Poor worker health costs productivity: study

From Modern Healthcare:

The cost of lost productivity from poor employee health outpaces employers’ spending on actual medical and pharmacy costs by more than two to one, according to multiyear study out this week in the Journal of Occupational and Environmental Medicine.

The study, Health and Productivity as a Business Strategy: A Multiemployer Study, found that on average every $1 of medical and pharmacy costs is matched by $2.30 of health-related lost productivity costs. “The wake-up call for U.S. employers is that simply looking at the costs of specific medical conditions by adding up medical and pharmacy claims alone won’t give a true picture of the full impact of poor health on the much greater costs of lost productivity in the workforce,” said Ronald Loeppke, executive vice president of Heath and Productivity Strategy at the Alere Center for Health Intelligence, which conducted the study.

Tele ICU: paradox or panacea?

From ScienceDirect:

Telemedicine has been studied in the intensive care unit for several decades, but many questions remain unanswered regarding the costs and the benefits of its application. Telemedicine ICU (Tele-ICU) is an electronic means to link physical ICUs to another location which assists in medical decision making. Given the shortage of intensive care physicians in the US, Tele-ICU systems could be an efficient mechanism for physicians to manage a larger number of critical care patients. This chapter will examine the current state of telemedicine in an age of rapidly expanding medical information technology and increasing demand for intensive care services. While we believe that the future of Tele-ICU is promising, there are multiple issues that must be addressed to increase the benefit of Tele-ICU. Tele-ICU is expensive to deploy and use, it may add burdens to existing intensivists, and it requires organizational and culture changes that can be difficult to accomplish.

A cellulitis guideline at a community hospital

From the Journal of Emergency Primary Care:

To assess whether there is: a) a clinical difference between patients with cellulitis treated according to the recommendations of a clinical cellulitis guideline, and those treated otherwise and b) a difference in the cost of antibiotic treatment of the two groups.

Emergency Department (ED) patients diagnosed with cellulitis at a community hospital were graded using a 4-point scale, and physicians were encouraged to treat based on an established practice guideline. Patients were contacted 5 days after their ED visit, and again at 10 days if they had not improved by 5 days. Physician ‘compliance’ was defined as having followed three or more of the five elements of the guideline.

Of the 272 patients, 147 (54.1%) were classified as Grade I, 53 (19.5%) Grade II, 33(12.1%) Grade III, and 6 (2.2%) Grade IV. In 12.1% the grade was not assigned. 43.5% were treated in compliance with the guidelines, of which 83.3% reported improvement at 5 days, compared to 87.7% of those treated otherwise. At 10 days, 98.8% of the patients treated in compliance with the protocol had improved compared to 94.7% of those treated otherwise. Average antibiotic cost/patient was: Grade 1: $8.48, Grade II: $16.65, Grade II: $96.53 in the ‘compliance’ group, and $35.68, $51.28, and $150.18 respectively in the ‘non-compliance’ group.

Patients treated in accordance with the cellulitis guideline had similar outcomes to those treated otherwise, at significantly lower cost. Efforts to encourage compliance with the guideline are indicated.

Diabetics Visiting the ER Have Greater Chance of Dementia

From the Wall Street Journal Health Blog:

Suffering even one severe bout with low blood sugar appears to increase the risk of dementia in older adults with Type 2 diabetes, according to a new study in the Journal of the American Medical Association.

Diabetes is a known risk factor for dementia, but the study is thought to be the first to examine the effect of hypoglycemia on dementia risk in those with Type 2 diabetes, a form of the disease whose numbers have grown rapidly — even in children — because of the obesity epidemic.

The large study of 16,667 patients, all of whom were in the Kaiser Permanente system, found that having one episode of hypoglycemia serious enough to result in a trip to the hospital or emergency room increased patients’ risk of dementia in later age by 45%. Experiencing two episodes increased the risk by 115% and three or more episodes raised risk by 160%.

Portable Defibrillator with 12-Lead Analysis

From Medgadget:

3fasdfacd3The HeartStart MRx is the only monitor/defibrillator to offer Philips’ new DXL ECG Algorithm, which enables analysis of 12-lead electrocardiogram (ECG) data. Unlike other 12-lead algorithms, the DXL Algorithm identifies the STEMI-CA (Culprit Artery) and provides Critical Values. Philips STEMI-CA pinpoints the probable congested artery, while Critical Values highlight any of four distinct life-threatening conditions requiring immediate clinical attention. In addition, enhanced gender-specific criteria provide valuable information for diagnosing cardiac emergencies in women. These tools provide user-friendly data designed to speed triage, quickly mobilize resources and more efficiently prepare for treatment in the Cath lab.