Here are what the editors at HealthDay consider to be the most important developments in Critical Care for August 2018. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Medical Bills in Collections Decrease With Patient Age

FRIDAY, Aug. 31, 2018 (HealthDay News) — Medical collections decrease substantially with age, possibly because of increased health insurance coverage and incomes, according to a study published in the August issue of Health Affairs.

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Medicare, Med Advantage Health Care Use Differs Regionally

THURSDAY, Aug. 30, 2018 (HealthDay News) — Geographic variation in the Medicare Advantage population exceeds that of traditional Medicare for use of skilled nursing facility and hospital care, according to study published in the August issue of Health Affairs.

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No Meaningful Increase in Physician Compensation Last Year

THURSDAY, Aug. 30, 2018 (HealthDay News) — There was no meaningful increase in physician compensation in 2017, and a decline in productivity was noted, according to the results of a survey conducted by AMGA Consulting.

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Marketplace Premiums Increase More With Monopolist Insurers

WEDNESDAY, Aug. 29, 2018 (HealthDay News) — Affordable Care Act Marketplace premiums increase more in areas with monopolist insurers, according to a study published in the August issue of Health Affairs.

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Laryngeal Tube Insertion Beats Endotracheal Intubation in OHCA

TUESDAY, Aug. 28, 2018 (HealthDay News) — For patients with out-of-hospital cardiac arrest (OHCA), 72-hour survival is better with initial laryngeal tube (LT) insertion compared to endotracheal intubation (ETI), while a supraglottic airway device (SGA) is no better than tracheal intubation (TI) for functional outcome at 30 days, according to two studies published in the Aug. 28 issue of the Journal of the American Medical Association.

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Medical Practices Should Address Negative Online Reviews

TUESDAY, Aug. 28, 2018 (HealthDay News) — Medical practice staff can effectively handle negative online reviews by staying calm and positive, looking for solutions, apologizing, and thanking the reviewers, according to an article published in Physicians Practice.

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Artificial Intelligence Holds Promise in Medicine

TUESDAY, Aug. 28, 2018 (HealthDay News) — Artificial intelligence (AI) in health care offers opportunities for early detection and triage, diagnostics and personalized medicine, and medical decision-making, according to an article published in Managed Healthcare Executive.

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Alcohol Is Leading Risk Factor for Global Disease Burden

TUESDAY, Aug. 28, 2018 (HealthDay News) — Globally, alcohol use is a leading risk factor for disease burden, according to research published online Aug. 23 in The Lancet.

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Experts Address Loss of the National Guideline Clearinghouse

TUESDAY, Aug. 28, 2018 (HealthDay News) — The demise of the National Guideline Clearinghouse (NGC) in July 2018 is likely to impact evidence-based health care around the world, according to an Ideas and Opinions piece published online Aug. 28 in the Annals of Internal Medicine.

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Most Research Participants Not Concerned About Data Sharing

MONDAY, Aug. 27, 2018 (HealthDay News) — Few participants in clinical trials have strong concerns about the risks of data sharing, according to a special article recently published in the New England Journal of Medicine.

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AMA Adopts Policy Promoting Health Equity As a Goal

FRIDAY, Aug. 24, 2018 (HealthDay News) — The American Medical Association (AMA) House of Delegates has adopted a policy that sets health equity as a goal for the U.S. health care system, according to a report published in the organization’s AMA Wire.

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Decline in Hospital-Acquired Conditions Continues

FRIDAY, Aug. 24, 2018 (HealthDay News) — The rate of hospital-acquired conditions (HACs) continued its decline from 2014 to 2016, according to the Agency for Healthcare Research and Quality (AHRQ) National Scorecard on Hospital-Acquired Conditions.

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Small Practices Also at Risk for Data Breaches

WEDNESDAY, Aug. 22, 2018 (HealthDay News) — Data breaches can happen to small medical practices, but staff can take steps to prevent them, according to an article published in Medical Economics.

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Strategy Outlined for Shooter Incident in Health Care Facility

WEDNESDAY, Aug. 22, 2018 (HealthDay News) — Adhering to a “secure, preserve, fight” strategy is recommended for health care professionals working with a vulnerable patient population, according to a Medicine and Society piece published in the Aug. 9 issue of the New England Journal of Medicine.

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Lower Long-Term Survival for In-Hospital Cardiac Arrests in Blacks

WEDNESDAY, Aug. 22, 2018 (HealthDay News) — Older black survivors of in-hospital cardiac arrest (IHCA) have worse long-term survival than whites, according to a study published online Aug. 17 in Circulation.

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National Provider Identifiers Are Vulnerable to Theft

WEDNESDAY, Aug. 22, 2018 (HealthDay News) — National Provider Identifiers (NPIs) are vulnerable to identity theft, according to an article published in Physicians Practice.

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Advantages for HDHP Enrollees in Large Versus Small Firms

WEDNESDAY, Aug. 22, 2018 (HealthDay News) — Workers in small firms are more likely to have higher deductible levels and lack employer contributions to help pay for out-of-pocket expenses compared to workers in larger firms, according to a study published in the August issue of Health Affairs.

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Doctors Often Not Discussing Risk Factors With Patients

TUESDAY, Aug. 21, 2018 (HealthDay News) — Patients report that doctors are routinely not discussing known risk factors for common causes of death, according to a survey conducted by ImagineMD.

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Pennsylvania Case Could Affect Evidence for Malpractice Defense

TUESDAY, Aug. 21, 2018 (HealthDay News) — The Pennsylvania Supreme Court has agreed to hear a case that could affect what evidence physicians may present in defense during medical malpractice suits, according to an article published in the American Medical Association’s AMA Wire.

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Large Number of Presumed Sudden Cardiac Deaths Are Not

TUESDAY, Aug. 21, 2018 (HealthDay News) — A large percentage of deaths attributed to cardiac arrest are neither sudden nor unexpected, according to a study published recently in Circulation.

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Preventable Adverse Drug Events Usually of Minor Severity in Kids

TUESDAY, Aug. 21, 2018 (HealthDay News) — The incidence of preventable adverse drug events (pADEs) is zero to 17 per 1,000 patient-days in general pediatric wards and zero to 29 in intensive care units, with most pADEs of minor severity, according to a review published online Aug. 10 in Pediatrics.

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Experts Offer Tips for Provider Appeal of Denied Medical Claims

MONDAY, Aug.20, 2018 (HealthDay News) — Knowing payer policies and regulatory requirements is critical to appealing denials, according to an article published in Medical Economics.

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NYU Becomes First Medical School to Cover All Tuition

MONDAY, Aug. 20, 2018 (HealthDay News) — The NYU School of Medicine has announced that it is offering full-tuition scholarships to all current and future students in its M.D. degree program, regardless of need or merit.

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Novel hs-cTnT Protocol Better Rules Out Myocardial Infarction

MONDAY, Aug. 20, 2018 (HealthDay News) — A novel high-sensitivity (hs) cardiac troponin T (cTnT) protocol for ruling out myocardial infarction (MI) rules out more patients than the existing protocol, according to a research letter published online Aug. 6 in Circulation.

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QI Program Can Up Outcomes for Neonatal Abstinence Syndrome

FRIDAY, Aug. 17, 2018 (HealthDay News) — Significant improvements in neonatal abstinence syndrome (NAS) outcomes can result from a comprehensive quality improvement (QI) program, according to a study published in the August issue of the Journal of Perinatology.

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Residents’ Sleep Deteriorates During Training

FRIDAY, Aug. 17, 2018 (HealthDay News) — First-year residents experience worsening sleep duration and quality as well as daytime sleepiness, according to a study published in the June issue of the Journal of General Internal Medicine.

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Patient Portals Don’t Appear to Have Much Traction

THURSDAY, Aug. 16, 2018 (HealthDay News) — Patient portals have not taken off as expected, according to an article published in Medical Economics.

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ACA Coverage Gains Include Workers Without Insurance

THURSDAY, Aug. 16, 2018 (HealthDay News) — After the expanded coverage provisions of the Affordable Care Act (ACA) were implemented in 2014, self-employed individuals and wage earners without employer-sponsored health coverage offers had coverage gains equal to or greater than those of people not employed, according to a report published in the August issue of Health Affairs.

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DNR Orders Linked to Increased Mortality in Older Adults

WEDNESDAY, Aug. 15, 2018 (HealthDay News) — For hospitalized older patients, the presence of a do-not-resuscitate (DNR) order is associated with poor short-term clinical outcomes, including mortality, according to a study recently published in the Journal of the American Geriatrics Society.

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Completing Sepsis Bundle Within an Hour Cuts Pediatric Mortality

TUESDAY, Aug. 14, 2018 (HealthDay News) — Completion of a one-hour sepsis bundle within one hour cuts mortality in pediatric patients, according to a study published in the July 24/31 issue of the Journal of the American Medical Association.

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6 Factors Related to Inclusion in Health Care Workplace ID’d

TUESDAY, Aug. 14, 2018 (HealthDay News) — There are six broad factors that can affect inclusion within health care organizations, according to a study published online Aug. 3 in JAMA Network Open.

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Four Pros to Integrating EHR, Practice Management Software

MONDAY, Aug. 13, 2018 (HealthDay News) — Consolidating electronic health records and practice management software allows practices to save time and money, make fewer mistakes, and reduce the risk of privacy breaches, according to an article published in Physicians Practice.

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Bundling Doesn’t Cut Medicare Payments for Medical Conditions

FRIDAY, Aug. 10, 2018 (HealthDay News) — Bundling of payments for five common medical conditions is not associated with changes in Medicare payments per episode or health outcomes, according to a study published in the July 19 issue of the New England Journal of Medicine.

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AMA Adopts Policy on Augmented Intelligence

FRIDAY, Aug. 10, 2018 (HealthDay News) — The American Medical Association (AMA) House of Delegates has adopted a policy on augmented intelligence, according to a report published in the association’s AMA Wire.

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ACS Briefing Discusses Use of Lessons From Combat Care

FRIDAY, Aug. 10, 2018 (HealthDay News) — The American College of Surgeons (ACS) hosted a briefing on Capitol Hill to discuss the successes and challenges of combat casualty care in Iraq and Afghanistan by the U.S. military, and how an integrated military-civilian trauma system can help save the lives of both soldiers and civilians.

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Military-Civilian Trauma System Partnership Developed

FRIDAY, Aug. 10, 2018 (HealthDay News) — A growing partnership between the Military Health System and permanent civilian trauma institutions is being fostered, according to an article published in the August issue of the Journal of the American College of Surgeons.

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Teen Sudden Cardiac Death Causes Often Not ID’d on Screens

FRIDAY, Aug. 10, 2018 (HealthDay News) — Among adolescent soccer players in the United Kingdom, the incidence of sudden cardiac death is 6.8 per 100,000 athletes, and most of the deaths were due to cardiomyopathies not identified on cardiac screening, according to a study published in the Aug. 9 issue of the New England Journal of Medicine.

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AMA Adopts Policy to Advance Gender Equity in Medicine

THURSDAY, Aug. 9, 2018 (HealthDay News) — The American Medical Association (AMA) House of Delegates has adopted a new policy to study, act for, and advocate to advance gender equity in medicine, according to a report published in the association’s AMA Wire.

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Steps Taken to Increase Use of Electronic Tools in Medicine

WEDNESDAY, Aug. 8, 2018 (HealthDay News) — Additional codes have been approved by the Current Procedural Terminology (CPT) Editorial Panel for chronic care remote physiologic monitoring and internet consultations, according to a report published by the American Medical Association (AMA).

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AMA Proposes Policy Opposing Medicaid ‘Lockout’ Provisions

TUESDAY, Aug. 7, 2018 (HealthDay News) — A new policy opposing lockout provisions that block Medicaid patients from the program for lengthy periods and instead supporting allowing patients to reapply immediately for redetermination was adopted by the American Medical Association (AMA) House of Delegates during the AMA’s annual meeting in Chicago, according to an article published in the association’s AMA Wire.

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Factors Examined for End-of-Life Spending Levels in Cancer Care

TUESDAY, Aug. 7, 2018 (HealthDay News) — Geographic variation in end-of-life spending can be explained by availability of services and physicians’ beliefs, but not patients’ beliefs, according to a study published in the July issue of Health Affairs.

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Routine X-Ray Not Needed After US-Guided Central Line Insertion

TUESDAY, Aug. 7, 2018 (HealthDay News) — Pneumothorax and catheter misplacement after ultrasound-guided central venous catheter (CVC) insertion are rare and thus do not justify post-procedural chest X-ray (CXR), according to a study published in the July issue of CHEST.

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Death Records Estimate 1,139 Deaths Due to Hurricane Maria

TUESDAY, Aug. 7, 2018 (HealthDay News) — Based on death records following Hurricane Maria, the hurricane-related mortality burden of excess deaths through December 2017 is estimated to be 1,139, higher than the official death toll of 64, according to a research letter published online Aug. 2 in the Journal of the American Medical Association.

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Plasma Copeptin More Accurate for Diabetes Insipidus Diagnosis

MONDAY, Aug. 6, 2018 (HealthDay News) — In patients with hypotonic polyuria, the direct measurement of hypertonic saline-stimulated plasma copeptin has better diagnostic accuracy than the water-deprivation test, according to a study published in the Aug. 2 issue of the New England Journal of Medicine.

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Some Bacteria Now More Tolerant of Alcohol-Based Sanitizers

FRIDAY, Aug. 3, 2018 (HealthDay News) — Some types of bacteria are developing tolerance of alcohol-based hand sanitizers used in hospitals, according to a study published in the Aug. 1 issue of Science Translational Medicine.

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Variation in Specialty Drug Coverage Across Health Plans

FRIDAY, Aug. 3, 2018 (HealthDay News) — There is considerable variation in specialty drug coverage across commercial health plans, according to a study published in the July issue of Health Affairs.

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Groups Urge CMS to Reconsider Suspending Risk Adjustment

FRIDAY, Aug. 3, 2018 (HealthDay News) — In a letter sent to Administrator Seema Verma of the Centers for Medicare & Medicaid Services (CMS), medical organizations are urging reconsideration of the decision to suspend payments to insurers as required under the Affordable Care Act’s risk-adjustment program.

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Health Affairs Announces Launch of New Three-Year Initiative

THURSDAY, Aug. 2, 2018 (HealthDay News) — A council on health care spending and value has been established by the journal Health Affairs.

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Three Financial Metrics Can Improve Practice Performance

THURSDAY, Aug. 2, 2018 (HealthDay News) — By understanding three indices and metrics, physicians can change the financial outcome of their medical practice, according to a report published in Medical Economics.

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New Short-Term Health Plans Have Large Coverage Gaps

THURSDAY, Aug. 2, 2018 (HealthDay News) — There are large coverage gaps in short-term health plans that were approved Wednesday by the Trump administration, and are described by critics as “junk insurance.”

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How Doctors Receive Feedback Is Key for Antimicrobial Programs

THURSDAY, Aug. 2, 2018 (HealthDay News) — Anticipation of how providers will receive feedback is important for antimicrobial stewardship programs to consider in informing educational messaging, according to a study published online June 7 in Infection Control & Hospital Epidemiology.

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National Guideline Clearinghouse Offline Due to Funding Cuts

WEDNESDAY, Aug. 1, 2018 (HealthDay News) — The National Guideline Clearinghouse (NGC) and National Quality Measures Clearinghouse (NQMC) websites were taken down on July 16 when funding for these federal databases ended, according to an announcement by the Agency for Healthcare Research and Quality (AHRQ).

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Telemedicine Cuts Inter-Hospital ICU Transfers of Critically Ill

WEDNESDAY, Aug. 1, 2018 (HealthDay News) — Telemedicine is associated with a decrease in inter-hospital intensive care unit (ICU) transfers, according to a study published in the July issue of CHEST.

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