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
“In this issue of JAMA Network Open, Hsia et al sought to determine whether efforts to improve access, treatment, and outcomes for patients with ST-elevation myocardial infarction (STEMI) by means of cardiac care regionalization were associated with widened or narrowed disparities between minority and nonminority communities at the zip code level across the state of California. Access was defined as admission to a hospital with percutaneous coronary intervention (PCI) capability; treatment was defined as receiving coronary angiography or PCI (as clinically indicated) the day of admission or at any time during hospitalization; and outcomes were defined as all-cause mortality at … Read More
“[Introduction] The American Heart Association (AHA), American College of Cardiology (ACC), and the US Preventive Services Task Force (USPSTF) all recommend hydroxymethyl glutaryl coenzyme A reductase inhibitors (statins) for primary prevention of cardiovascular events in adults aged 40 to 75 years who have an elevated risk (most often defined as ≥7.5% risk of major adverse cardiovascular event [MACE] within 10 years). [..] Although the benefits of statins to decrease cardiovascular events such as myocardial infarction and stroke have been well documented for adults younger than 75 years, when these benefits occur is unclear. In contrast, the burdens of statins appear … Read More
“[Introduction] [..] In one study of a large Accountable Care Organization, PCP relocation, retirement, or death was the dominant factor associated with the reassignment of approximately one-third of Medicare beneficiaries to a new Accountable Care Organization every year. [Methods] This cohort study used Medicare administrative claims data for a 20% random sample of continuously enrolled, fee-for-service beneficiaries. For the main study sample as well as subgroup analyses, we included beneficiaries visiting a PCP for at least 1 evaluation and management visit from January 1, 2008, to December 31, 2017. We then limited the study sample to PCPs who treated 30 … Read More