“findings in these articles are consistent with literature on the adverse impact of weight stigma, which may be exacerbated by the increased focus on weight. Specifically, health promotion approaches that focus on obesity and target the individual perpetuate weight stigma and fail to address the profound inequities that drive disparities in health and weight. For example, BMI report cards, a widely used school-based childhood obesity intervention, inform parents of their child’s weight status and increase parents’ weight-related anxiety but provide little guidance about evidence-based health promotion strategies and offer no structural support for behavior change. Furthermore, weight-focused health promotion approaches … Read More
All posts by Anupam
“While overnight VS [vital sign] measurements disrupt sleep, they are often indicated and necessary for high-risk and potentially unstable patients. Identifying these patients in a reliable and timely manner is an area of active investigation, with efforts focused on models that vary from single parameter tools to weighted early warning scores and advanced predictive models using machine learning techniques. By contrast, relatively little work has been done to identify the low-risk cohort unlikely to benefit from such care that may, in fact, be harmed by these frequent assessments. Identifying this subset of patients has the potential to enhance recovery, improve … Read More
“Since February, like ethicists around the world, I have spent most of my time thinking about the tip of the health care rationing iceberg. As Covid-19 cases exploded across epidemiologic maps, I scrambled to write new guidelines for my health network for the ethical allocation of mechanical ventilators, just in case we ran out. [..] Despite that heady challenge and the urgency of the Covid-19 pandemic, I couldn’t shake the feeling that this effort was all a distraction. Here I was, trying to do a perfect job allocating a handful of mechanical ventilators for an unprecedented viral pandemic, while every … Read More
This week’s refresh of the excess mortality count from the CDC (last updated November 25). The federal agency identified nearly 331,000 excess deaths across the country since the start of this year (about 17,000 more than last week’s estimate). The overall excess mortality rate rose slightly from 11.3% last week to 11.6% this week. Data from CDC’s National Center of Health Statistics, updated November 25, 2020
“Hospital at home (HaH), a care model that provides acute hospital-level care in patients’ homes, has been well characterized. Controlled trials and subsequent meta-analyses have suggested the efficacy of HaH, demonstrating noninferior or even superior mortality, readmission, and length of stay outcomes compared with traditional hospitalization for heterogeneous patient populations. [..] Reasons for low adoption include misaligned or lack of financial incentives and challenges inherent in implementing a complex intervention. For example, even when home hospitalization models have been implemented in the United States in study settings or those with aligned payment incentives, low participation rates have been ubiquitous (ranging … Read More
This week’s refresh of the excess mortality count from the CDC (last updated November 19, I think). The federal agency identified over 314,000 excess deaths across the country since the start of this year (about 10 thousand more than last week’s estimate). The overall excess mortality rate rose slightly from 11.2% last week to 11.3% this week. Data from CDC’s National Center for Health Statistics, updated November 19, 2020
“[Introduction] Hepatocellular carcinoma (HCC) is the fastest rising cause of cancer-related mortality in the US. The incidence of HCC has increased over the last 2 decades owing to the hepatitis C virus (HCV) epidemic. Most HCC cases are diagnosed in advanced stages, with a median survival less than 1 year. Regular surveillance for HCC may help improve early cancer detection rates when curative treatment can be applied and is recommended in patients with HCV-associated cirrhosis. The availability of direct-acting antiviral agents (DAAs) for HCV treatment has substantially altered the landscape of HCV. Though new DAA regimens can result in a … Read More
Summary of findings: U.S. hospitals charge on average $417 for every $100 of their total costs, in statistical terms a 417 percent charge-to-cost ratio. Over the last 20 years, hospital expenditures have grown faster than overall health care expenditures. Hospital expenditures as a percentage of national health expenditures have increased from 30.8 percent in 1999 to 32.7 percent in 2018. In 2018 hospital expenditures alone comprised close to 6 percent of the national GDP. Of the 100 hospitals with the highest charges relative to their costs, for-profit corporations own or operate 95 of them. All of the top 100 hospitals … Read More
“[Methods] [..] We included studies that reported LCS [lung cancer screening] adherence rates in the US and/or determinants of LCS adherence. We considered prospective or retrospective studies that screened adult patients at any risk level of developing cancer who opted to initiate LCS and continued to undergo additional screening after the first LDCT (low-dose computed tomography). [Results] [..] Fifteen studies (19 publications) involving a total of 16 863 individuals were included in this systematic review. [..] 12 studies (80%) did not have a follow-up time that was long enough to adequately assess periodic adherence beyond 1 year. All of the studies … Read More
“Enthusiasm for the potential impact of AI [artificial intelligence] on hospital operations is often based on its impact in other industries. However, non-health care companies invest in AI after having digitized and optimized their operations with a variety of older mathematical methods. In contrast, hospitals may invest in AI while still scheduling patient appointments using fax machines and allocating resources based largely on anecdotal experience. [..] For decades before the advent of modern AI, the operational management of capital, labor, and resources of large manufacturing, retail, airline, and most other large-scale industries were being designed and refined with rigorous methods … Read More