LONG-TERM CARE

More Empty Beds

New data from the Census Bureau indicates that fewer seniors are living in nursing homes than ever before, USA Today reports. Presently, 7.4 percent of those 75 or older live in nursing homes, compared to 8.1 percent in 2000 and over 10 percent in 1990. The decline is most likely caused by the increasing popularity of assisted living facilites, which offer a midpoint between one’s own home and a nursing facility. The data also found that females compromise a disproportionate share of nursing home residents, accounting for 70 percent of that population. Additionally, whites were the ethnic group most likely to utilize a nursing home, while Hispanics were the least likely.

WELLNESS

Serious Gaps in Care for Children

When it comes to getting the right care at the right time, children in the United States fare worse than adults, according to a study published Oct. 11 in the New England Journal of Medicine. The survey of the medical records of more than 1,500 children from 12 metropolitan areas found that kids fail to get recommended health services more than half of the time. Nearly all the children had some form of health insurance; 82 percent were privately insured. Previous research by RAND Health found that adults, on average, receive only about half of recommended care for the leading causes of death and illness. “Up until now, most people probably assumed that quality was not a problem for children,” said senior study author Elizabeth McGlynn of RAND Health. “This new study tells us that’s not true.” The study assessed 175 measures of quality covering 12 clinical areas. Among the key findings:
Forty-four percent of children with persistent asthma had a prescription for an anti-inflammatory medication; One-third of American children are obese or at risk for obesity. But during regular check-ups, only 31 percent of children ages 3 to 6 were weighed and measured; Only 42 percent of adolescent girls in the study were screened for chlamydia, an often silent infection that leads to pelvic inflammatory disease (PID) in 40 percent of untreated women; Children receive only 38 percent of recommended care for acute diarrhea Some 300 to 500 children die each year in the U.S. from this very treatable condition.

Work Can be Bad for Your Health

A stressful work environment can be just as hazardous to one’s heart as smoking or poor diet, according to a new study in this month’s Journal of the American Medical Association. The study of 972 patients found that job strain combined with high demands and low decision latitude increased the risk of a heart attack 2.2 times over those in lower stress jobs. High-stress jobs are generally defined by having more things to do with less time and little control over work decisions. Such traits are more common for lower level workers than for managers. Suggestions for improving conditions for heart-sensitive employees include fostering collaboration rather than competition and providing ways for employees to air their job frustrations. Improved diet and regular exericse also were recommended.

MEDICAID

The Waiting Game

During its 2007 session, the Texas Legislature resurrected a long-standing issue among states. Lone Star lawmakers passed a resolution (HCR 35) urging Congress to eliminate the mandatory 24-month waiting period for Medicare for people younger than 65 who have become eligible for Social Security Disability Insurance (SSDI). SSDI payments begin five months after an applicant has been declared permanently disabled. But under federal policy, individuals who have qualified for SSDI must wait 24 months before they can begin receiving Medicare benefits. That makes the total wait for Medicare nearly 2 1/2-years. According to the Commonwealth Fund, about 1.5 million Americans who are getting SSDI are waiting for Medicare coverage. About 40 percent of those who are “waiting” are in Medicaid; about 26 percent are uninsured for the entire 29-month period. Eliminating the wait would reduce annual Medicaid spending by about $4.3 billion dollars, $1.8 billion of which would be state savings, says Representative Eddie Rodriguez, author of HCR 35. There is some support in Congress for change. On Sept. 21, U.S. Senator Jeff Bingaman and others introduced S 2102, which would eliminate the waiting period.

HIV/AIDS

HIV Testing for African-Americans

The Centers for Disease Control and Prevention is providing $35 million to 23 states and the 5 largest cities to increase HIV testing among disproportionately affected groups, including African-Americans. Blacks make up only 13 percent of the U.S. population, but they account for half of all HIV/AIDS cases, the CDC reports. Grants will range in size from $690,000 to $5.4 million. Testing will be done in settings such as emergency departments, community health centers, STD clinics and correctional health facilities. The goal is to make HIV testing a routine part of a clinical visit. “We estimate this program alone could identify nearly 20,000 people who are unaware that they are infected, allowing them to seek care for their own health and take steps to protect their partners,” said Dr. Kevin Fenton of the CDC. The jurisdictions receiving funding are: California, Connecticut, Florida, Georgia, Louisiana, Maryland, Massachusetts, Michigan, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Virginia and Washington, D.C. The cities receiving funding are Chicago, Houston, Los Angeles, Philadelphia and New York City.