Culture | Science Codex

Doctors Say Patients Should Bear the Cost of Practice Transformation

Researchers address the opportunities as well as the challenges and costs of transforming practice toward the patient-centered medical home model of care in this editorial.

The authors assert that primary care practices cannot bear the costs of transformation unless they are reimbursed for the costs they incur.

For the needed changes to occur on a wide and sustainable basis, they argue that payers should fund the full cost to primary care practices, which is estimated at a minimum of $7-12 per patient per month in addition to usual fee-for-service reimbursement.

Hospitals' cardiac arrest incidence and survival rates go hand in hand

ANN ARBOR, Mich. — Hospitals with the highest rates of cardiac arrests tend to have the poorest survival rates for those cases, new University of Michigan Health System research shows.

Meanwhile, hospitals that do the best job of preventing cardiac arrest among their patients tend to be better at saving patients with cardiac arrest, according to the findings that appear in JAMA Internal Medicine.

Bronchodilators appear associated with increased risk of cardiovascular events

A study of older patients with chronic obstructive pulmonary disease (COPD) suggests that new use of the long-acting bronchodilators β-agonists and anticholinergics was associated with similar increased risks of cardiovascular events, according to a study published Online First by JAMA Internal Medicine, a JAMA Network publication.

Association between in-hospital cardiac arrest survival rates, prevention of cardiac arrests

Hospitals with higher rates of survival among patients who experience in-hospital cardiac arrest also appear to have a lower incidence of in-hospital cardiac arrest, according to a study published Online First by JAMA Internal Medicine, a JAMA Network publication.

Lena M. Chen, M.D., M.S., of the University of Michigan, Ann Arbor, and colleagues identified 102,153 cases of in-hospital cardiac arrest at 358 hospitals between January 2000 and November 2009.

Practice makes perfect? Not so much

EAST LANSING, Mich. — Turns out, that old "practice makes perfect" adage may be overblown.

New research led by Michigan State University's Zach Hambrick finds that a copious amount of practice is not enough to explain why people differ in level of skill in two widely studied activities, chess and music.

In other words, it takes more than hard work to become an expert. Hambrick, writing in the research journal Intelligence, said natural talent and other factors likely play a role in mastering a complicated activity.

Listening to favorite music lowers anxiety, sedation in ICU patients on ventilators

COLUMBUS, Ohio – New research suggests that for some hospitalized ICU patients on mechanical ventilators, using headphones to listen to their favorite types of music could lower anxiety and reduce their need for sedative medications.

Having a nighttime critical care physician in the ICU doesn't improve patient outcomes

PHILADELPHIA—With little evidence to guide them, many hospital intensive care units (ICUs) have been employing critical care physicians at night with the notion it would improve patients' outcomes.

Music therapy reduces anxiety, use of sedatives for patients receiving ventilator support

Among intensive care unit patients receiving acute ventilatory support for respiratory failure, use of patient-preferred music resulted in greater reduction in anxiety and sedation frequency and intensity compared with usual care, according to a study published online by JAMA. The study is being released early online to coincide with its presentation at the American Thoracic Society international conference.

Early IV nutrition for certain patients does improve survival or reduce ICU length of stay

The early (within 24 hours of intensive care unit [ICU] admission) provision of intravenous nutrition among critically ill patients with contraindications (a condition that makes a particular procedure potentially inadvisable) to early use of enteral nutrition (such as through a feeding tube) did not result in significant differences in 60 day mortality or shorter ICU or hospital length of stay, compared with standard care, according to a study in the May 22/29 issue of JAMA.

Telerehabilitation allows accurate assessment of patients with low back pain

Philadelphia, Pa. (May 20, 2013) - A new "telerehabilitation" approach lets physical therapists assess patients with low back pain (LBP) over the Internet, with good accuracy compared with face-to-face examinations, reports a study in the May 15 issue of Spine.

Diabetes drug tested in Parkinson's disease patients

Parkinson's disease (PD) is a degenerative neurological disorder marked by a progressive loss of motor control. Despite intensive research, there are currently no approved therapies that have been demonstrated to alter the progression of the disease. In this issue of the Journal of Clinical Investigation, Dr. Thomas Foltynie and colleagues at the National Hospital for Neurology and Neurosurgery in London investigated the use of a drug approved for diabetes care, Exenatide, in PD patients.

Breakup of physician, drug company relationship could improve health care, cut cost

PORTLAND, Ore. – A new report suggests that improved health care and significant reductions in drug costs might be attained by breaking up the age-old relationship between physicians and drug company representatives who promote the newest, more costly and often unnecessary prescription drugs.

This system, which has been in place for decades, at one time benefitted doctors by keeping them up to date on new medications, and always provided generous amounts of "free" samples to get patients started on the newest drugs, as well as other supplies and gifts.

Women with severe injuries are less likely than men to be treated in a trauma center

ATS 2013, PHILADELPHIA - Women are less likely than men to receive care in a trauma center after severe injury, according to a new study of almost 100,000 Canadian patients.

Atherosclerotic disease heredity mapped in nationwide study

Researchers at Lund University in Sweden have mapped the significance of heredity for common forms of atherosclerotic disease. No studies have previously examined whether different forms of the disease share heredity.

The study looked at coronary heart disease, ischemic stroke, peripheral arterial disease and atherosclerosis of the aorta in individuals whose siblings and parents have suffered different types of cardiovascular disease.

Disney researchers develop fast, economical method for high-definition video compositing

ZURICH - Video compositing to create special effects, replace backgrounds or combine multiple takes of an actor's performance is an integral, but highly labor-intensive, part of modern film making. Researchers at Disney Research, Zürich, however, have found an innovative way to create these composite videos that is simple, fast, and easy to use.