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Examining Trends in HF Hospitalizations

Examining Trends in HF Hospitalizations

According to recent estimates, heart failure (HF) is one of the most common reasons for hospital admission in the United States. Efforts have been made to reduce the number of hospitalizations related to HF, and several therapies have been developed over the last 20 years that have been shown to reduce disease-related hospitalizations. Furthermore, quality improvement initiatives are being developed and launched to ensure the appropriate delivery of evidence-based therapies in HF. CMS has been reporting on the quality of care and rate of HF rehospitalization for hospitals in an effort to encourage quality improvement initiatives. “While previous analyses have shown that rates of HF hospitalizations increased in the 1980s and 1990s, more recent CMS data indicate that hospitalizations with a primary diagnosis of HF in the elderly declined over the last decade,” explains Saul B. Blecker, MD, MHS. “These findings have been attributed to improvements in treatment and reductions in prevalent HF. However, most hospitalizations involving these patients are for reasons other than acute HF.” Gaining Perspective on Secondary HF Hospitalizations Quality improvement initiatives typically target only hospitalizations with a primary diagnosis of HF. As a result, these initiatives may not affect comorbid conditions that are associated with HF but are not directly caused by it. “Characterizing trends in hospitalizations with HF as a primary or secondary diagnosis can help clinicians further understand and recognize the role of cardiac disease and non-cardiac conditions,” Dr. Blecker says. “It can also help educate future initiatives to improve quality improvement initiatives.” A study by Dr. Blecker and colleagues published in the Journal of the American College of Cardiology evaluated trends in...

Emergency Medicine Info on the Web

A recent national survey reported that 60% of adults access health information online. Although the internet can be a helpful resource for many consumers, prior studies have suggested that the accessibility and accuracy of web-based health information are not always adequate. When patients can correctly identify risk factors and symptoms of potential medical emergencies, appropriate and timely medical care may be provided. Health information gathered from the internet may impact medical choices and outcomes. Improvements of Medical Info on the Internet In the November 2011 issue of Western Journal of Emergency Medicine, my colleagues and I published results from a study in which we sought to determine whether the completeness and accuracy of emergency medical information available online has improved over time. We evaluated medical content (descriptive information, completeness, and accuracy) on the top 15 healthcare information sites, as determined by internet traffic, for four common ED diagnoses: myocardial infarction, stroke, influenza, and febrile child. Online Exclusive: Table of Most Accurate Medical Websites According to our findings, the completeness and accuracy of online emergency medical information available to the general public has improved since 2002. Only two of 12 of the websites reviewed in 2002 boasted greater than 50% of aggregated medical information. In our study, 11 of 12 websites accomplished this feat. In addition, seven contained greater than 70% of aggregated medical information on the four common ED diagnoses we analyzed. None of the websites reviewed in 2008 contained questionable or dangerous information or recommendations, representing an improvement since 2002. Importantly, our analysis did not find a significant correlation between credentialing and completeness of website or credentialing and...
A New Program for Newly Diagnosed Diabetes Patients

A New Program for Newly Diagnosed Diabetes Patients

Every 17 seconds, someone in the United States is diagnosed with diabetes, according to the American Diabetes Association. More than 26 million Americans have diabetes, and about 90% of cases are type 2. Data from the CDC estimate that 1.9 million Americans were diagnosed with diabetes in 2010 (Figure). Many patients who are newly diagnosed with diabetes may be distressed after receiving the news. They may fear the worst about the treatments and lifestyle changes that lie ahead. Others may choose to ignore the disease or fail to grasp the severity of the situation. They may leave their doctor’s office with a poor understanding of what is required of them to get their diabetes under control so they can avoid serious complications, such as heart attack, stroke, kidney disease, blindness, amputation, and even death. A Critical Moment “It can be challenging for healthcare providers to get patients to understand the seriousness of their disease at the time of diagnosis,” says Vivian A. Fonseca, MD. Healthcare providers play a vital role in clearing up any confusion patients may have about their diagnosis. However, it can be difficult to inform patients about all the key components of managing their disease. Prescription drugs and lifestyle changes are required. Informing patients about why they need specific treatments is important, but key messages can be lost because of the psychological impact of being newly diagnosed. Assemble the Team “The dialogue between physicians and patients is important,” adds Dr. Fonseca. “Providers need to be open and honest with their patients and take the extra time that may be needed to address inquiries. At diagnosis, it’s...
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