Friday, February 14th, 2014
A new study has linked routine well-child visits–which are advised and recommended at least on an annual basis–with an increased risk that children will be exposed to flu or flu-like germs in the waiting or examination rooms. The study, published in the journal Infection Control and Hospital Epidemiology, emphasized that the findings, which translate to more than 700,000 potentially avoidable illnesses and a $492 million pricetag each year, underscore the importance that doctor’s offices follow existing infection control guidelines.
“Well child visits are critically important. However, our results demonstrate that healthcare professionals should devote more attention to reducing the risk of spreading infections in waiting rooms and clinics. Infection control guidelines currently exist. To increase patient safety in outpatient settings, more attention should be paid to these guidelines by healthcare professionals, patients, and their families,” said Phil Polgreen, MD, MPH, lead author of the study, in a statement.
Researchers from the University of Iowa used data from the Agency for Healthcare Research and Quality’s (AHRQ) Medical Expenditure Panel Survey to examine the healthcare trends of 84,595 families collected from 1996-2008. Included in the analysis were demographic, office-based, emergency room, and outpatient cases records. After controlling for factors, such as the presence of other children, insurance, and demographics, the authors found that well-child visits for children younger than six years old increased the probability of a flu-like illness in these children or their families during the subsequent two weeks by 3.2 percentage points.
This incremental risk could amount to more than 700,000 avoidable cases of flu-like illness each year and $492 million in direct and indirect costs, based on established estimates for outpatient influenza.
In a commentary accompanying the study, Lisa Saiman, MD, notes, “The true cost of flu-like illnesses are much higher since only a fraction result in ambulatory visits and many more cases are likely to result in missed work or school days. Furthermore, these flu-like illness visits are associated with inappropriate antimicrobial use.”
The authors stress the importance of infection prevention and control in ambulatory settings, suggesting pediatric clinics follow recommended guidelines that include improving environmental cleaning, cough etiquette, and hand hygiene compliance.
“Even with interventions, such as the restricted use of communal toys or separate sick and well-child waiting areas, if hand-hygiene compliance is poor, and potentially infectious patients are not wearing masks, preventable infections will continue to occur,” said Polgreen.
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Image: Pediatrician’s office, via Shutterstock
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Friday, January 24th, 2014
The overall U.S. birth rate has dropped by more than 10 percent since 2008, placing it at an historic low of 3.8 million children born in 2011, according to federal statistics released by the Agency for Health Research and Quality. More from CNN.com:
Lots of data shows the U.S. birth rate is headed downwards, and some link this with the economic recession. The birth rate among teenagers has reached new historic lows every year for the past five years
And overall U.S. births have fallen steadily since hitting all-time high of more than 4.3 million in 2007.
The AHRQ also breaks down how much it costs to give birth and who pays for it. Most births are covered by private health insurance, but a growing number are paid for by Medicaid, the joint state-federal health insurance plan for the low income.
“In 2008, Medicaid covered 40.5 percent of hospital stays for newborns, which increased to 44.7 percent in 2011,” the report reads.
“On average, newborns stayed in the hospital for 3.4 days and incurred average hospital costs of $3,200,” it adds. But premature babies stayed on average 14 days and their care cost $21,500.
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Image: Family, via Shutterstock
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Friday, January 17th, 2014
The cost of having a baby ranges from $3,000 to $37,000 in the state of California, a new study published in the journal BMJ Open has found, with no apparent logical explanation for the wild range or the high costs. The study highlights some of the issues with soaring health care costs in the U.S. More from NBC News:
“Even after adjusting for patient characteristics like their length of stay and their age and even adjusting for hospital characteristics and things like the cost of living, we found significant variations in price,” said Dr. Renee Hsia of the University of California, San Francisco, who led the study.
For a simple, uncomplicated vaginal delivery, prices ranged from $3,296 to $37,227, Hsia’s team found. For a C-section, women were billed between $8,312 and nearly $71,000.
“This is, unfortunately, the appalling state of affairs of health care in the United States,” Hsia said.
Even getting the prices wasn’t easy. Hsia’s team had to tease it out from state data on each patient admission. They figured out which ones were for childbirth, and then eliminated any complicated cases.
“Of course we would expect that if woman is in the hospital for six days as opposed to for two days, she would have larger charges,” Hsia said. “And if you deliver a baby in San Francisco, it will be more expensive than if you deliver in a cheaper suburban area.”
But the prices her team found — they are not naming individual hospitals — varied way more than these differences should account for.
The main problem is that patients do not know how much their insurers are paying on their behalf, and they certainly don’t know the price up front, Hsia says.
“This study shows that the market doesn’t take care of health care the way that we would like,” Hsia said in a telephone interview.
“If I go to buy a dozen eggs at the grocery store, I know if they are cage-free,” she added. “As a consumer, I know what I am buying and why there might be price differences. But as a patient, I don’t even know what things cost.”
Health experts say this is one of the main reason U.S. health care is so much more expensive than in other countries — $8,915 per person in 2012, for a total of $2.8 trillion. Of that, $882 billion is spent on hospitals services, like giving birth.
In May, the federal government said it would start publishing data on hospital charges. Their first numbers confirmed what health reform advocates complained about for years: The charges vary enormously, and for seemingly unclear reasons.
The Obama administration hopes that publishing prices will help force health care providers to be more consistent in their billing.
Image: Woman giving birth, via Shutterstock
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Tuesday, September 24th, 2013
Over the past 15 years, the cost of delivering a baby vaginally in a hospital has more than doubled, and the cost of Cesarean sections–which have also increased in frequency–have skyrocketed by 70 percent during that period. More from NBC.com:
Over the last 15 years, the cost of vaginal deliveries has practically doubled in the United States, shooting up from $4,918 to $9,294, while the cost of C-sections has increased 70 percent from an average of $8,268 to $14,055, according to Truven Health Analytics.
By contrast, the average cost for an uncomplicated vaginal delivery last year in Switzerland was $4,039 and the average cost in France was $3,541, according to the International Federation of Health Plans (IFHP). That’s nearly half to a third of what it cost in the U.S.
In fact, the United States is the most expensive place in the world to give birth, according to the IFHP. The reason, experts say, has to do with the way hospitals calculate our bills.
“Every time you walk into the hospital, they look at everything that happens to you and say, ‘Can I bill for that?’” explained Gerard Anderson, director of the Johns Hopkins Center for Hospital Finance and Management.
“So, if you get an aspirin, they’re going to bill for that. If you get seen by a specialist, they’re going to bill for that.”
Even when families do have insurance, their portion of the bill can be staggering.
Image: Pregnant woman in the hospital, via Shutterstock
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Wednesday, September 18th, 2013
The average out-of-pocket cost of fertility treatments tops $5,000, according to a new study of fertility clinics in the San Francisco area. More from Reuters.com:
As expected, researchers found costs were especially high for couples undergoing in vitro fertilization (IVF) – over $19,000, on average – and rose with each additional treatment cycle.
“One of the very early questions people ask after we figure out what we need to do to help them get pregnant is how much the treatment is going to cost,” Dr. James Smith, director of male reproductive health at the University of California, San Francisco, and the study’s senior author, said.
That expense, he told Reuters Health, “has a big impact – they’re taking out second mortgages on homes, they’re borrowing from friends and family.”
Smith and his colleagues interviewed 332 couples attending one of eight fertility clinics for their first evaluation and gave each a cost diary to record all treatment-related expenses. They then interviewed the couples three more times over the next year and a half about those expenses, including money spent on clinic visits and procedures, medications and miscellaneous items such as travel and parking.
Among all couples, the average out-of-pocket cost of fertility treatment was $5,338. However, that varied depending on what type of treatment they received – from $595 for basic, one-time procedures such as uterine fibroid removal or counseling about timing sex to $19,234 for IVF, the technique used by a majority of couples.
Expenses were higher for couples who took more time to get pregnant and underwent more treatment cycles, the researchers found.
However, there was no clear difference in out-of-pocket expenses based on whether couples reported having insurance coverage for fertility care, according to findings published in The Journal of Urology.
“Usually insurance companies will cover things like labs, the basic diagnostic testing,” Smith said. “But the expensive items, like in vitro fertilization, that’s much less well covered.”
He said that is the case in California and most other states, but that a few – including Massachusetts and Illinois – require insurance companies to have more extensive coverage of fertility treatment.
According to the Society for Assisted Reproductive Technology, women received more than 150,000 cycles of IVF in 2011.
Image: Fertility lab technician, via Shutterstock
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