Depression Care in Hospital Helps Cardiac Patients

By Crystal Phend, Senior Staff Writer, MedPage Today

A collaborative program to manage depression among heart patients before hospital discharge appears to ease both mood and cardiac symptoms, researchers found.

A prospective, randomized trial also found that the program improved self-reported adherence to medication and advice on diet, exercise, and stress reduction six months later, Jeff C. Huffman, MD, of Massachusetts General Hospital in Boston, and colleagues, reported in the March issue of Circulation: Cardiovascular Quality and Outcomes.

Such programs have proven successful before, but were only conducted among patients after discharge, the group noted.

Their program showed the feasibility of screening for depression and starting treatment during a "teachable moment" while patients were still in the cardiac unit, Huffman and colleagues explained.

Thus "these results may represent a substantial first step in the systematic treatment of depression in hospitalized cardiac patients, a population for whom depression is independently associated with cardiac morbidity and mortality, and effective therapy remains greatly underrealized," they wrote.

More

Cost Keeps Stroke Meds Out of Reach for Some

By Todd Neale, Staff Writer, MedPage Today

Some stroke survivors skip prescribed medications because the cost is too high -- a situation that may be worsening, particularly among young and uninsured patients, researchers found.
Full Article

Inverse Benefits Due to Drug Marketing Undermine Patient Safety and Public Health, Study Finds

ScienceDaily (2011-01-13) -- Drugs that pharmaceutical companies market most aggressively to physicians and patients tend to offer less benefit and more harm to most patients -- a phenomenon described as the "inverse benefit law," according to new research.

Link Between Fracture Prevention and Treatment Adherence Not Fully Understood by Patients

ScienceDaily (2011-01-12) -- Newly released findings of a multinational survey conducted on behalf of the International Osteoporosis Foundation show clear disparities between patients' and doctors' perceptions of osteoporosis and its management.
Full Article

What Is Value in Health Care? | Health Policy and Reform

 


by Michael E. Porter, Ph.D.

Two framework papers that develop the concepts outlined in this article, “Value in Health Care” and “Measuring Health Outcomes,” are available as Supplementary Appendixes.

In any field, improving performance and accountability depends on having a shared goal that unites the interests and activities of all stakeholders. In health care, however, stakeholders have myriad, often conflicting goals, including access to services, profitability, high quality, cost containment, safety, convenience, patient-centeredness, and satisfaction. Lack of clarity about goals has led to divergent approaches, gaming of the system, and slow progress in performance improvement.

Achieving high value for patients must become the overarching goal of health care delivery, with value defined as the health outcomes achieved per dollar spent.¹ This goal is what matters for patients and unites the interests of all actors in the system. If value improves, patients, payers, providers, and suppliers can all benefit while the economic sustainability of the health care system increases.

Value — neither an abstract ideal nor a code word for cost reduction — should define the framework for performance improvement in health care. Rigorous, disciplined measurement and improvement of value is the best way to drive system progress. Yet value in health care remains largely unmeasured and misunderstood.

Value should always be defined around the customer, and in a well-functioning health care system, the creation of value for patients should determine the rewards for all other actors in the system. Since value depends on results, not inputs, value in health care is measured by the outcomes achieved, not the volume of services delivered, and shifting focus from volume to value is a central challenge. Nor is value measured by the process of care used; process measurement and improvement are important tactics but are no substitutes for measuring outcomes and costs.

Since value is defined as outcomes relative to costs, it encompasses efficiency. Cost reduction without regard to the outcomes achieved is dangerous and self-defeating, leading to false “savings” and potentially limiting effective care.
Full Article

Gail Gibson Hunt Appointed to the Governing Board of the Patient Centered Outcomes Research Institute (PCORI)

Washington DC - (Nov. 12, 2010) - Acting Comptroller General of the United States Gene Dodaro today announced the appointment of Gail Gibson Hunt, President and CEO of the National Alliance for Caregiving, to the Governing Board of the Patient Centered Outcomes Research Institute (PCORI).

"Ms. Hunt brings to the PCORI Board the important perspective of a broad spectrum of patients and their caregivers," Dodaro said.

Hunt has been appointed to the Board to replace Andrew Imparato. Imparato is leaving his position as President and CEO of the American Association of People with Disabilities and his appointment to the PCORI Board of Governors to become Senior Counsel and Disability Policy Director for the Senate Committee on Health, Education, Labor & Pensions (HELP).

Gail Gibson Hunt is President and CEO of the National Alliance for Caregiving, located in Bethesda, MD. The Alliance is a diverse coalition of national organizations that seeks to advocate for and serve as a research and training resource for family caregivers of patients/consumers across the lifespan. Ms. Hunt's previous positions include President of a management consulting firm specializing in aging and a senior manager for human services at KPMG Peat Marwick. Ms. Hunt serves as a member of the Advisory Panel for Medicare Education, and as a board member of the Center for Advancing Health and of Vinson Hall in McLean, VA, and was on the NIH State of the Science Panel on Preventing Alzheimer's and Cognitive Decline. She was a member of the Policy Committee of the 2005 White House Conference on Aging. She has been active in many national and international conferences on family caregiving, and also helped to develop an international coalition of caregiving groups. Ms. Hunt received her BA from Columbia University.