Millions of Back Problems
Back pain is one of the most expensive conditions treated in the United States, according to the Agency for Healthcare Research and Quality. In 2008, 7.3 million emergency department visits and 2.3 million hospital stays were related to back problems. The cost of the hospital stays alone was $9.5 billion, making back pain the ninth most expensive condition in that category. People 85 years and older had the highest rates of emergency visits and hospitalizations for back problems as a primary or secondary diagnosis, but individuals 18–44 years old were most likely to visit emergency departments with back pain as their main problem.
The study showed that rural patients had the highest rates of back-related emergency department visits and inpatient stays, while patients from large metropolitan areas had the lowest. “Not only do back problems result in expensive and resource-intensive medical care, but they also result in loss of functioning, reduced quality of life, and reduced productivity in the workforce,” the researchers noted.
Stricter Standards for Stroke Care
The American Heart Association and its American Stroke Association are recommending creation of a specialized class of stroke-care centers in the United States. Called Comprehensive Stroke Centers, they would be held to stricter standards than are current Primary Stroke Centers, which would continue to exist. For instance, the comprehensive centers would be measured by the time from hospitalization to blood vessel repair for patients with ruptured aneurysms. “Initiatives such as primary and now comprehensive stroke center certification will greatly help us reach our 2020 goal” of reducing cardiac and stroke deaths by 20%, Dr. Ralph L. Sacco, president of the AHA, said in a statement. The recommendations were published in Stroke: Journal of the American Heart Association.
Medicaid Hospital Admissions Rise
Medicaid hospital admissions rose 30% between 1997 and 2008, while admissions of privately insured patients grew by 5%, the Agency for Healthcare Research and Quality found in an analysis. By 2008, Medicaid paid for 18% of the nearly 40 million hospital stays by U.S. patients. Maternity-related and newborn care accounted for half of the Medicaid-financed hospitalizations. In that year, the public insurance program spent $51 billion on hospital care, compared with $117 billion paid by private insurers and a cost of $15 billion for the care of uninsured patients.
Medicare Use is Uneven
The amount of Medicare service used by beneficiaries varies substantially across the country. Beneficiaries in high-service-use areas get Medicare-funded care about 30% more than do beneficiaries in low-service areas, according to a report from the Medicare Payment Advisory Commission. This regional variation is particularly high for postacute care, such as home health, MedPAC reported.
However, a region with high utilization for one group of services typically has high utilization overall. For instance, areas that have high service use among Medicare beneficiaries during the year before their deaths tend to have high utilization overall. Medicare drug plans also tend to have a similar pattern of utilization. “In short, the pattern of high use often extends across different services and different groups of beneficiaries,” the report said.
Stealth Grants to Advocacy Groups
Health-advocacy groups are not routinely disclosing their financial ties to pharmaceutical companies, according to a new study. Researchers led by Sheila Rothman, Ph.D., of Columbia University, New York, studied grants made by Eli Lilly to such groups in 2007. The company was the first drugmaker to disclose its payouts. During the first half of the year, Lilly gave $3.2 million to 161 organizations that were generally concerned with diseases that the company's products treat. Only 25% of those organizations acknowledged getting Lilly grants on Web sites, and none disclosed the amount. Two-thirds of the funds went to mental health groups. Only 18% of those advocacy groups identified Lilly as a corporate sponsor.