Today’s Top Story
Study: Increased financial integration between physicians and hospitals associated with increased spending by consumers.
Data from a study published in the Oct. 19 issue of the journal JAMA Internal Medicine suggest that financial integration between physicians and hospitals may be associated with increased spending for outpatient care. The research team analyzed information from 240 metropolitan statistical areas (MSAs) covering 7,391,335 nonelderly enrollees in preferred-provider organizations or point-of-service plans. Over the 5-year study period (Jan. 1, 2008 – Dec. 31, 2012), they found that physician-hospital integration increased by a mean of 3.3 percent. Overall, an increase in physician-hospital integration equivalent to the 75th percentile of changes across MSAs was linked to a mean increase of $75 in annual outpatient spending per enrollee. The research team states that associated changes in utilization were minimal, leading them to conclude that the increase in outpatient spending was driven almost entirely by price increases. Read more…
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Other News
Healthgrades report finds significant range in outcomes and mortality across U.S. hospitals.
Healthgrades has released its 2016 Report to the Nation, which compares the patient outcomes from various hospitals across the United States. The report notes significant variation in health outcomes, with patients treated at hospitals that have received 5-star ratings having, on average, a 71 percent lower risk of dying and a 65 percent lower risk of experiencing a complication during their hospital stay than those treated at hospitals receiving a 1-star rating. The report is based on approximately 45 million Medicare patient records for nearly 4,500 short-term, acute care hospitals. Read more…
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Study: Addition of cyclobenzaprine or oxycodone/acetaminophen to naproxen may offer little benefit to patients with acute, nontraumatic, nonradicular LBP.
A study published in the Oct. 20 issue of The Journal of the American Medical Association finds that adding cyclobenzaprine or oxycodone/acetaminophen to naproxen alone may not improve short-term functional outcomes or pain for patients with acute, nontraumatic, nonradicular low back pain (LBP). The authors conducted a randomized, double-blind study of 323 patients who received a 10-day course of naproxen + cyclobenzaprine (n = 108), naproxen + oxycodone/acetaminophen (n = 108), or naproxen + placebo (n = 107). At 1-week follow-up, the mean improvement in scores for the Roland-Morris Disability Questionnaire (RMDQ) was 9.8 in the placebo group, 10.1 in the cyclobenzaprine group, and 11.1 in the oxycodone/acetaminophen group. Between-group differences in RMDQ mean improvement scores were 0.3 for cyclobenzaprine vs. placebo, 1.3 for oxycodone/acetaminophen vs. placebo, and 0.9 for oxycodone/acetaminophen vs. cyclobenzaprine. Read more…
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Study: Denosumab may offer long-term benefit in reducing effects of osteoporosis.
According to findings presented at the annual meeting of the American Society for Bone and Mineral Research and reported on in Medscape, patients treated with denosumab may see a persistent reduction in bone turnover, continued increases in bone density, and low incidences of fracture over a 10-year period. The researchers presented data based on the 3-year Fracture Reduction Evaluation of Denosumab in Osteoporosis Every Six Months (FREEDOM) study and its 7-year extension phase, covering more than 2,000 women. During the 3-year FREEDOM trial, 2.3 percent of women who received active treatment and 7.2 percent of women given placebo had a new vertebral fracture. After the 3-year study, women on placebo were offered treatment, and a “virtual” model was used to project the number of fractures that would occur if the placebo group had continued. During the 7-year extension, 7.0 percent of women on active treatment had a new vertebral fracture, compared with an estimated 11.5 percent of women on placebo. Similarly, 6.5 percent of women who received denosumab and 8.0 percent of women taking placebo had a nonvertebral fracture during the 3-year study, while during the extension, 9.3 percent of women on active treatment and an estimated 14.5 percent of women on placebo had a nonvertebral fracture. The researchers noted 13 cases of osteonecrosis of the jaw and two cases of atypical femoral fracture in the group taking denosumab. Read more…
Study: Orthopaedic service admission may reduce length of stay for geriatric patients with hip fracture.
Findings from a study published online in the Journal of Orthopaedic Trauma suggest that geriatric hip fracture patients may see shorter lengths of stay and reduced readmissions if they are admitted to a hospital’s orthopaedic service, compared to the medicine service. The authors conducted a retrospective study of 614 geriatric hip fracture patients who were seen at a single center during a 10-year period. They found that 302 (49.2 percent) were admitted to the orthopaedic service and 312 (50.8 percent) to medicine. The median length of stay for patients admitted to orthopaedics was 4.5 days, compared to 7 days for patients admitted to medicine. In addition, readmission was significantly higher for patients admitted to medicine (n = 92, 29.8 percent) compared to orthopaedics (n = 70, 23.1 percent). After controlling for patient factors, the authors determined that medicine patients could be expected to stay about 1.5 times longer in the hospital than orthopaedic patients. Read the abstract…
Study: High-resolution radiography may help predict risk of reoperation after hip arthroplasty.
Data from research conducted in Sweden suggest that use of a high-resolution radiograph may help predict which patients are at increased risk of reoperation after hip arthroplasty. A doctoral thesis presented at the Sahlgrenska Academy at the University of Gothenburg evaluates a radiographic examination method that measures prosthesis movement relative to bone. According to the presenter, broader clinical use of the radiostereometric technique may help predict at an early stage if new prosthetic models and surgical techniques are safe, and if they can be expected to improve the outcome in patients. The technique has so far primarily been used in research. Read more…
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Medical manikins help train young providers and hospital staff.
An article in The Wall Street Journal looks at the use of medical manikins as a training device for healthcare providers. The writer cites a 2014 study of 666 students that found that substituting simulation-based training for up to half of traditional clinical hours produced comparable educational outcomes, and notes that similar research has shown that simulator training improves patient outcomes across a variety of medical specialties. One provider notes that simulations conducted on the hospital floor may help hospitals assess emergency-response times and ensure rooms are stocked with the proper equipment. In addition, simulators may give medical staff a chance to practice rarely used procedures and keep routine skills up-to-date. Read more…
Call for volunteers: Brookings Institution National Medical Device Postmarket Surveillance System Planning Board.
AAOS seeks to nominate members to serve on the Brookings Institution National Medical Device Postmarket Surveillance System Planning Board. The board was originally convened in 2014 through a grant from the U.S. Food and Drug Administration, with the goal of creating a long-term vision for a sustainable national system to evaluate the risks and benefits of medical devices. Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, a 100-word biosketch, and a letter of interest that describes his or her specific qualifications. All supporting materials must be submitted by Tuesday, Oct. 27, 2015 at 11:59 p.m. CT, to Kyle Shah, at: shah@aaos.org
Learn more and submit your application…(member login required)
