Commissioning Healthcare Policy: Hospital Readmission and Its Price Tag

By ANISH KOKA MD  The message comes in over the office slack line at 1:05 pm. There are four patients in rooms, one new, 3 patients in the waiting room. Really, not an ideal time to deal with this particular message. “Kathy the home care nurse for Mrs. C called and said her weight yesterday was 185, today it is 194, she has +4 pitting edema, heart rate 120, BP 140/70 standing, 120/64 sitting” I know Mrs. C well. She has severe COPD from smoking for 45 of the last 55 years. Every breath looks like an effort because it is. The worst part of it all is that Mrs. C just returned home from the hospital just days ago. The youngest of six children, Mrs. C was born with many embedded disadvantages. Being born black in a poor West Philadelphia neighborhood in the 1960s is a story that too often writes itself with a bad ending.  But Mrs. C avoided the usual pitfalls that derail young women in the neighborhood early. No drugs. No alcohol. No teenage pregnancies. Finished high school. Mrs. C. worked for the hospital as a unit clerk, had her own place, health benefits, and even a retirement plan. Certain life habits, however, carry a heavy price. George Burns, the comedian never pictured without a cigar who died past his hundredth birthday, may have been immune to the effects of tobacco.  Mrs. C was not. She started smoking when she was 16. She doesn’t recall why. Her dad smoking didn’t help perhaps. Nausea racked her body after that first drag. It ea...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Health Policy Hospitals Medicare Anish Koka hospital readmissions HRRP MedPAC Source Type: blogs

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CONCLUSIONS: Liver fibrosis was associated with LV diastolic dysfunction in patients with T2DM and may be an independent risk factor for diastolic dysfunction, especially in patients without systemic insulin resistance. PMID: 30877708 [PubMed - as supplied by publisher]
Source: Diabetes and Metabolism Journal - Category: Endocrinology Tags: Diabetes Metab J Source Type: research
The most safe and effective antithrombotic regimen may involve neither warfarin nor aspirin, suggested a trial that might allay bleeding-risk concerns in a tough-to-treat atrial fibrillation population.Medscape Medical News
Source: Medscape Medical News Headlines - Category: Consumer Health News Tags: Cardiology News Source Type: news
[The Conversation Africa] South Africa introduced a community-based primary health care programme in 2012. The aim of the programme, which includes a large HIV component, is to improve access to health care.
Source: AllAfrica News: HIV-Aids and STDs - Category: Infectious Diseases Source Type: news
In conclusion, Cap showed a protective effect on TAC-induced cardiac apoptosis, which could be attributed to the inhibition of Wnt3a/β-catenin signaling pathway. Cap also attenuated myocardial hypertrophy induced by TAC via suppression of Jak2/Stat3 pathway.
Source: Biomedicine and Pharmacotherapy - Category: Drugs & Pharmacology Source Type: research
Authors: Pergolizzi JV, Lequang JA, Passik S, Coluzzi F Abstract Healthcare professionals and organizations increasingly face the conundrum of treating patients with active substance use disorder, a history of personal or familial substance use disorder, or those at elevated risk for substance abuse. Such patients need compassionate care when facing painful conditions; in fact, denying them pain control makes it likely that they will seek out ways to self- medicate with illicit drugs. Yet it remains unclear how to safely and effectively treat patients in these challenging situations. The authors have formulated ten...
Source: Minerva Anestesiologica - Category: Anesthesiology Tags: Minerva Anestesiol Source Type: research
Authors: Boutagy NE, Feher A, Alkhalil I, Umoh N, Sinusas AJ Abstract Multimodality cardiovascular imaging is routinely used to assess cardiac function, structure, and physiological parameters to facilitate the diagnosis, characterization, and phenotyping of numerous cardiovascular diseases (CVD), as well as allows for risk stratification and guidance in medical therapy decision-making. Although useful, these imaging strategies are unable to assess the underlying cellular and molecular processes that modulate pathophysiological changes. Over the last decade, there have been great advancements in imaging instrumenta...
Source: Comprehensive Physiology - Category: Physiology Tags: Compr Physiol Source Type: research
My colleagues and I in the tobacco control movement have based our entire careers on the principle that it is wrong to lie to the public. The bulk of our campaign against Big Tobacco was based on the contention that the cigarette companies lied to the public about the health risks of smoking. Numerous lawsuits were filed against Big Tobacco, seeking damages based on the claim that the companies are responsible because they misrepresented the health effects of their products, thus preventing smokers from making an informed choice. The name of the major youth anti-tobacco campaign is called " Truth. " Clearly, hone...
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Another 43 lots of the blood pressure and heart failure drug Losartan have been recalled over the detection of a possible carcinogen in the tablets.
Source: Health News - - Category: Consumer Health News Source Type: news
This study provides a possible reason why genes carrying health risks have persisted in human populations. The second found evidence for multiple variants in genes related to ageing that exhibited antagonistic pleiotropic effects. They found higher risk allele frequencies with large effect sizes for late-onset diseases (relative to early-onset diseases) and an excess of variants with antagonistic effects expressed through early and late life diseases. There also exists other recent tangible evidence of antagonistic pleiotropy in specific human genes. The SPATA31 gene has been found under strong positive genomic sele...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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