teaching women to do breast self-examinations and that there is insufficient evidence showing any health advantages in screening women age 75 years and older.
Two studies presented at Radiological Society of North America's annual meeting found cause for caution with regard to these changes.
For quite some time, the healthcare system has been in need of an update as providers are bogged down by outdated and time-consuming paperwork.
To streamline and better integrate care with less redundancy, the government established an incentive program for electronic health records (EHR).
Healthcare professionals, including physicians, dentists, podiatrists, and chiropractors, as well as various hospitals are eligible to take part in the program and receive payments to incorporate a certified form of EHR system. They must also show that they are using the system in a way that will lead to improved healthcare quality and efficiency.
But confirming that health professionals and hospitals are meaningfully using EHR needs to be made more foolproof, according to the Department of Health and Human Services.
By Peter Sergo, medwireNews Reporter