Today’s Top Story
CDC: Injuries cost the U.S. $671 billion in one year.
Costs attributable to injuries and violence in the United States in 2013 totaled $671 billion, the Centers for Disease Control and Prevention (CDC) reports. Of that total, $214 billion arose from fatal injuries and $457 billion from nonfatal injuries. In that year, injuries, both intentional and violence-related, accounted for 59 percent of all deaths among persons aged 1 to 44 years—more deaths than those caused by noncommunicable and infectious diseases combined. More than 192,000 persons die as a result of unintentional and violence-related injuries each year. Males accounted for 78 percent of the fatal injury costs and 63 percent of nonfatal injury costs. Drug poisonings, which include prescription drug overdoses, accounted for the largest share (78 percent) of fatal injury costs and nonfatal injury costs (63 percent). “Injuries cost Americans far too much money, suffering and preventable death,” CDC Director Thomas R. Frieden, MD, MPH, said. “The doubling of deaths by drug poisoning, including prescription drug overdose and heroin, is particularly alarming.” The findings appear in two studies described in the Morbidity and Mortality Weekly Reports (MMWR). Read more…
Read the MMWR reports…
Other News
Study: No benefit seen with corticosteroids and physical therapy for tennis elbow.
In patients with acute lateral epicondylitis of the elbow, or tennis elbow, the condition resolved within a year whether or not the patients received treatment, a Norwegian study published in BMC Musculoskeletal Disorders found. The study involved 177 patients (157 to completion), who were assigned to one of three groups: physical therapy for 6 weeks along with two corticosteroid injections; physical therapy and two placebo injections; and no treatment other than symptomatic pain drugs such as naproxen (control group). Although the investigators found that the physical therapy and corticosteroids showed no clear benefit or added effect over a year, they reported that the patients in the corticosteroid group had superior results at 6 weeks but then had a worsening of symptoms over the 12- to 26-week interval. The placebo-injection and control groups both demonstrated a gradual increase in success. The authors concluded: “Corticosteroid injections combined with physiotherapy might be considered for patients needing a quick improvement, but intermediate worsening of symptoms makes the treatment difficult to recommend.” Read more…
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Researchers find genetic variant in common osteoporotic fracture sites.
A large-scale genomic study uncovered genetic variants in two sites—the lumbar spine and the femoral neck—that are common sites of osteoporotic fractures, leading researchers to findings about the role of the engrailed homeobox-1 gene (EN1) in bone physiology, specifically bone mineral density, the National Institutes of Health (NIH) reports. Researchers used data from the UK10K Project—a massive whole-genome, sequence-based resource of the general European population. They performed whole-genome sequencing of 2,800 persons from that project, and they sequenced the exomes, or protein-coding regions, of more than 3,500 people. The researchers said the EN1 gene had not been previously linked to osteoporosis in humans. The finding “opens up a brand new pathway to pursue in developing drugs to block the disease,” said the research team leader, Brent Richards, MD. “These discoveries indicate that more comprehensive sequencing of diverse populations can lead to the discovery of rare variants influencing common diseases,” the NIH summary noted. The findings appear in the Sept. 14 issue of Nature. Read more…
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Study: Cost-effectiveness of microfracture and OAT is comparable for the treatment of articular cartilage lesions of the distal femur.
According to a study published in The American Journal of Sports Medicine, microfracture and osteochondral autograft transplantation (OAT) are both cost-effective first-line treatment options for isolated articular cartilage lesions of the distal femur. The researchers reviewed data on surgical time, failure rates, revision surgeries, outcomes scores, and return to play from clinical studies comparing the two treatments, and constructed a cost model for all procedure, operating room, and instrumentation costs. Although microfracture had a lower initial cost, the savings lessened over time. OAT was associated with a significantly lower cost for return to play in athletes at 1 year, 3 years, and 10 years, compared with microfracture. The researchers concluded, however, that the net cost and cost-effectiveness of microfracture and OAT are comparable for the treatment of isolated articular cartilage lesions of the distal femur. Read more…
Pennsylvania.
Insurance officials in Pennsylvania will begin reviewing cases of balance billing in response to complaints by dozens of patients in the state, Trib Total Media reports. According to the article, balance billing occurs when a provider charges a patient for treatment that is not covered by the patient’s insurer. Although Pennsylvania law protects people from balance billing in emergency situations, it provides no other protections, the article states. According to a Pennsylvania Insurance Department spokesman, some patients have received surprise balance bills even after checking that the hospital and surgeon are in-network before undergoing a procedure. Read more…
Nevada.
The Nevada Supreme Court voted yesterday to uphold the cap on medical malpractice damages and other provisions of the state’s medical malpractice law, the Las Vegas Review-Journal reports. In a unanimous decision, the court overruled a judge who found that a $350,000 cap on noneconomic damages was unconstitutional. The lower court’s determination that the cap applied per plaintiff and per defendant was also overturned, as was the finding that tort reform law applied only to professional negligence and not to medical malpractice. The judge also had ruled that the right of the plaintiff to a trial by jury in a malpractice suit included the right to assess and award damages. The Supreme Court ruled that the cap did not violate a plaintiff’s constitutional right to a trial by jury. Nevada voters approved the cap on noneconomic damages in 2004 as part of the medical malpractice reform ballot measure “Keep Our Doctors in Nevada.” Read more…
Connecticut.
An advocacy group said that a new 6 percent provider tax will adversely affect ambulatory surgical centers (ASCs) in Connecticut, driving up healthcare costs and leading to closures of facilities. Connecticut Citizens for Affordable Health Care (CCAHC) said that the tax will cause a quarter of the state’s ASCs to operate at a loss. The CCAHC said that ASCs are reimbursed at nearly half (53 percent) of the rate as hospital outpatient departments, resulting in lower costs to patients, insurers, and taxpayers. The group said the tax is the highest among states that impose such a levy, and it noted that Rhode Island recently repealed its 2 percent provider tax. “Ambulatory surgery centers are a critical part of quality and affordable healthcare across the state, and this tax seriously jeopardizes our ability to stay operational and serve our patients,” said Cathy Bartell, administrator of Connecticut Surgery Center. Read more…
October AAOS Now is online now in web and ePub format; new podcast available!
AAOS members will soon receive the print edition of the October issue of AAOS Now, but the electronic editions are already available on the AAOS Now website. This month’s issue includes a look at changes recommended by the American Association of Orthopaedic Surgeons (AAOS) regarding the U.S. Centers for Medicare & Medicaid Services (CMS) 2016 physician fee schedule, an article on the first bilateral pediatric hand transplant, and much more! In addition, a new AAOS Now podcast has been posted as a companion to the article “Giving Zion Two Hands.” Read the web version of AAOS Now…
Read “AAOS Urges Changes to 2016 Fee Schedule”…
Download and read the ePub edition of AAOS Now…(member login required)
Listen to the podcast (MP3)…
