Telemedicine for Stroke Care
A flagship hospital with an established stroke care program can legally set up telemedicine equipment in local community hospitals for stroke consultations, with the goal of reducing the transfer of patients with neuro-emergencies, according to an opinion issued by the U.S. Health and Human Services Department's Office of Inspector General. The opinion, which redacted the name of the requesting hospital, said that the collaboration would not violate federal antikickback laws. “For legal reasons, community hospitals frequently transfer suspected stroke patients to comprehensive stroke centers” even though the patients may not be in critical condition, according to background information in the opinion. The telemedicine consultation could reduce such unnecessary transfers. Under the agreement, the flagship hospital would provide the telemedicine equipment and 24-hour physician staffing, while the local hospitals will have to have at least one CT scanner and the ability to transmit imaging studies. Both hospitals would be allowed to use each other's trademarks for certain marketing activities, according to the opinion.
Specialty Work Intensity Equal
When neurologists are compared with physicians in several other specialties including primary care, their work intensity is relatively equal, according to a study published in the journal Medical Care and funded by the American Academy of Neurology (AAN). Researchers evaluated a sample of 45 family physicians, 20 general internists, 22 neurologists, and 21 surgeons located in Kansas, Kentucky, Maryland, Ohio, and Virginia. The physicians' responses to questionnaires were then measured via several statistical formulas. “The findings of this and other studies suggest that the instruments can be utilized in further investigation of clinical work intensity and that currently accepted assumptions of grossly differing work intensity among medical specialists may be flawed. These possibly incorrect assumptions have contributed to the development of current inequalities in relative value unit (RVU) distribution for procedures and evaluation and management (E/M) services,” said study author Dr. Jerzy P. Szaflarski in a statement on the AAN's website.
Stroke Rate Rises in Young
Risk of hospitalization due to ischemic stroke among children and young adults rose by nearly 37% between 1995 and 2008, according to a study published in Annals of Neurology. Researchers at the Centers for Disease Control and Prevention analyzed a nationwide hospital discharge databank, and broke down the data based on sex and three age groups. Results showed that “the prevalence of hospitalizations of acute ischemic stroke increased among all age and [sex] groups except females aged 5 to 14 years.” Hospitalization risk among boys and men between 5 and 44 had the highest increase, by roughly 50%. The authors indicated that the rate of common risk factors for stroke, such as hypertension and diabetes, has been on the rise in this age group. “Our results from national surveillance data accentuate the need for public health initiatives to reduce risk factors for stroke among adolescents and young adults,” they wrote.
More Medicare-Fraud Charges
The U.S. Department of Justice has charged 91 doctors, nurses, and other health professionals with Medicare fraud amounting to $295 million in false billing in eight cities. In Miami, a doctor, a nurse, and 43 other defendants were charged with a total of $159 million in false charges for home health care, mental health services, occupational and physical therapy, durable medical equipment, and HIV infusions. Some of those defendants are charged with coercing poor people to pose as Medicare beneficiaries at a community mental health care center. The indictments constitute the highest amount of false Medicare billings in a single takedown in the history of the Medicare Fraud Strike Force, HHS Secretary Kathleen Sebelius said in announcing the indictments with Attorney General Eric Holder. Secretary Sebelius added that “our efforts to stop criminals don't end here, because the Affordable Care Act gives us new tools to prevent Medicare fraud before it is committed,” according to an HHS statement.
Patients Think Newer Is Better
Patients are more likely to choose newer drugs over older when they're not provided information about the products' safety and effectiveness, according to a study published in Archives of Internal Medicine. The researchers gave participants a choice between two fictitious drugs for heartburn and two for high cholesterol. More people chose a drug described as older if they were also told the newer drug many not be as safe and effective. But for the heartburn drug, most people who were not given that warning chose the newer drug. In their Internet survey, the researchers also found that 39% of respondents believed that the Food and Drug Administration approves only “extremely effective” drugs, and 25% believed that the FDA approves only drugs without serious side effects.