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| News and Notes
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Healthcare facilities are reimbursed the same amount for colorectal cancer screenings regardless of the patient's race or gender, but studies have shown that they screen a disproportionate number of affluent white males in their sixties. Researchers say that expanded Medicare coverage for the procedure hasn't significantly changed those demographics.
For a study published in the February 12 issue of the Archives of Internal Medicine, researchers from the Medical College of Wisconsin in Milwaukee examined data from 596,470 Medicare beneficiaries who submitted claims from New York, Illinois and Florida in 2002 and 2003 - after Medicare's 2001 expansion allowed a once-a-decade colonoscopy for patients at moderate risk of colorectal cancer.
Of the 18.3 percent of those patients who underwent a colon cancer screening during this period, non-white patients were 48 percent less likely to have had the procedure than white patients, the study says, noting that "blacks (9.7%) and Hispanics (8.1%) had lower rates of colon cancer screening compared with whites (19.3%)."
When researchers looked at age, they found that 22 percent of patients between the ages of 65 and 69 had been screened as compared to 11.7 percent of the patients over the age of 80. Women over the age of 80 were 36 percent less likely to be screened than their male counterparts.
Higher income levels were associated with higher screening rates in white patients of both gender, but not for non-white patients. The study's authors suggest public health policy initiatives to raise awareness of colorectal screening among women and racial and ethnic groups and to also alert physicians to the need to advise these populations about screenings.
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| Despite Expanded Coverage, Colorectal Screening Disparities Exist
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Healthcare facilities are reimbursed the same amount for colorectal cancer screenings regardless of the patient's race or gender, but studies have shown that they screen a disproportionate number of affluent white males in their sixties. Researchers say that expanded Medicare coverage for the procedure hasn't significantly changed those demographics.
For a study published in the February 12 issue of the Archives of Internal Medicine, researchers from the Medical College of Wisconsin in Milwaukee examined data from 596,470 Medicare beneficiaries who submitted claims from New York, Illinois and Florida in 2002 and 2003 - after Medicare's 2001 expansion allowed a once-a-decade colonoscopy for patients at moderate risk of colorectal cancer.
Of the 18.3 percent of those patients who underwent a colon cancer screening during this period, non-white patients were 48 percent less likely to have had the procedure than white patients, the study says, noting that "blacks (9.7%) and Hispanics (8.1%) had lower rates of colon cancer screening compared with whites (19.3%)."
When researchers looked at age, they found that 22 percent of patients between the ages of 65 and 69 had been screened as compared to 11.7 percent of the patients over the age of 80. Women over the age of 80 were 36 percent less likely to be screened than their male counterparts.
Higher income levels were associated with higher screening rates in white patients of both gender, but not for non-white patients. The study's authors suggest public health policy initiatives to raise awareness of colorectal screening among women and racial and ethnic groups and to also alert physicians to the need to advise these populations about screenings.
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| Survey Examines Drawbacks of IV Pain Treatment
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The death of a patient following elective spine surgery at a specialty hospital In Texas has rekindled a longstanding debate between lawmakers and advocates of physician-owned hospitals. Last month, staff at the West Texas Hospital in Abilene reportedly called 911 after a patient went into respiratory arrest. The patient was then transferred to a community hospital, where he later died.
U.S. Sens. Max Baucus (D-Mont.) and Chuck Grassley (R-Iowa) and U.S. Rep. Pete Stark (D-Calif.), previous and frequent critics of physician ownership, were indignant in a Feb. 8 letter to the Centers for Medicare and Medicaid Services, stating that every physician-owned hospital should have the staff and abilities necessary to perform basic lifesaving measures. The legislators also expressed outrage that the West Texas Hospital received a Medicare number in May 2005, during the 18-month moratorium on their issuance to new physician-owned specialty hospitals that was imposed by the Medicare Modernization Act of 2003.
In the letter, the lawmakers have petitioned CMS for the reasons behind the granting of the Medicare number and demanded an accounting for nearly $4.2 million in Medicare payments made to the hospital since 2005. The lawmakers also register their concerns that the Texas incident appears to mirror the 2006 death of a patient at a specialty hospital in Oregon, where staff also called 911 when post-op complications arose. The Oregon hospital also reportedly opened during the MMA moratorium.
The advocacy group Physician Hospitals of America responded quickly to the complaints from Capitol Hill and vigorously defended the quality of care found in specialty hospitals. "Each day thousands of patients are treated at physician-owned hospitals with very positive results," says Molly Gutierrez, executive director of the PHA, in a statement. "Time and again studies have shown that physician-owned hospitals provide a high level of quality care and measurably lower complication and mortality rates."
Ms. Gutierrez says calling 911 is part of the emergency care protocol for many types of hospitals. She also notes that patient deaths are not limited to physician-owned facilities, citing a study by the Institute of Medicine which tallies between 44,000 and 98,000 deaths each year at community hospitals as a result of surgical errors.
"We believe that when physicians are directly involved in all aspects of care, patients benefit, and patient satisfaction at our members' hospitals bears this out," she says.
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| Specialty Hospitals Back in Spotlight After Patient's Death
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The death of a patient following elective spine surgery at a specialty hospital In Texas has rekindled a longstanding debate between lawmakers and advocates of physician-owned hospitals. Last month, staff at the West Texas Hospital in Abilene reportedly called 911 after a patient went into respiratory arrest. The patient was then transferred to a community hospital, where he later died.
U.S. Sens. Max Baucus (D-Mont.) and Chuck Grassley (R-Iowa) and U.S. Rep. Pete Stark (D-Calif.), previous and frequent critics of physician ownership, were indignant in a Feb. 8 letter to the Centers for Medicare and Medicaid Services, stating that every physician-owned hospital should have the staff and abilities necessary to perform basic lifesaving measures. The legislators also expressed outrage that the West Texas Hospital received a Medicare number in May 2005, during the 18-month moratorium on their issuance to new physician-owned specialty hospitals that was imposed by the Medicare Modernization Act of 2003.
In the letter, the lawmakers have petitioned CMS for the reasons behind the granting of the Medicare number and demanded an accounting for nearly $4.2 million in Medicare payments made to the hospital since 2005. The lawmakers also register their concerns that the Texas incident appears to mirror the 2006 death of a patient at a specialty hospital in Oregon, where staff also called 911 when post-op complications arose. The Oregon hospital also reportedly opened during the MMA moratorium.
The advocacy group Physician Hospitals of America responded quickly to the complaints from Capitol Hill and vigorously defended the quality of care found in specialty hospitals. "Each day thousands of patients are treated at physician-owned hospitals with very positive results," says Molly Gutierrez, executive director of the PHA, in a statement. "Time and again studies have shown that physician-owned hospitals provide a high level of quality care and measurably lower complication and mortality rates."
Ms. Gutierrez says calling 911 is part of the emergency care protocol for many types of hospitals. She also notes that patient deaths are not limited to physician-owned facilities, citing a study by the Institute of Medicine which tallies between 44,000 and 98,000 deaths each year at community hospitals as a result of surgical errors.
"We believe that when physicians are directly involved in all aspects of care, patients benefit, and patient satisfaction at our members' hospitals bears this out," she says.
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