The Rundown | Week of 11.12.2018

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Study: Rise in Crime Rates Can Cause Rise in Blood Pressure

New research has correlated higher rates of violent crime in urban environments to higher blood pressure for residents — even those who live in relatively safe areas. The study analyzed more than 53,000 adults in Chicago from 2014 to 2016 as well as rates of robberies, assaults, and murders. Results indicated that regions with lower crime rates had 14 percent fewer patients with high blood pressure than residents of high-crime areas. Interestingly, a 2015 spike in crime activity elevated high blood-pressure cases in low-crime areas by 5 percent. The study’s lead author Elizabeth L. Tung, MD, noted, “When you look at the rise in crime over that time period, we saw a rise in blood pressure, a rise in outpatient appointments, and a rise in hospital admissions for both all-cause reasons and even more so for cardiovascular reasons.” The spike was not as pronounced on high-crime areas. Researchers speculate this has to do with an immunity to, or tolerance of, crime that rendered the uptick imperceptible. Unsafe areas can also discourage residents from seeking care or engaging in healthy behaviors such as exercise.
>> Read More: Rising Crime Rate Tied to Rising Blood Pressure

Study: Surgeons Prescribe 4x the Opioids Needed

A study in JAMA Surgery demonstrates that surgeons have over-prescribed opioids at a rate that is nearly four times as much as patients require. Researchers concluded that patients only consumed 27 percent of their opioid prescriptions. Furthermore, patients who were prescribed larger number of doses used more of the medication. The study suggests that the quantity of opioids prescribed — as opposed to a patient’s level of pain — was the foremost factor in determining the amount of medication patients consumed. The population-based study analyzed 2,932 surgical patients from January 1 to September 30, 2017. Researchers concluded that using “patient-reported opioid consumption will improve postoperative opioid prescribing to better match patient opioid requirements,” and in the process, lower patients’ risk of addiction.
>> Read More: Association of Opioid Prescribing With Opioid Consumption After Surgery in Michigan

Report: Physician Intervention Needed to Combat Superbugs

A report from the Organisation for Economic Co-operation and Development (OECD) suggests that superbug infections could “cost the lives of around 2.4 million people in Europe, North America and Australia over the next 30 years unless more is done to stem antibiotic resistance.” Over-prescribing antibiotics for ailments that do not require them and poor medication adherence are two of the culprits. Data from the Centers for Disease Control and Prevention show that 23,000 of the 2 million Americans who acquire antibiotic-resistant infections die each year. Five measures that could reduce the risk of antimicrobial resistance (AMR) conditions include “promoting better hygiene, ending the over-prescription of antibiotics, rapid testing for patients to determine whether they have viral or bacterial infections, delays in prescribing antibiotics, and mass media campaigns.” Researchers from OECD noted that three-quarters of the projected fatalities are preventable through measures such as hand washing, “more prudent prescription of antibiotics,” and allocating $2 per person every year for public health initiatives.
>> Read More: Stopping antimicrobial resistance would cost just USD 2 per person a year

Geisinger CEO to Join Google

CEO and president of Geisinger, David Feinberg, will vacate his position at the hospital system for a new role at Google beginning in December. Earlier this year, Feinberg declined an offer to lead the unnamed Amazon-Berkshire Hathaway-JPMorgan healthcare venture; the position was later filled by Atul Gawande, MD. While Google has kept their healthcare initiatives a secret, experts speculate that Feinberg will assist with deep learning AI endeavor Google Brain, Nest home automation, and Google Fit, a health and activity tracker. So far, Google’s forays into healthcare include transcribing patient-doctor conversations into electronic health records (EHRs) to minimize errors and physician burnout. Under Feinberg’s leadership, the Pennsylvania-based healthcare system’s revenue increased by 9 percent to $5.1 billion in the first three quarters of this year as well as a 4.6 percent increase in patient service revenue. Executive Vice President and Chief Medical Officer Jaewon Ryu, MD, will serve as Geisinger’s interim CEO.
>> Read More: Geisinger CEO Feinberg packs for Google months after shrugging off Amazon

Azar Announces CMS’s Mandatory Payment Model

The Centers for Medicare and Medicaid Services (CMS) plans to debut a mandatory payment model for Medicare cancer patients, according to Alex Azar, secretary of the Department of Health and Human Services. “Real experimentation with episodic bundles requires a willingness to try mandatory models,” Azar said at the Patient-Centered Primary Care Collaborative conference, where the announcement was made. However, many oncologists have pushed back, suggesting that the model be made voluntary. The proposed model is particularly focused on radiation oncology, which is projected to increase by 38 percent from 2010 to 2020 due to the growing number of elderly patients. With regards to whether mandatory models can drive the shift to value-based care, Azar said, “We know they are the most effective way to know whether these bundles can successfully save money and improve quality.” Also announced were two unspecified, voluntary models for cardiac procedures.
>> Read More: Azar says new mandatory oncology pay model is coming

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