Hospitals Building Emergency Rooms for the Elderly - NYTimes.com

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By ALYSON MARTIN and NUSHIN RASHIDIAN

Hospitals nationwide are trying to redefine the E.R. experience for the elderly by building facilities dedicated solely to their needs. St. Joseph Mercy’s parent company, Trinity Health System, opened the nation’s first senior E.R. at Holy Cross Hospital in Silver Spring, Md., in 2008 and plans to put one in 19 other hospitals by 2013. Senior E.R.’s, also called geriatric emergency departments, also have opened in Texas, New Jersey, Missouri and Kansas. By year’s end, Mount Sinai Medical Center plans to open Manhattan’s first such facility.

“We’re going to have an increase in people over the age of 65 who are going to take their medical problems with them to hospital emergency departments,” said Dr. Georges Benjamin, executive director of the American Public Health Association. “The fact that we’re really preparing for that wave, I think, is important.”


The drive to build senior E.R.’s is motivated in part by hospitals’ desire to find an edge in the increasingly competitive health care marketplace.
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More Vets Approved for Agent Orange Claims from MedPage Today

By Joyce Frieden, News Editor, MedPage  Today

Veterans who served in Korea from 1968 through 1971 were probably exposed to Agent Orange, which makes them eligible for treatment at VA medical centers, according to a ruling from the Department of Veterans Affairs.
"VA's primary mission is to be an advocate for veterans," Secretary of Veterans Affairs Eric K. Shinseki said in a statement. "With this new regulation VA has cleared a path for more veterans who served in the demilitarized zone in Korea to receive access to our quality healthcare and disability benefits for exposure to Agent Orange."


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Bone Mineral Density Screening: Older Women With Normal T-Scores Can Wait For 10 Years

Since 2002, the U.S. Preventive Services Task Force has recommended that women ages 65 and older be routinely screened for osteoporosis and has suggested that a 2-year screening interval might be appropriate. However, what length the screening interval should be is a topic that remains controversial and undecided, with no definitive scientific evidence to provide guidance.

Now a new study led by Margaret L. Gourlay, MD, MPH of the University of North Carolina at Chapel Hill School of Medicine finds that women aged 67 years and older with normal bone mineral density scores may not need screening again for 10 years.

"If a woman's bone density at age 67 is very good, then she doesn't need to be re-screened in two years or three years, because we're not likely to see much change," Gourlay said. "Our study found it would take about 16 years for 10 percent of women in the highest bone density ranges to develop osteoporosis."

Source: Tom Hughes University of North Carolina School of Medicine

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The Potential of Global Payment: Insights from the Field - The Commonwealth Fund

In the 80s and early 90s, health care providers in the managed care world were frequently paid via capitation—that is, a flat fee per patient. Use of the practice has eroded significantly, but experienced provider and plan leaders believe moving to improved models of capitation, called global payment, would result in much better care for all types of patients at more reasonable cost. In researching this report, the author interviewed 16 individuals from four geographic markets with extensive expertise managing capitation and global payment. These experts unanimously supported global payment and estimated that proper alignment of payment and quality incentives could generate a 20 percent to 30 percent cost reduction while greatly improving care quality. They believe it is now possible to resolve problems that plagued capitation in the past, such as avoidance of sicker patients and excessive risk assumption, but that environmental changes have also created new challenges.

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Seniors Stymied In Wait For Kidney Transplants

from Medical News Today

One-third of people over the age of 65 wait longer than necessary for lifesaving, new kidneys because their doctors fail to put them in a queue for organs unsuitable to transplant in younger patients but well-suited to seniors, research from Johns Hopkins suggests.
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