An annual report on birth rates in Massachusetts shows that the number of women who develop diabetes during pregnancy is on the rise.
Diabetes brought on by pregnancy is a serious concern because it increases the risk that mother and child will develop Type 2 diabetes later in life. Lauren Smith, medical director at the state Department of Public Health, attributes the twelve percent jump in gestational diabetes cases to two main factors.
“Mothers who are over 40 have substantially higher rates of gestational diabetes compared to younger mothers,” Smith says. “Women whose body mass index puts them into the obese or overweight category are also much more likely to develop gestational diabetes.”
The report, which covers the year 2007, also shows that Caesarian-section deliveries continue to be slightly higher in the state than in the rest of the country. One-third of all births in Massachusetts were done by Caesarian, while the national statistic is 31 percent.
Health experts say the reasons Caesarian deliveries have become more common include the increasing age and medical risks of childbearing women; the rising number of multiple births; and malpractice concerns among physicians and hospitals.
Massachusetts did better than the national average in areas such as low birth weight, infant mortality, smoking during pregnancy, and teen birth rates. The full report is available on the Department of Public Health’s website.
As a physician practicing in Rhode Island, I have watched the rapid growth of hospice programs locally. A similar trend has occurred across the USA.
An increase in number of hospice programs is important to expanding access to hospice for seriously ill persons and their families. However, it is important that these newer programs, many of which are “for-profit,” deliver high-quality care that focuses on the unique needs of dying persons and their loved ones. My research based on interviews with family member about their perceptions of the quality of hospice shows that reported concerns, unmet needs, and satisfaction vary by hospice programs.
Doctors, patients, and family are now faced with an important decision at one of the most trying time periods.
A new study by the Dana-Farber Cancer Institute says that when doctors prescribe drugs electronically, they ignore computer alerts about possible medication errors more than 75 percent of the time.
The report finds that doctors disregard the automatic alerts because they trust their own judgment more than the software. Saul Weingart, vice president for patient safety at Dana-Farber, says the problem is that the computers generate too many alerts — so doctors tune them out.
“Something called ‘alert fatigue’ occurs,” Weingart says. “They get so many alerts that they get habituated to them, and they don’t pay attention to an important one. And that’s really the hazard of this over-alerting phenomenon.”
Weingart says a solution is to create smarter software that only alerts doctors to the most serious potential errors.
The study, which appears in the current issue of the Archives of Internal Medicine, tracked more than 2,800 doctors at outpatient clinics in Massachusetts, New Jersey, and Pennsylvania.
Two recent news stories highlight how the hidden flow of government health dollars provides cover for public officials who slash funding for the poor while idly watching as wealthy private institutions drain the public treasury.
Faced with a mounting budget crisis, our leaders have cut hundreds of millions from Medicaid, and tens of millions more from block grants to safety net institutions like Cambridge Hospital (disclosure: I work there). As a result, thousands of patients with severe mental illness will find care unavailable, and many of the poor face unaffordable co-payments. At the same time, the Globe tells us that Partners HealthCare (disclosure: I also work there) has used its market muscle to extract higher rates – about 20% above average for the same services, and twice as much as Cambridge Hospital – from private insurers. That’s how Partners has managed to amass huge surpluses in recent years, money they’ve invested in expensive high tech facilities that drive costs ever higher, while studiously avoiding investments in facilities for the chronically mentally ill or other unprofitable patients.
The Partners story may seem disconnected from the state’s budget woes, but its not. Read more…
New health rules went into effect today in Boston that prohibit the sale of tobacco products at pharmacies and drug stores, and on college and university campuses.
City officials say the ban on tobacco sales is meant to keep a harmful substance away from young people and protect workers from secondhand smoke. Barbara Ferrer of the Boston Public Health Commission says counseling and nicotine patches will be available to people who want to quit smoking.
“This isn’t really an anti-smoker campaign,” Ferrer says. “This is: let’s not sell a dangerous product, and if you’re using that product let’s help you break an addictive habit.”
Ferrer also says drug stores and college campuses are being targeted because they shouldn’t be allowed to sell products that make people sick.
“We’re not prohibiting the sale of tobacco products in the city,” Ferrer says. “We’re not prohibiting anybody from smoking cigarettes. We’re saying if you work you should be entitled to work in a safe environment and not be exposed to secondhand smoke, which is a known carcinogen.”
Ferrer says city officials will be inspecting educational and healthcare institutions in the next few weeks to make sure they’ve removed tobacco from their shelves. Cigarettes and other tobacco products can still be sold in Boston at places such as off-campus mini-marts and gas stations.
There is a growing consensus that Massachusetts must shift health care spending to reward the quality of care patients receive, not the volume. There is a lot of concern about who will win and lose if/when that shift happens. I’m linking to a few of the blueprints offered at public hearing yesterday hosted by a new state commission looking into payment reform.
Secretary for Health and Human Services JudyAnn Bigby asked the commission to consider a system where private and public insurance programs would pay all doctors, hospitals and other health care providers the same rate for the same service. You can read her testimony here. She talks about payments based on a episode of care…could be a single surgery or a year of treatment for patients with chronic conditions like diabetes. This system assumes that someone would coordinate and be responsible for our “episode.” It would be tough for all the docs who practice on their own or in small groups. Bigby suggests that docs in western Mass for example could join some kind of regional center for help with IT and other back office operations.
Lucian Leape from the Harvard School of Public Health also stressed the need for coordinated care to help end waste, errors and uneven care. Read more…
here’s the letter:
February 5, 2009
The President
The White House
1600 Pennsylvania Avenue N.W.
Washington, D.C. 20500
Dear Sir:
We were saddened to hear about Senator Daschle’s decision to withdraw from the nomination process. While we continue to believe that Senator Daschle is highly qualified to hold the position of Secretary of Health and Human Services, we respect his decision and wish him all the best in his future endeavors.
We are writing to affirm our continuing commitment to enacting comprehensive health care reform this year, and to express our confidence that you will swiftly choose an exceptionally qualified and dedicated alternate nominee for Secretary of Health and Human Services to assist in our efforts. As you have emphasized, we must act now. Read more…
The Department of Revenue is now in the second year of enforcing the individual mandate requirements under health care reform which requires most Massachusetts residents 18 and older to have health insurance.
Similar to last year, Massachusetts taxpayers will be required to file a Schedule HC as part of their tax return indicating whether or not they had health insurance. Taxpayers with access to affordable health insurance are subject to monthly penalties for each month of non-compliance. However, in 2008 there is a grace period permitting lapses in coverage of three consecutive months without penalty. The penalty for 2007 was the loss of a taxpayer’s personal exemption, which amounted to $219 for an individual for those who were not insured on December 31, 2007. The requirement to have health insurance for 2008 was in effect from January 1, 2008 through the end of the year. The penalty also increased, and is up to $76 a month or $912 for the full year for an individual taxpayer, depending on the taxpayer’s age and income.
To help taxpayers fill out Schedule HC, DOR has developed a new instructional video and a new affordability calculator. Read more…
I don’t know where this is coming from…but at least three (the Christian Science Monitor, Time, and the Atlantic) national media outlets are suggesting that President Obama consider former Governor Mitt Romney as his health care czar. There are lots of reasons this seems an unlikely choice: Romney may want to run against Obama in 2012, Romney’s position on abortion and the fact that his work on health coverage in Massachusetts didn’t help his campaign. A Romney spokesman says “Mitt Romney is not seeking a job in the Obama administration, and it’s highly unlikely any such job would be offered.” Are we missing something?
Martha Bebinger
Aides to Governor Deval Patrick are tamping down the latest speculation that their boss may be joining the Obama administration. At least one blog puts the Governor on the short list to replace former Senator Tom Daschle, President Obama’s first nominee for Health and Human Services Secretary. Daschle withdrew yesterday amid questions about unpaid taxes and close ties to health care industry clients. Here’s the comment from a spokesman for Governor Patrick; “as the Governor has said countless times, he is staying put and running for re-election.”