Weekend Update / Miscellany

• Audiologists are licking their chops over the enhanced hearing benefits that FEHB plans are offering in 2009.
• Morpace issued a "study, fielded in September, reveals that 48 percent of American adults
  support creation of a nationwide system of medical records, while 23
  percent oppose such a system." 29 percent are undecided. The National Health Information Network currently underdevelopment would serve a national electronic patient registry. Unquestionably, privacy protections must be extended to the NHIN and its components. Perhaps a greater issue connected with electronic health records is their longevity. I doubt that anyone could find my childhood medical records but if a child born in the next decade could have cradle to grave medical records accessible through the NHIN. I'm not sure that's a good idea. Your doctor need to know your relevant medical history. It might be difficult for a doctor to discern that history from all of the records available via the NHIN.
• EBRI issued its 2008 health confidence survey.
• Health Grades issued its 11th annual hospital quality study. "Patients have on average a 70 percent lower chance of dying at the nation’s top-rated hospitals compared with the lowest-rated hospitals across 17 procedures and conditions" analyzed in the study. "The study’s major findings are:
  • The nation’s inhospital risk-adjusted mortality rate improved, on average, 14.17 percent from 2005 to 2007, but the degree of improvement varied widely by procedure and diagnosis studied (range: 6.30% to 20.94%). Five star-rated hospitals’ mortality rates continue to improve at a faster rate (13.18%) than 1- or 3-star hospitals (12.30% and 13.14%, respectively).
  • Large gaps persist between the “best” and the “worst” hospitals across all procedures and
  diagnoses studied. Five star-rated hospitals had significantly lower risk-adjusted mortality across all three years studied. Across all procedures and diagnoses studied, there was an approximate 70 percent lower chance of dying in a 5-star rated hospital compared to a 1-star rated hospital. Across all procedures and diagnoses studied, there was an approximate 50 percent lower chance of dying in a 5-star rated hospital compared to the U.S. hospital average.
  • If all hospitals performed at the level of a 5-star rated hospital across the 17 procedures and diagnoses studied, 237,420 Medicare lives could have potentially been saved from 2005 to 2007.
  • Fifty-four percent (128,749) of the potentially preventable deaths were associated with just four diagnoses: Sepsis, heart failure, pneumonia and respiratory failure.
  • Variation in risk-adjusted mortality exists not only at the national level but also at the state and regional levels. The greatest quality differences between states occurred in hospital death rates for heart failure, pulmonary, stroke and cardiac surgery.
  • The region with the lowest overall risk-adjusted mortality rates was the East North Central region (IL, IN, MI, OH, and WI), while the East South Central region (AL, KY, MS, and TN) had the highest mortality rates.
  • The East North Central region (IL, IN, MI, OH, and WI), had the highest percentage of bestperforming hospitals at 26 percent. Less than seven percent of hospitals within the New England region (CT, MA, ME, NH, RI, and VT) were top-performing hospitals."