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Volume 27, Issue 462 |
March 6, 2006 |
The racial and ethnic disparities in access to high-quality health care have been well documented, but a study just released by the RAND Corporation indicates that minorities might have the upper hand when in comes to being prepared to deal with the aftermath of a terrorist attack. According to the study, only one-third of Los Angeles County residents have prepared for such an event, and more black and Hispanic residents were prepared than were whites or Asian Americans. Based on the Los Angeles Health Survey, the study shows that in total, 37 percent of respondents had either gathered emergency supplies or developed a family plan in anticipation of a terrorist attack. Researchers found that 37 percent of Latinos and 31 percent of African Americans reported that they had gathered emergency supplies, compared with only 21 percent of whites and 19 percent of Asian Americans. About 28 percent of blacks said they had prepared an emergency plan, compared with 17 percent of Asian Americans, 16 percent of Latinos and 14 percent of whites. Researchers posit that African Americans and Latinos in LA may be motivated to be prepared for terrorist attacks by beliefs that their communities will receive fewer services when disaster strikes. In addition, say the authors, many immigrants – a category that includes many Latinos from Central America – have lived through natural disasters and political strife in their homelands, which may instill an interest in being personally prepared for disasters. “Despite a consensus that Los Angeles is a likely target for terrorists, few of us have taken steps to prepare for the consequences of an attack,” said Dr. David Eiseman, RAND researcher and assistant professor at UCLA. “We need to better understand what motivates people to plan ahead, and use that knowledge to encourage all groups to be better prepared for terrorist attacks and other disasters.”
QUALITY
As Medicare Goes, So Goes the Health-Care World
An agreement signed in mid-December by Congress and the American Medical Association has the physician organization developing standard measures of performance in order to improve the quality of care. The effort is part of the “pay-for-performance” push by the Bush administration, which links high-quality care to Medicare reimbursement rates. It also mirrors efforts by consumer groups, insurance companies, large employers and other private- sector groups who pay for health care who are demanding more information about the quality of care, says a New York Times report. The performance measures will focus on diagnostic tests and treatments that are known to produce better outcomes for patients, such as extending the length of life, improving its quality and producing fewer complications. While Congress and AARP strongly support the idea, some physician specialty groups are wary of the effort, and “are concerned that the push to measure quality will become just a smoke screen to cut costs and to reduce the resources devoted to health care,” Dr. Frederick C. Blum, president of the American College of Emergency Physicians, told the Times. The AMA agreed to develop approximately 140 physician performance measures covering 34 clinical areas by the end of 2006. By 2007, doctors will voluntarily report to the federal government on at least three to five measures per physician; doctors will also receive additional payment to offset the costs of collecting and reporting data. According to the agreement, by the end of 2007 physician groups will have developed performance measures to cover the majority of Medicare spending for physician services.
PRESCRIPTION Rx
Fewer Drugs Reimported
Sales of prescription drugs from Canadian pharmacies to U.S. residents have declined dramatically since the inception of the Medicare prescription drug benefit on Jan. 1, 2006, says the Canadian International Pharmacy Association. According to CIPA, cross-border sales have fallen by as much as 30 percent. In addition, there also is a reported decline in purchases on state Web sites that assist U.S. residents in ordering prescription drugs from other countries, says the AP/News. The president of the CIPA told The Detroit News that the decrease in sales is due in part to the start of the Medicare Part D drug benefit, as well as an uptick in seizures of imported drugs by the U.S. government.
HEALTH INSURANCE
Copay Cuts Save $
Cutting drug copays for sicker patients would keep those patients healthier and enable the United States to slash medical costs, according to a new RAND Corporation study. Researchers simulated the effect of various copays by analyzing information from 88 health insurance plans that served more than 62,000 patients. They found that patients who paid $10 per month in copays for their cholesterol-lowering medications were 6 percent to 10 percent more likely to fully comply with doctors’ orders to take the drugs than patients who paid $20 per month. The researchers estimate that cutting copays for cholesterol-lowering drugs for the sickest patients would avert nearly 80,000 hospitalizations and more than 31,000 emergency department visits each year – accounting for more than $1 billion in nationwide savings. The study was published in the January edition of The American Journal of Managed Care.
CHIDLREN’S HEALTH
Vaccine Recommendations
The Advisory Committee on Immunization Practices at the Centers for Disease Control and Prevention on Feb. 22 announced new flu vaccine guidelines for children, increasing the recommended age for vaccination to five years. The committee also recommended that "household contacts" of these children, such as parents and older siblings, also receive annual flu vaccinations. The CDC currently recommends flu vaccinations for children ages six months to 23 months, pregnant women, individuals ages 65 and older and individuals with chronic health conditions. The recommendations stem from recent research that indicates flu causes health-care usage and lost work time by the parents of children ages two to five, despite the small number of serious illnesses and deaths caused by the disease among those children. Approximately 85 of every 1,000 four-year-old children receive physician care for flu each year. In addition, recent research indicates that flu vaccinations among children could help protect individuals at the highest risk for complications from the disease. The new recommendations would add about 5.3 million children and 11.4 million household contacts to the group of individuals that CDC recommends receive annual flu vaccinations, and require 20 million to 30 million additional doses of flu vaccine because previously unvaccinated children will require two doses.
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