Public Reporting Impact
Public reporting could be causing physicians to shy away from aggressive approaches in high-risk cardiac patients, according to a published study (J. Am. Coll. Cardiol. 2005;45:1759-65). Researchers compared the use of percutaneous coronary intervention (PCI) in patients in Michigan, where public reporting is not required, and patients in New York, where it is mandatory. They found that patients in Michigan underwent PCI for acute myocardial infarction, cardiac arrest, and cardiogenic shock more often than did patients in New York. And patients in New York had a significantly lower unadjusted mortality than did patients in Michigan. However, after adjustment for comorbidities there was no significant difference between patients in the two states. “Although making accurate outcomes information accessible has the potential to improve health care, our study suggests that public reporting of outcome data might also have an unintended effect on case selection, leading to a tendency toward not intervening on higher-risk patients,” the researchers wrote.
Heart Disease Fears
More women may be getting the message that heart disease poses a serious risk to them, according to a survey commissioned by the Society for Women's Health Research. The survey, which included responses from more than 1,000 adult women, found that 9.7% list heart disease as the disease they fear most, up from 5.3% in 2002. Heart disease came in as the third most feared disease in the survey. An unspecified type of cancer ranked first with 24% of women citing that as their most feared disease. Breast cancer ranked second (22.1%). “Women increasingly recognize that heart disease is the biggest health threat they face over the course of their life,” Phyllis Greenberger, president and CEO of SWHR said in a statement.
Boston Scientific Settlement
Officials at Boston Scientific have agreed to pay $74 million to the federal government to resolve an investigation into the company's 1998 distribution and recall of one of its coronary stent delivery systems. This resolves a civil complaint filed by the U.S. Attorney's Office that alleged that the company distributed 34,589 of the NIR ON Ranger with SOX stent systems which had a manufacturing defect that resulted in random failures of the balloons used to deploy the stents. The complaints also alleged that the company failed to identify and separate the defective devices and that it failed to establish proper internal procedures to identify the causes of the defects. Boston Scientific's agreement to pay $74 million resolves the allegations without admitting liability. Boston Scientific President and CEO Jim Tobin said the company's employees acted “legally, responsibly, and appropriately. … We elected to settle this lingering matter so we could put it behind us and devote our full energies to developing our life-saving medical technologies.”
The Cost of Smoking Deaths
Smoking deaths cost the nation $92 billion in lost productivity annually, from 1997 to 2001, the Centers for Disease Control and Prevention reported. This reflects an increase of about $10 billion from the annual mortality losses for the years 1995-1999. During the same period, an estimated 438,000 premature deaths occurred each year as a result of smoking and exposure to secondhand smoke. In an independent action, the American Medical Association's House of Delegates took measures to discourage tobacco use at its annual meeting, voting to support increases in federal, state, and local excise taxes on tobacco. Such increases in the excise taxes should be used to fund the treatment of those afflicted by tobacco-related illness, and to support counter-advertising efforts, the resolution stated.
Health Insurance Statistics
The ranks of the uninsured appear to be leveling off, according to a survey conducted by the CDC's National Center for Health Statistics. In 2004, 42 million Americans of all ages were without health insurance, about the same level as in 1997, the first year this survey began tracking these statistics. In addition, one in five working age adults (aged 18-64 years) were without health insurance last year, a number that had been steadily rising in recent years, but also leveled off in 2004. The survey showed continued improvements in coverage for children: Seven million children aged under 18 years were without health insurance in 2004, compared with 10 million children in 1997.
NIH Extends Disclosure Deadline
Officials at the Department of Health and Human Services are giving employees at the National Institutes of Health more time to report prohibited financial interests and to divest stock. In its announcement of the extension, HHS wrote that the it is considering issuing revisions to its current ethics regulations. In February, the agency issued regulations prohibiting NIH employees from engaging in consulting relationships with organizations that are substantially affected by NIH decisions. And NIH employees who are required to file financial disclosure statements are prohibited from acquiring or holding financial interests in these affected organizations. NIH employees now have until Oct. 3, 2005, to file financial disclosure reports and until Jan. 2, 2006, to divest of prohibited financial interests. “There's no doubt in my mind that at the end of the day the advice that NIH gives has to be completely untainted, completely unimpeachable, and completely trusted,” NIH Director Elias Zerhouni, M.D., said during a teleconference sponsored by the Kaiser Family Foundation.